Healthcare Staff Wellbeing Research Articles

A New Test for Evaluating the Psychological Impact of COVID-19 in Nurses

Introduction During the COVID-19 pandemic, many health care workers were involved and suffered significant physical and psychological strain, and nursing was one of the main players. Clearly and objectively establishing the psychological impact on nurses during the pandemic is necessary for long-term recovery and to be prepared for new outbreaks in the future. Aim The aims of this study were to evaluate the perceived impact on nurses at risk of psychological stress at work during a major health care crisis and determine the psychological impact and its influencing factors. Methods An online questionnaire was designed and distributed between April 9 and April 19, 2020, in Spain. The comprehensive self-conducted questionnaire included demographic information and the Psychological Stress and Adaptation at work Score. For the analysis, descriptive statistics, logistic regressions, and receiver operating characteristic curves were determined. Results A total of 825 nurses (33% working in intensive care units and emergency departments) answered the questionnaire. A logistic regression analysis revealed that nurses with higher psychological stress scores experienced more physical overload (P = .02), higher psychological overload (P < .01), poor teamwork (P = .02), more distress due to new circumstances (P < .01), more personal impact of how society responded to COVID-19 (P < .01), anticipation of negative future consequences (P < .01), and worse balance between family and work (P < .01). The area under the curve for the cutoff point of Psychological Stress and Adaptation at work Score 40 was 0.82 (95% confidence interval, 0.79-0.91), with 70% sensitivity and 81% specificity. The positive predictive value was 72%, and the negative predictive value was 80%. Conclusion Psychological Stress and Adaptation at work Score is a rapid and accurate test for evaluating the psychological well-being of health care staff that can be used when crisis prevents the use of conventional stress diagnosis methods. Higher psychological impact was observed in nurses who worked in the intensive care unit and in the hospital ward.

Healthy lifestyle promotion project among healthcare workers

Abstract Background The psychosocial risks generated from difficult work conditions are damaging not only for the workers’ health and safety, but also have a huge impact on the organization and management efficiency. Description Some of the primary challenges that health workers face are demanding schedules and stressful shift patterns which lead to higher levels of worker burnout. Ensuring the well-being of healthcare staff is crucial not only for the individual workers, but it also brings important lessons to the community creating an environment built on a culture of health. Results In the past year, the Hospital of Cittadella (Province of Padua) has launched a set of programmes structured to help the staff make better lifestyle choices that affect not only their personal life but also create a more sustainable work environment. One of the projects involved various meetings with a Physical Medicine-Rehabilitation physician, a physical therapist, an Occupational Medicine physician and a medical yoga teacher. The encounters, attended by nearly 10% of the hospital staff, were aimed to help healthcare workers create a more balanced lifestyle and to implement physical activity and posture exercises in their daily routine. Four nutrition classes were also organized with the help of a nutritional biologist. The aim of this course was to show the basics of healthy diets supported by scientific data and guide the participants towards realistic and healthy meal plans. Lessons In conclusion, increasing the general wellbeing within the healthcare context is not an easy task, especially when organizational circumstances like staff reduction are being faced. These projects represent a small step towards facing these difficulties. It is important to note that the motivation, collaboration, inclusivity, flexibility and reliance are all elements that contribute to better mental and physical health of the healthcare staff which is crucial on an individual, organizational and societal level. Key messages • Increasing personal well being amongst healthcare workers can help create a more sustainable work environment. • A healthy work environment is crucial for a better functioning organization.

Survey analysis of workplace violence among public healthcare workers in Yogyakarta, Indonesia

BackgroundWorkplace violence in the healthcare sector has become a global issue that poses a threat to the safety and well-being of healthcare staff. This study aims to understand and analyze workplace violence experienced by public healthcare workers in Yogyakarta, Indonesia.ResultsThis is an observational analytical descriptive study using a cross-sectional design across 482 healthcare workers from 7 general public hospitals taken through stratified random sampling with a standardized questionnaire. The surveys found that 65 from 482 healthcare workers (13.6%) admitted to experiencing physical violence, verbal abuse, bullying, and/or sexual harassment. It is most prevalent among nurses, with the majority occurring in the emergency department ward. Verbal abuse is the most common type, mainly perpetrated by patients’ relatives. Most workers who experience violence take no action. In the bivariate analysis, there was a significant relationship between professions (p = 0.045) and their workplace (p < 0.001) with workers experiencing violence. No significant relationships were found regarding age, gender, marital status, duration of work, and years of service.ConclusionsA low prevalence of workplace violence was noted in public hospitals in Yogyakarta, suggesting that underreporting might be a major concern. Nurses and the emergency department are the most vulnerable and thus need more urgent interventions. Further research should focus on private hospitals and more effective preventive and responsive measures.

