Nursing staff in all settings have multiple work-related problems due to patient handling and occupational stressors, which result in high stress levels and low back pain. In this context the importance of health promotion becomes apparent. The aim of this study is to analyse whether nursing staff (in elderly care, hospitals, home care, or trainees) show different levels of work-related burdens and whether they require individualized components in health promotion programs. N = 242 German nurses were included in a quantitative survey (Health survey, Screening Scale (SSCS) of Trier Inventory for Chronic Stress, Slesina). The differences were tested using Chi²-Tests, Kruskal–Wallis Test and one-way ANOVA. Nurses differed in stress loads and were chronically stressed (F₍₃₂₃₆₎ = 5.775, p = 0.001). Nurses in home care showed the highest SSCS-values with time pressure as the most important straining factor. The physical strains also placed a particular burden on nurses in home care, whereas they still reported higher physical well-being in contrast to nurses in elderly care (Chi² = 24.734, p < 0.001). Nurses in elderly care and home care preferred strength training whereas nurses in hospitals and trainees favoured endurance training. Targeted programs are desirable for the reduction of work-related burdens. While nurses in elderly care and home care need a combination of ergonomic and strength training, all nurses require additional stress management. Planning should take into account barriers like perceived additional time consumption. Therefore, health promotion programs for all settings should be implemented during working time at the work setting and should consider the working schedule.

Background: Nurses in geriatric care are exposed to various burdens in the workplace that result in high stress levels. The perceived stress may result in a lack of professional caring and burnout. Objectives: The study aim was to identify work-related and personal factors that determine stress levels to design tailored interventions. Research design: cross-sectional study. Subjects: N = 195 geriatric nursing staff members. Measures: The survey included validated questionnaires (Trier Inventory for Chronic Stress (TICS), Health Survey Short form 12 (SF-12), Nordic Questionnaire) to identify work-related burdens, resulting stress levels and work-related behavior (AVEM). According to the limits of the Screening Subscale for chronic stress (SSCS) of the TICS, nurses were classified as stressed or non-stressed. With four-step regression analysis, main predictors for the stress level were identified. Results: The analysis revealed body postures, handling heavy loads, time pressure, deadlines and pressure to perform as the main burdens of the participants. Chronically stressed nurses showed different work patterns in comparison to nurses with lower stress levels. The regression analysis showed significance for the models including the work-related patterns and resilience aspects (step three (F (3.42) = 4.168; p = 0.010) and four (F (7.35) = 4.194; p = 0.002). Pattern B was a main factor for determining stress. The stress level determined the perceived burdens. Conclusions: Experiencing and managing stressors depends on the individual’s perception, while coping patterns—especially pattern B—can be decisive. The tailored interventions to reduce stress in geriatric nurses should focus on personal patterns.

Background: Sports science is making an important contribution to health services research and supports the development of tailored interventions, e.g., in nursing settings. Working in elderly care is associated with a high prevalence of low back pain (LBP). Due to the diverse requirements and high strains, multicomponent programs are essential to address all relevant factors. This randomized controlled trial investigated the effects of a tailored ten-week ergonomics and twelve-week strength training on lifting behavior, strength endurance, LBP, functional impairment and adherence. Methods: n = 42 nurses were randomly assigned to the intervention (IG; n = 20) or control group (CG; n = 22). They were eligible for participation if they were active in residential care and if they provided written informed consent. Other employees were excluded. The data were collected at baseline, at ten weeks (after ergonomics training), at 22 weeks (after strength training), and at 34 weeks (follow-up). The analysis combined physical tests with questionnaires (Progressive Isoinertial Lifting Evaluation, PILE-Test; Biering-Sørensen-Test; Visual Analog Scale Pain, VAS; Oswestry Disability Index, ODI; self-developed questionnaire for adherence). Group differences were analyzed by Chi²-Tests, ANOVA, and Linear Mixed Models. Results: The IG showed an improved lifting performance (PILE-Test; 95% CI 1.378–7.810, p = .006) and a reduced LBP compared to the CG (VAS; 95% CI − 1.987 to 0.034, p = .043) after ergonomics training (PILE-Test, F_(1,34) = 21.070, p < .001; VAS, F_(1,34) = 5.021, p = .032). The results showed no differences concerning the Biering-Sørensen-Test and the ODI. Positive adherence rates were observed. Conclusions: This approach and the positive results are essential to derive specific recommendations for effective prevention. The study results can be completed in future research with additional strategies to reduce nurses’ burden further. Trial registration: The trial was registered at DRKS.de (DRKS00015249, registration date: 05/09/2018).

Background: Interdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents. Methods: The study included n = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05). Results: Indices showed (Chi²(148) = 217, PCMIN/DF = 1.47; p < .001; Comparative Fit Index = .940; Tucker Lewes Index = .902, RMSEA = .033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p < .01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance. Discussion and conclusion: Objective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance. Trial registration: Trial registration number: DRKS00014957.

Background: Improving the work ability of nurses is highly important for ensuring a functioning healthcare system, which can be achieved via exercising and enhancing ergonomic work behaviors of the nurses. The objective of this systematic review was to synthesize work ability-enhancing exercise and ergonomic workplace health promotion interventions in different nursing settings and their effects on work ability. Methods: Intervention studies incorporating at least one component of physical exercise or ergonomic work behavior for nurses were eligible for inclusion. Three electronic databases (Medline, PsycInfo, CINAHL) were searched for studies published until October 2022. The methodological quality of interventions was assessed. Due to intervention and outcome heterogeneity, narrative synthesis was conducted. Results: The search identified a total of 37 studies. Sample size ranged from 14 to 316 (N = 3487). Overall quality was moderate (M = 0.76). Programs comprised aerobic exercising, “back school,” ergonomics, increasing physical activity, multicomponent programs, physiotherapy, and yoga. Positive effects on work ability (e.g., reduced back pain or stress levels) were reported in 34 studies. However, if follow-up analyses were included, the effects typically diminished. Common training principles and training control mechanisms were applied in studies. Discussion: The review indicates the efficacy of exercise-based health promotion for increasing nurses’ work ability. However, results are limited by the lack of long-term improvements and scarcity of application of training principles. Therefore, setting-specific interventions, respecting work demands and training principles, are recommended.