Staff Working In Services Research Articles

'It's that camaraderie': Experiences of a Long-COVID peer support group for staff working in health, social care and emergency services.

Health, social care and emergency services staff, continue to feel the impact of Long-COVID. Using quantitative and qualitative methods, this study aims to evaluate the experience of UK health and social care staff who participated in a virtual Long-COVID peer support group between May 2021 and May 2023. The outcome measures (SWEMWBS and PHQ9) show an improvement in post-group scores, suggesting participation in the peer support group is linked to improved wellbeing. Thematic analysis identified five key themes: finding connectedness, reciprocity, effective facilitation, filling the gaps and virtual format. This evaluation shows how peer support groups provided space for reciprocity and the positive outcomes associated with this. This evaluation highlights the importance of co-produced, needs-based services providing Long-COVID peer support.

Voluntary sector specialist service provision and commissioning for victim-survivors of sexual violence: results from two national surveys in England

BackgroundIn England, voluntary sector specialist (VSS) services are central to supporting victim-survivors of sexual violence (SV). However, empirical evidence is lacking about the scope, range and effectiveness of VSS provision...

Supporting staff wellbeing in healthcare settings through multi-levelled creative psychological intervention – a feasibility study

ABSTRACT Background There is growing evidence that the arts and arts-based therapies can support the wellbeing of healthcare workers. However, there are few large trials, limiting the use of such therapies in routine practice. Aim To establish the feasibility of introducing a multi-levelled, evidence-based creative psychological intervention delivered by qualified arts psychotherapists and targeting the wellbeing of NHS clinical staff. Methods This is a feasibility study with pre/post mixed methods design, the first to explore the value of an evidence-based, multi-levelled creative psychological package targeting the diverse needs of clinical staff within different healthcare settings. The intervention wasadapted from a 12-session group therapy titled Arts for the Blues into a three-level package that included: (i) one-off drop-in sessions to release tension, (ii) workshops for staff development, (iii) group sessions for psychological support. It was delivered by qualified arts psychotherapists (i.e., art, drama and dance movement psychotherapists) and used brief evaluation forms, arts-based data and standardised outcome measures to establish acceptability. Results Findings indicate difficulties with recruitment, but the 49 participants placed high value on the different levels offered. All the outcome measures used identified positive change and indicated medium to large effects of the multi-levelled intervention on improvement of wellbeing and resilience, as well as reduction of distress, anxiety, depression and trauma. Conclusions Although the small sample does not allow the generalisation of results, the study suggests that this multi-levelled creative psychological intervention offers acceptable support. Implications for practice/policy/research Further research is needed to establish the effectiveness of this intervention with specific teams of professionals. However, the diverse options proposed in this intervention need to be considered further for routine practice, expanding on current job descriptions for art psychotherapists. Plain-language summary Pressures on healthcare services mean that healthcare workers need support for their wellbeing. It is possible that the arts and arts therapies can offer this support, but we need to conduct more research to be certain. In this study we wanted to see if clinical staff working in health services liked a new creative intervention we developed based on our review of the research literature. We modified this intervention from the Arts for the Blues model, a 12-session group therapy that uses a mixture of different artistic forms. We used this new model to support the wellbeing of clinical staff in a large hospital in the North West of England. We did this in three different ways: Creative activities for the whole organisation to release tension (up to 30 min) Creative psychoeducational workshops with teams for staff development (up to 4 h) Creative psychotherapy sessions with individuals in a group for psychological support (up to 18 h). Arts psychotherapists, including art psychotherapists, designed the content of this work and facilitated their delivery. We collected information from 49 clinical staff before and after each of these activities through questionnaires and a brief evaluation form. Although clinical staff were very busy, they liked the different options of the intervention and their wellbeing scores improved. We need to do further research with a larger number of participants. However, the findings so far show that art psychotherapists can work not only with patients, but also with other healthcare workers to improve their wellbeing.

Structural associations between self-perception of support and knowledge of disability characteristics of autism spectrum disorder among staff in facilities providing after-school day services.