Workload balancing for the nurse scheduling problem: A real-world case study from a French hospital

To improve the efficiency and viability of healthcare organizations, it is crucial to enhance both the quality of patient care and the well-being of healthcare staff, particularly nurses. They play a vital role as a key human resource in healthcare, and their well-being and job satisfaction are significantly influenced by effective scheduling. Improved scheduling practices not only enhance the quality of care provided but also contribute to better job satisfaction and overall well-being of the nursing staff. Despite the importance of this task, nurse scheduling is often conducted manually by head nurses, which is both challenging and time-consuming. This study proposes a mathematical model that addresses the nurse scheduling problem, with a specific application in a French hospital department. The objectives of the model are to accommodate a wide range of constraints flexibly, ensure balanced workloads and shifts, and align with the preferences of the nursing staff. A significant contribution of this research is the theoretical investigation and comparison of various workload balancing criteria tailored to the specific context of the problem. The study analyzes different workload balancing criteria to formulate an efficient scheduling solution. The effectiveness of the proposed approach is demonstrated through large experiments and practice feedback, confirming its potential to enhance both healthcare efficiency and nurses’ well-being.

Impact of COVID-19 on Sleep, Anxiety, and Depression Among Medical Call Center Staff: Insights from a January 2021 Study.

BACKGROUND The COVID-19 outbreak emerged as a dual threat, effecting both the physical and mental well-being of healthcare staff. This study aimed to evaluate sleep quality using the Pittsburgh Sleep Quality Index (PSQI), levels of anxiety and depression using the Hospital Anxiety Depression Scale (HADS), and the significant influencing factors during COVID-19 pandemic in 284 workers in a medical call center in January 2021. MATERIAL AND METHODS Out of 443 pre-hospital care providers, 284 consented to participate. Data collection was done using an introductory information form, the PSQI for sleep quality, and the HADS for anxiety (HADS-A) and depression (HADS-D). Surveys were hosted on an online survey website and distributed via WhatsApp, with completed forms retrieved from the website. RESULTS Male sex (P=0.0001) and extended working hours in current workplace (P=0.017) were associated with higher HADS-A scores. Health problems, increased need for mental support, and poor job satisfaction correlated with lower HADS-D scores (P=0.025, P=0.005, P=0.0001, respectively) and higher PSQI scores (P=0.008, P=0.009, P=0.008, respectively). A moderately significant positive correlation was found between overall sleep quality and HADS-A (P=0.001, r=0.538) and HADS-D scores (P=0.001, r=0.493). CONCLUSIONS The pandemic significantly impacted the mental health and sleep quality of frontline healthcare personnel, necessitating the identification and mitigation of adverse psychosocial factors. Implementing and evaluating psychoeducational programs and establishing multidisciplinary mental health teams can provide for essential support and counseling, promoting the well-being of healthcare staff and ensuring effective emergency care.

The Gaziantep Model: Integrated Mother-Child Health Services for Healthy Communities After Disasters

