A Resiliency Intervention to Support Nurses Engaged in the Provision of HIV Care in KwaZulu-Natal, South Africa: Protocol for a pilot Randomized Control Trial (Preprint)
Notice bibliographique
Résumé
Background: South Africa has the largest HIV epidemic in the world; in KwaZulu-Natal Province, over 40.8% of adults aged 15 years and older are living with HIV. Despite this, South Africa is home to only 3% of the world's health care workers. Nurses constitute the largest group of providers in South Africa and experience high levels of burnout, which can contribute to negative patient outcomes for people living with HIV, including reduced treatment adherence. Nurse-centered interventions that offset these effects are urgently needed. Objective: This study aims to test the feasibility and acceptability of an adapted resiliency intervention (Stress Management and Resiliency Training-Relaxation Response Resiliency Program) for professional nurses who provide care for people living with HIV in South Africa. Methods: In phase 1 (Human Research Ethics Committee [Medical] of the University of the Witwatersrand [220813, Johannesburg, South Africa] and the Massachusetts General Brigham Institutional Review Board [2022P002765, Boston, Massachusetts, United States]), we conducted 3 focus group discussions to solicit feedback on the lived experiences of stress, sources of stress, impact on job functioning, coping strategies, the proposed intervention, and recruitment strategies for nurses. These data informed adaptations to the intervention. In phase 2 (Human Research Ethics Committee [240106, Johannesburg, South Africa]; Massachusetts General Brigham Institutional Review Board [2024P001407, Boston, Massachusetts, United States]), we conducted a small proof-of-concept study (N=8) with preintervention and postintervention assessments, 6 intervention sessions with a nurse interventionist, and a qualitative exit interview. Following appropriate adaptations, we conducted a pilot randomized controlled trial (N=60) in which participants were randomized to the intervention or the control condition. The control condition received a one-time, 90-minute didactic stress management session. The intervention condition consisted of two 4-hour group skills-based sessions on the relaxation response, components of stress, recuperative sleep, mindful awareness, resilience, and social support. Sessions included practice-based exercises and videos to complement the intervention materials. Baseline, posttreatment (intervention only), and follow-up assessments, as well as qualitative exit interviews (n=15, intervention only), were conducted. Primary outcomes are feasibility (number screened, eligible, and enrolled; the number of treatment sessions and assessments completed in the intervention arm; assessment duration; and reasons for declining enrollment and prematurely leaving the trial) and acceptability (Client Satisfaction Questionnaire-8 and qualitative data). Results: The project is funded by the National Institute of Mental Health (R34MH126753; September 2022). As of October 2025, we have completed both the proof-of-concept study (n=8; February 2025) and the pilot randomized controlled trial (n=60; August 2025). Data analysis is in progress and is expected to be completed in August 2026. Conclusions: Structural changes are needed to ensure the well-being of health care providers; however, given that structural changes take time, money, and political capital to execute, we must develop interventions to support providers' mental health while advocating for systematic change.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,016 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,004 | 0,003 |
| Méta-épidémiologie (sens large) | 0,005 | 0,003 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,005 | 0,003 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,003 | 0,003 |
| Intégrité de la recherche | 0,004 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,062 | 0,006 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».