We constructed a hypothetical model of the knowledge of autism spectrum disorder (ASD) and self-perception of support of staff working in after-school day services to clarify structural relationships. A questionnaire survey was conducted at 194 facilities providing after-school day services in Fukushima Prefecture (October 2020), including a basic attributes questionnaire, the Literacy Scale of Characteristics of Autistic Spectrum Disorder (LS-ASD), and a staff questionnaire. We developed a hypothetical model of the relationship between self-perception and LS-ASD total scores of after-school service staff. To obtain latent variables for structural equation modeling (SEM) to confirm factor extraction and the interrelationships among variables, exploratory factor analysis was performed. SEM was used to examine the fit of the hypothetical model to the data and the relationships among variables. The study included 302 staff members from 58 of 194 facilities. Four factors (Factor 1, motivation; 2, self-perception of knowledge; 3, information sharing; 4, self-confidence) were extracted. The final model showed that Factor 2 had a positive direct effect (path coefficient = 0.64) and Factor 4 had a negative direct effect (path coefficient = -0.22) on LS-ASD scores. The model goodness of fit was acceptable (Goodness-of-Fit Index = 0.890; Comparative Fit Index = 0.912; Root Mean Square Error of Approximation = 0.086; Akaike's Information Criterion = 392.7). Self-perception of knowledge contributes greatly to knowledge acquisition, while excessive confidence may hinder knowledge retention.

A compassionate communication skills training course for staff working in cancer services

A compassionate communication skills training course for staff working in cancer services

Employee engagement in shared services in a regional university context

ABSTRACT A reflexive thematic analysis was used to identify factors that enhance and inhibit employee engagement amongst professional staff working in shared services teams in an Australian regional university. With efficient and effective client service delivery expected of people working in a shared services structure, employee buy-in and the need for them to feel engaged are important. However, little is known about the employee experiences of working in a shared services team. Despite this, shared services have become popular in universities by offering cost savings while improving service quality and output. We found that professional staff responded generally positively to working in a shared services team. Moreover, they indicated positive employee engagement when their working experiences responded to specific ‘rules of engagement’ applicable to their shared services environment.

Evaluating the effectiveness of trauma-informed care training delivered to staff in community Older Adult Mental Health Services

PurposeBy older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.Design/methodology/approachTIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.FindingsThere were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.Practical implicationsTraining was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.Originality/valueTo the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.

Generative AI, UK Copyright and Open Licences: considerations for UK HEI copyright advice services.

With the enormous growth in interest and use of generative artificial intelligence (AI) systems seen since the launch of ChatGPT in autumn 2022 have come questions both about the legal status of AI outputs, and of using protected works as training inputs. It is inevitable that UK higher education institution (HEI) library copyright advice services will see an increase in questions around use of works with AI as a result. Staff working in such library services are not lawyers or able to offer legal advice to their academic researchers. Nonetheless, they must look at the issues raised, consider how to advise in analogous situations of using copyright material, and offer opinion to researchers accordingly. While the legal questions remain to be answered definitively, copyright librarians can still offer advice on both open licences and use of copyright material under permitted exceptions. We look here at how library services can address questions on copyright and open licences for generative AI for researchers in UK HEIs.

Investigating a multi-session virtual reality relaxation intervention for mental health staff: protocol for a feasibility and acceptability study

PurposeClinical staff working in mental health services experience high levels of work-related stress, burnout and poor well-being. Increased levels of stress, burnout, depression and anxiety and poorer mental well-being among health-care workers are associated with more sick days, absenteeism, lower work satisfaction, increased staff turnover and reduced quality of patient care. Virtual reality (VR) relaxation is a technique whereby experiences of pleasant and calming environments are accessed through a head-mounted display to promote relaxation. The purpose of this paper is to describe the design of a study that assesses the feasibility and acceptability of implementing a multi-session VR relaxation intervention amongst mental health professionals, to improve their relaxation levels and mental well-being.Design/methodology/approachThe study follows a pre–post-test design. Mental health staff will be recruited for five weeks of VR relaxation. The authors will measure the feasibility and acceptability of the VR relaxation intervention as primary outcomes, alongside secondary outcomes evaluating the benefits of VR relaxation for mental well-being.FindingsThe study aims to recruit 20–25 health-care professionals working in both inpatient and specialist community mental health settings.Originality/valueResearch indicates the potential of VR relaxation as a low-intensity intervention to promote relaxation and reduce stress in the workplace. If VR relaxation is shown to be feasible and acceptable, when delivered across multiple sessions, there would be scope for large-scale work to investigate its effectiveness as an approach to enable health-care professionals to de-stress, relax and optimise their mental well-being. In turn, this may consequently reduce turnover and improve stress-related sick leave across health-care services.