This article discusses the Gaziantep Model, which focuses on integrated mother-child health services in the aftermath of disasters, with a particular focus on the 2023 earthquakes in Turkey. The model emphasizes the importance of maternal and child health in building healthy communities post-disaster and offers a comprehensive approach to address physical and mental health. The Gaziantep model uses a hybrid structure of mobile and fixed healthcare services to provide care at both individual and societal levels. It also recognizes the importance of healthcare staff's well-being. The article highlights the significant impact of the earthquakes, including damage to healthcare facilities and the strain on healthcare personnel, especially in regions with a high population of Syrian refugees. Gaziantep, with its existing maternal and infant mortality challenges, serves as a suitable province for implementing this model. The article emphasizes the long-term consequences of disasters on maternal and child health, including increased risks during pregnancy, mental health issues, and developmental challenges for children. The Gaziantep model aims to foster collaboration among various agencies and organizations, develop targeted interventions, and collect data to improve maternal and child health, reduce burnout among medical personnel, and enhance the overall well-being of communities. It involves the partnership of Gaziantep University, the ZERU Association, Gaziantep Provincial Health Directorate, and Gaziantep Municipality. Overall, the Gaziantep Model offers a comprehensive approach to address the unique healthcare needs of mothers, children, and families in the aftermath of disasters, with a focus on collaboration and long-term community health.

Organizational justice and organizational citizenship behavior: exploring the mediating role of psychological well-being at work

PurposeThe present research paper aims to examine the inter-relationship between organizational justice (Henceforth termed as OJ), psychological well-being at work (henceforth termed as PWBW) and organizational citizenship behavior (henceforth termed as OCB). More specifically, this paper attempts to critically analyze the mediating role of PWBW in the relationship between OJ and OCB. The study solely focuses on nurses working at private hospitals in Kerala, who are the largest group of healthcare personnel.Design/methodology/approachData collected from 308 nursing employees were analyzed by using statistical package for the social sciences (SPSS) software.FindingsThe outcomes of the analysis demonstrate that significant correlations exist between all the three key variables and their dimensions. Moreover, it has been found that the relationship between OJ and OCB is partially mediated by PWBW.Research limitations/implicationsIn the present healthcare scenario, just after the Covid-19 pandemic, there is a paramount need for the well-being of healthcare staff in order to improve the functioning of the healthcare system.Originality/valueThe study enabled us to develop and provide an explanation as to how social exchange relationship works between OJ and OCB.

Would’ve, could’ve, should’ve: a cross-sectional investigation of whether and how healthcare staff’s working conditions and mental health symptoms have changed throughout 3 pandemic years

ObjectivesMental health and well-being of healthcare staff were majorly impacted by the COVID-19 pandemic. Little attention has been devoted to the role employers could choose to play in mitigating long-term...

Rudolph, the kids’ ward reindeer: a scoping review of the effects of support animals on the well-being of healthcare staff

BackgroundMany systematic reviews identify support animals or animal assisted activity as a beneficial and standard practice in several medical disciplines for patients (children, adolescents, and adults) and residents in care homes. A variety of animals are used such as dogs, cats, ponies, horses, alpacas, reindeer, penguins, rabbits, and tarantulas. Our objective was to explore the evidence regarding effects of animal assisted activity on a further population of interest; namely, healthcare staff.MethodsWe asked the question “how do support animals in healthcare settings affect the well-being of healthcare staff?” As an addendum, we were also interested in what - possibly more unique - animals have visited healthcare settings at Christmas time in particular. We conducted a scoping literature review using PubMed and Web of Science (search as of 26 April 2023). ResultsTwenty studies (in the USA, Australia, Europe; dogs: n = 19; cats: n = 1) since 2002 included: studies with biological measures (n = 3), longitudinal survey studies with analyses (n = 5), cross-sectional survey studies with analyses (n = 2), and cross-sectional survey studies with descriptive statistics (n = 10). Overall, animal assisted activities appear to be well-received by staff and there do not seem to be negative impacts on staff well-being.ConclusionsRelevant positive effects and avenues of research are identified. Our review suggests that, but not exactly how, animal assisted activity benefits staff. Study evidence is limited with most studies being cross-sectional, descriptive, having low participant numbers, and mostly only involving dogs. Nonetheless, the evidence is mostly positive. The potential of animal assisted activities impacting positively on staff well-being warrants systematic research. Gaps in hard-fact-evidence should not deter us – especially at the festive season – to encourage work with, and systematic research regarding, support animals that provide warmth, empathy, comfort, and more in healthcare settings.

Development and initial validation of the staff perception of residential care environments (SPORE) instrument.

