Improving mental health of student and novice nurses to prevent dropout: a systematic review.

Bakker, Ellen J M; Kox, Jos H A M; Boot, Cécile R L; Francke, Anneke L; Van Der Beek, Allard J; Roelofs, Pepijn D D M

AIMS To provide: (1) an overview of interventions aimed at improving mental health of student or novice nurses; and (2) an evaluation of their effectiveness on dropout-related outcomes. DESIGN Systematic review. DATA SOURCES Research papers published between January 1971 - February 2019 were identified from the following databases: Embase, Medline, PsycInfo, CINAHL, ERIC, the Cochrane Library, Web of Science and Google Scholar. REVIEW METHODS We followed the procedures recommended by the Editorial Board of the Cochrane Collaboration Back Review Group. We included peer-reviewed articles with a quantitative research design, examining interventions aimed at improving mental health of student and novice nurses and their effect on dropout-related outcomes. The large variation in studies prohibited statistical pooling and a synthesis without meta-analysis of studies was performed. RESULTS We identified 21 studies with three areas of focus: managing stress or stressors (N=4); facilitating the transition to nursing practice (N=14); and a combined approach (N=3). Five studies showed a statistically significant effect on dropout-related outcomes. The overall risk of bias was high. CONCLUSION A wide range of interventions are available, but the evidence for their effectiveness is limited. There is a need for high-quality studies in this field, preferably with a randomised controlled design.