Wellbeing Practitioners Research Articles

"I seemed calmer, clearer, and better able to react to challenging situations": phenomenological reflections on learning about mindfulness in health professions education.

It is widely acknowledged that healthcare practitioner well-being is under threat, as many factors like excessive workloads, perceived lack of organizational support, the rapid introduction of new technologies, repercussions of the COVID-19 pandemic, and other factors have transformed the health care workplace. Distress, anxiety and burnout are on the rise, and are particularly concerning for health professions' students who must navigate challenging academic and clinical demands, in addition to personal responsibilities. While not a panacea for the systemic issues at play, 'mindfulness practices' have shown some promise in supporting students to navigate stressful environments. Yet despite calls for more phenomenological studies, little is known about health professions students' lived experiences of learning about and using mindfulness in higher education contexts. The objective of this hermeneutic phenomenological study was to inquire into the first-hand lived experiences of health professions students by examining their written reflections on learning about and using mindfulness in a higher education context. The study reports on themes identified in an analysis of students' phenomenological reflections written during and following a mindfulness elective course offered at a Canadian University. The analysis revealed four predominant themes: (a) reframing perceptions, (b)'being' while 'doing', (c) witnessing the struggle, and (d) compassion for self and others. In a time when health professionals are increasingly under strain, and systemic reform is needed but slow to take shape, the findings of this study reveal potential affordances of mindfulness for helping students to navigate the myriad of challenges they face. The findings are unique in their in-depth exploration of students' reflections on the experience of learning about and engaging in 'mindfulness practices' in a higher education context. The findings contribute first-hand perspectives to the evolving field of mindfulness education research and generate new conversations about mindfulness education in the health professions curriculum.

Children and Young People’s Mental Health Practitioner: A pilot evaluation

New roles have been developed to meet increased demands for children and young people’s (CYP) mental health support. In 2017, Children’s Wellbeing Practitioners (CWP) and Education Mental Health Practitioners (EMHP) psychological professions’ training programmes were introduced. A new Children & Young People’s Mental Health Practitioner (CYP-MHP) role has now been piloted with the aim of improving access to CYP mental health support through early intervention, providing psychoeducation, advice and signposting. This pilot provides a new service; CWP/EMHP require training and deliver therapy, whereas CYP-MHP provides a triage/assessment therapeutic service and does not require NHS-funded training. Outcomes of the pilot evaluation demonstrate a place for this role in primary care, where there existed a gap before.

Identifying the essential elements to inform the development of a research agenda for Paramedicine in Ireland: a Delphi Study

BackgroundParamedicine is a dynamic profession which has evolved from a “treat and transport” service into a complex network of health professionals working in a diverse range of clinical roles. Research is challenging in the paramedicine context, and internationally, research capacity and culture has developed slowly. International examples of research agendas and strategies in paramedicine exist, however, research priorities have not previously been identified in Ireland.MethodsThis study was a three round electronic modified Delphi design which aimed to establish the key aspects of the research priorities via end-user consensus. Participants included interested stakeholders involved in prehospital care or research in Ireland. The first round questionnaire consisted of open-ended questions with results coded and developed into themes for the closed-ended questions used in the second and third round questionnaires. A consensus level of 70% was set a priori for second and third rounds.ResultsResearch Priorities that reached consensus included Staff Wellbeing, Education and Professionalism and Acute Medical Conditions. Respondents indicated that these three areas should be a priority in the next 2 years. Education, Staffing and Leadership were imperative Key Resources that required change. Education was a Key Processes change deemed imperative to allow the future research to occur. Outcomes that should be included in the future research strategy were Patient Outcomes, Practitioner Development, Practitioner Wellbeing, Alternate Pathways, Evidence-based Practice and Staff Satisfaction.ConclusionThe results of this study are similar to previously published international studies, with some key differences. There was a greater emphasis on Education and Practitioner Wellbeing with the latter possibly attributed to the timing of the research in relation to the COVID-19 pandemic. The disseminated findings of this study should inform sustainable funding models to aid the development of paramedicine research in Ireland.

