51
|
Football and Zumba Training in Female Hospital Staff: Effects after 12 and 40 Weeks on Self-Reported Health Status, Emotional Wellbeing, General Self-Efficacy and Sleep Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031685. [PMID: 35162706 PMCID: PMC8834773 DOI: 10.3390/ijerph19031685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 11/26/2022]
Abstract
Background: This 40-weeks intervention study evaluates the effects on self-reported health status, emotional wellbeing, general self-efficacy and sleep problems among female hospital employees. Methods: 107 employees were cluster-randomized into three groups; football (FG), Zumba (ZG) and control (CG). Outcome measurements were conducted at baseline, 12 and 40 weeks. Weekly training frequencies in the first 12 and next 28 weeks were 2.4 ± 0.3 and 0.8 ± 0.2 in FG and 2.3 ± 0.3 and 0.9 ± 0.2 in ZG. Results: Compared to the CG, the ZG showed significant improvement in self-reported health status (p = 0.025), a reduced frequency of poor and restless sleep (on a 0–4 scale) (p = 0.004), as well as a tendency for reduction in the frequency of problems falling asleep (p = 0.055) and overall sleep problems (p = 0.051). Between baseline and 12 weeks, both the FG (p = 0.017) and the ZG (p = 0.017) showed within-group improvements in emotional wellbeing, whereas this improvement was maintained only in the ZG between baseline and 40 weeks (p = 0.002). The FG showed a significant within-group improvement in general self-efficacy (p = 0.012) between baseline and 12 weeks follow-up, with no such improvements in the other groups. Conclusion: The present findings revealed that a physical activity intervention with Zumba as well as football training may improve mental health and sleep outcomes in female hospital staff.
Collapse
|
52
|
Herbert P. Promoting exercise in older people to support healthy ageing. Nurs Stand 2022; 37:46-50. [PMID: 35156355 DOI: 10.7748/ns.2022.e11787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 01/05/2023]
Abstract
As people in the UK continue to live longer, the concept of healthy ageing has become increasingly important. Regular exercise that is appropriate for the ability of each individual can have several benefits for older people, such as slowing the loss of muscle mass, increasing aerobic capacity, maintaining cognitive function and improving health-related quality of life. This article explores the benefits of various forms of exercise and physical activity in older people, and offers practical advice that can assist nurses in supporting a person-centred approach to this aspect of care.
Collapse
Affiliation(s)
- Peter Herbert
- University of Wales Trinity Saint David, Carmarthen, Wales
| |
Collapse
|
53
|
Lucas D, Brient S, Eveillard BM, Gressier A, LeGrand T, Pougnet R, Dewitte JD, Loddé B. Health impact of work stressors and psychosocial perceptions among French hospital workers during the COVID-19 outbreak: a cross-sectional survey. BMJ Open 2022; 12:e053638. [PMID: 34983765 PMCID: PMC8727685 DOI: 10.1136/bmjopen-2021-053638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To compare global health, mental health impact of work stressors and psychosocial perception of healthcare workers (HCWs) and non-HCWs in a hospital after the first peak of the COVID-19 outbreak in France. METHODS A validated version of the SATIN (Santé Au Travail Inrs université Nancy 2)questionnaire with adapted scoring was used to collect data on health and impact of work stressors. This questionnaire was sent to all workers at a hospital in July 2020 and was self-administered online. In a multinomial regression model, we included HCW status, age, gender and front-line worker status as covariates. RESULTS Data from a total of 1405 participants were included. We found that being an HCW, male and front-line worker was a risk factor for negative perception of work demand (OR 7.35, 95% CI 4.2 to 11.47; OR 2.55, 95% CI 1.11 to 5.89; OR 1.78, 95% CI 1.04 to 3.06). Being an HCW was a predictive factor for stress (OR 1.47, 95% CI 1.04 to 2.08), poor global health (OR 1.71, 95% CI 1.14 to 2.55) and negative perception of work activity environment (OR 1.9, 95% CI 1.3 to 2.8). CONCLUSION We have shown that all HCWs suffered from some health impact shortly after the first peak of the COVID-19 outbreak. We underline some stressors with high impact, including work demand, work abilities and organisational context, and emphasise the need for risk management.
Collapse
Affiliation(s)
- David Lucas
- Occupational Health Unit, CHU Brest, Brest, France
- Orphy Laboratory, Bretagne Occidentale University, Brest, France
| | | | | | | | | | | | | | - Brice Loddé
- Occupational Health Unit, CHU Brest, Brest, France
- Orphy Laboratory, Bretagne Occidentale University, Brest, France
| |
Collapse
|
54
|
De Kock JH, Ann Latham H, Cowden RG, Cullen B, Narzisi K, Jerdan S, Muñoz SA, Leslie SJ, McNamara N, Boggon A, Humphry RW. The mental health of NHS staff during the COVID-19 pandemic: two-wave Scottish cohort study. BJPsych Open 2022; 8:e23. [PMID: 35043077 PMCID: PMC8755549 DOI: 10.1192/bjo.2021.1079] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/01/2021] [Accepted: 12/06/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Health and social care workers (HSCWs) are at risk of experiencing adverse mental health outcomes (e.g. higher levels of anxiety and depression) because of the COVID-19 pandemic. This can have a detrimental effect on quality of care, the national response to the pandemic and its aftermath. AIMS A longitudinal design provided follow-up evidence on the mental health (changes in prevalence of disease over time) of NHS staff working at a remote health board in Scotland during the COVID-19 pandemic, and investigated the determinants of mental health outcomes over time. METHOD A two-wave longitudinal study was conducted from July to September 2020. Participants self-reported levels of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7) and mental well-being (Warwick-Edinburgh Mental Well-being Scale) at baseline and 1.5 months later. RESULTS The analytic sample of 169 participants, working in community (43%) and hospital (44%) settings, reported substantial levels of depression and anxiety, and low mental well-being at baseline (depression, 30.8%; anxiety, 20.1%; well-being, 31.9%). Although mental health remained mostly constant over time, the proportion of participants meeting the threshold for anxiety increased to 27.2% at follow-up. Multivariable modelling indicated that working with, and disruption because of, COVID-19 were associated with adverse mental health changes over time. CONCLUSIONS HSCWs working in a remote area with low COVID-19 prevalence reported substantial levels of anxiety and depression, similar to those working in areas with high COVID-19 prevalence. Efforts to support HSCW mental health must remain a priority, and should minimise the adverse effects of working with, and disruption caused by, the COVID-19 pandemic.
