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The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses

Majken Epstein Orcid Logo, Marie Söderström, Ann Rudman, Philip Tucker Orcid Logo, Anna Dahlgren

International Journal of Nursing Studies Advances, Volume: 10, Start page: 100485

Swansea University Author: Philip Tucker Orcid Logo

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DOI (Published version): 10.1016/j.ijnsa.2026.100485

Abstract

Background: Newly graduated nurses often face demanding working conditions including high workload, stress, and irregular working hours. During the first years of practice, burnout symptoms are common. Recovery, including sleep, can be seen as a key protective factor in the associations between stre...

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Published in: International Journal of Nursing Studies Advances
ISSN: 2666-142X
Published: Elsevier BV 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71229
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Previously, a proactive, group-based intervention (recovery programme) for new nurses, promoting individual strategies for recovery, decreased burnout and fatigue symptoms post-intervention and showed preventive effects on somatic symptoms over time. To optimise the implementation and outcomes of an intervention, it is important to understand its mechanisms of impact (i.e., how it produces change) as well as to identify contextual factors influencing its implementation. Objective: To deepen the understanding of the recovery programme&#x2019;s mechanisms of impact and to explore how its implementation, including participants&#x2019; opportunities for recovery and the feasibility of recovery strategies, was influenced by the context. Design: Qualitative descriptive design. Participants and setting: Twelve nurses (nine women) who had participated in the intervention at four Swedish hospitals, between 12 and 25 months (M = 19) after participation. Methods: Semi-structured individual telephone interviews were conducted and analysed using thematic analysis. Results: The programme&#x2019;s proposed mechanisms of impact, including increased knowledge about sleep, enhanced motivation for behavioural change, and the use of recovery strategies, were confirmed. Motivation to apply recovery strategies was supported by a shift in mind-set regarding the importance of self-care; to improve readability; and follow-up on the behavioural change process during sessions. Contextual factors influencing recovery opportunities and the feasibility of strategies were related to both the work context and the individual. These factors included demanding schedules, extended and disrupted working hours, workload, opportunities for recovery at work, social norms, the organisation of work procedures, private life circumstances, and the deprioritisation of personal recovery needs. Booster sessions and reminders were suggested to facilitate the continued use of recovery strategies after the programme. Conclusions: When supporting nurses in developing individual recovery strategies, it is important to provide opportunities to share experiences with other new nurses and to follow-up on their behavioural change process. Importantly, several organisational factors should also be considered. Organisations should work systematically with the planning and management of working hours that promote recovery, create opportunities for recovery during work shifts, organise work procedures with recovery in mind, and continuously monitor and manage employees&#x2019; stress and fatigue symptoms. Together, such efforts could promote a social norm that supports recovery.</abstract><type>Journal Article</type><journal>International Journal of Nursing Studies Advances</journal><volume>10</volume><journalNumber/><paginationStart>100485</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2666-142X</issnElectronic><keywords>Nurses; Occupational health; Primary prevention; Qualitative research; Recovery; Shift work schedule; Sleep</keywords><publishedDay>1</publishedDay><publishedMonth>6</publishedMonth><publishedYear>2026</publishedYear><publishedDate>2026-06-01</publishedDate><doi>10.1016/j.ijnsa.2026.100485</doi><url/><notes/><college>COLLEGE NANME</college><department>Psychology School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PSYS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This study was funded by AFA F&#xF6;rs&#xE4;kring (180242).</funders><projectreference>180242</projectreference><lastEdited>2026-02-06T15:16:20.3905966</lastEdited><Created>2026-01-13T08:29:23.1719561</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Psychology</level></path><authors><author><firstname>Majken</firstname><surname>Epstein</surname><orcid>0000-0001-8397-5986</orcid><order>1</order></author><author><firstname>Marie</firstname><surname>S&#xF6;derstr&#xF6;m</surname><order>2</order></author><author><firstname>Ann</firstname><surname>Rudman</surname><order>3</order></author><author><firstname>Philip</firstname><surname>Tucker</surname><orcid>0000-0002-8105-0901</orcid><order>4</order></author><author><firstname>Anna</firstname><surname>Dahlgren</surname><order>5</order></author></authors><documents><document><filename>71229__36206__9760fb6882924444a6a111701b39429e.pdf</filename><originalFilename>71229.VOR.pdf</originalFilename><uploaded>2026-02-06T15:03:17.6750189</uploaded><type>Output</type><contentLength>996107</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2026 The Authors. 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spelling 2026-02-06T15:16:20.3905966 v2 71229 2026-01-13 The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses 7d07250cf5f1cbaf8788af9f48cf000a 0000-0002-8105-0901 Philip Tucker Philip Tucker true false 2026-01-13 PSYS Background: Newly graduated nurses often face demanding working conditions including high workload, stress, and irregular working hours. During the first years of practice, burnout symptoms are common. Recovery, including sleep, can be seen as a key protective factor in the associations between stress, shift work and negative health outcomes. Previously, a proactive, group-based intervention (recovery programme) for new nurses, promoting individual strategies for recovery, decreased burnout and fatigue symptoms post-intervention and showed preventive effects on somatic symptoms over time. To optimise the implementation and outcomes of an intervention, it is important to understand its mechanisms of impact (i.e., how it produces change) as well as to identify contextual factors influencing its implementation. Objective: To deepen the understanding of the recovery programme’s mechanisms of impact and to explore how its implementation, including participants’ opportunities for recovery and the feasibility of recovery strategies, was influenced by the context. Design: Qualitative descriptive design. Participants and setting: Twelve nurses (nine women) who had participated in the