Improve Staff Wellbeing Research Articles

Improving health workers’ well-being in Cittadella Hospital (Province of Padua)

Abstract Issue A healthy workplace increases productivity, creativity and decreases absenteeism and turn-over. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work related stress that are often unsustainable. Description In an effort to improve staff well-being, in the Hospital of Cittadella, which counts nearly 1,250 employees, a wide range of activities have been initiated. A questionnaire was submitted to the hospital’s staff and the results showed that nearly 10% of workers had experienced physical symptomatology related to work. The most commonly experienced symptoms included: anxiety, nervousness, headache, stomach ache, excessive fatigue and insomnia. Participants also indicated feeling excessive mental fatigue and emotional overload at the end of their work shift. Results Psychomotor practice, held according to the Aucouturier method, is one of the projects intended especially for the staff operating in Intensive Care, Emergency and Pneumology Units. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue. A Qigong course, which is an ancient Chinese practice designed to optimize the energy within the body reducing the stress levels and increasing general wellbeing, was held every two weeks for 5 months. And finally, Tibetan singing crystal bowls sessions consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Lessons In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and consequently user’s satisfaction of the services provided. Key messages • Stress management is important amongst healthcare professionals as they are continuously exposed to different job stressors. • Promoting self awareness and self care can help create a healthier work environment.

Abstract P300: Evaluation of Organizational Behavior in a Rural Cardiology Clinic

Introduction: In the healthcare industry, organizational behavior plays a pivotal role in patient care and staff well-being. Exploring these dynamics in a rural setting may add the unique factors of community engagement, resource allocation, and staffing limitations. Taking steps to understand how these concepts manifest can improve the effectiveness of healthcare delivery and form positive work environments that benefit both patients and providers. Research Question: How do healthcare staff at a rural cardiology clinic operate in the context of organizational behavior? Goal: The goal is to understand the organizational behavior in a rural clinic to optimize healthcare delivery and tackle operational-related challenges. Methods: Conducted in 2022 during the COVID-19 pandemic, this study employed a mixed-methods approach featuring interviews with staff at the rural Georgia cardiology clinic of Lake Country Medical Group (LCMG) and a five-point Likert scale survey of twenty-three questions developed from qualitative data gathered through the interviews. The survey queried organizational behavior concepts such as job satisfaction, communication, and leadership, with answers being graded on a scale of 1 being “strongly disagree” to 5 being “strongly agree.” Descriptive statistics were used to analyze survey responses. Results: Twenty LCMG staff responded to the survey. Key survey results were analyzed according to organizational behavior categories (Figure 1). Qualitative data from interviews described operational inefficiencies and day-to-day challenges including scheduling issues, billing difficulties, and deficient recordkeeping perpetuated by “siloed” teams at the clinic. Conclusion: LCMG faces some operational challenges that can be ameliorated by organizational behavior approaches. Solutions oriented around enhancing synchronous work, cross-training, and stress-reduction could improve staff well-being and ultimately lead to improved patient care.

#73 : Common Problems Faced by Indian Assisted Reproductive Technologies Laboratory Professionals

Background and Aims: There has been tremendous growth in the offering of Assisted Reproductive Technologies (ART) in India creating a critical shortage of experienced clinical embryologists thus inevitably leading reduced training opportunities. The aim of this study was to investigate problems faced by laboratory professionals in the ART industry in India. Method: An online questionnaire survey was distributed to ART laboratory professionals globally through professional societies, social media, and email databases. The questionnaire included demographic questions and open-ended questions on problems faced by ART laboratory professionals at the clinic level, professional level, and personal level. The survey was active from May 2016 until February 2017. The Indian data was collected and analysed as a global sub-population. The identified common problems were used to categorise the responses and the percentage distribution was calculated. Results: Among 136 survey responders, 79 provided responses on problems faced by ART laboratory professionals, including 11 junior embryologists, 19 embryologists, 31 senior embryologists, 18 managers and directors. The problems identified from the responses were ‘overworking’ (18%), ‘respect / recognition’ (16%), ‘clinician and embryologist relationship’ (14%), ‘management’ (12%), ‘lack of training’ (11%), ‘regulation / certification’ (7%), ‘blamed for clinical outcomes’ (7%), ‘decision making’ (6%), ‘salary’ (5%), ‘staffing’ (3%). When stratified into roles, the top problems for junior embryologists were ‘overworking’ (21%), ‘respect / recognition’ (21%), and ‘lack of training’ (21%), for embryologists was ‘overworking’ (21%), for senior embryologists was ‘respect / recognition’ (18%) and ‘management’ (18%), for managers and directors was ‘respect / recognition’ (21%). Conclusion: The problems faced in the Indian ART industry are broad but are prioritised differently by staff members depending on their roles. Future research should investigate reasons underlining these problems and strategies to improve staff wellbeing particularly considering the recently introduced government regulations on ART in India.