Collapse
Affiliation(s)
- Johannes H De Kock
- Institute for Health Research and Innovation, University of the Highlands and Islands; and Department of Clinical Psychology, New Craigs Psychiatric Hospital, NHS Highland, UK
| | | | - Richard G Cowden
- Institute for Quantitative Social Science, Harvard University, USA
| | - Breda Cullen
- Institute of Health & Wellbeing, University of Glasgow, UK
| | - Katia Narzisi
- Institute for Health Research and Innovation, University of the Highlands and Islands, UK
| | - Shaun Jerdan
- Institute for Health Research and Innovation, University of the Highlands and Islands, UK
| | - Sarah-Anne Muñoz
- Institute for Health Research and Innovation, University of the Highlands and Islands, UK
| | - Stephen J Leslie
- Institute for Health Research and Innovation, University of the Highlands and Islands; and Cardiac Unit, Raigmore Hospital, NHS Highland, UK
| | - Neil McNamara
- Department of Psychiatry, New Craigs Psychiatric Hospital, NHS Highland, UK
| | - Adam Boggon
- University College London Medical School, Royal Free Hospital, UK
| | | |
Collapse
|
55
|
Sasidharan S, Chhabra S, Malhotra N, Singh Bajwa S, Choubey S, Sahni N. Breaking barriers to remain healthy and fit during a residency in anaesthesiology. Indian J Anaesth 2022; 66:77-81. [PMID: 35309027 PMCID: PMC8929323 DOI: 10.4103/ija.ija_1110_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 11/04/2022] Open
Abstract
Anaesthesiology is a high-demand speciality of medicine in terms of long and unpredictable work hours, stressful work requirements, pressure for a cent per cent productivity in academics, clinical work and research. Higher stress levels can cause non-communicable diseases like hypertension, obesity and depressed immunity, among many others. In the journey as a trainee anaesthetist, vigorous and diligent efforts are needed to gain perfection in knowledge and skills ultimately. While this path is being transversed, it is essential to address physical and mental fitness by exercising it to the recommended benefits, to ward away stress and burnout. In this special article, the authors will discuss the barriers young anaesthesia trainees face to staying healthy and fit during their training and practical and appropriate measures to mitigate the same through intervention at various levels of hierarchy.
Collapse
|
56
|
Dalton KR, Altekruse W, Campbell P, Ruble K, Carroll KC, Thorpe RJ, Agnew J, Davis MF. Perceptions and Practices of Key Worker Stakeholder Groups in Hospital Animal-Assisted Intervention Programs on Occupational Benefits and Perceived Risks. PEOPLE AND ANIMALS (WEST LAFAYETTE, IN) 2022; 5:4. [PMID: 35765567 PMCID: PMC9235541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Animal-assisted intervention (AAI) programs, used widely for patient benefit, have increasingly been used for healthcare workers (HCW) to reduce occupational stress. However, there are barriers to these programs which limit their utilization, for both patients and HCW, specifically infectious disease concerns. The aim of the research project is to identify barriers and facilitators to AAI program use for healthcare worker benefit, and determine knowledge, beliefs, and practices regarding infectious disease risk and control policies, in order to understand the contextual parameters of program implementation. METHODS We collected perceptions of key stakeholders involved with hospital AAI programs (HCW and AAI workers) through semi-structured in-depth interviews. We used framework analysis to guide thematic coding, completed independently by three researchers. RESULTS We interviewed 37 participants in this study. We divided our themes into two topic areas: program use for HCW and perceived infectious disease risk. Use for healthcare workers included perspectives on the benefits for HCW and program barriers and facilitators (specifically collaboration and leadership). Perceived risk included opinions on infection concerns with AAI, thoughts on control measures to reduce this risk, and responsibility for safety during these programs. CONCLUSIONS While significant benefits were reported for HCW, they were limited by administrative barriers and hazard concerns. Facilitators to surmount these barriers are best implemented with collaboration across the hospital and appropriate leadership roles to direct safe program implementation. By addressing these barriers through targeted facilitators in the form of evidence-backed guidelines, AAI programs can be used to benefit both patients and HCW.
Collapse
Affiliation(s)
- Kathryn R. Dalton
- Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore Maryland
| | | | | | - Kathy Ruble
- Johns Hopkins University School of Medicine, Department of Pediatric Oncology, Baltimore Maryland
| | - Karen C. Carroll
- Johns Hopkins University School of Medicine, Department of Pathology, Division of Medical Microbiology, Baltimore Maryland
| | - Roland J. Thorpe
- Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore Maryland
| | - Jacqueline Agnew
- Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore Maryland
| | - Meghan F. Davis
- Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore Maryland
- Johns Hopkins Medicine, Department of Molecular and Comparative Pathobiology, Baltimore Maryland
| |
Collapse
|
57
|
Nyberg A, Peristera P, Toivanen S, Johansson G. Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? A Longitudinal Study of a Swedish Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:53. [PMID: 35010313 PMCID: PMC8744622 DOI: 10.3390/ijerph19010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/05/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The aim of this paper was to investigate if job demands, decision authority, and workplace violence mediate the association between employment in the health and social care industry and register-based sickness absence. METHODS Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in 2006-2016 (n = 3951) were included. Multilevel autoregressive cross-lagged mediation models were fitted to the data. Employment in the health and social care industry at one time point was used as the predictor variable and register-based sickness absence >14 days as the outcome variable. Self-reported levels of job demands, decision authority, and exposure to workplace violence from the first time point were used as mediating variables. RESULTS The direct path between employment in the health and social care industry and sickness absence >14 days was, while adjusting for the reverse path, 0.032, p = 0.002. The indirect effect mediated by low decision authority was 0.002, p = 0.006 and the one mediated by exposure to workplace violence was 0.008, p = 0.002. High job demands were not found to mediate the association. CONCLUSION Workplace violence and low decision authority may, to a small extent, mediate the association between employment in the health and social care industry and sickness absence.
