Satisfaction with nursing care and work during a year of clinical supervision and individualized care. Comparison between two wards for the care of severely demented patients.
An intervention study was set up to explore the effects of the implementation of planned individualized care and regular systematic clinical supervision regarding nurses' degree of satisfaction with nursing care and work. All nurses on two similar wards caring for severely demented patients participated as experimental ward (EW) (n = 19) and control ward (CW) (n = 20). Data were collected before intervention and at 6 months and 12 months during intervention, by means of a questionnaire developed in Sweden which assesses aspects of satisfaction with nursing care and work. Analysis was performed by means of principal component analysis, Wilcoxon rank sum test and Friedman two-way ANOVA. The baseline data showed no significant differences in the responses from the nurses on the two wards; they were found to be more satisfied than dissatisfied with their job although recognition from management was poor. During the intervention, the experimental ward nurses' experience of praise, professional growth, autonomy and quality of care, as well as their feeling of co-operation with colleagues and comfort improved significantly, while no changes occurred on the control ward. The quality of the written documentation on patients' needs and care improved significantly, and the experimental ward nurses also rejected significantly more strongly that their knowledge about patients and work was unsatisfactory. Their improved satisfaction with nursing care and work was believed to be related to the support they received in cognitive and emotional coping, the possibility of reflective learning and the change in management style associated with intervention.