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- All Subjects: Mentorship
- Creators: Nunez, Diane
Nurse practitioners and physician assistants, collectively termed advanced practice providers (APPs), report a lack of onboarding and professional support which has been shown to lead to job dissatisfaction, high turnover rates, professional attrition, and gaps in patient care; wasting billions of healthcare dollars and falling short of the Quadruple Aim. A time-honored, integral means of support in many industries is mentorship. This is a dynamic, evolving relationship between an experienced professional and a novice professional that promotes knowledge application, systems navigation, organizational socialization and personal role integration.
Unfortunately, healthcare organizations have been slow to adopt mentorship, as evidenced by the paucity of studies on mentorship programs in health care, and APP turnover rates twice that of physicians. This evidenced-based project expands on the limited existing studies regarding the associations between mentorship and organizational commitment, as well as explores the desired characteristics of quality mentors and perceived barriers to APP mentorship.
A survey of multispecialty APPs at an oncology practice within a larger, multi-state integrated healthcare delivery system reveals access to mentors and time are the biggest barriers. The most desired mentorship characteristics are professional knowledge and motivational support. Career development through mentorship can increase job satisfaction and retention, as well as improve the quality of care provided by APPs. By strengthening the professional foundations, patients will benefit with continuity of care, improved quality measures, and efficient systems communication reaching the Quadruple Aim targets.
Purpose: This evidence-based practice (EBP) project was a gap analysis that surveyed 156 caregivers at an urban PACE program in the Midwest to examine caregiver demographics, caregiver burden, caregiver interest in support services, and the relationship between these variables to guide the development of caregiver programs.
Methods: Caregiver Assessments were administered to 156 caregivers via telephone or in person. The assessment included caregiver demographics, interest in caregiver services, and the 12-item Zarit Burden Interview (ZBI-12) to assess caregiver burden. The ZBI-12 has good reliability and validity as indicated by a Cronbach’s alpha of 0.88 and a correlation with the full version ZBI scores of 0.95. Results were analyzed using descriptive statistics, the Pearson r correlation test, the Wilcoxon signed rank test, and the Mann-Whitney U test on SPSS version 25. This project was approved by the Arizona State University IRB.
Results/Outcomes: Of 171 eligible informal caregivers of program participants living outside of an institution, 156 completed the survey, 3 refused, and 12 were unreachable. Most informal caregivers surveyed were Caucasian (69.5%) females (66%), children of the care recipients (45.5%), caring for people with dementia (40.6%), with some college education (37.2%), who earned $10,000-$25,000 annually (38.7%), provided over 30 hours of care per week (55.8%), and averaged 61.4 years old (SD=7.7). The average ZBI-12 score was 12.15 (SD=9.04), indicating a moderate level of burden. The most common stressors indicated by caregivers were activities of daily living (ADL) assistance (63.5%) and the time commitment involved in caregiving (57.7%). Correlates to high burden score included: limited time, aggressive behavior, financial stress, grief, assistance with ADLs, wandering behavior, toileting assistance/incontinence, and lack of sleep. Respite care was identified by 42.9% of those surveyed as the most helpful resource provided by PACE. 55.1% and 50.6% of caregivers indicated an interest in educational sessions and support groups respectively, if these services were offered in the future.
Conclusion: Through the exploration of caregiver demographics, factors correlated to increased burden, and caregiver interest in support services, the results from this EBP project provide guidance to programs, particularly other PACE programs, seeking to proactively mitigate caregiver burden through support services. The results indicate that respite care, educational sessions, and support groups should be prioritized when developing informal caregiver support services.