Collapse
Affiliation(s)
- Anna Nyberg
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, SE-113 65 Stockholm, Sweden;
| | - Paraskevi Peristera
- Department of Psychology, Stress Research Institute, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Susanna Toivanen
- School of Health, Care and Social Welfare, Mälardalen University, P.O. Box 883, SE-721 23 Vasteras, Sweden;
| | - Gun Johansson
- Institute of Environmental Medicine, Karolinska Institutet, SE-113 65 Stockholm, Sweden;
| |
Collapse
|
58
|
Asghar ZB, Wankhade P, Bell F, Sanderson K, Hird K, Phung VH, Siriwardena AN. Trends, variations and prediction of staff sickness absence rates among NHS ambulance services in England: a time series study. BMJ Open 2021; 11:e053885. [PMID: 34588266 PMCID: PMC8483034 DOI: 10.1136/bmjopen-2021-053885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Our aim was to measure ambulance sickness absence rates over time, comparing ambulance services and investigate the predictability of rates for future forecasting. SETTING All English ambulance services, UK. DESIGN We used a time series design analysing published monthly National Health Service staff sickness rates by gender, age, job role and region, comparing the 10 regional ambulance services in England between 2009 and 2018. Autoregressive Integrated Moving Average (ARIMA) and Seasonal ARIMA (SARIMA) models were developed using Stata V.14.2 and trends displayed graphically. PARTICIPANTS Individual participant data were not available. The total number of full-time equivalent (FTE) days lost due to sickness absence (including non-working days) and total number of days available for work for each staff group and level were available. In line with The Data Protection Act, if the organisation had less than 330 FTE days available during the study period it was censored for analysis. RESULTS A total of 1117 months of sickness absence rate data for all English ambulance services were included in the analysis. We found considerable variation in annual sickness absence rates between ambulance services and over the 10-year duration of the study in England. Across all the ambulance services the median days available were 1 336 888 with IQR of 548 796 and 73 346 median days lost due to sickness absence, with IQR of 30 551 days. Among clinical staff sickness absence varied seasonally with peaks in winter and falls over summer. The winter increases in sickness absence were largely predictable using seasonally adjusted (SARIMA) time series models. CONCLUSION Sickness rates for clinical staff were found to vary considerably over time and by ambulance trust. Statistical models had sufficient predictive capability to help forecast sickness absence, enabling services to plan human resources more effectively at times of increased demand.
Collapse
Affiliation(s)
- Zahid B Asghar
- Community and Health Research Unit, Lincoln Medical School, School of Health and Social Care, University of Lincoln-Brayford Campus, Lincoln, UK
| | - Paresh Wankhade
- Business School, Edge Hill University, Ormskirk, Liverpool, UK
| | - Fiona Bell
- Yorkshire Ambulance Service NHS Trust, Wakefield, UK
| | - Kristy Sanderson
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Kelly Hird
- Yorkshire Ambulance Service NHS Trust, Wakefield, UK
| | - Viet-Hai Phung
- Community and Health Research Unit, Lincoln Medical School, School of Health and Social Care, University of Lincoln-Brayford Campus, Lincoln, UK
| | - Aloysius Niroshan Siriwardena
- Community and Health Research Unit, Lincoln Medical School, School of Health and Social Care, University of Lincoln-Brayford Campus, Lincoln, UK
| |
Collapse
|
59
|
Weigl M, Schreyer J. [Is this the parallel pandemic? : Measures to improve working conditions and stress levels among health care personnel]. Internist (Berl) 2021; 62:928-936. [PMID: 34386829 PMCID: PMC8359916 DOI: 10.1007/s00108-021-01120-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 01/08/2023]
Abstract
Employee health and ability to perform is essential to a functioning health care system. Even before the coronavirus disease 2019 (COVID-19) pandemic, a substantial proportion of employees reported impaired mental health at work. This paper outlines the state of knowledge and evidence on interventions to promote mental health in the workplace, with particular focus on the organization of work and activities. In addition to an initial review of approaches, the factors facilitating successful and effective approaches are addressed.
Collapse
Affiliation(s)
- Matthias Weigl
- Institut für Patientensicherheit, Medizinische Fakultät, Universität Bonn, Gebäude 02 (Auenbruggerhaus), Venusberg-Campus 1, 53127, Bonn, Deutschland.
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Klinikum der Universität München, München, Deutschland.
| | - Julia Schreyer
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Klinikum der Universität München, München, Deutschland
| |
Collapse
|
60
|
Akutsu RDC, Rocha A, Viana V, Akutsu L, Silva IC, Botelho RBA, Han H, Raposo A, Ariza-Montes A, Araya-Castillo L, Zandonadi RP. Well-Being at Work: A Cross-Sectional Study on the Portuguese Nutritionists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7839. [PMID: 34360131 PMCID: PMC8345680 DOI: 10.3390/ijerph18157839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022]
Abstract
This exploratory, nationwide cross-sectional study was performed to investigate the well-being of Portuguese nutritionists, in addition to outlining their professional and demographic profile. Descriptive analyses were carried out to determine the measures relating to centralising tendency and dispersion of the sample. We compared means and proportions through t-tests and Analysis of Variance (ANOVA). The sample size was 206 individuals, respecting a minimum of eight respondents per item to validate the instrument. We recruited Nutritionists from Portugal nationwide using the list of electronic mail provided by the Order of Nutritionists. We sent an electronic mail to all the Nutritionists registered in this Order. We also used messaging applications and social networks (Instagram, Facebook) to reach Nutritionists who were not accessing electronic mail. Most respondents are women (92.5%), young (mean age = 31.4 ± 8.07 years; 54.2% of participants aging under 30 years), single, and with no children. More than half are Catholic (73.8%) and have less than ten years of nutritionist undergraduate completion (55.4%). The only variable that influences well-being at work is the economic variable Household Monthly Income. Those who earn less than €500.00 per month perceive themselves at a lesser state of work well-being than those who earn from €2501.00 to €5000.00 per month.
Collapse
Affiliation(s)
- Rita de Cássia Akutsu
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
| | - Ada Rocha
- GreenUPorto, Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.R.); (V.V.)
| | - Victor Viana
- GreenUPorto, Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.R.); (V.V.)
| | - Luiz Akutsu
- Court Union Accounts, Brasília 70042-900, Brazil;
| | | | - Raquel Braz Assunção Botelho
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
| | - Heesup Han
- College of Hospitality and Tourism Management, Sejong University, 98 Gunja-Dong, Gwanjin-Gu, Seoul 143-747, Korea
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Antonio Ariza-Montes
- Social Matters Research Group, Universidad Loyola Andalucía, C/Escritor Castilla Aguayo, 4, 14004 Córdoba, Spain;
- Faculty of Business Administration, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Luis Araya-Castillo
- Facultad de Economía y Negocios, Universidad Andrés Bello, Santiago 7591538, Chile;
| | - Renata Puppin Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília 70910-900, Brazil; (R.d.C.A.); (R.B.A.B.); (R.P.Z.)
