Workforce resilience supporting staff in managing stress: A coherent breathing intervention for the long-term care workforce

Background: Staff in long-term care (LTC) homes have long-standing stressors, such as short staffing and high workloads. These stressors increased during the COVID-19 pandemic; better resources are needed to help staff manage stress and well-being. The purpose of this study was to evaluate the effect of a simple stress management strategy (coherent breathing). Methods: We conducted a pre–post intervention study to evaluate a self-managed coherent breathing intervention from February to September 2022. The intervention included basic (breathing only) and comprehensive (breathing plus a biofeedback device) groups. Six hundred eighty-six participants were initially recruited (359 and 327 in the comprehensive and basic groups respectively) from 31 LTC homes in Alberta, Canada. Two hundred fifty-four participants completed pre-and post-intervention questionnaires (142 [55.9%] in comprehensive and 112 [44.1%] in basic). Participants were asked to use coherent breathing based on a schedule increasing from 2 to 10 min daily, 5–7 times a week over 8 weeks. Participants completed self-administered online questionnaires pre- and post-intervention to assess outcomes—stress, psychological distress, anxiety, depression, resilience, insomnia, compassion satisfaction, compassion fatigue, and burnout. We used a mixed-effects regression model to test the main effect of time (pre- and post-intervention) and group while testing the interaction between time and group and controlling for covariates. Results: We found statistically significant changes from pre- to post-intervention in stress (b = −2.5, p < 0.001, 95% CI = −3.1, −1.9), anxiety (b = −0.5, p < 0.001, 95% CI = −0.7, −0.3), depression (b = −0.4, p < 0.001, 95% CI = −0.6, −0.2), insomnia (b = −1.5, p < 0.001, 95% CI = −2.1, −0.9), and resilience (b = 0.2, p < 0.001, 95% CI = 0.1, 0.2). We observed no statistically significant differences between the two intervention groups on any outcome. Conclusions: Our findings suggest that coherent breathing is a promising strategy for improving stress-related outcomes and resilience. This intervention warrants further, more rigorous testing.