Driving improvements in the quality, safety, consistency and coordination of care and support for children using health and social care services, through the collaborative development of national standards. 

Background: Ireland has national strategies and policies setting out the importance of integrated care and coordination of care and support between health and social care services, to enable children to get timely and appropriate care and support. Despite Government commitment to a coordinated approach, delivery of care and support to children continues to be inconsistent and fragmented. While children with complex needs are more likely to experience significant gaps and delays in the care and support they need, evidence shows that any child in need of care and support from a health or social care service is at risk of gaps and delays.
 The Health Information and Quality Authority (HIQA) and the Mental Health Commission (MHC) are the regulatory bodies for health and social care services, and mental health services, in Ireland. To promote and support greater integration and collaboration between health and social care services, HIQA and the MHC worked together to develop national standards for all health and social care services working with children. Throughout the standards development process, we collaborated with children and families with lived experience, and advocates and staff working in health and social care services.
 Methods: These evidence-based standards cover all health and social care services working with children, including healthcare, disability, mental health and children’s social services. They provide a shared framework for all services and aim to support them to work together in a coordinated and collaborative way to improve the experience and outcomes of children and families.
 The standards were informed by a literature review, and extensive stakeholder involvement including focus groups with 217 children, young people and families with lived experience, advocates, staff, inspectors, and policy-makers; and 130 responses to two public consultations. An Advisory Group representing key stakeholders and a Children’s Reference Group informed the standards. The Children’s Reference Group comprised of young people and family members with experience of health and social care to ensure active people involvement and engagement in design and implementation of the standards. Their input helped ensure the standards authentically reflected what children should expect from a health and social care service committed to child-centred care. 
 
 Initiative: This is the first time a set of Irish national standards has been developed focused on the needs of all children across health and social care services. The standards are underpinned by the principles of a children’s rights-based approach, safety and wellbeing, responsiveness, and accountability. Presented in the child’s voice, they articulate what outcomes a child should expect and what a service needs to do to achieve these outcomes.
 Impact: These standards will help to drive quality, safety, consistency and coordination across health and social care services working with children, as all organisations and services will be operating to one set of consistent national standards. Although an important lever for change, we recognise that services will need tools to support implementation of the standards and we will work with the sector to identify and collaboratively develop relevant tools to support implementation of the standards in day-to-day practice.

A bite of dark chocolate? Black humour in mental health services.

Black humour permits expression of what may otherwise be unspeakable and is observed and used by staff working in mental health services. The aim of this study was to identify how humour, particularly black humour, was perceived by different health professionals in psychiatric practice. Participants were invited to complete a survey. Data was collated and statistically analysed by a biostatistician. Chi square and univariate tests were performed to identify associations between categories. The sub-question relating to the benefits of black humour was analysed. Main findings were that the majority of staff perceived black humour to be beneficial in psychiatric practice (n = 564 of 710 total; 79.4%), particularly if they used general and black humour with patients, families and colleagues. Those who observed black humour being used collegially about patients and families were more likely to find black humour beneficial; and even those uncomfortable with black humour being used by colleagues were more likely to see the benefits of black humour. Black humour was perceived to be beneficial in mental health settings when used mindfully, sensitively and in context. Further study with patients and relatives may shed light on how widely the perception of benefit is shared.

Preference-based patient participation in intermediate care: Translation, validation and piloting of the 4Ps in Norway.