The impact of the physical environment on healthcare staff well-being and work performance is well recognised, yet there is a lack of instruments assessing environmental features from the perspective of staff working in residential care facilities (RCFs) for older people. To develop and provide initial validation of the instrument Staff Perceptions Of Residential care facility Environments (SPORE). An instrument development and psychometric evaluation study. Based on material from a British project, items were translated and adapted for Swedish residential care facilities as SPORE. Care staff (N = 200), recruited from 20 Swedish RCFs, completed a questionnaire-based survey containing the SPORE instrument and two other instruments selected as suitable for use in the validation. In addition, an environmental assessment instrument was used for further validation. Analyses were performed at individual (staff) level and home (RCF) level. The SPORE subscales demonstrated good internal consistency reliability and were moderately to strongly correlated at the individual level with the subscales of measures of person-centred care, and strongly correlated with the same measures at the home level. The SPORE subscales were also highly correlated with the total score of the instrument used to assess the quality of the physical environment. The initial validation indicates that the SPORE instrument is promising for measuring care staff perceptions of environmental features in care facilities for older people. SPORE can be a valuable instrument for use in research and in practice to evaluate the environment as part of working towards high-quality care. The design of the physical environment within RCFs can affect the staff's health and work performance. The instrument is useful for evaluating the environment and informing decisions about design solutions that support staff in their important work.

Caregiving and receiving experiences in UK community mental health services during COVID-19 pandemic restrictions: A qualitative, co-produced study.

WHAT IS KNOWN ON THE SUBJECT?: At the outset of the COVID-19 pandemic, little was known about ways of delivering registered nurse practice within CMHTs under restrictions associated with a global pandemic. Emerging research focused on broad healthcare staff wellbeing during the pandemic. Qualitative research explored the overall response of COVID-19 on people with existing health needs or remote working more specifically. Over the past 2 years studies have emerged detailing experiences but no studies have used qualitative research to understand community mental health nurses and service users experience of services. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This co-produced qualitative study is the first to explore the changes to CMHT care from the experience of service users and nurses later in the COVID-19 pandemic. The study questions whether recovery-based approaches are possible in a hybrid way of working. The findings identify challenges for nurses' well-being and work-life boundaries when working from home. The study adds to historical professional narratives of mental health nursing. WHAT ARE THE IMPLICATIONS FOR PRACTICE: While hybrid approaches developed in response to COVID-19 restrictions may offer more choice these approaches need further co-produced evaluation on the impact of recovery-focused care and therapeutic relationships. Mental health nurses need to review how future hybrid working continues to impact nurses' mental health and emotional safety. Nurses and service users need to raise awareness within society and policy on the impact that COVID-19 had on people with existing mental health conditions. ABSTRACT: Introduction Community Mental Health Team responses to COVID-19 included fundamental service delivery adaptations. Aim/Question Our co-produced study sought to understand which service delivery changes experienced by service users and registered nurses were helpful or unhelpful to caregiving and receiving. Method Qualitative semi-structured interviews were undertaken with 10 service users and 13 registered nurses from 3 NHS England sites. Co-produced throughout, people with lived experience of mental health services and nurses wishing to improve their research experience undertook interviews following training. Data were analysed thematically. Findings Care radically changed from in-person to large phone or video contact. This reportedly altered therapeutic relationship building and raised questions about whether recovery-focused care was possible. Hybrid working was viewed as helpful but raised challenges for nurse wellbeing. Discussion Changes to care delivery challenged the fundamentals of recovery-focused interventions and therapeutic relationships. Service users and nurses well-being consequently suffered. The impact of the pandemic on people with existing mental health conditions was poorly acknowledged in the media. Implications for Practice Recovery-focused interventions and relationship building need evaluating in the light of ongoing hybrid working. Teams need to consider the well-being of nurses engaged in complex service-user interactions from home.