1.N. Workshop: Improving the wellbeing of the health workforce in Europe: Issues and lessons from Ireland

Abstract Health systems have been subject to a series of crises over the last fifteen years from economic austerity to the COVID-19 pandemic and now the cost of living crisis. At the same time many high-income countries have bolstered their own deficient supply of health workers by importing skilled health professionals from other countries. The health workforce has borne the brunt of each of these shocks and it is no surprise that there is demotivation, burnout and high attrition across staff cadres across Europe. Not enough is known about the root causes of these phenomena and therefore what can be done to effectively enhance workforce wellbeing and engagement and also assist health systems to deal effectively with the legacy of pent up demand from the pandemic which is threatening to overwhelm services. This session seeks to identify and evaluate the different factors that have led to disengagement of staff and assess strategies to improve staff wellbeing, retention and health system recovery, based on quantitative and qualitative research. Three case studies from Ireland distinguish different elements of the problem: 1) an investigation of the dimensions of disengagement and their underlying causes after austerity across staff cadres with particular focus on bullying and discrimination 2) an evaluation of turnover amongst nurses post COVID and the factors which are linked to this, and 3) an examination of racial attitudes and discrimination towards non-Irish health professionals in Irish hospitals. Each study highlights particular factors which have caused disengagement and evaluates their consequences and causes. Together they paint a powerful picture of a health system and its workforce struggling to cope with crisis after crisis, mismanagement and ambitious change programmes. A fourth presentation will compare and contrast this picture with analysis from other high-income countries and examine optimal investment strategies to solve the heath workforce problems. This high-level analysis places the Irish case studies in perspective and allows a more thorough evaluation of key factors and strategies to turn round the situation across Europe. Each presenter will be given a strict deadline of 10 minutes each by the chair and then the audience will be invited to debate the problems identified and strategies proposed to discuss: (i) the appropriate course of action for health systems in Europe at this time, (ii) the conditions under which strategies will achieve the desired results for the health workforce and (iii) how and whether a coordinated approach across Europe would be more effective. Key messages • This session will improve understanding of the causes of burnout, disengagement and high turnover amongst the health workforce in order to address these problems. • Strategies for investing in the education, protection and wellbeing of the European health workforce will be evaluated to assist with our readiness for future shocks.

A new scale assessing the stressors and rewards of children’s hospice work

BackgroundThere is a workforce shortage in the children’s hospice sector, but there has been little research on the specific challenges of working in this setting and on how these challenges might be alleviated. To identify appropriate interventions to improve staff wellbeing, the drivers of wellbeing in children’s hospices need to be known and measured. This paper reports on the development of two measures, one for work-related rewards and one for work-related stressors, for use in children’s hospice care teams.MethodsA mixed-methods, four-stage study; the first three phases focused on the development of the scales, and the last stage focused on the validation of the scales. Participants of all stages were children’s hospice care team staff members in the UK. Stage 1: survey assessing the relevance and comprehensiveness of the original scale items (N = 60); Stages 2 (focus groups; N = 16) and 3 (cognitive interviews; N = 14) to assess content validity; Stage 4: UK-wide survey (N = 414) to validate the final version of the new, children’s hospice-specific scales using Rasch Analysis (RA) and Confirmatory Factor Analysis (CFA).ResultsDue to poor fitting indices shown in the results from the RA, five items (out of 36) were removed from the new rewards scale used in the UK-wide survey and 20 (out of 62) were removed from the new stressors scale. CFA also supported the removal of the items and showed a one-factor structure for the rewards scale and a three-factor structure for the stressors scale were adequate—the sub-scales for the stressors scale related to caring for an ill or dying child (“Child” sub-scale), working with parents and families (“Parent” sub-scale), and stressors related to organisational factors, such as team conflict and workload (“Organisation” sub-scale).ConclusionsBoth of the new scales showed good psychometric properties and can be useful in clinical settings and research to assess the perceived intensity of the work-related rewards and stressors for children’s hospice staff.

