Building and sustaining work engagement – a participatory action intervention to increase work engagement in nursing staff

Abstract

This study evaluated whether a participatory action research intervention with nursing staff on acute care older people National Health Service wards in the United Kingdom was effective for increasing work engagement. Mediation analyses between job resources (social support, influence in decision-making), job demands, work-related needs (autonomy, competence, relatedness), and work engagement explored the presumed psychological mechanisms underlying the intervention. A non-randomized, matched control group, pretest, post-test design involved three intervention and five control wards. A significant decrease in relatedness, and a borderline significant decrease in competence, was observed in the intervention group compared to the control group, with no effect on work engagement (N = 45). Work-related needs mediated between resources and work engagement, supporting the job demands-resources model and self-determination theory as an underlying explanatory theory. Intervention implementation was difficult, highlighting the need for participant and organizational readiness for change, and strong management support. This is the first known study to apply participatory techniques to increase work engagement in nursing staff and explore the underlying explanatory psychological mechanisms, offering a novel means of taking work engagement research forward. Crucially, it highlights the challenges involved in intervention research and the importance of including evaluations of intervention implementation alongside statistical evaluations to avoid erroneous conclusions.