Using experience-based co-design approach to address mental health issues among healthcare workers and leaders in long-term care
School of Nursing, McMaster University
How they used Delve
Nursing researchers at McMaster University used Delve to code transcripts of eleven focus groups with 24 Ontario long-term care workers and leaders about burnout and distress, organising data with tags and categories, building a coding framework with an expert panel, and sorting codes into inductive themes that two researchers reviewed independently before member checking.
“Once cleaned, the transcripts were uploaded into Delve, an online platform designed for the efficient analysis of large qualitative datasets. Using Delve, we systematically coded the data to identify key [...] The qualitative analysis in Delve involved the following steps. First, the data organization process employed tags and categories, with individual data points labeled with tags and related points grouped into categories. Second, the coding process began with the development of an initial coding framework crafted through careful reading of interview transcripts.”
- Field
- Long-term care workforce / burnout and mental health
- Data
- Eleven focus group sessions (June to October 2024) with a purposive sample of 24 Ontario long-term care workers and leaders, plus memos and reflections from the co-design process
- Approach
- Experience-based co-design; focus group transcripts (Otter.ai) analysed in Delve with tags and categories, an initial coding framework, engagement-driven coding of whole transcripts, inductive themes by keyness, member checking, and two researchers independently reviewing themes; directed qualitative content analysis for the tool-adaptation phase
- Data types
- Focus groups
Abstract
Introduction: Burnout remains a critical issue within the long-term care (LTC) sector, underscoring the urgent need for early detection and prevention strategies targeting the healthcare workforce. This paper aimed to describe the processes of uncovering the underlying drivers of burnout and distress among LTC workers, providing a foundational understanding to inform the development of a Burnout Assessment Tool (BAT). Materials and methods: Using an experience-based co-design approach, 11 focus groups were held with a purposive sample of 24 Ontario LTC workers between July 2023 and October 2024. Each session, lasting 2 h, included 4-5 participants representing a diverse range of professional and occupational roles, including personal support workers, nurses, social workers, and administrators or leaders. The objectives of this approach were two-fold: (1) to explore the work-related experiences of LTC workers; and (2) to examine their perceptions of existing burnout and distress tools, including the Maslach Burnout Inventory-Human Services Survey, to assess their relevance and applicability within the LTC context. Each focus group session was audio-recorded and transcribed verbatim. An iterative process generated codes from the transcripts that culminated in a thematic framework of key findings. Results: Four interrelated themes emerged: (1) challenges inherent in the LTC work environment; (2) the impacts of workplace pressures on employee health and well-being; (3) managing psychosocial risk factors in the workplace; and (4) the need for a context-specific tool to assess burnout in LTC settings. Participants provided in-depth perspectives on their roles within the LTC sector, highlighting the profound impact of burnout on their well-being and the persistent challenges they face in their work environment. Discussion/conclusion: The findings highlight the pressing need for tailored systemic interventions to effectively address burnout and moral distress among LTC workers and leaders. By employing a co-design approach, this study offers critical insights into the lived experiences of these workers, informing the development and refinement of burnout assessment tools to better reflect the unique needs of this workforce. Developing a BAT, co-created by and for LTC workers, coupled with robust support systems, is crucial to addressing the rising distress and fostering resilience within this vital sector.
Citation
Sheila A. Boamah, Mawukoenya Theresa Sedzro, Humayun Kabir, Brenda Vrkljan, Scott G. Mitchell, Laura Pérez, Marilina Santero (2025). Using experience-based co-design approach to address mental health issues among healthcare workers and leaders in long-term care. Frontiers in Medicine. https://doi.org/10.3389/fmed.2025.1535017