Development of a behaviour change intervention for preventing stress-related ill health among new registered nurses


  • E. Frögéli
  • A. Rudman
  • B. Ljótsson
  • P. Gustavsson


Background: Stress-related ill health and turnover intentions are common among new registered nurses (RNs) with serious consequences for the quality and provision of health care. This study sought to identify behaviours contributing to stress-related ill health in this professional group and develop a behaviour change intervention to target this problem. Methods: Data was collected through interviews with 12 new RNs, transcribed, and analysed using functional behavioural analysis. A behaviour change model and intervention was developed using principles from organizational socialization and learning theory. Furthermore, the feasibility of conducting an evaluation of the effect of the intervention as part of a transition-to-practice program for new RNs was investigated in a trial with a within-group design with 65 new RNs. Feasibility objectives included recruitment, randomization, data collection, participation, acceptability, and deliverability. Findings: Engagement in proactive behaviours was found to reduce new RNs’ experiences of stress. The socialization processes role clarity, social acceptance, and task mastery were suggested to mediate this effect. Fear of aversive consequences was found to function as an antecedent for engaging in avoidance behaviours that hindered proactive behaviours and increased experiences of stress. An intervention was developed to increase proactive behaviours and reduce avoidance behaviours using behavioural activation, action planning, and systematic exposure. The feasibility of conducting an effect evaluation was confirmed and the intervention was highly accepted by the participating nurses. Discussion: A behaviour change intervention can support new RNs engagement in proactive behaviours and could potentially reduce the risk of stress-related ill health in this professional group.





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