Drawing on the Locus of Control Framework to Explore the Role of School Leaders in Teacher Well-Being.

This scoping review explores the role of school leadership in the improvement of teacher well-being by utilizing the Locus of Control (LOC) Framework identified by psychologist Julian Rotter in 1954. The internal and external environments impacting teacher well-being were explored, and the specific responsibilities of school leadership were identified. The literature reports that while teachers are responsible for many aspects of their well-being, school leaders can improve a teacher’s mental health and create a positive school culture by taking responsibility for factors external to the teacher’s LOC. This paper outlines school leadership responsibilities in actively implementing strategies to improve staff well-being in the school environment.

In this June issue

In line with several other journals we co-publish the Australian Commission on Safety and Quality in Health Care Low Back Pain Clinical Care Standard. It describes the early clinical management of people who present with a new acute episode of low back pain. The background to how the standard was developed and finalised are described in an introductory editorial. Coronial findings and royal commissions have repeatedly identified deficiencies in the emergency health care provided to prisoners in Australia. These deficiencies are operational, clinical and stigmatic and not limited to a single prison or jurisdiction. Applying a health quality of care framework focused on prevention and chronic health management appropriate assessment and escalation when urgent medical assistance is requested, and a structured audit framework could avoid future preventable deaths in prisons. We publish an editorial on this topic to accompany the paper written by a team from Victoria and Queensland. A group from the neurosurgery department of the Royal Brisbane and Women's Hospital report that the availability of cranial access equipment outside Queensland tertiary centres is limited. Inter-hospital transfers are likely to persist in Queensland and so improving access to cranial access equipment in hospitals where it is currently lacking is highly warranted. They surveyed senior theatre nurse or surgical service directors from rural and regional Queensland hospitals located outside the local catchment of a tertiary centre and had a CT scanner. Questions regarded availability, location and storage conditions of mechanical cranial access kits, as well as last usage, and associated patient outcomes. Life-threatening thoracic trauma requires emergency pleural decompression, and thoracostomy and chest drain insertion are core trauma procedures. Reliably determining a safe site for pleural decompression in children is challenging, even for experienced clinicians. A team from Melbourne report that the Mid-Arm-Point (MAP) technique, a procedural aid for use with injured adults, is also a safe site for pleural decompression in children <4 years and with a very minor modification is safe in children ≥4 years. An excellent study from Queensland describes the demographics, presentation characteristics, clinical features and cardiac outcomes for Aboriginal and Torres Strait Islander patients who present to a regional cardiac referral centre ED with suspected acute coronary syndrome (ACS). The authors conclude this cohort with suspected ACS have a high burden of traditional cardiac risk factors, regardless of whether they are eventually diagnosed with ACS. These patients may benefit from assessment for coronary artery disease regardless of age at presentation. In a nice paper, James Mallows explores the concept of collegiality, something considered to be any extra-role behaviour that is discretionary, not recognised by a formal reward system and that promotes the effective functioning of the organisation. There are few studies examining collegiality in the medical profession and none looking at collegiality among emergency physicians (EPs). He explores the perceptions of different ED health care professionals on the meaning of collegiality among EPs, the benefits of collegiality and behaviours they identify as indicative of collegiality. He identifies distinct themes and behaviours indicative of collegiality among EPs. Promoting these behaviours could improve staff well-being, ED efficiency, patient safety and productivity. Continuing with the previous theme, team culture underpins team performance. Psychological safety is a critical component of team culture for high performing teams. A group from the Gold Coast Hospital decided to explore this further. They conclude that familiarity of team members and leaders is critical to the development of psychological safety within the ED. Fostering familiarity should be a focus for frontline leadership each shift and a priority in broader departmental decisions for those seeking to enhance the psychological safety of their teams. The focus in this issue is on the anaesthetic component of the Fellowship training programme.