The implementation and evaluation of patient participation to obtain high-quality transitional care for older people is an international priority. Intermediate care (IC) services are regarded as an important part of the patient's pathway from the specialist to the primary care levels, bridging the gap between the hospital and the home. Patients may experience varying capacities and conditions for patient participation. Yet, few tools for evaluating patients' preferences for patient participation within IC services are at hand. Accordingly, further knowledge is needed to understand and scaffold processes for patient participation in IC. Therefore, the aim of this project was to translate, validate and pilot test the Patient Preferences for Patient Participation (the 4Ps) with patients in IC services in Norway. This project comprised two phases: (1) a careful translation and cultural adaptation process, followed by a content validity trial among 15 patients and staff in Norwegian IC and (2) a cross-sectional survey of the instrument with 60 patients admitted to IC. The translation between Swedish and Norwegian required no conceptual or contextual adaptations. The subsequent cross-sectional study, designed as a dialogue between the patients and staff, revealed that only 50% of the participants received a sufficient level of patient participation based on their preferences, mostly indicating that patients were receiving less-than-preferred conditions for engaging in their health and healthcare issues. The 4Ps instrument was deemed suitable for measuring patient participation based on patient preferences in the IC context and was feasible for both healthcare professionals and patients to complete in an interview when arriving at and leaving services. This may support person-centred communication and collaboration, calling for further research on what facilitates patient participation and the implementation of person-centred services for patients in IC. First, the current paper is part of the IPIC study (i.e., the implementation of patient participation in IC). Influenced by a James Lind Alliance process, the study addresses research uncertainties identified by patients, next of kin, staffand researchers in the cocreation process. Second, cognitive interviewing was conducted with 15 representatives of the target population: seven patients receiving IC services, one home-dwelling previous IC patient (altogether four women and four men, most of them 80 years or older) and seven healthcare staff working in IC services. The interviews determined the relevance, comprehensiveness and clarity of the 4Ps. Finally, 60 patients admitted to IC took part in the cross-sectional study.

Systematic review and meta-analysis of verbal and physical violence against healthcare workers in the Eastern Mediterranean Region.

Workplace violence is a serious threat to healthcare workers worldwide. We aimed to determine the prevalence of physical and verbal violence against healthcare workers in the WHO Eastern Mediterranean Region and Türkiye. We searched the Medline (via PubMed), Cochrane Library, Scopus, Science Direct, Web of Science and ProQuest databases along with reference lists from selected articles. Studies of health workers exposed to verbal and/or physical violence by patients or their relatives conducted in the WHO Eastern Mediterranean Region and Türkiye among staff working in hospitals and primary health care services were included. Seventy-five of the 3513 articles identified of studies conducted during 1999-2021 were eligible. The data were analysed using MetaXL version 5.3 and STATA version 16. This study covered 69 024 healthcare workers from 22 countries. Meta-analysis showed that 63.0% (95% CI: 46.7- 79.2) of them had experienced verbal violence and 17.0% (95.0% CI: 14.0-21.0) experienced physical violence. There was no significant difference for sample size, professional group, quality score, or response rate. The frequency of physical and verbal violence in the subgroup analysis was statistically significantly different for countries and years. Findings from this study provide useful information for policymaking regarding interventions to prevent or minimize violence against healthcare workers in the Eastern Mediterranean Region and Türkiye.

Fear, loss and disconnection: the emotional impact of the Covid-19 pandemic upon staff working in mental health services and how the organization can help – a psychoanalytic perspective

ABSTRACT This paper describes the work of a psychoanalyst working within NHS mental health services in the UK . The central contribution of a psychoanalytic approach within psychiatric care in offering a committed attempt towards understanding the patients’ presentation, rather than treatment primarily aimed at symptom control, is described. Beyond this, the specific contribution of psychoanalytic ideas in establishing a containing framework for staff, and how this strengthens the capacity of the organisation as a whole to contain anxiety and to metabolize complex projective processes is outlined. Examples are given with clinical illustrations of activities which enhance this capacity in ordinary times. The author then turns to the impact of the covid-19 pandemic upon staff and patients, describing how fear, threat and experiences of multiple losses have permeated all areas of our lives and activated primitive defences. The pandemic starkly revealed profoundly disturbing questions about our assumptions and habits, adding to the intensity and multi-layered quality of the anxieties evoked . Urgent attention has been drawn to our deeply problematic relationship with the natural world, our own habitat, and indefensible social inequities have been crudely exposed. Staff have been caught between their own fear, the need to contain increased disturbance in their patients, already struggling with fragmented and disordered states of mind, and pressures from an organisation under intense strain. The capacity of mental health staff to act as containers for their patient’s distress has been profoundly challenged and compromised. This paper outlines how the pandemic has highlighted the crucial role of the organisation as a container for anxiety and in supporting staff to do their work in mental health care. In order to strengthen this capacity during the crisis, the author describes how ideas derived from psychoanalytic principles were developed into guidance for NHS Mental Health Trusts during the early days of the pandemic . This guidance was adopted nationally by the Royal College of Psychiatrists and is summarised in this paper.