| |
Collapse
|
61
|
Jonsdottir IH, Degl'Innocenti A, Ahlstrom L, Finizia C, Wijk H, Åkerström M. A pre/post analysis of the impact of the COVID-19 pandemic on the psychosocial work environment and recovery among healthcare workers in a large university hospital in Sweden. J Public Health Res 2021; 10. [PMID: 34278769 PMCID: PMC8715269 DOI: 10.4081/jphr.2021.2329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The impact of the COVID-19 pandemic on workload, mental health, and well-being of healthcare workers, and particularly those on the front-line, has received considerable attention. DESIGN AND METHODS We surveyed hospital employees about their working environment during the pandemic and identified departments which were negatively affected in comparison to the pre-pandemic situation, as well as factors contributing to this. Setting and participants We surveyed all hospital employees at Sahlgrenska University Hospital, Sweden in September 2020 and compared results across departments and to the results of a large employee survey from October 2019. RESULTS The overall impact of the pandemic on perceived working conditions and possibility for recovery differed among departments. During the pandemic, healthcare workers working with COVID-19 patients reported poorer working environments than other employees. Factors significantly related to perception of work environment and recovery during the pandemic included worries of being infected, departmental transfer, and having insufficient access to personal protective equipment. Men reported better working conditions than women in all, but one item and higher age was related to better perceived working environment. CONCLUSIONS Our results indicate that the pandemic differentially affects hospital departments and underscores the multifactorial nature of this topic. Contributing factors to poor perceived working environment could be addressed at times of high workload, such as during the pandemic, including providing appropriate support to managers, ensuring possibility for recovery during working hours, and acknowledging worries about infection. Young healthcare workers and staff who are relocated due to the pandemic warrant special attention.
Collapse
Affiliation(s)
- Ingibjörg H Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
| | - Alessio Degl'Innocenti
- Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg.
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Department of Orthopaedics, Gothenburg.
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Department of Research, Development, Education and Innovation, Sahlgrenska University Hospital, Gothenburg .
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
| | - Magnus Åkerström
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
| |
Collapse
|
62
|
Effectiveness of Psychological Support to Healthcare Workers by the Occupational Health Service: A Pilot Experience. Healthcare (Basel) 2021; 9:healthcare9060732. [PMID: 34198556 PMCID: PMC8231947 DOI: 10.3390/healthcare9060732] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/06/2021] [Accepted: 06/10/2021] [Indexed: 12/03/2022] Open
Abstract
Work-related stress is a significant risk for healthcare workers (HCWs). This study aims at evaluating the effectiveness of an individual psychological support programme for hospital workers. In all, 35 workers participated (n). A control group of 245 workers (7n) was set. Occupational distress was measured by the General Health Questionnaire, (GHQ-12), the quality of life by the Short Form-36 health survey, (SF-36), and sickness absence was recorded. Costs and benefits of the service were evaluated and the return on investment (ROI) was calculated. The level of distress was significantly reduced in the treated group at the end of the follow-up (p < 0.001). Quality of life had significantly improved (p < 0.003). A 60% reduction of sickness absence days (SADs) following the intervention was recorded. After the treatment, absenteeism in cases was significantly lower than in controls (p < 0.02). The individual improvement of mental health and quality of life was significantly correlated with the number of meetings with the psychologist (p < 0.01 and p < 0.03, respectively). The recovery of direct costs due to reduced sick leave absence was significantly higher than the costs of the programme; ROI was 2.73. The results must be examined with caution, given the very limited number of workers treated; this first study, however, encouraged us to continue the experience.
Collapse
|
63
|
Dadar Singh NK, Loo JL, Ko AMN, Husain SS, Dony JF, Syed Sharizman SAR. Obesity and mental health issues among healthcare workers: a cross-sectional study in Sabah, Malaysia. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-07-2020-0269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
This study aims to determine the prevalence of obesity and its relationship with mental health issues among healthcare workers in Kota Kinabalu District Health Office, Sabah Borneo and its associating factors.
Design/methodology/approach
This cross-sectional study was conducted among 387 healthcare workers working in the Kota Kinabalu District Health Office, Sabah. Sociodemographic data and anthropometric measurements were collected and DASS 21 questionnaire was used to assess mental health status.
Findings
The prevalence of obesity among healthcare workers was 29%, which is significantly associated with years of service (p = 0.016) and abnormal depression subscale scores (p = 0.012) at univariate analysis. The percentage of abnormal subscale score for depression, anxiety and stress was 16, 26 and 12%, respectively. Multivariable logistic regression revealed that more than five years of service years (OR 2.23, 95%CI 1.16–4.28) and high depressive subscale score (OR 2.09, 95%CI 1.18–3.71) were both significantly associated with obesity.
Originality/value
This study has affirmed the link between physical and mental health. Policies that tackle both issues should be put in place to promote wellness among healthcare workers.
Collapse
|
64
|
Liu S, Xu R, Liu L. Influencing Factors of Acute Stress Disorder Among Frontline Nurses in Wuhan, China. J Psychosoc Nurs Ment Health Serv 2021; 59:38-47. [PMID: 34110951 DOI: 10.3928/02793695-20210324-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The current study aimed to investigate the influencing factors of acute stress disorder (ASD) in frontline nurses delivering care in a hospital for COVID-19 in Wuhan, China. In this cross-sectional study, 298 frontline nurses were surveyed during the first month of direct care delivery for patients with COVID-19 via the Stanford Acute Stress Reaction Questionnaire, Simplified Coping Style Questionnaire, and Multidimensional Scale of Perceived Social Support. Through logistic regression analysis, we identified the influencing factors of ASD. Our results showed that 13.8% of participants had ASD; frontline nurses were affected by ASD symptoms in different degrees; higher perceived social support from friends and colleagues were the major protective factors of ASD; and a negative coping style was a risk factor for ASD. Psychological crisis management interventions aimed at frontline nurses may be essential to prevent ASD during public health crisis events. [Journal of Psychosocial Nursing and Mental Health Services, 59(9), 38-47.].
Collapse
|
65
|
Walking the Wellness Talk: Creating a Culture of Classroom Wellness in Nurse Practitioner Education. Nurse Educ 2021; 47:6-7. [PMID: 34132232 DOI: 10.1097/nne.0000000000001047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
66
|
The Healers Are Broken: A Call for Trauma-Informed Professional Development in Nursing. J Nurses Prof Dev 2021; 38:273-278. [PMID: 34101709 DOI: 10.1097/nnd.0000000000000761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The COVID-19 pandemic has highlighted the fact that nurses are at risk for poor mental health, but there is evidence that this risk existed long before the pandemic started. Nurses in professional development have a unique opportunity to support nurses through trauma-informed professional development. Evidence-based interventions, such as peer support, attention to cultural differences, and empowerment, can enhance protective factors and also promote recovery from trauma-related poor mental health outcomes.