Perspectives on implementing exercise bikes for use by inpatient mental health staff in the workplace: A qualitative study investigating staff attitudes.

INTRODUCTION: Exercise equipment for mental health staff may improve staff wellbeing, mitigate against stress and improve staff attitudes towards physical activity. This said, there is a lack of researching investigating the attitudes of mental health staff towards the provision of fitness facilities in the workplace. The study investigated staff attitudes towards being offered exercise bikes in the workplace. Three focus groups and one individual interview were conducted with 12 healthcare professionals. Data were subject to a thematic analysis. Three themes were identified. (1) 'This sounds like a good idea', which reflected positive views in the provision of exercise in the workplace for staff use. (2) 'I'm not sure it would work because …', which reflected implementation concerns including not having access to shower facilities and time constraints. (3) 'Balancing choice', which reflected participant's desire to have access to varied gym equipment. The introduction of fitness facilities in the workplace for staff use was endorsed. However, implementation barriers were noted. This research provides justification for the exploration of the feasibility and benefits of providing exercise equipment for mental health staff in the workplace but presents implementation barriers that are worth considering before trialling provision of exercise equipment.

Resilience of hospital staff facing COVID-19 pandemic: Lessons from Israel.

The COVID-19 pandemic has placed additional burden on already strained healthcare systems worldwide, intensifying the responsibility and burden of healthcare workers. Although most hospital staff continued working during this stressful and challenging unprecedented pandemic, differences in the characteristics and attributes were noted between sectors and hospital departments. Israeli healthcare workers are trained and experienced in coping with national emergencies, but the pandemic has exposed variations in staff reactions. Understanding the intrinsic differences between sectors and departments is a key factor in staff and hospital preparedness for unexpected events, better resource utilization for timely interventions to mitigate risk and improve staff wellbeing. To identify and compare the level of resilience, secondary traumatization and burnout among hospital workers, between different sectors and hospital departments, during the COVID-19 pandemic. Cross-sectional research to assess the resiliency, secondary traumatization and burnout of healthcare workers at a large general public hospital in central Israel. The sample consisted of 655 participants across various hospital units exposed to COVID-19 patients. Emergency department physicians had higher rates of resilience and lower rates of burnout and secondary traumatization than staff in other hospital departments. In contrast, staff from internal medicine departments demonstrated the highest levels of burnout (4.29). Overall, physicians demonstrated higher levels of resilience (7.26) and lower levels of burnout compared to other workers. Identifying resilience characteristics across hospital staff, sectors and departments can guide hospital management in education, preparation and training of healthcare workers for future large-scale health emergencies such as pandemics, natural disasters, and war.

Qualitative study using grounded theory examining collegiality among emergency physicians.

Collegiality is considered to be any extra-role behaviour that is discretionary, not recognised by a formal reward system and that promotes the effective functioning of the organisation. Although there is much literature on the concept of collegiality, there are few studies examining collegiality in the medical profession and none looking at collegiality among emergency physicians (EPs). The aim of the present study is to explore the perceptions of different ED healthcare professionals on the meaning of collegiality among EPs, the benefits of collegiality and behaviours they identify as indicative of collegiality. This was a qualitative study using grounded theory. Data collection was via focus group interviews of three to four participants per group. Participants included EPs, emergency medicine trainees, senior emergency nurses and nurse practitioners. Three questions were explored: 'what does collegiality mean to you?'; 'what are the benefits of collegiality?'; and 'what specific behaviours do you see as part of collegiality?' Ten focus group interviews involving a total of 33 participants were conducted. Several themes were identified for both the meaning of collegiality and the benefits of collegiality among EPs. Eight themes regarding collegial behaviour were identified: (i) mutual respect and trust; (ii) mutual support; (iii) attitude; (iv) work ethic; (v) staff welfare; (vi) patient management; (vii) handover; and (viii) education. The present study identified distinct themes and behaviours indicative of collegiality among EPs. Promoting these behaviours could improve staff well-being, ED efficiency, patient safety and productivity.