How is physical healthcare experienced by staff, service users, and carers in adult community mental health services in a south London mental health trust? A service evaluation.

Adults with a serious mental illness (SMI) are at greater risk of physical health morbidity and premature death than the general population, largely as a result of preventable physical health issues. Staff working in mental health services have a role to play in addressing these inequalities, but little is known about how they perceive their role and how this impacts on their practice. Understanding this better would enable services to improve their approach and support better health outcomes for SMI patients. A service evaluation was undertaken to investigate how physical healthcare is approached within adult community mental health teams (CMHTs) at a South London (UK) Mental Health Trust. This was a prospective, cross-sectional evaluation design. Interviews and focus groups were conducted with clinical staff, service users and carers (non-professional caregivers e.g., family or friends, of adults living with an SMI), to understand their experiences and to identify key barriers and facilitators to supporting physical healthcare support for adults with SMI. Thematic analysis was conducted to identify key themes which were classified into five main categories. 50 participants took part in the study, 38 were clinical staff, eight were service users and four were carers. We found staff widely recognised the importance of supporting physical healthcare. However, there was variability in how staff approached physical healthcare in routine practice, and differences in how physical healthcare is experienced by service users and carers. Staff were keen to engage in changes to the way physical healthcare is delivered in CMHTs. However, they sought clearer guidance on their roles and responsibilities, and wanted to better understand the rationale for changes in community mental health practice, such as increased screening for physical healthcare. Service users and carers felt equally that the role of CMHTs in physical healthcare was unclear, which limited their ability to access it and understand the benefit for their overall care. Staff articulated gaps in leadership and training that impacted on their ability to implement the overall vision for physical healthcare within the Trust. Mental health staff recognise the role they play in supporting the physical health of adults living with SMI. This evaluation provides insight into common barriers and facilitators faced by staff, service users and carers when providing or accessing physical healthcare within adult CMHTs. These findings indicate a more comprehensive and better articulated approach to physical healthcare in mental health Trusts is needed to ensure service users and their carers understand what support is available and how to access it and to equip staff to provide and sustain that care in routine practice.

Primary SARS-CoV-2 Infections, Re-infections and Vaccine Effectiveness during the Omicron Transmission Period in Healthcare Workers of Trieste and Gorizia (Northeast Italy), 1 December 2021-31 May 2022.

Objective: To evaluate the incidence of primary and recurrent COVID-19 infections in healthcare workers (HCWs) routinely screened for SARS-CoV-2 by nasopharyngeal swabs during the Omicron wave. Design: Dynamic Cohort study of HCWs (N = 7723) of the University Health Agency Giuliano Isontina (ASUGI), covering health services of the provinces of Trieste and Gorizia (Northeast Italy). Cox proportional hazard model was employed to estimate the risk of primary as well as recurrent SARS-CoV-2 infection from 1 December 2021 through 31 May 2022, adjusting for a number of confounding factors. Results: By 1 December 2021, 46.8% HCWs of ASUGI had received the booster, 37.2% were immunized only with two doses of COVID-19 vaccines, 6.0% only with one dose and 10.0% were unvaccinated. During 1 March 2020-31 May 2022, 3571 primary against 406 SARS-CoV-2 recurrent infections were counted among HCWs of ASUGI, 59.7% (=2130/3571) versus 95.1% (=386/406) of which occurring from 1 December 2021 through 31 May 2022, respectively. All HCWs infected by SARS-CoV-2 during 1 December 2021 through 31 May 2022 presented mild flu-like disease. Compared to staff working in administrative services, the risk of primary as well as recurrent SARS-CoV-2 infection increased in HCWs with patient-facing clinical tasks (especially nurses and other categories of HCWs) and in all clinical wards but COVID-19 units and community health services. Regardless of the number of swab tests performed during the study period, primary infections were less likely in HCWs immunized with one dose of COVID-19 vaccine. By contrast, the risk of SARS-CoV-2 re-infection was significantly lower in HCWs immunized with three doses (aHR = 0.58; 95%CI: 0.41; 0.80). During the study period, vaccine effectiveness (VE = 1-aHR) of the booster dose declined to 42% against re-infections, vanishing against primary SARS-CoV-2 infections. Conclusions: Though generally mild, SARS-CoV-2 infections and re-infections surged during the Omicron transmission period. Compared to unvaccinated colleagues, the risk of primary SARS-CoV-2 infection was significantly lower in HCWs immunized just with one dose of COVID-19 vaccines. By Italian law, HCWs immunized only with one dose were either suspended or re-assigned to job tasks not entailing patient facing contact; hence, while sharing the same biological risk of unvaccinated colleagues, they arguably had a higher level of protection against COVID-19 infection. By contrast, SARS-CoV-2 re-infections were less likely in HCWs vaccinated with three doses, suggesting that hybrid humoral immunity by vaccination combined with natural infection provided a higher level of protection than vaccination only. In this stage of the pandemic, where SARS-CoV-2 is more infectious yet much less pathogenic, health protection measures in healthcare premises at higher biological risk seem the rational approach to control the transmission of the virus.