Collapse
|
67
|
Wolderslund M, Kofoed PE, Ammentorp J. The effectiveness of a person-centred communication skills training programme for the health care professionals of a large hospital in Denmark. PATIENT EDUCATION AND COUNSELING 2021; 104:1423-1430. [PMID: 33303282 DOI: 10.1016/j.pec.2020.11.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/20/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE As a part of an evaluation of a large-scale communication skills training (CST) programme, this study aimed to investigate the effect on health care professionals' (HCPs) self-efficacy (SE) and perceived importance (PI) of the skills taught. METHODS A pre-post intervention design was used, and 1647 HCPs responded to the SE-12 questionnaire. Changes in self-efficacy were examined at an item and scale level. RESULTS The responses of 74% of the HCPs who replied to at least two of the three questionnaires were analysed. A significant increase in the SE-12 scale scores by 12.45 points between Q1 (baseline) and Q2 (immediately after the intervention) across all professions was found. There was a small albeit statistically significant decrease in the SE-12 scale scores by 2.06 points between Q2 and Q3 (24 weeks after the intervention). CONCLUSION The implementation of the CST course significantly improved the self-efficacy of HCPs. The findings were supported by an increase in the number of HCPs who considered the skills that they had acquired to be very important. PRACTICE IMPLICATIONS The findings suggest that the large-scale implementation of evidence-based CST programmes can yield the same outcomes that have been observed in smaller and better controlled studies.
Collapse
Affiliation(s)
- Maiken Wolderslund
- Health Services Research Unit, Lillebaelt University Hospital, Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Poul-Erik Kofoed
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Pediatrics, Lillebaelt University Hospital, Kolding, Denmark.
| | - Jette Ammentorp
- Health Services Research Unit, Lillebaelt University Hospital, Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| |
Collapse
|
68
|
Ferreira PL, Raposo V, Tavares AI, Pinto A. Burnout and health status differences among primary healthcare professionals in Portugal. BMC FAMILY PRACTICE 2021; 22:81. [PMID: 33910526 PMCID: PMC8082847 DOI: 10.1186/s12875-021-01425-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 03/29/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND This paper is focused on two indicators which may be considered as proxies of individuals' well-being: self-assessed health and burnout intensity. There is little research relating these concepts with the type of the primary healthcare setting, its urbanization density and the region. The aims of this work are threefold: (i) to find determinant factors of individual health status and burnout, (ii) to find possible differences across different types of health care units, differently urbanized areas, and different administrative regions, and (iii) to verify if there are differences in between GPs and nurses. METHODS Data was gathered from an online questionnaire implemented on primary health care. A sample of 9,094 professionals from all 1,212 primary health care settings in Portugal mainland was obtained from an online questionnaire filled from January and April 2018. Statistical analyses include the estimation of two ordered probits, one explaining self-assessed health and the other the burnout. RESULTS The individual drivers for good health and lower levels of burnout, that is, better well-being, are estimated for GPs and nurses. Main findings support that, first, nurses report worst health than GPs, but the latter tend to suffer higher levels of burnout, and also that, 'place' effects arising from the health unit settings and regional location are more significant in GPs than in nurses. However, urbanization density is not significantly associated with health or burnout. CONCLUSIONS A set of policy recommendations are suggested to improve the healthcare workforce well-being, such as improving job satisfaction and income. These policies should be taken at the health care unit level and at the regional administrative level.
Collapse
Affiliation(s)
- Pedro L Ferreira
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FEUC - Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Vitor Raposo
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FEUC - Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Aida Isabel Tavares
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal.
- ISEG -UL - Lisbon School of Economics and Management, University of Lisbon, Lisbon, Portugal.
| | - Ana Pinto
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FCTUC - Faculty of Science and Technology, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
69
|
Pérula-de Torres LÁ, Verdes-Montenegro-Atalaya JC, Melús-Palazón E, García-de Vinuesa L, Valverde FJ, Rodríguez LA, Lietor-Villajos N, Bartolomé-Moreno C, Moreno-Martos H, García-Campayo J, González-Santos J, Rodríguez-Fernández P, León-del-Barco B, Soto-Cámara R, González-Bernal JJ. Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4340. [PMID: 33923868 PMCID: PMC8073262 DOI: 10.3390/ijerph18084340] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022]
Abstract
Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.
Collapse
Affiliation(s)
- Luis Ángel Pérula-de Torres
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (Imibic), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | | | - Elena Melús-Palazón
- Family and Community Medicine Teaching Department of Zaragoza Sector 1, 5018 Zaragoza, Spain; (E.M.-P.); (C.B.-M.)
| | - Leonor García-de Vinuesa
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, 14001 Córdoba, Spain;
| | | | - Luis Alberto Rodríguez
- Family and Community Medicine Teaching Department of Ponferrada, Ponferrada, 24400 León, Spain;
| | - Norberto Lietor-Villajos
- Family and Community Medicine Teaching Department of Jaen, 23007 Jaen, Spain; (F.J.V.); (N.L.-V.)
| | - Cruz Bartolomé-Moreno
- Family and Community Medicine Teaching Department of Zaragoza Sector 1, 5018 Zaragoza, Spain; (E.M.-P.); (C.B.-M.)
| | - Herminia Moreno-Martos
- Multi-Professional Teaching Unit for Family and Community Care of Almería, 04009 Almería, Spain;
| | | | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (P.R.-F.); (J.J.G.-B.)
| | | | - Benito León-del-Barco
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, 10071 Caceres, Spain;
| | - Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (P.R.-F.); (J.J.G.-B.)
| | | | | |
Collapse
|
70
|
Shockey TM, Tsai RJ, Cho P. Prevalence of Diagnosed Diabetes Among Employed US Adults by Demographic Characteristics and Occupation, 36 States, 2014 to 2018. J Occup Environ Med 2021; 63:302-310. [PMID: 33350659 PMCID: PMC8669571 DOI: 10.1097/jom.0000000000002117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess the prevalence of diagnosed diabetes among employed US adults from 36 states by occupation group using data from 2014 to 2018 Behavioral Risk Factor Surveillance System. METHODS Prevalence of diabetes was calculated by 22 broad and 93 detailed occupation groups among a sample of 366,633 employed respondents. Wald chi-square values were used to determine the significance of associations between diabetes and occupation groups after adjusting for sex, age, and race/ethnicity. RESULTS The prevalence of diabetes was 6.4% among employed US adults. The three broad occupation groups with the highest adjusted prevalence of diabetes were protective services (8.9%), farming, fishing, and forestry (8.8%), and community and social services (8.4%). CONCLUSIONS Prevalence of diabetes differed by occupation. Work-related factors (eg, shift work, job stress) should be further examined in relation to risk of developing diabetes.
Collapse
Affiliation(s)
- Taylor M Shockey
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio (Dr Shockey, Dr Tsai); Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Cho)
| | | | | |
Collapse
|
71
|
Valdivieso Portilla DL, Gonzalez Rosero A, Alvarado-Villa G, Moncayo-Rizzo J. Psychometric Properties of the Bern Illegitimate Tasks Scale - Spanish Version. Front Psychol 2021; 12:593870. [PMID: 33815195 PMCID: PMC8010297 DOI: 10.3389/fpsyg.2021.593870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/23/2021] [Indexed: 12/04/2022] Open
Abstract
In recent years, a new factor for work stress has been studied along with stress as an offense to self-theory. Illegitimate tasks refer to assignments that are unnecessary or are not related to the employee’s role. Because of this, the Bern Illegitimate Tasks Scale was developed, which measures illegitimate tasks in terms of unreasonable tasks and unnecessary tasks. There are no studies in Latin America on illegitimate tasks, so the purpose of this research is to translate and validate the Bern Illegitimate Tasks Scale. The study was performed with a sample of nursing staff from a hospital in Guayaquil, Ecuador. Written informed consent was obtained from each of the participants. The reliability of the questionnaire was evaluated and its structural validity was verified by exploratory factor analysis and confirmatory factor analysis. The internal consistency of the whole scale, measured by Cronbach’s alpha, was 0.857. Moreover, the unnecessary and unreasonable subscales measure were 0.846 and 0.841, respectively. The exploratory factor analysis supported a two-factor model that explained 73.96% of the variance. Additionally, the confirmatory factor analysis showed good indexes of fit (GFI = 0.915, CFI = 0.955, TLI = 0.933, SRMR = 0.084, and RMSEA = 0.087). The Spanish version of the Bern Illegitimate Tasks Scale presents good psychometric properties and can be applied to nurses in the Ecuadorian population.
Collapse
Affiliation(s)
| | - Angélica Gonzalez Rosero
- Occupational Safety and Health Program, Universidad de Especialidades Espíritu Santo, Samborondón, Ecuador.,Ecuadorian Social Security Institute (IESS), Quito, Ecuador
| | | | - Jorge Moncayo-Rizzo
- Medicine School, Universidad de Especialidades Espíritu Santo, Samborondón, Ecuador
| |
Collapse
|
72
|
Otokiti AU, Craven CK, Shetreat-Klein A, Cohen S, Darrow B. Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System. JMIR Res Protoc 2021; 10:e25148. [PMID: 33724202 PMCID: PMC8294464 DOI: 10.2196/25148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Up to 60% of health care providers experience one or more symptoms of burnout. Perceived clinician burden resulting in burnout arises from factors such as electronic health record (EHR) usability or lack thereof, perceived loss of autonomy, and documentation burden leading to less clinical time with patients. Burnout can have detrimental effects on health care quality and contributes to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. OBJECTIVE This project aims to improve the user-centered design of the EHR by obtaining direct input from clinicians about deficiencies. Fixing identified deficiencies via user-centered design has the potential to improve usability, thereby increasing satisfaction by reducing EHR-induced burnout. METHODS Quantitative and qualitative data will be obtained from clinician EHR users. The input will be received through a form built in a REDCap database via a link embedded in the home page of the EHR. The REDCap data will be analyzed in 2 main dimensions, based on nature of the input, what section of the EHR is affected, and what is required to fix the issue(s). Identified issues will be escalated to relevant stakeholders responsible for rectifying the problems identified. Data analysis, project evaluation, and lessons learned from the evaluation will be incorporated in a Plan-Do-Study-Act (PDSA) manner every 4-6 weeks. RESULTS The pilot phase of the study began in October 2020 in the Gastroenterology Division at Mount Sinai Hospital, New York City, NY, which includes 39 physicians and 15 nurses. The pilot is expected to run over a 4-6-month period. The results of the REDCap data analysis will be reported within 1 month of completing the pilot phase. We will analyze the nature of requests received and the impact of rectified issues on the clinician EHR user. We expect that the results will reveal which sections of the EHR have the highest deficiencies while also highlighting issues about workflow difficulties. Perceived impact of the project on provider engagement, patient safety, and workflow efficiency will also be captured by evaluation survey and other qualitative methods where possible. CONCLUSIONS The project aims to improve user-centered design of the EHR by soliciting direct input from clinician EHR users. The ultimate goal is to improve efficiency, reduce EHR inefficiencies with the possibility of improving staff engagement, and lessen EHR-induced clinician burnout. Our project implementation includes using informatics expertise to achieve the desired state of a learning health system as recommended by the National Academy of Medicine as we facilitate feedback loops and rapid cycles of improvement. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/25148.
Collapse
Affiliation(s)
- Ahmed Umar Otokiti
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, United States.,Clinical Informatics Group, Information Technology Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, United States
| | - Catherine K Craven
- Clinical Informatics Group, Information Technology Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, United States.,Institute for Health Care Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, United States
| | - Avniel Shetreat-Klein
- Clinical Informatics Group, Information Technology Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, United States.,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, United States
| | - Stacey Cohen
- Clinical Informatics Group, Information Technology Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, United States.,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY, United States
| | - Bruce Darrow
- Department of Cardiology and Health Information Technology, Mount Sinai Health System, New York, NY, United States
| |
Collapse
|
73
|
|
74
|
Abstract
Health care professionals represent a population at high risk for poor health. Although this may be counterintuitive given their expertise in health, the high stress and long hours of many medical work environments present challenges for health care professionals to engage in healthy lifestyle behaviors. This is extremely problematic for the health and well-being of both health care professionals and the patients they treat. Medical settings are encouraged to implement interventions that intervene at both the enviornmental and personal level to help faciliate behavior change among health care providers.
Collapse
Affiliation(s)
- Lauren Holtzclaw
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Katherine R. Arlinghaus
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Craig A. Johnston
- Department of Health and Human Performance, University of Houston, Texas
| |
Collapse
|
75
|
Wilson V, Donsante J, Pai P, Franklin A, Bowden A, Almeida S. Building workforce well-being capability: The findings of a wellness self-care programme. J Nurs Manag 2021; 29:1742-1751. [PMID: 33501710 DOI: 10.1111/jonm.13280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/20/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022]
Abstract
AIM To implement and evaluate a co-designed staff well-being programme. BACKGROUND Working in health care can be physically and psychologically demanding. The job demands-resources model indicates job resources moderate the impact of job demands on staff well-being. Well-being initiatives introduced by organisations improve staff commitment, and reduce absences and incidents. METHODS A qualitative descriptive design was applied. In 2019, within an Australian local health district, 232 health care professionals across eight hospitals and two community settings attended a six-week well-being programme, which included a variety of self-care strategies, for example mindfulness. Nine 1-hr focus groups were completed 2-4 weeks post-programme. Data were analysed using thematic analysis to explore participants' thoughts and experiences. RESULTS Participants experienced joy from workshops and guilt for leaving peers with their workload. Participants developed strong interpersonal relationships with workshop attendees within a 'safe well-being space'. Broader impacts expressed by participants were; learnt coping mechanisms and proactive self-care practices and can be easily embedded into daily routines. Participants shared their 'toolkit' with colleagues, family and friends, positively impacting the well-being of people around them. CONCLUSION Participants encouraged by their new well-being 'toolkit' engaged with colleagues, better managed stressors and shared learnings. IMPLICATIONS FOR NURSING MANAGEMENT Building well-being capability within a health organisation requires nursing management to make staff well-being a strategic priority, use a co-design approach and embed coping mechanisms at the grassroots levels.