Resilience – understanding staff needs

Aims:The project aimed to explore how the system (e.g. the work environment and role) affects staff resilience and how the system could support staff resilience.Background:Understanding factors impacting staff resilience and how staff can be supported is seen as important for improving staff wellbeing, increasing job satisfaction, staff retention and recruitment.Methods:Fifteen female participants working as staff members on a dementia ward were recruited to complete a qualitative questionnaire about their resilience. All participants were of working age. Responses were transcribed and analysed using thematic analysis.Results: Seven themes were identified from their responses as affecting resilience; staffing issues, staff stress, lack of support, not being listened to, not being valued, communication and feeling at risk. Staff also provided ideas for positive change and support that has previously been helpful which formed two additional themes. Recommendations and conclusions: Staff resilience was affected by different aspects of the system. Feedback suggested support that could be put in place to improve resilience such as drop-in sessions, debrief sessions and improved communication.

Collective leadership to improve professional practice, healthcare outcomes and staff well-being.

Collective leadership is strongly advocated by international stakeholders as a key approach for health service delivery, as a response to increasingly complex forms of organisation defined by rapid changes in health technology, professionalisation and growing specialisation. Inadequate leadership weakens health systems and can contribute to adverse events, including refusal to prioritise and implement safety recommendations consistently, and resistance to addressing staff burnout. Globally, increases in life expectancy and the number of people living with multiple long-term conditions contribute to greatercomplexity of healthcare systems. Such a complex environment requires the contribution and leadership of multiple professionals sharing viewpoints and knowledge. OBJECTIVES: To assess the effects of collective leadership for healthcare providers onprofessional practice, healthcare outcomes and staff well-being, when compared with usual centralised leadership approaches. We searched CENTRAL, MEDLINE, Embase, five other databases and two trials registers on 5 January 2021. We also searched grey literature, checked references for additional citations and contacted study authors to identify additional studies. We did not apply any limits on language. Two groups of two authors independently reviewed, screened and selected studies for inclusion; the principal author was part of both groups to ensure consistency. We included randomised controlled trials (RCTs) that compared collective leadership interventions with usual centralised leadership or no intervention. Three groups of two authors independently extracted data from the included studies and evaluated study quality; the principal author took part in all groups. We followed standard methodological procedures expected by Cochrane and the Effective Practice and Organisation of Care (EPOC) Group. We used the GRADE approach to assess the certainty of the evidence. We identified three randomised trials for inclusion in our synthesis. All studies were conducted in acute care inpatient settings; the country settings were Canada, Iran and the USA. A total of 955 participants were included across all the studies. There was considerable variation in participants, interventions and measures for quantifying outcomes. We were only able to complete a meta-analysis for one outcome (leadership) and completed a narrative synthesis for other outcomes. We judged all studies as having an unclear risk of bias overall. Collective leadership interventions probably improve leadership (3 RCTs, 955 participants). Collective leadership may improve team performance (1 RCT, 164 participants). We are uncertain about the effect of collective leadership on clinical performance (1 RCT, 60 participants). We are uncertain about the intervention effect on healthcare outcomes, including health status (inpatient mortality) (1 RCT, 60 participants). Collective leadership may slightly improve staff well-being by reducing work-related stress (1 RCT, 164 participants). We identified no direct evidence concerning burnout and psychological symptoms. We are uncertain of the intervention effects on unintended consequences, specifically on staff absence (1 RCT, 60 participants). AUTHORS' CONCLUSIONS: Collective leadership involves multiple professionals sharing viewpoints and knowledge with the potential to influence positively the quality of care and staff well-being. Our confidence in the effects of collective leadership interventions on professional practice, healthcare outcomes and staff well-being is moderate in leadership outcomes, low in team performance and work-related stress, and very low for clinical performance, inpatient mortality and staff absence outcomes. The evidence was of moderate, low and very low certainty due to risk of bias and imprecision, meaning future evidence may change our interpretation of the results. There is a need for more high-quality studies in this area, with consistent reporting of leadership, team performance, clinical performance, health status and staff well-being outcomes.