intervention at four Swedish hospitals, between 12 and 25 months (M = 19) after participation. Methods: Semi-structured individual telephone interviews were conducted and analysed using thematic analysis. Results: The programme’s proposed mechanisms of impact, including increased knowledge about sleep, enhanced motivation for behavioural change, and the use of recovery strategies, were confirmed. Motivation to apply recovery strategies was supported by a shift in mind-set regarding the importance of self-care; to improve readability; and follow-up on the behavioural change process during sessions. Contextual factors influencing recovery opportunities and the feasibility of strategies were related to both the work context and the individual. These factors included demanding schedules, extended and disrupted working hours, workload, opportunities for recovery at work, social norms, the organisation of work procedures, private life circumstances, and the deprioritisation of personal recovery needs. Booster sessions and reminders were suggested to facilitate the continued use of recovery strategies after the programme. Conclusions: When supporting nurses in developing individual recovery strategies, it is important to provide opportunities to share experiences with other new nurses and to follow-up on their behavioural change process. Importantly, several organisational factors should also be considered. Organisations should work systematically with the planning and management of working hours that promote recovery, create opportunities for recovery during work shifts, organise work procedures with recovery in mind, and continuously monitor and manage employees’ stress and fatigue symptoms. Together, such efforts could promote a social norm that supports recovery. Journal Article International Journal of Nursing Studies Advances 10 100485 Elsevier BV 2666-142X Nurses; Occupational health; Primary prevention; Qualitative research; Recovery; Shift work schedule; Sleep 1 6 2026 2026-06-01 10.1016/j.ijnsa.2026.100485 COLLEGE NANME Psychology School COLLEGE CODE PSYS Swansea University Another institution paid the OA fee This study was funded by AFA Försäkring (180242). 180242 2026-02-06T15:16:20.3905966 2026-01-13T08:29:23.1719561 Faculty of Medicine, Health and Life Sciences School of Psychology Majken Epstein 0000-0001-8397-5986 1 Marie Söderström 2 Ann Rudman 3 Philip Tucker 0000-0002-8105-0901 4 Anna Dahlgren 5 71229__36206__9760fb6882924444a6a111701b39429e.pdf 71229.VOR.pdf 2026-02-06T15:03:17.6750189 Output 996107 application/pdf Version of Record true © 2026 The Authors. This is an open access article distributed under the terms of the Creative Commons CC-BY license. true eng http://creativecommons.org/licenses/by/4.0/
title The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses
spellingShingle The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses
Philip Tucker
title_short The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses
title_full The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses
title_fullStr The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses
title_full_unstemmed The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses
title_sort The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses
author_id_str_mv 7d07250cf5f1cbaf8788af9f48cf000a
author_id_fullname_str_mv 7d07250cf5f1cbaf8788af9f48cf000a_***_Philip Tucker
author Philip Tucker
author2 Majken Epstein
Marie Söderström
Ann Rudman
Philip Tucker
Anna Dahlgren
format Journal article
container_title International Journal of Nursing Studies Advances
container_volume 10
container_start_page 100485
publishDate 2026
institution Swansea University
issn 2666-142X
doi_str_mv 10.1016/j.ijnsa.2026.100485
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
document_store_str 1
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description Background: Newly graduated nurses often face demanding working conditions including high workload, stress, and irregular working hours. During the first years of practice, burnout symptoms are common. Recovery, including sleep, can be seen as a key protective factor in the associations between stress, shift work and negative health outcomes. Previously, a proactive, group-based intervention (recovery programme) for new nurses, promoting individual strategies for recovery, decreased burnout and fatigue symptoms post-intervention and showed preventive effects on somatic symptoms over time. To optimise the implementation and outcomes of an intervention, it is important to understand its mechanisms of impact (i.e., how it produces change) as well as to identify contextual factors influencing its implementation. Objective: To deepen the understanding of the recovery programme’s mechanisms of impact and to explore how its implementation, including participants’ opportunities for recovery and the feasibility of recovery strategies, was influenced by the context. Design: Qualitative descriptive design. Participants and setting: Twelve nurses (nine women) who had participated in the intervention at four Swedish hospitals, between 12 and 25 months (M = 19) after participation. Methods: Semi-structured individual telephone interviews were conducted and analysed using thematic analysis. Results: The programme’s proposed mechanisms of impact, including increased knowledge about sleep, enhanced motivation for behavioural change, and the use of recovery strategies, were confirmed. Motivation to apply recovery strategies was supported by a shift in mind-set regarding the importance of self-care; to improve readability; and follow-up on the behavioural change process during sessions. Contextual factors influencing recovery opportunities and the feasibility of strategies were related to both the work context and the individual. These factors included demanding schedules, extended and disrupted working hours, workload, opportunities for recovery at work, social norms, the organisation of work procedures, private life circumstances, and the deprioritisation of personal recovery needs. Booster sessions and reminders were suggested to facilitate the continued use of recovery strategies after the programme. Conclusions: When supporting nurses in developing individual recovery strategies, it is important to provide opportunities to share experiences with other new nurses and to follow-up on their behavioural change process. Importantly, several organisational factors should also be considered. Organisations should work systematically with the planning and management of working hours that promote recovery, create opportunities for recovery during work shifts, organise work procedures with recovery in mind, and continuously monitor and manage employees’ stress and fatigue symptoms. Together, such efforts could promote a social norm that supports recovery.
published_date 2026-06-01T05:31:51Z
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score 11.095883

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