Outcomes of a quality improvement project integrating an EHR (electronic health record) for improved adverse drug reaction (ADR) communication at an adult outpatient cancer infusion center.

372 Background: An adult oncology practice achieved 41% compliance with communication of ADRs involving infusion drugs to ordering provider during the year 2020. We aim at achieving communication of ADRs to ordering provider with a goal compliance rate of 75% over a period of 8 months. Methods: We assembled an interdisciplinary team comprising of medical oncologists, fellows, clinical nurse managers, infusion & clinic nurses, information technology (IT))providers and a clinical pharmacist. We reviewed ADRs occurring between April-December of 2021 in adult patients receiving outpatient infusion therapy at our institution. We created a current-state process map of ADRs in our infusion center. We identified issues that needed to be addressed including no clear standard for documenting or reporting an infusion reaction, no standard process was in place for proper notification to all parties involved nor was there a consistent location in the EHR regarding the description of events that took place. Acknowledgment by ordering provider to an ADR was used as a primary outcome measure. The RL6 (internal tracking system) patient safety events reported was used as a process measure. PDSA cycle 1 January 2021:We implemented a new flowsheet section in the EHR titled “Adverse Drug Reaction”. We created a smart phrase for clarification of documentation, when used will pull information from the flowsheet section into the note. Education was provided to nursing on this new standardized process. Clinicians were educated where to find this information as a standardized location within the EHR. The ordering provider was notified when an ADR occurred by having the infusion nurse document a clinical support note that is routed to the provider’s EHR in-basket. PDSA cycle 2 June 2021: Once nursing documented an ADR, an automated message was sent to all the care-team members via the ADR event folder within the EHR in-basket. The nursing staff then would add the ADR orders group to the treatment plan for clinician review. An alert was generated which prompted the clinician to acknowledge the ADR within the Beacon plan thereby alerting the nursing team if any changes were made. Results: In 2021 there were 73 ADR events that have occurred in Infusion Services. Our interventions were associated with an 80% improvement in communication of ADRs to ordering providers and 35% increase in reporting ADR within our internal tracking system. Conclusions: Developing a standardized ADR process enhanced communication of ADRs to the ordering providers as our intervention was associated with an 80% improvement in communication of ADRs over a 8-month period. Involving all major stakeholders, especially the staff working in information technology services, resulted in exponential results demonstrating the potential future solutions within the EHR.

Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial

BackgroundMore than half of people who use antipsychotic medication for psychosis report having sexual dysfunction. The REMEDY trial aimed to find out if switching antipsychotic medication provides an effective way to reduce sexual dysfunction among people with psychosis. We set out to recruit 216 participants over a two-year period, but recruitment was stopped after an extended 12-month pilot phase, during which we recruited only 10 participants. As part of a nested process evaluation, we conducted qualitative interviews with front-line clinicians to examine barriers to recruitment to the trial.MethodsWe developed a semi-structured interview schedule to explore staff views on factors that influenced whether they referred potential participants to the study. We interviewed a purposive sample of 51 staff from four National Health Service (NHS) Trusts in England, ensuring a range of different backgrounds, seniority, and levels of involvement in the trial. Audio recordings of interviews were transcribed for verbatim, and data were analysed using an inductive approach to thematic analysis.ResultsNine interconnected themes were generated. Six themes concerned barriers to recruitment; including; prioritising patients’ mental stability, mutual discomfort and embarrassment about discussing a “taboo” subject, and concerns about unintended consequences of asking people with psychosis about their sexual functioning. Three themes, including the quality of treatment relationships and strategies for opening dialogue suggested ways to improve recognition of these “hidden” side effects.ConclusionThe identification and management of sexual dysfunction among people with psychosis are not priorities for mental health services in England at this time. Many staff working in front-line services feel unprepared and uncomfortable asking people with psychosis about these problems. While greater use of screening tools may improve the identification of sexual dysfunction among people with psychosis, the evaluation and implementation of interventions to manage them will continue to be challenging unless NHS leaders and senior clinicians demonstrate greater commitment to changing current clinical practice.Trial registrationCurrent Controlled Trials ISRCTN12307891.

Predicting staff turnover in learning disability social care services

Background Staff working in learning disability social care services have high turnover rates resulting in disruption to care and financial costs to employers in relation to recruiting new staff.Aims To explore whether the theory of planned behaviour can be used as a framework to predict intention to leave their job and actual staff turnover, and to identify whether including measures of organisational ‘fulfilment’, work-related stress, perceived job equity and receiving positive behaviour support (PBS) training improved prediction of staff turnover.Method A quantitative design was used. Respondents were 285 social care staff working in learning disability services. Path analysis was used to explore the relationships between staff turnover and the theory of planned behaviour components, perceived equity score (the extent to which respondents believed they benefited from work compared with what they put into it), organisational fulfilment score (the extent to which respondents believed their organisation offered the elements they valued), stress score and group status (that is, whether respondents had undergone the PBS programme).Results Staff turnover was significantly predicted by perceived equity score at one and nine months after baseline, by stress score at six months and by whether respondents had undergone the PBS programme at six and nine months.Conclusion Reducing staff stress, increasing their perceived equity and offering PBS training may be ways of increasing staff retention.

Marital Status and Gender Differences as Key Determinants of COVID-19 Impact on Wellbeing, Job Satisfaction and Resilience in Health Care Workers and Staff Working in Academia in the UK During the First Wave of the Pandemic.

BackgroundThe COVID-19 pandemic is an unprecedented global public health crisis that continues to exert immense pressure on healthcare and related professional staff and services. The impact on staff wellbeing is likely to be influenced by a combination of modifiable and non-modifiable factors.ObjectivesThe aim of this study is to evaluate the effect of the COVID-19 pandemic on the self-reported wellbeing, resilience, and job satisfaction of National Health Service (NHS) and university staff working in the field of healthcare and medical research.MethodsWe conducted a cross sectional survey of NHS and UK university staff throughout the COVID-19 pandemic between May-November 2020. The anonymous and voluntary survey was disseminated through social media platforms, and via e-mail to members of professional and medical bodies. The data was analyzed using descriptive and regression (R) statistics.ResultsThe enjoyment of work and satisfaction outside of work was significantly negatively impacted by the COVID-19 pandemic for all of staff groups independent of other variables. Furthermore, married women reporting significantly lower wellbeing than married men (P = 0.028). Additionally, the wellbeing of single females was significantly lower than both married women and men (P = 0.017 and P < 0.0001, respectively). Gender differences were also found in satisfaction outside of work, with women reporting higher satisfaction than men before the COVID-19 pandemic (P = 0.0002).ConclusionOur study confirms that the enjoyment of work and general satisfaction of staff members has been significantly affected by the first wave of the COVID-19 pandemic. Interestingly, being married appears to be a protective factor for wellbeing and resilience but the effect may be reversed for life satisfaction outside work. Our survey highlights the critical need for further research to examine gender differences using a wider range of methods.