Vos Eline E, de Bruin Simone R, van der Beek Allard J, Smit Denise J M, Proper Karin I
National Institute for Public Health and the Environment, Center for Prevention, Lifestyle and Health, Department Behaviour and Health, Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands.
Department of Health and Wellbeing, Research Group, Windesheim University of Applied Sciences, Living well with dementia, Campus 2, P.O. Box 10090, Zwolle, 8000 GB, The Netherlands.
BMC Public Health. 2025 Jan 9;25(1):105. doi: 10.1186/s12889-024-21100-9.
Many organizations are faced with growing numbers of employees who combine their jobs with informal caregiving responsibilities. To support working caregivers in maintaining a good balance between work, private life and informal care, a workplace participatory approach (PA) intervention was implemented in four Dutch organizations. This study's aims were to evaluate the degree of PA implementation, contextual factors influencing implementation, and stakeholder experiences with the PA.
A mixed methods process evaluation was conducted alongside a randomized controlled trial among three stakeholder groups: caregiving employees, their supervisors, and trained occupational professionals who acted as PA process facilitators. The implementation frameworks of Steckler and Linnan (2002) and Carrol et al. (2007) were applied to evaluate recruitment, reach, dosage, fidelity and context, as well as stakeholders' satisfaction, experiences and perceived intervention outcomes. Data were collected after PA implementation (4-7 months) using questionnaires, semi-structured interviews, checklists and research logs.
Of the 57 caregivers in the intervention group, 48 participated in the stepwise intervention. Among them, 20 (42%) completed all seven steps of the PA, and 30 (63%) involved their supervisors. PA implementation and supervisor involvement varied based on personal factors (e.g. a need for balance-related improvements; preference to keep caregiving private), interpersonal factors (e.g. caregiver-supervisor relationship quality), and organizational factors (high work demands; a supportive workplace culture for caregivers). Caregivers, supervisors, and process facilitators reported positive experiences with the PA, finding it valuable for addressing informal caregiving, receiving support and working on balance-related changes in multiple life domains. Some caregivers, however, needed more than the standard 3 PA meetings to identify key issues and implement solutions.
Stakeholders found the PA helpful in addressing working caregivers' work-life balance, but PA implementation can be further stimulated by creating a supportive organizational culture in which it is encouraged and safe to discuss informal care. Moreover, to better support working caregivers in the long term, the PA should be viewed as an ongoing and iterative process taking into account their evolving balance and circumstances.
Current Controlled Trials ISRCTN15363783 (Registration date 21 November 2022; Retrospectively registered).
许多组织面临着越来越多将工作与非正式护理责任相结合的员工。为了支持在职护理人员在工作、私人生活和非正式护理之间保持良好平衡，在荷兰的四个组织中实施了一种工作场所参与式方法（PA）干预措施。本研究的目的是评估PA的实施程度、影响实施的背景因素以及利益相关者对PA的体验。
在一项随机对照试验的同时，对三个利益相关者群体进行了混合方法过程评估：护理员工、他们的主管以及担任PA过程促进者的受过培训的职业专业人员。应用Steckler和Linnan（2002年）以及Carrol等人（2007年）的实施框架来评估招募、覆盖范围、剂量、保真度和背景，以及利益相关者的满意度、体验和感知的干预结果。在PA实施后（4 - 7个月），使用问卷、半结构化访谈、清单和研究日志收集数据。
干预组的57名护理人员中，48人参与了逐步干预。其中，20人（42%）完成了PA的所有七个步骤，30人（63%）让他们的主管参与其中。PA的实施和主管的参与因个人因素（例如需要与平衡相关的改进；倾向于将护理工作保密）、人际因素（例如护理人员与主管的关系质量）和组织因素（高工作需求；对护理人员支持性的工作场所文化）而有所不同。护理人员、主管和过程促进者对PA都有积极的体验，认为它对于解决非正式护理问题、获得支持以及在多个生活领域进行与平衡相关的改变很有价值。然而，一些护理人员需要超过标准的3次PA会议来确定关键问题并实施解决方案。
利益相关者发现PA有助于解决在职护理人员的工作与生活平衡问题，但通过营造一种鼓励并安全讨论非正式护理的支持性组织文化，可以进一步促进PA的实施。此外，为了长期更好地支持在职护理人员，PA应被视为一个持续迭代的过程，要考虑到他们不断变化的平衡和情况。
当前受控试验ISRCTN15363783（注册日期2022年11月21日；追溯注册）