A Most Significant Change evaluation of a new co-designed tool to measure holistic well-being in consumers of community aged care services.

To evaluate a Wellbeing Check-in tool and process for use with BlueCare's home care package (HCP) clients by care and well-being practitioners. The tool had been co-designed with HCP clients and trialled with 15 clients. The Most Significant Change (MSC) methodology was used to gather stories from five practitioners, five HCP staff and seven clients. A workshop with senior staff was held to determine themes and whether the tool met its aims. Out of 22 MSC stories, 18 were judged in scope by workshop participants. Eight themes were then identified. Four themes reflected the content of the narratives (i.e. what was discussed): Isolation and connection; Grief; Faith/explicit spirituality; and Client preference. The other four themes reflected the process (i.e. what the discussions meant to participants): Being there/Meaningful conversations; Impact on significant others; New insight; and Purpose of the check-in. These eight themes largely reflected the aims of the Wellbeing Check-in tool in terms of providing a means to optimise connectedness, well-being and spiritual care in accordance with the client's needs, goals and preferences. Unanticipated findings included its benefits for family members and uncertainty about the aim or value of the tool, which highlighted the need for BlueCare to be clear about the purpose of the tool in promoting it to clients and their informal carers. The Wellbeing Check-in tool was found to be fit for purpose. A tool used flexibly to prompt discussion about well-being can be helpful to clients and pastoral care staff.

Psychotropic substance use among medical residents: prevalence and characteristics

Introduction Psychotropic substance use among medical residents represents a critical concern due to its potential impact on patient care and practitioner well-being. This topic looks into the prevalence and characteristics of psychotropic substance use, including prescription medications and illicit drugs, among individuals pursuing medical residency. Understanding the scope of the problem and its distinctive features is essential for developing targeted interventions and support mechanisms within the medical community.ObjectivesTo assess psychotropic substance use among medical residents, describe its characteristics and determine the prevalence of problematic use.MethodsWe conducted a cross-sectional and descriptive studyamong Tunisian medical residents over a three-month period (August - September 2022) using an online survey. Different specialties and levels of residency were included. An online self-questionnaire was used including a data collection form and the DAST-10 (Drug Abuse Screening Test) scale. The data was analyzed using the SPSS 20th version softwareResultsAmong the 80 residents in our study, 19 (23.8%) reported psychotropic substance use, and 12 (15%) reportedthat they had misused psychotropic drugs at least once in their lives (without a prescription and/or with a prescription but not following the instructions). The most commonly psychotropic drugs used were benzodiazepines, followed by amphetamines, analgesics, anesthetics, and pregabalin (28%, 16%, 12%, 12%, 12%, respectively). Consumption was regular for 41.7% of those who reported psychotropic drugs misuse. The initiation of psychotropic use followed a desire to experiment various substances (41.7%), a medical prescription (33.3%), or their availability due to medical practice (25%). Self-medication and recreational use were the most common reasons for use (41.7% each). Furthermore, 31.6% of consumers revealed a problematic substance use as assessed by the DAST-10 scale.ConclusionsOur study showed a concerning prevalence of psychotropic substance use among medical residents, benzodiazepines being the most prevalent. Notably, 15% acknowledged misuse and a significant proportion displayed problematic substance use. These results highlight the potential health risks and the importance of addressing this issue within the medical community.Disclosure of InterestNone Declared

Let's Talk About Ethics: Addressing Ethical Tensions and Building Moral Resilience in the Occupational Therapy Profession.

Health professionals across all care delivery settings, including occupational therapy practitioners, are experiencing high levels of moral distress. The mental, emotional, and physical consequences of unresolved moral distress are resulting in burnout, decreased quality of care, and poor patient outcomes. Moral resilience is a teachable and learnable skill that can nullify some of the adverse consequences of moral distress. To ensure quality care outcomes and improve the well-being of individual occupational therapy practitioners and the profession, it is essential that occupational therapy practitioners be provided with the education, training, resources, and strategies needed to address moral distress, foster moral resilience, and cultivate the skills necessary to cope with ethical tensions. In this column, we call the profession to action to address the phenomenon of moral distress as it relates to occupational therapy practitioner well-being. We also discuss resources and strategies for addressing ethical tensions and building moral resilience in occupational therapy practice.

