Which resources moderate the effects of demanding work schedules on nurses working in residential elder care? A longitudinal study.

BACKGROUND: Shiftwork is a major job demand for nurses and has been related to various negative consequences. Research suggests that personal and job resources moderate the impact of work schedules on stress, health and well-being. OBJECTIVES: This longitudinal study examined whether the interactions of personal and job resources with work schedule demands predicted work engagement and emotional exhaustion in nursing. DESIGN: This longitudinal study included two waves of data collection with a one year follow-up using self-report questionnaires among 247 nurses working shifts or irregular working hours in residential care for the elderly in the Netherlands. METHODS: Moderated structural equation modelling was conducted to examine the interactions between personal and job resources and work schedule demands. Two work schedule demands were assessed: type of work schedule (demanding vs. less demanding) and average weekly working hours. Two personal resources, active coping and healthy lifestyle, and two job resources, work schedule control and the work schedule fit with nurses' private life, were assessed. RESULTS: Results showed that the work schedule fit with nurses' private life buffered the relationship between work schedule demands and emotional exhaustion one year later. Furthermore, the work schedule fit with nurses' private life increased work engagement one year later when work schedule demands were high. Work schedule control strengthened the positive relationship between work schedule demands and emotional exhaustion one year later. The personal resources, active coping and healthy lifestyle were no moderators in this model. CONCLUSION: Nurses suffer less from decreasing work engagement and emotional exhaustion due to work schedule demands when their work schedules fit with their private lives. Work schedule control did not buffer, but strengthened the positive relationship between weekly working hours and emotional exhaustion one year later. Job resources appeared to be more important for nurses' well-being than personal resources. These findings highlight the importance of the fit of a work schedule with nurse's private life, if the work schedule is demanding.

Core self-evaluation as a predictor of strength training adoption in older adults.

OBJECTIVE: Progressive resistance training (PRT) counteracts sarcopenia and has been demonstrated to improve physical function and quality of life in older adults. Despite the clear benefits of PRT, participation remains low. The core self-evaluation (CSE) construct is theoretically antecedent to four personality traits: locus of control, self-esteem, neuroticism (emotional stability), and generalized self-efficacy. We have examined the association of CSE with exercise adoption among older adults invited to participate in a PRT trial. We hypothesized that CSE would positively predict adoption of PRT. STUDY DESIGN: All residents of two retirement communities were invited to complete questionnaires with items on demographics, physical activity, CSE, and general health. Following completion of questionnaires, residents were invited to take part in an on-site, 10-week randomized controlled trial of a PRT-based exercise trial. RESULTS: Thirty-eight of 358 residents (63.2% women; 76.6±6.1 year; range 58-92) enrolled and 118 residents completed the questionnaires. Multiple regression analysis predicting PRT adoption indicated that the demographic variables accounted for 38% of the variance. Inclusion of CSE (ß=.405) accounted for an additional 10% of the variance in PRT adoption. CONCLUSION: CSE was predictive of PRT adoption in this cohort, adding significantly to the predictive efficacy of known demographic predictors. This is the first study to show that CSE may influence adoption of PRT in any cohort.

Efficacy and feasibility of a novel tri-modal robust exercise prescription in a retirement community: a randomized, controlled trial.

OBJECTIVES: To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults. DESIGN: Randomized, controlled trial. SETTING: Retirement village. PARTICIPANTS: Thirty-eight subjects (14 men and 24 women) aged 76.6 +/- 6.1. INTERVENTION: A wait list control or 10 weeks of supervised exercise consisting of high-intensity (80% of one-repetition maximum (1RM)) progressive resistance training (PRT) 3 days per week, moderate-intensity (rating of perceived exertion 11 to 14/20) aerobic training 2 days per week, and progressive balance training 1 day per week. MEASUREMENTS: Blinded assessments of dynamic muscle strength (1RM), balance, 6-minute walk, gait velocity, chair stand, stair climb, depressive symptoms, self-efficacy, and habitual physical activity level. RESULTS: Higher baseline strength and psychological well-being were associated with better functional performance. Strength gains over 10 weeks averaged 39+/-31% in exercise, versus 21+/-24% in controls (P=.10), with greater improvements in hip flexion (P=.01), hip abduction (P=.02), and chest press (P=.04) in the exercise group. Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved. Stair climb power (12.3+/-15%, P=.002) and chair stand time (-7.1+/-15%, P=.006) improved significantly and similarly in both groups. Reduction in depressive symptoms was significantly related to compliance (attendance rate r=-0.568, P=.009, PRT progression in loading r=-0.587, P=.02, and total volume of aerobic training r=-0.541, P=.01), as well as improvements in muscle strength (r=-0.498, P=.002). CONCLUSION: Robust physical and psychological adaptations to exercise are linked, although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults.