Effects of Training to Improve Novice Nurses’ Sense of Coherence

Abstract

Background: Our previous research concerned the relation between Sense of Coherence, workplace stress, and burnout for nurses in their first three years of work. We found that their psychological state in the first three months on the job was particularly critical to their success and retention. As workplace stress increased over their first three years, their Sense of Coherence declined, and their burnout increased. Follow-up interviews after five years revealed the importance of identifying role models early on and feeling their own growth in the responses of their patients. Based on these findings, in 2015 we instituted a program to improve new nurses’ Sense of Coherence. The present research was to evaluate the effectiveness of this training program. Purpose: The purpose of this study was to evaluate the effectiveness of a training program in raising Sense of Coherence. Method: From June of 2015 to March of 2017, we surveyed Sense of Coherence of 137 new nurses who completed our training program, comparing them to a cohort of 960 nurses whom we had studied in 2010-11 without such a training program. We analyzed their responses using SPSS Version 24.0, taking a probability of less than 5% to be significant. Results: In terms of Sense of Coherence, the training program improved new nurses’ “comprehensibility” and “manageability” in the first three months, but both dropped to levels comparable to the untrained nurses after six months. There was no significant difference in “meaningfulness”, which dropped over the first year in both groups. Categorized into three groups according to SOC score at the time of employment in the intervention group, 36 participants were classified into the low score group, 41 participants were classified into the medium score group, and 44 participants were classified into the high score group. Then changes in SOC in each group were then compared. In the LOW group, the scores for “comprehensibility”, “manageability”, and “meaningfulness” increased significantly throughout the year, while in the HIGH group, scores decreased significantly. Conclusions: Our training program did raise new nurses’ sense of growth over the first year, and significantly improved their “comprehensibility” and “manageability” over the first three months. However, the fact that their Sense of Coherence dropped to control group levels after six months suggests the need for further intervention to maintain “comprehensibility” and “manageability” over the longer term. In the LOW group, the scores for “comprehensibility”, “manageability”, and “meaningfulness” increased significantly throughout the year, however, the total SOC score for the LOW group remained low throughout the year. Thus, additional support is needed over-and-above the training presented in this study for those nurses with low SOC scores at time of employment.