Twelve tips for developing healthcare learners’ uncertainty tolerance

Background Uncertainty is pervasive throughout healthcare practice. Uncertainty tolerance (i.e. adaptively responding to perceived uncertainty) is considered to benefit practitioner wellbeing, encourage person-centred care, and support judicious healthcare resource utilisation. Accordingly, uncertainty tolerance development is increasingly referenced within training frameworks. Practical approaches to support healthcare learners’ uncertainty tolerance development, however, are lacking. Aims Drawing on findings across the literature, and the authors’ educational experiences, twelve tips for promoting healthcare learners’ uncertainty tolerance were developed. Results Tips are divided into 1. Tips for Learners, 2. Tips for Educators and Supervisors, and 3. Tips for Healthcare Education Institutions and Systems. Each tip summarises relevant research findings, alongside applications to educational practice. Conclusions Approaches to developing uncertainty tolerance balance factors supporting learners through uncertain experiences, with introducing challenges for learners to further develop uncertainty tolerance. These tips can reassure healthcare education stakeholders that developing learner uncertainty tolerance, alongside core knowledge, is achievable.

Ethical challenges experienced by veterinary practitioners in relation to adverse events: Insights from a qualitative study.

Understanding ethical challenges experienced in relation to adverse events is necessary to inform strategies that optimise patient safety and practitioner wellbeing. A qualitative exploration of UK veterinary practitioners' experiences of adverse events was conducted. Data were collected via 12 focus groups and 20 interviews and analysed using an inductive coding technique. Questions surrounding acceptable boundaries of care, decision-making autonomy, personal scope of practice, use of evidence and speaking up about patient safety concerns were identified as ethically challenging to practitioners when endeavouring to prevent adverse events. Issues of appropriate accountability, interaction and communication with animal owners and the prioritisation of emotional and technical support for themselves and others were identified as ethically challenging in the aftermath of adverse events. The qualitative nature of this study limits the generalisability of the findings. Ethical challenges are experienced by veterinary practitioners in relation to both preventing and responding in the aftermath of adverse events. Strategies that facilitate ethical decision making and reflection and encourage openness and learning from adverse events would likely improve patient safety and enhance practitioner wellbeing. Further research is needed to develop and implement support for practitioners who experience ethical challenges in relation to adverse events.

Driving Prosperity: Assessing Empowerment, MSME Performance and Welfare

Micro, small, and medium-sized companies (MSMEs) play a critical role in improving societal well-being. However, empowering programs are critical to the success of MSME practitioners. Despite considerable initiatives in Banda Aceh to empower MSMEs, the direct impact on practitioner welfare remains unknown. The purpose of this quantitative study is to investigate the impact of empowerment effectiveness and MSME performance on practitioner wellbeing in Banda Aceh. The study includes 9691 MSMEs, based on data from the MSME Office of Cooperatives and MSME Aceh, and using random sample methodologies. A Likert scale was used for measurement. The data show that, while empowerment has a moderate impact on MSME welfare, MSME performance has a strong and meaningful influence. Furthermore, empowerment effectiveness and MSME success, when combined, contribute significantly to the welfare of MSME practitioners in Banda Aceh, accounting for 31.014% of the variance. This study emphasizes the necessity of not only empowering MSMEs but also improving their performance in order to significantly boost practitioner welfare

Expanding the early intervention offer: A new care pathway for children's wellbeing practitioners in a south London child and adolescent mental health service.

Child and Adolescent Mental Health Services (CAMHS) have been under recent increased demand, with increasingly limited resources, contributing to longer waiting lists, and a growing proportion of rejected referrals due to limited capacity and increasing thresholds. Child and Wellbeing Practitioners (CWPs) provide an opportunity to meet the needs of rejected referrals. We aimed to determine the feasibility of a new and direct referral route within a South London CAMHS. All referrals rejected to the local CAMHS in one year were assessed for inclusion to an embedded child and youth wellbeing in schools team (CYWS), and data collected on reasons for rejection, demographics and eligibility for the CYWS team. Of the 1,322 referrals made to CAMHS in this period, 317 were rejected. The most common reason for referral rejection was not meeting the severity threshold. One third of rejected referrals were judged to be eligible for inclusion to the CYWS team. Therefore, a significant number of children and young people (CYP) being rejected by CAMHS would be eligible for assessment and possible treatment under the CYWS team, making a new referral route potentially feasible, allowing more CYP to access mental health support and have a positive impact on waiting times.

Therapeutic Goal Types in Young People’s Mental Health Providers and Changes in Anxiety and Mood

Clinical goal setting is an important area of practice within mental health interventions for children and young people (CYP). The present research aimed to explore the type of intervention goals set by CYP during mental health interventions. Further, changes in goal progress from pre- to post-intervention were compared between externally observed behavioural goals and subjective feelings-based goals. The relationship between therapeutic goal achievement and changes in symptoms of depression and anxiety (measured using the Revised Children’s Anxiety and Depression Scale) was also investigated. Data were collected from 792 participants aged 3 to 18 years (mean age: 13.8, SD: 2.85) across all gender identities and ethnicities, who received low-intensity cognitive behavioural therapy interventions from Children’s Wellbeing Practitioners in the Southwest of England. A mixed methods approach involving conceptual content analysis, correlational analysis, and group comparisons was utilised. Eleven categories of child-rated goals were identified. The most commonly developed goals focused on understanding, managing, and expressing emotions and feelings. No significant differences were found between behavioural and feelings-based goals (p = 0.061). Partial correlations demonstrated that improvements in goal progress were significantly associated with reductions in depression and anxiety symptoms (rs > −0.157, p < 0.001), even when controlling for the number of sessions attended (rs > −0.146, p < 0.001). Integrating goal-based outcomes with standardised measures could enhance a comprehensive approach to service delivery and evaluation.

Organizational Outcomes of Supervision within Human Services: A Scoping Review

ABSTRACT Workplace-based supervision is positioned as a resource within human service organizations with the potential to enhance practitioner well-being and performance under stressful, demanding conditions. This article presents a scoping review synthesizing 175 empirical peer-reviewed publications between 2011 and 2021, including study characteristics, key concepts, methods, and outcomes examined. Providing a comprehensive perspective as its unique contribution, this review mapped the supervision outcomes across the international, multi-disciplinary human services literature. It generally reported the beneficial impact of workplace-based supervision, with notable positive impacts found for competence, implementation, job satisfaction, wellbeing, and retention. Our analysis provides support for workplace-based supervision as an organizational investment.

Views from Australian osteopaths and industry stakeholders about the profession: A qualitative study

BackgroundThe future health and longevity of the osteopathy profession relies heavily on its practitioners and industry stakeholders to support it. Possessing a deeper understanding of practitioner and stakeholder views of the profession may provide crucial insights into the wellbeing of the workforce and their perceived skills and expertise in the wider healthcare landscape. ObjectiveTo provide a review of current and emerging attitudes, beliefs and behaviours of Australian osteopaths and supportive external stakeholders towards the profession. MethodsA qualitative approach using grounded theory explored the attitudes, beliefs and behaviours of Australian osteopaths and supportive external stakeholders. Purposive sampling identified 18 practitioners (Victoria 10, Western Australia 5, and New South Wales 3) and 6 external stakeholders. All participated in semi-structured focus groups. A constant comparative method followed data collection whereby repeated ideas formed the extraction of the emerging themes presented. ResultsCentral themes for each group included: 1) practitioner wellbeing and 2) osteopathic skills and expertise. Subthemes included: 1) career sustainability and longevity for practitioners, and 2) osteopathy within the broader context of allied healthcare in Australia. ConclusionThreats to practitioner wellbeing included lack of early career support, limited career pathways, and uncertainty surrounding the future of the profession. External stakeholders echoed similar concerns regarding the future of the profession, acknowledging whilst osteopathy may play a sustainable role in managing the health and wellbeing of Australians, their skills and expertise are not unique nor exclusive to the profession, are under-evidenced, and undervalued by other healthcare professionals. Fostering a healthy and fulfilled workforce lies in securing a sustainable role for the profession by addressing these limitations.