Advantages of greenery in hospital environment - a literature review

Abstract Background: Incorporating greenery into hospital environment contributes to the sustainable development goals by mitigating health, environmental and economic problems. Despite the increasing interest in plants, gardens and green roofs in general built environments, the benefits of greenery in hospital environment are still under-researched. The aim of this review was to summarize the relevant literature and describe the benefits of greenery in hospital environment. Methods: The PubMed, Springer Link and CINAHL databases were searched to identify relevant studies and articles published between 2012 and 2023. The keywords used were hospitals, greenery, green systems, vegetation, and room plants. The language restriction was that articles were published in English. Results: Following the PRISMA methodology, seven eligible studies were included in the literature review. Evidence shows that the presence of greenery affects patient health outcomes and the well-being of healthcare staff. Moreover, the healing and therapeutic effects greenery in the hospital environment have been identified. Greenery also has a positive psychological effect on healthcare workers and visitors. Humanizing healthcare spaces and connecting them with nature empowers patients, reduces stress and pain, and improves emotional well-being. Conclusion: The biophilic design concept increases occupant connectivity to the natural environment through vegetation at the location, including implemented green building envelope systems (green walls and roofs) and the introduction of indoor plants. It should be incorporated into the established steps of hospital design. In summary, more research is needed, particularly on the potential impact of plants on hospital-acquired infections.

Compassion, collaboration, and community: Strategies for staff well-being.

Compassion, collaboration, and community: Strategies for staff well-being.

Boosting morale among NHS staff: what can managers do?

British Journal of Healthcare ManagementVol. 29, No. 4 EditorialBoosting morale among NHS staff: what can managers do?Robert ConwayRobert ConwayCorrespondence to: Robert Conway; E-mail Address: [email protected]Frimley Health NHS Foundation Trust, Surrey, UKSearch for more papers by this authorRobert ConwayPublished Online:10 Apr 2023https://doi.org/10.12968/bjhc.2023.0032AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References BBC. Junior doctor strike led to 175,000 cancellations. 2023. https://www.bbc.co.uk/news/health-64995025 (accessed 23 March 2023) Google ScholarBradler C, Dur R, Neckermann S et al.. Employee recognition and performance: a field experiment. Manage Sci. 2016;62(11):iv–vi. https://doi.org/10.1287/mnsc.2015.2291 Google ScholarChaudhury H, Mahmood A, Valente M. The effect of environmental design on reducing nursing errors and increasing efficiency in acute care settings: a review and analysis of the literature. Environment and Behavior. 2009;41(6):755–786. https://doi.org/10.1177/0013916508330392 Crossref, Google ScholarElmblad R, Kodjebacheva, Lebeck L. Workplace incivility affecting CRNAs: a study of prevalence, severity, and consequences with proposed interventions. J Am Asoc Nurs Anesth. 2014;82(6):437–445 Google ScholarGarcia CL, Abreu LC, Ramos JLS et al.. Influence of burnout on patient safety: systematic review and meta-analysis. Medicina (Kaunas). 2019;55(9):553. https://doi.org/10.3390/medicina55090553 Crossref, Google ScholarGemine R, Davies GR, Tarrant S et al.. Factors associated with work-related burnout in NHS staff during COVID-19: a cross-sectional mixed methods study. BMJ Open. 2021;11:e042591. https://doi.org/10.1136/bmjopen-2020-042591 Crossref, Google ScholarGraber JE, Huang ES, Drum ML et al.. Predicting changes in staff morale and burnout at community health centers participating in the health disparities collaboratives. Health Serv Res. 2008;43(4):1403–1423. https://doi.org/10.1111/j.1475-6773.2007.00828.x Crossref, Google ScholarHall LH, Johnson J, Watt I et al.. Healthcare staff wellbeing, burnout and patient safety: a systematic review. PLoS One. 2016 Jul 8;11(7):e0159015. https://doi.org/10.1371/journal.pone.0159015 Crossref, Google ScholarKatz D, Blasius K, Isaak R et al.. Exposure to incivility hinders clinical performance in a simulated operative crisis. BMJ Qual Saf. 2019;28:750–757 Crossref, Google ScholarNHS Staff Survey. NHS Staff Survey national results. 2022. https://www.nhsstaffsurveys.com/results/national-results/ (accessed 23 March 2023) Google ScholarRothenberger DA. Physician burnout and well-being: a systematic review and framework for action. Dis Colon Rectum. 2017;60(6):567–576. https://doi.org/10.1097/DCR.0000000000000844 Crossref, Google ScholarSmith JG, Morin KH, Lake ET. Association of the nurse work environment with nurse incivility in hospitals. J Nurs Manag. 2018;26(2):219–226. https://doi.org/10.1111/jonm.12537 Crossref, Google ScholarStefancyk AL. One-hour, off-unit meal breaks. Am J Nurs. 2009;109(1):64–66. https://doi.org/10.1097/01.NAJ.0000344043.57392.ce Crossref, Google ScholarTeng C-I, Shyu Y-IL, Chiou W-K et al.. Interactive effects of nurse-experienced time pressure and burnout on patient safety: a cross-sectional survey. Int J Nurs Stud. 2010;47(11)1442–1450. https://doi.org/10.1016/j.ijnurstu.2010.04.005 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 April 2023Volume 29Issue 4ISSN (print): 1358-0574ISSN (online): 1759-7382 Metrics History Published online 10 April 2023 Published in print 2 April 2023 Information© MA Healthcare LimitedPDF download