Toward Unity and Inclusion in the Clinical Workplace: An Evaluation of Healthcare Workforce Belonging During the COVID-19 Pandemic.

Introduction: In a challenging time for the healthcare workforce responding to the coronavirus disease 2019 (COVID-19) pandemic, it is critical to identify factors contributing to team members' feelings of “belonging” in the workplace. The Institute for Healthcare Improvement’s Quintuple Aim’s principle of improving healthcare worker well-being could be applied to explore the implications of the increased turnover and stress, which connect to components of belonging. This study applies a qualitative approach to the organizational issues impacting healthcare teams, particularly during a complex and uncertain time.Methods: To elucidate factors contributing to belonging, we conducted a series of semi-structured interviews with an interdisciplinary cross-sectional sample of healthcare workers. Interviews were conducted with 23 total staff members in two clinical settings, the emergency department and hospital medicine groups at a large urban teaching hospital, to evaluate team members’ perspectives of the work environment.Results: Participants discuss their degree of inclusion, excitement, challenges, and respective needs from the organization. Perspectives of workers representing varied professional roles of the healthcare team were gathered to provide robust and unique insights into initiatives that can enhance belonging in the clinical workplace.Conclusion: Our findings provide a preliminary framework to identify strategies that can potentially reinforce collective team member belonging and consequently improve staff well-being, morale, and retention.

ENACT study: What has helped health and social care workers maintain their mental well-being during the COVID-19 pandemic?

A growing body of research has highlighted the adverse impact of COVID‐19 stressors on health and social care workers' (HSCWs) mental health. Complementing this work, we report on the psychosocial factors that have had both a positive and negative impact on the mental well‐being of HSCWs during the third lockdown period in Scotland. Using a cross‐sectional design, participants (n = 1364) completed an online survey providing quantitative data and free open‐text responses. A multi‐method approach to analysis was used. The majority of HSCWs were found to have low well‐being scores, high levels of COVID‐19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut‐off for acute stress (indicative of PTSD). HSCWs with higher scores on adaptive coping strategies and team resilience reported higher scores on mental well‐being. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems compared to formal supports. Barriers to formal help‐seeking were identified including stigma and fear of the consequences of disclosure. HSCWs mostly valued peer support, workplace supports, visible leadership and teamwork in maintaining their mental well‐being. Our findings illuminate the complexity of the effects of the COVID‐19 pandemic on HSCWs' well‐being and will inform future intervention development seeking to increase positive adaptation and improve staff well‐being. Addressing barriers to mental health help‐seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics.

Occupational risk factors and their impact on migration of radiographers from KwaZulu-Natal, South Africa

Radiography is one of the allied healthcare professions known to be stressful. It is often associated with long working hours, ethical dilemmas, high patient demands and frequent disruptions from ancillary departments, which are all known to result in negative physical and psychosocial effects that may motivate migration. In this context, migration means; leaving one health sector to seek employment in another (i.e. private and public), resignation to join other professions or moving to a foreign country to practise radiography. The aim of this study was to identify occupational-risk factors that contribute to the migration of radiographers in order to provide input for mechanisms that can be put in place to alleviate the negative physical and psychosocial effects identified, thereby improving staff wellbeing and service delivery in KwaZulu-Natal. A cross-sectional, quantitative study, using a questionnaire as the data collection instrument was employed. The study targeted three categories of respondents: radiographers who left the profession (n=19), those who emigrated (n=29) and those who were employed in KwaZulu-Natal (KZN) (n=300). The results revealed that of the 348 participants, 221 (63 %) responded. The ages ranged from 19 to 60 (mean 39) years. The common negative occupational risk factors found across the three categories of radiographers included headaches, neck pain and spasms, lower back pain, knee pain and painful feet. The negative psychosocial effects identified were; job dissatisfaction, anxiety, stress, insomnia, depression and a sense of isolation. The study revealed that the identified occupation-related risk factors resulted in negative physical and psychosocial effects that could contribute to the migration of KZN radiographers. The introduction of employee assistance programmes and improved reporting systems are recommended to reduce the negative impact of occupation-related factors on radiographers and thereby improve staff wellbeing and reduce migration.&#x0D; Keywords: Radiography; workload; physical; psychosocial; migration