Collapse
Affiliation(s)
- Valerie Wilson
- University of Wollongong, Wollongong, NSW, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | | | - Padmini Pai
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Alison Franklin
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Alera Bowden
- University of Wollongong, Wollongong, NSW, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | | |
Collapse
|
76
|
Komashie A, Ward J, Bashford T, Dickerson T, Kaya GK, Liu Y, Kuhn I, Günay A, Kohler K, Boddy N, O'Kelly E, Masters J, Dean J, Meads C, Clarkson PJ. Systems approach to health service design, delivery and improvement: a systematic review and meta-analysis. BMJ Open 2021; 11:e037667. [PMID: 33468455 PMCID: PMC7817809 DOI: 10.1136/bmjopen-2020-037667] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 10/02/2020] [Accepted: 11/18/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To systematically review the evidence base for a systems approach to healthcare design, delivery or improvement. DESIGN Systematic review with meta-analyses. METHODS Included were studies in any patients, in any healthcare setting where a systems approach was compared with usual care which reported quantitative results for any outcomes for both groups. We searched Medline, Embase, HMIC, Health Business Elite, Web of Science, Scopus, PsycINFO and CINAHL from inception to 28 May 2019 for relevant studies. These were screened, and data extracted independently and in duplicate. Study outcomes were stratified by study design and whether they reported patient and/or service outcomes. Meta-analysis was conducted with Revman software V.5.3 using ORs-heterogeneity was assessed using I2 statistics. RESULTS Of 11 405 records 35 studies were included, of which 28 (80%) were before-and-after design only, five were both before-and-after and concurrent design, and two were randomised controlled trials (RCTs). There was heterogeneity of interventions and wide variation in reported outcome types. Almost all results showed health improvement where systems approaches were used. Study quality varied widely. Exploratory meta-analysis of these suggested favourable effects on both patient outcomes (n=14, OR=0.52 (95% CI 0.38 to 0.71) I2=91%), and service outcomes (n=18, OR=0.40 (95% CI 0.31 to 0.52) I2=97%). CONCLUSIONS This study suggests that a systems approaches to healthcare design and delivery results in a statistically significant improvement to both patient and service outcomes. However, better quality studies, particularly RCTs are needed.PROSPERO registration numberCRD42017065920.
Collapse
Affiliation(s)
- Alexander Komashie
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, Cambridgeshire, UK
- NIHR Global Health Research Group on Neurotrauma, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - James Ward
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Tom Bashford
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
- NIHR Global Health Research Group on Neurotrauma, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
- Division of Anaesthesia, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - Terry Dickerson
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Gulsum Kubra Kaya
- Faculty of Engineering and Natural Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Yuanyuan Liu
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Isla Kuhn
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Aslι Günay
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
- Media and Visual Arts, Koc University, Istanbul, Turkey
| | - Katharina Kohler
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
- Division of Anaesthesia, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - Nicholas Boddy
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Eugenia O'Kelly
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Joseph Masters
- Major Trauma Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - John Dean
- Department of Care Quality Improvement, Royal College of Physicians, London, London, UK
| | - Catherine Meads
- School of Nursing and Midwifery, Anglia Ruskin University - Cambridge Campus, Cambridge, Cambridgeshire, UK
| | - P John Clarkson
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire, UK
| |
Collapse
|
77
|
Smoktunowicz E, Lesnierowska M, Carlbring P, Andersson G, Cieslak R. Resource-Based Internet Intervention (Med-Stress) to Improve Well-Being Among Medical Professionals: Randomized Controlled Trial. J Med Internet Res 2021; 23:e21445. [PMID: 33427674 PMCID: PMC7834939 DOI: 10.2196/21445] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/28/2020] [Indexed: 12/02/2022] Open
Abstract
Background Medical professionals are exposed to multiple and often excessive demands in their work environment. Low-intensity internet interventions allow them to benefit from psychological support even when institutional help is not available. Focusing on enhancing psychological resources—self-efficacy and perceived social support—makes an intervention relevant for various occupations within the medical profession. Previously, these resources were found to operate both individually or sequentially with self-efficacy either preceding social support (cultivation process) or following it (enabling process). Objective The objective of this randomized controlled trial is to compare the efficacy of 4 variants of Med-Stress, a self-guided internet intervention that aims to improve the multifaceted well-being of medical professionals. Methods This study was conducted before the COVID-19 pandemic. Participants (N=1240) were recruited mainly via media campaigns and social media targeted ads. They were assigned to 1 of the following 4 groups: experimental condition reflecting the cultivation process, experimental condition reflecting the enabling process, active comparator enhancing only self-efficacy, and active comparator enhancing only perceived social support. Outcomes included 5 facets of well-being: job stress, job burnout, work engagement, depression, and job-related traumatic stress. Measurements were taken on the web at baseline (time 1), immediately after intervention (time 2), and at a 6-month follow-up (time 3). To analyze the data, linear mixed effects models were used on the intention-to-treat sample. The trial was partially blinded as the information about the duration of the trial, which was different for experimental and control conditions, was public. Results At time 2, job stress was lower in the condition reflecting the cultivation process than in the one enhancing social support only (d=−0.21), and at time 3, participants in that experimental condition reported the lowest job stress when compared with all 3 remaining study groups (ds between −0.24 and −0.41). For job-related traumatic stress, we found a significant difference between study groups only at time 3: stress was lower in the experimental condition in which self-efficacy was enhanced first than in the active comparator enhancing solely social support (d=−0.24). The same result was found for work engagement (d=−0.20), which means that it was lower in exactly the same condition that was found beneficial for stress relief. There were no differences between study conditions for burnout and depression neither at time 2 nor at time 3. There was a high dropout in the study (1023/1240, 82.50% at posttest), reflecting the pragmatic nature of this trial. Conclusions The Med-Stress internet intervention improves some components of well-being—most notably job stress—when activities are completed in a specific sequence. The decrease in work engagement could support the notion of dark side of this phenomenon, but further research is needed. Trial Registration ClinicalTrials.gov NCT03475290; https://clinicaltrials.gov/ct2/show/NCT03475290 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-019-3401-9