Errata: Volume 10; Issue 4, 2022

The following items published in the International Journal of Medical Students (IJMS) Volume 10, Issue 4 of 2022 were corrected on February 20, 2023: "A Cross-Sectional Study of p66Shc Gene Expression in Liquid Biopsy of Diabetic Patients. Is it Possible to Predict the Onset of Renal Disease?" was corrected for capitalization errors in the title.1 "Elective Courses in Global Surgery for Undergraduate Medical Students: A Narrative Review and a Proposal for European Universities" contained an error in the DOI on the footer of page 395. The correct DOI is: 10.5195/ijms.2022.1598.2 "Why the Furor about Polio?" was corrected for a spacing error in the title in the PDF version.3 In the article entitled "Research Experience of Medical Students Collaborating in an International Peer Research Mentorship Program", there were errors in the fourth and fifth authors’ names. The correct names are: Aysha Zulfiqar and Tejaswini Ashok.4 "‘First, Do No Harm'… A Call to Re-evaluate the Wellbeing of Healthcare Staff" was corrected for a spacing error in the title.5

Exploring the impact of COVID-19 on frontline health workers through a photovoice study in Kaduna, Kwara and Ogun States, Nigeria.

Described as the 'backbone of health systems', particularly in low- and middle-income countries, community health workers (CHWs) are a critical cadre on the frontline of any outbreak response. However, it is widely recognised that CHWs are frequently lacking in appropriate support from the health system due to inadequate physical, social and financial resources. Furthermore, despite their critical role in service delivery, the health and well-being of CHWs is seldom considered and the additional emotional and physical burdens that health systems shocks can present are frequently ignored. Thus a critical step in strengthening health systems to manage disease outbreaks or other system shocks is to ensure that CHWs are adequately supported. Within this study we document the experiences of CHWs within Nigeria during the coronavirus disease 2019 (COVID-19) outbreak to understand the impact of the pandemic on CHW well-being with a view to identifying strategies that could support CHWs during COVID-19 and subsequent health system shocks. This study was based in Ogun, Kaduna and Kwara States, Nigeria. We used the creative participatory methodology of photovoice with 30 CHWs (10 in each state). Participants were asked to take photos documenting their experiences of working and living through the pandemic. Participants sent photos with captions to the research team via WhatsApp following one-on-one discussions. Photos were co-analysed among participants in focus group discussions using thematic analysis. Our findings reveal similar experiences of CHWs across Ogun, Kwara and Kaduna States in Nigeria, providing a unique insight into how the Nigerian health system was impacted and how this closely aligns to the performance and well-being of CHWs. CHW experiences related to three overarching themes: major stressors and challenges experienced due to COVID-19 (fear of contracting COVID-19, food insecurity, personal and gendered impacts), the impact of COVID-19 on providing routine care (stigma from community members, heavy workloads and inadequate equipment provision) and motivation and support from the community (pride in their roles and valued support from community leaders). The challenges highlighted through photovoice led to developing recommendations to address some of the challenges. This included training, adequate resource provision, routine supervision and peer support. COVID-19 highlighted the burden health workers often face. Photovoice allowed a space for frontline health workers to come together to share common experiences, particularly the psychosocial impact of working during health system shocks and its impact on performance. This underlines the need to acknowledge mental health and prioritise the well-being of healthcare staff. Sharing stories from the perspectives of health workers provides a platform to share learning and strategies on how to best support health workers holistically, particularly during health system shocks.