Time Outdoors in Nature to Improve Staff Well-Being: Examining Changes in Behaviors and Motivations Among University Staff in the Use of Natural Outdoor Environments Since the Emergence of the COVID-19 Pandemic.

BackgroundWork-related stress is of growing concern to employers because of its significant implications for employee dissatisfaction, reduced productivity, and lowered emotional and physical health. Job-related stress is particularly acute among staff members in higher education, negatively impacting the professional work and personal welfare of staff. During the COVID-19 pandemic, stress levels increased, due to work- and non-work-related factors. Work expectations and environments shifted, as did new non-work responsibilities, such as care of dependents. As a result, many people were forced to spend much more time at home. Given the anticipated levels of stress (higher) and the change in time spent at home (increased), we sought to explore if adults were spending more time outdoors, as compared to pre-pandemic times, and if so, for what purposes. We hypothesized that people would be spending more time outdoors in nature during the pandemic, and that they would be doing so to achieve some of the well-documented benefits including managing stress, and bolstering mental health and wellbeing. We further hypothesized that some staff would experience barriers to spending time outdoors in natural outdoor environments (NOEs), potentially limiting their ability to experience these beneficial effects.Materials and MethodsThis study surveyed 507 staff from a large United States university to examine the degree to which staff were spending time in natural outdoor environments (NOEs) during the pandemic (two time-points, compared to pre-pandemic), and whether and how nature-based routines changed as a result of its emergence. The study also examined whether staff were motivated to spend time in nature to improve their mental health and/or wellbeing.ResultsThe majority of respondents reported spending more time in NOEs since COVID-19 emerged, particularly early in the pandemic. Respondents reported doing so for restorative purposes, including stress relief, improved mental health, and improved physical health. Relative accessibility of NOEs, both in terms of proximity and number of barriers to access, significantly impacted both time outdoors and the number of NOEs used. Access to safe, high-quality NOEs was not experienced equally across staff respondents; barriers to access tended to be higher among staff living with dependents or others in their household, and for staff who identify as non-White.ConclusionSpending time outdoors may have served as a protective factor for many university staff against some of the potentially detrimental effects of the pandemic, particularly reduced mental health and well-being. Universities can contribute to the ongoing well-being of their staff by supporting access to safe, high-quality NOEs on or adjacent to campus. This may also serve to reduce disparities in access to nature and experience of its benefits. Universities may also consider alternative work arrangements for staff to allow for more time for health and wellness self-care during the work day, including spending time outdoors in nature.

Research Evaluating Staff Training Online for Resilience (RESTORE): Protocol for a single-arm feasibility study of an online Acceptance and Commitment Therapy intervention to improve staff wellbeing in palliative care settings.

Palliative care staff commonly experience workplace stress and distress. General stressors include unmanageable workloads and staff shortages. Stressors specific to palliative care include regular exposure to death, loss and grief. The COVID-19 pandemic exacerbated exhaustion and burnout across the healthcare system, including for those providing palliative care. Evidence based psychological support interventions, tailored to the needs and context of palliative care staff, are needed. Acceptance and Commitment Therapy (ACT) is an established form of cognitive behavioural therapy which uses behavioural psychology, values, acceptance, and mindfulness techniques to improve mental health and wellbeing. ACT is effective in improving workplace wellbeing in many occupational settings. Our study examines the acceptability and feasibility of an online ACT-based intervention to improve mental health and wellbeing in staff caring for people with an advanced progressive illness. We plan a single-arm feasibility trial. We will seek to recruit 30 participants to take part in an 8- week online ACT-based intervention, consisting of three synchronous facilitated group sessions and five asynchronous self-directed learning modules. We will use convergent mixed methods to evaluate the feasibility of the intervention. Quantitative feasibility outcomes will include participant recruitment and retention rates, alongside completion rates of measures assessing stress, quality of life, wellbeing, and psychological flexibility. Focus groups and interviews will explore participant perspectives on the intervention. We will run a stakeholder workshop to further refine the intervention and identify outcomes for use in a future evaluation. We will describe participant perspectives on intervention acceptability, format, content, and perceived impact, alongside rates of intervention recruitment, retention, and outcome measure completion. We will show whether a brief, online ACT intervention is acceptable to, and feasible for palliative care staff. Findings will be used to further refine the intervention and provide essential information on outcome assessment prior to a full-scale evaluation.