Reimagining reflective practice and reflective practice environments in a post pandemic world: A discussion paper

ABSTRACT Covid-19, the disease caused by severe acute respiratory syndrome coronavirus 2 is recognised as one of the most challenging global events of the twenty-first Century. The detrimental impact of the pandemic resulted in high rates of infection, morbidity, and mortality, with health-care workers firmly positioned on the frontline of this unparalleled international crisis. An emerging literature detailing the impact of COVID-19 on health-care practitioners identifies high levels of depression, anxiety, and distress. Accordingly, there are calls for the implementation of effective interventions to tackle the impending spectre of psychological morbidities and staff burnout. While it is important to explore new approaches, it is also valuable to examine how existing strategies, such as reflective practice, can be repurposed to specifically address practitioner well-being. This requires a reimagining of reflective practice and a reimagining of the reflective practice contexts in which reflective activity occurs. This paper presents The Reflective Practice Integrative Framework, which illustrates how reflective practice can be used to address the complex aims of supporting effective patient care, while also facilitating practitioner well-being. The Reflective Organisational Learning Framework is also presented which can be used to develop effective reflective practice environments through single, double, and/or triple loop learning.

Program to Enhance Well-being and Psychospiritual Understanding Implications in Indian Medical Care Perspective.

Spirituality is an important dimension of life. The medical practitioner's well-being is an under-appreciated priority in India. As research on spirituality is minimal, this study attempts to introduce an online 6-week Eastern spirituality-based educational program for physicians. The primary aim was to see the effects of the intervention on the well-being of the participants. The secondary aim was to form an opinion about an extension to medical practice. A total of 60 medical practitioners were randomized into two groups- one attended the spirituality sessions while the other placebo "self-care" sessions. Quantitative outcome measures were Warwick-Edinburg Mental Well-being Scale (WEMWBS) and World Health Organization (WHO) Well-being Index (WHO-5) noted pre and postprogram. Qualitative data was collected to support the quantitative outcomes. Statistical tests used were unpaired and paired t-tests for quantitative data. A 5-point Likert scale and Cochran's Q test were used for the qualitative data. In the spirituality group, postsession WEMWBS and WHO-5 scores improved with p &lt; 0.0001 and p = 0.0033, respectively. Regarding qualitative data, 94.44% of physicians "agreed/strongly agreed" in favor of the benefits of sessions with p = 0.0242 and Q = 5.0793. A total of 86.67% of physicians felt the sessions have helped them to understand other's spirituality-related problems and made them more confident to discuss spirituality with others. The online Eastern spirituality program had a positive impact on the well-being of Indian medical practitioners. There appears to be a potential for extension to the medical care setting. The results need to be substantiated by further studies.

A pilot evaluation of the role of a children's wellbeing practitioner (CWP) in a child and adolescent mental health service (CAMHS).

