Tai Chi for the older nurse: a workplace wellness pilot study.

There is an earnest call from the nursing workforce community for implementing effective and easily replicable interventions to improve health and wellbeing, reduce risks of musculoskeletal injuries, and reduce the work limitations of the older nurse workforce. The widely documented positive effects of Tai Chi in the elderly population encouraged the consideration of Tai Chi as an effective intervention for older nurses (age 40+) in terms of promoting their mental and physical health, reducing the risks for work-related injuries, and improving their work productivity.

The Office of Nursing Workforce at the University of Vermont, in collaboration with Fletcher Allen Health Care, and the General Clinical Research Center, conducted a Tai Chi workplace wellness pilot study involving 14 nurses over age 45. The results of this study were presented in a paper and a poster at the 18th International Nursing Research Congress Focusing on Evidence-Based Practice in Vienna, Austria July 11-14, 2007. Authors of the paper were Mary Val Palumbo, Ge Wu, Holly Shaner-McRae, Barbara McIntosh and Betty Rambur.

The pilot study was conducted at Fletcher Allen Health Care from August to December, 2006. Over 70 nurses expressed interest in participating. Fourteen female nurses, working in the hospital setting (mean age of 54.4 years, range: 49-63), participated. Tai Chi classes were offered once a week for 15 weeks at the hospital. Participants were to practice Tai Chi on their own for 10 minutes at least 4 times per week.

Results: Tai Chi outcomes generally moved in the right direction, however few results reached significance with this small sample. The drop out rate was as predicted (25%). There was a significant group difference in pre-post functional reach (p=0.026) with the Tai Chi group showing improvement, while the control group showed decline. There was no significant group difference in pre-post sit-and-reach (p=0.34), but the Tai Chi group showed a larger improvement (6.4%) than the control group did (1.2%). Nurse stress, in the area of "lack of support," declined in the experimental group.

Cost benefit analysis documented a cost savings for the employer as measured by reduced absenteeism. The control group took 49 unscheduled time-off hours compared to none for the experimental group during the 15 weeks of the intervention. Therefore the total cost of the program (instructor fee) was recuperated by not having to use replacement nurses for the time off taken by the experimental group. With a greater decrease in Work Limitations Questionnaire score, the Tai Chi group showed a 3% increase in work productivity (p = 0.13).

Participant evaluation: The experimental group all reported being "very satisfied" with the Tai Chi exercise instruction. Other comments included: "Continue to make offerings for older nurses;" "Many nurses wanted to do it and were disappointed because they couldn't get in;" "Perfect right after work--didn't have time to dilly dally;" "Could learn it quicker going twice a week;" "Too much distance between classes makes it easy to forget about it;" "Missed it when it stopped."

This investigation of an intervention aimed at older nurses' health and safety, could have far reaching significance. Two more proposals for larger studies of Tai Chi wellness interventions, tested by older nurses in Vermont and New Hampshire hospitals, have been submitted by the Office of Nursing Workforce to the National Institute of Health.