“We are our own worst enemy”: a qualitative exploration of work-related stress in the construction industry

PurposeAround 400,000 working days per year are lost in the construction industry due to stress, depression or anxiety, but a large proportion of the industry – those primarily not based “on-site” – is not included in these statistics. Little research has been conducted in this group about their experiences of occupational stress. The authors explored how stress was experienced and managed by construction professionals and its perceived impact on health.Design/methodology/approachThe authors interviewed 32 construction professionals in a British construction company, with varying levels of seniority and years in the industry. Interviews were transcribed, coded and analysed thematically.FindingsStress was viewed an inevitable and increasing part of the construction industry, exacerbated by recent economic challenges. Participants talked about a culture of stress and overwork but often felt unable to challenge it due to job insecurity. Senior management acknowledged stress was a problem within the industry and something that potentially threatened company productivity. Company-wide initiatives had been implemented to address stress levels (e.g. Mental Health First Aiders), but were criticised for ignoring underlying issues. Informal means of managing stress were identified, such as careful consideration of team dynamics, which allowed employees to form close bonds and using “banter” and camaraderie to relieve stress. However, the persistence of a macho male image meant some participants were reluctant to talk about their feelings at work. Participants described individual coping strategies, such as exercise, but these were hard to prioritise in challenging times.Originality/valueThere is growing recognition that health and well-being must be given greater priority in the construction industry. Industry pressures and competitive practices undermine efforts to improve staff well-being. Action must be taken at senior levels to address this conflict, while building on existing informal mechanisms of support and stress relief.

An Intensive Approach to Improving Diversity, Equity, and Inclusion in an Academic Emergency Department.

A healthcare workforce that demonstrates cultural competence and humility while reflecting the diversity of the surrounding community has the potential to significantly benefit the patient population it serves. In this context and given numerous societal influences and the events of 2020, the leadership of the Department of Emergency Medicine at Albany Medical Center recognized the need to promote diversity, equity, and inclusion (DEI) in multiple areas. These included premedical education, medical education, postgraduate medical education, faculty development, staff satisfaction, and patient care. The department formed a DEI taskforce that developed an ongoing, multipronged, interdisciplinary approach to address these important aspects of our work and clinical environment with the goals of improving staff wellbeing, reducing burnout, and promoting the health of our community. Our experience is shared here to illustrate how a small, dedicated team can implement a variety of DEI initiatives quickly and with relatively little cost at a large academic medical center.

Effects of EMDR Group Traumatic Episode Protocol on Burnout Within IAPT Healthcare Professionals: A Feasibility and Acceptability Study

Mental health professionals face a high degree of burnout. This study aimed to explore the effectiveness of Eye Movement Desensitisation and Reprocessing Group Traumatic Episode Protocol (EMDR G-TEP) at reducing distress and burnout in staff working within an Improving Access to Psychological Therapies (IAPT) service and if outcomes changed over number of sessions attended. Twenty-two staff attended and measures examining burnout and subjective distress ratings of the targeted memory were taken pre- and post-intervention and at one-month follow-up. 95.5% reported finding the sessions helpful. A statistically significant reduction was observed on total burnout and on personal and work-related subscales; and a significant improvement in subjective units of disturbance was also observed. There was no interaction between changes in burnout and number of sessions attended. EMDR G-TEP has the potential to offer a novel method to improve staff wellbeing within mental health settings. Further research is recommended.