Doctor of Nursing Practice
Dr. Sheri Rowland PhD, APRN, FNP-BC
Background. Burnout among nurses has been on the rise and was exacerbated with the pandemic. Reflective journaling after work may be a strategy to decrease feelings of burnout. Reflective journaling, as an intervention, has been shown to improve self-awareness, compassion fatigue, and burnout among nurses. The purpose of this study was to pilot a 4-week reflective journaling intervention in hospital-based nurses and describe participant professional quality of life, self-awareness, and overall well-being.
Theoretical Framework. The Theory of Reasoned Action (TRA) was chosen as the theoretical framework because it identifies the belief that performing a particular behavior will lead to a specific outcome. The model focuses on how intentions and behaviors are affected by attitudes over time.
Methods. A single group pre/post quasi-experimental design was used with measures collected at baseline and immediately following the 4-week reflective journaling intervention. Nebraska hospital-based registered nurses who worked at least two shifts per week were asked to participate. The intervention included viewing a 15-minute training video on reflective journaling. Journaling prompts and reminders were sent via email twice a week. Participants were asked to journal at least five minutes after a shift using a journal prompt link that was sent via email using REDCap, a secure electronic database. Demographic data was collected only at baseline and measures of professional quality of life (ProQOL), self-awareness (SAOQ), and overall well-being (SF-36) were collected at baseline and at the completion of the study.
Results. Twelve nurses were enrolled in total and completed baseline measures. The sample was comprised of all Caucasian females with an age range of 23-58 years and average of 7.1 years in nursing. The nurses worked in a variety of settings including emergency, intensive care, transport, oncology, organ transplant, pediatrics, and step-down critical care. Both night shift and 3 day shift nurses participated in the study. Five participants completed 50% (4/8) of the requested journal entries. Journal entries were between 1 and 306 words in length. Participants were separated between completers and non-completers. One component of the SF-36 was statistically significant, completers were more emotionally stressed than the non-completers. Topics written about included feelings of being overwhelmed, frustration, and gratitude for journaling as an outlet.
Conclusions. Recruitment and intervention engagement of nurses on the front lines during a pandemic was a challenge and has implications for future interventions. Only one participant completed both pre and post measures and only half of the participants completed at least one journal. At baseline, participants who completed journaling reported a higher level of emotional problems that affected their ability to work effectively. Participant comments suggest reflective journaling has value, which should be investigated further. Strategies to recruit and retain participants in a reflective journaling intervention study will be needed.
Langan, Brittany M. and Keppen, Katherine, "Reflective Journaling Intervention to Impact Self-awareness, Professional Health, and Overall Well-being in Nurses" (2022). Doctor of Nursing Practice Projects: College of Nursing. 10.