In 2017, the Children and Young People's Improving Access to Psychological Therapies (CYP-IAPT) project was extended to deliver low-intensity Cognitive Behavioural Therapy (CBT), delivered by Children's Wellbeing Practitioners (CWPs), but to date evaluation is sparse. To evaluate low-intensity interventions delivered by trainee CWPs for the treatment of anxiety and depression in a child and adolescent mental health service (CAMHS). The evaluation adopted a quantitative, within-subjects, cross-sectional design. The outcome measures of 98 service users aged 8-17years were included in the evaluation. Service users were children and young people accessing CAMHS in the North East of England. Outcome measures included the Revised Children's Anxiety and Depression Scale (RCADS-47) and Goal Based Outcomes (GBOs). Descriptive data relating to the types of interventions used and outcomes following CWP involvement were also explored. Analysis of pre and post intervention data highlighted significant reduction in symptomatology across all RCADS subscales and composite total scales, and significant goal progress as measures by GBO's. Effect sizes ranged from moderate to large (d = 0.75 - 0.90) across all subscales of the RCADS. Large effect sizes were found for depression, total anxiety and total RCADS scores (d = 0.86, d = 1.12, d = 1.14), and GBOs (d = -1.33). Findings support the potential value of low intensity CBT interventions delivered by CWPs in reducing anxiety and depression in this population. Recommendations for the development of the CWP role and CWP services are discussed.

Individual Responsibility and Disconnection: Practitioner Experiences of the First Wave COVID19 Lockdown

ABSTRACT The first wave of the COVID-19 pandemic in Australia called for a lockdown that impacted the delivery of social work and human services. This study investigated the experiences of 15 social work and human service practitioners in Southeast Queensland, Australia. Telephone and Zoom interviews were conducted with practitioners and analysed using interpretative phenomenological analysis (IPA). Three themes arose: 1) technology problems; 2) flexibility in work roles; 3) supportive and unsupportive organisations. Findings suggested that practitioners faced challenges due to poor technology, reduced role clarity, and in some cases limited organisational support. Findings also provided insight into benefits that included increased flexibility, regular communication from the organisation, and acts of kindness and care from individuals and organisations. A fundamental lesson from this study was the importance for organisations to nurture connections that demonstrated care for employees during times of crisis. IMPLICATIONS Social work and human service practitioners need continued support in accessing and using software and hardware in preparation for crisis. While practitioners displayed resilience and flexibility during the COVID19 lockdown, clarity about work roles and responsibilities is necessary. Employers play a vital role in maintaining practitioner wellbeing during crisis by showing care and connection between individuals and across the wider organisation.

A Review on Early Intervention Systems.

Early intervention programs have been shown to increase the overall socio-emotional and physical wellbeing of children in early childhood and educational settings. The goal of this narrative review is to explore recent literature that describes implementation of these systems and highlights innovative practices in the early childhood intervention sector. Twenty-three articles were included, and we identified three themes in this review. The literature addressed concepts of innovative techniques in relation to childhood disability interventions; policy practices that promote child, family, and practitioner wellbeing; and attention to the importance of trauma-informed care in education for children and families who face the impacts of social marginalization such as racism and colonization. Notable shifts in the current early intervention paradigms are approaches to understanding disability informed by intersectional and critical theories, as well as systems level thinking that goes beyond focusing on individual intervention by influencing policy to advance innovative practice in the sector.

General practitioner well-being during the COVID-19 pandemic: a qualitative interview study

ObjectivesThe COVID-19 pandemic presented new challenges for general practitioners’ (GPs’) mental health and well-being, with growing international evidence of its negative impact. While there has been a wide UK commentary...

Virtual wobble spaces: A pilot study of the outcomes of online therapeutic spaces on practitioner well-being and social work practice

Abstract Stress, emotional exhaustion and job dissatisfaction have been prevailing issues in social work for decades, with recent research by BASW demonstrating poor psychological outcomes for social workers, amidst inadequate levels of staff retention and high burn out rates. The Covid-19 pandemic added to these existing stresses, with social workers experiencing multiple losses, including bereavements and changes to working practices. As a response to the pandemic, many hospitals and health care settings established bespoke wobble spaces, dedicated to enhancing staff well-being. However, despite the reported success of these wobble spaces, results from a literature review show that they have not been established within social work. The pilot study discussed in this article explored and evaluated the impacts of a virtual wobble space provided for social workers over three months at fortnightly intervals. The research design was purposefully creative and aimed at focussing on positivity and fun as a counter to much of the existing literature on stress and burnout in social work. The study is limited by a small sample size but nevertheless the unanimously positive findings and wider interest, suggest there may be a broader role for wobble space provision in social work.