Moral injury and psychological wellbeing in UK healthcare staff

Background Potentially morally injurious events (PMIEs) can negatively impact mental health. The COVID-19 pandemic may have placed healthcare staff at risk of moral injury. Aim To examine the impact of PMIE on healthcare staff wellbeing. Methods Twelve thousand nine hundred and sixty-five healthcare staff (clinical and non-clinical) were recruited from 18 NHS-England trusts into a survey of PMIE exposure and wellbeing. Results PMIEs were significantly associated with adverse mental health symptoms across healthcare staff. Specific work factors were significantly associated with experiences of moral injury, including being redeployed, lack of PPE, and having a colleague die of COVID-19. Nurses who reported symptoms of mental disorders were more likely to report all forms of PMIEs than those without symptoms (AOR 2.7; 95% CI 2.2, 3.3). Doctors who reported symptoms were only more likely to report betrayal events, such as breach of trust by colleagues (AOR 2.7, 95% CI 1.5, 4.9). Conclusion A considerable proportion of NHS healthcare staff in both clinical and non-clinical roles report exposure to PMIEs during the COVID-19 pandemic. Prospective research is needed to identify the direction of causation between moral injury and mental disorder as well as continuing to monitor the longer term outcomes of exposure to PMIEs.

A narrative inquiry into healthcare staff resilience and the sustainability of Quality Improvement implementation efforts during Covid-19

BackgroundRecent research, which explored the use of Quality Improvement (QI) methods in the Covid-19 pandemic response, found that Quality Improvement principles were utilised during the crisis management period, albeit without direct intention. Following on from this work, the aim of this paper extends that study by investigating the sustainability and resilience of not only the changes implemented by healthcare staff during Covid-19 in Ireland, but the resilience of the wellbeing of healthcare staff themselves through the various waves of Covid-19.MethodsTo explore healthcare staffs experience of Quality Improvement and the sustainability and resilience of both Quality Improvement initiatives and healthcare staff, a qualitative design was implemented. Semi-structured interviews took place online over Zoom with 11 healthcare staff members from the Irish healthcare service in the Spring of 2022. An analysis of the narratives was conducted using thematic analysis supported by NVivo12.ResultsFour key themes were evident from the data: (i) From fear to exhaustion; (ii) maintaining person-centred approaches to care; (iii) Covid-19 as a medium for change, and; (iv) staff resilience and appetite for Quality Improvement.DiscussionThe results of this work identified three key learnings; (i) integrating learning into policies and practice: (ii) the role of collective leadership and devolving/sharing power; and (iii) key drivers/factors that promote sustainability of QI interventions. Despite the challenges in recruitment of research participants experienced during the pandemic, a narrative approach supported the collation of rich and nuanced insights into the experiences of healthcare staff during this time.ConclusionA growing body of literature currently exists on how healthcare staff felt during the Covid-19 pandemic. However, as the waves of Covid-19 have declined, it is vital to examine how the feelings of burnout and disillusionment will affect engagement with Quality Improvement in the future. It is also worth noting and examining the feeling of purpose and pride participants expressed from working through the Covid-19 pandemic. This study has helped to address this gap.

‘First, Do No Harm'… A Call to Re-evaluate the Wellbeing of Healthcare Staff

‘Primum non nocere’ or ‘do no harm’ is the timeless Hippocratic mantra instilled in every healthcare professional at the beginning of their career. It is the ethical compass which guides all decision making in healthcare working in the best interests of patients to give them the best possible treatment and quality of life. This vocation of course does not come without its challenges, long working hours, stress, time constraints and demands which affect the professional and personal life of healthcare workers and in some instances their own health and wellbeing. It is time to raise the profile of this truth and call for ways to practically encourage health professionals to make their well being a priority too.

Learning from Covid-19; lessons for healthcare staff wellbeing

This article explores the reflections of psychologists from working with healthcare staff on the frontline during the Covid-19 pandemic. The psychological impact of the pandemic on healthcare staff is discussed using a compassion-based approach. Consideration is given to possible lessons to take forward from this time to psychologically protect staff against potential future periods of crisis and the ongoing difficulties facing health service organisations.