Collapse
Affiliation(s)
- Ewelina Smoktunowicz
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Magdalena Lesnierowska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Roman Cieslak
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Trauma, Health, and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| |
Collapse
|
78
|
Teo YH, Xu JTK, Ho C, Leong JM, Tan BKJ, Tan EKH, Goh WA, Neo E, Chua JYJ, Ng SJY, Cheong JJY, Hwang JYF, Lim SM, Soo T, Sng JGK, Yi S. Factors associated with self-reported burnout level in allied healthcare professionals in a tertiary hospital in Singapore. PLoS One 2021; 16:e0244338. [PMID: 33406132 PMCID: PMC7787466 DOI: 10.1371/journal.pone.0244338] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Burnout has adverse implications in healthcare settings, compromising patient care. Allied health professionals (AHPs) are defined as individuals who work collaboratively to deliver routine and essential healthcare services, excluding physicians and nurses. There is a lack of studies on burnout among AHPs in Singapore. This study explored factors associated with a self-reported burnout level and barriers to seeking psychological help among AHPs in Singapore. METHODS We conducted a cross-sectional study in a sample of AHPs in a tertiary hospital from October to December 2019. We emailed a four-component survey to 1127 eligible participants. The survey comprised four components: (1) sociodemographic characteristics, (2) Maslach Burnout Inventory (MBI-HSS), (3) Areas of Worklife Survey, and (4) Perceived Barriers to Psychological Treatment (PBPT). We performed a multiple logistic regression analysis to identify factors associated with burnout. Adjusted odds ratios (AORs) and associated 95% confidence intervals (CIs) were computed. RESULTS In total, 328 participants completed the questionnaire. The self-reported burnout level (emotional exhaustion>27 and/or depersonalization>10) was 67.4%. The majority of the respondents were female (83.9%), Singaporean (73.5%), aged 40 years and below (84.2%), and Chinese ethnicity (79.9%). In the multiple logistic regression model, high burnout level was negatively associated with being in the age groups of 31 to 40 (AOR 0.39, 95% CI 0.16-0.93) and 40 years and older (AOR 0.30, 95% CI 0.10-0.87) and a low self-reported workload (AOR 0.35, 95% CI 0.23-0.52). High burnout level was positively associated with a work experience of three to five years (AOR 5.27, 95% CI 1.44-20.93) and more than five years (AOR 4.24; 95% CI 1.16-16.79. One hundred and ninety participants completed the PBPT component. The most frequently cited barriers to seeking psychological help by participants with burnout (n = 130) were 'negative evaluation of therapy' and 'time constraints.' CONCLUSIONS This study shows a high self-reported burnout level and identifies its associated factors among AHPs in a tertiary hospital. The findings revealed the urgency of addressing burnout in AHPs and the need for effective interventions to reduce burnout. Concurrently, proper consideration of the barriers to seeking help is warranted to improve AHPs' mental well-being.
Collapse
Affiliation(s)
- Yao Hao Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jordan Thet Ke Xu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cowan Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jui Min Leong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Benjamin Kye Jyn Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Wei-An Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elson Neo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jonathan Yu Jing Chua
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sean Jun Yi Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Julia Jie Yi Cheong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jeff Yi-Fu Hwang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - See Ming Lim
- Occupational Health Clinic, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Thomas Soo
- Occupational Health Clinic, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Judy Gek Khim Sng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Center for Global Health Research, Touro University California, Vallejo, CA, United States of America
- School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia
| |
Collapse
|
79
|
Vera San Juan N, Aceituno D, Djellouli N, Sumray K, Regenold N, Syversen A, Mulcahy Symmons S, Dowrick A, Mitchinson L, Singleton G, Vindrola-Padros C. Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice. BJPsych Open 2020; 7:e15. [PMID: 33298229 PMCID: PMC7844154 DOI: 10.1192/bjo.2020.148] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well-being and the evidence base behind such guidelines remain unclear. AIMS The aims of the study are to assess the applicability of well-being guidelines in practice, identify unaddressed healthcare workers' needs and provide recommendations for supporting front-line staff during the current and future pandemics. METHOD This paper discusses the findings of a qualitative study based on interviews with front-line healthcare workers in the UK (n = 33), and examines them in relation to a rapid review of well-being guidelines developed in response to the COVID-19 pandemic (n = 14). RESULTS The guidelines placed greater emphasis on individual mental health and psychological support, whereas healthcare workers placed greater emphasis on structural conditions at work, responsibilities outside the hospital and the invaluable support of the community. The well-being support interventions proposed in the guidelines did not always respond to the lived experiences of staff, as some reported not being able to participate in these interventions because of understaffing, exhaustion or clashing schedules. CONCLUSIONS Healthcare workers expressed well-being needs that aligned with socio-ecological conceptualisations of well-being related to quality of life. This approach to well-being has been highlighted in literature on support of healthcare workers in previous health emergencies, but it has not been monitored during this pandemic. Well-being guidelines should explore the needs of healthcare workers, and contextual characteristics affecting the implementation of recommendations.
Collapse
Affiliation(s)
- Norha Vera San Juan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Rapid Research Evaluation and Appraisal Lab, University College London, UK
| | - David Aceituno
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Department of Psychiatry, School of Medicine, Pontifical Catholic University of Chile, Chile
| | - Nehla Djellouli
- Institute for Global Health, University College London, UK; and Rapid Research Evaluation and Appraisal Lab, University College London, UK
| | - Kirsi Sumray
- Institute of Epidemiology and Health Care, University College London, UK
| | - Nina Regenold
- Department of Anthropology, University College London, UK
| | - Aron Syversen
- Institute of Epidemiology and Health Care, University College London, UK
| | | | - Anna Dowrick
- Institute of Population Health Science, Queen Mary University of London, UK
| | - Lucy Mitchinson
- Marie Curie Palliative Care Research Department, University College London, UK
| | - Georgina Singleton
- Health Services Research Centre, National Institute of Academic Anaesthesia, London, UK; and Rapid Research Evaluation and Appraisal Lab, University College London, UK
| | - Cecilia Vindrola-Padros
- Department of Targeted Intervention, University College London, UK; and Rapid Research Evaluation and Appraisal Lab, University College London, UK
| |
Collapse
|
80
|
Forberger S, Wichmann F, Comito CNN. Using nudges to promote physical activity and to reduce sedentary behaviour in the workplace: a scoping review protocol. BMJ Open 2020; 10:e038205. [PMID: 33444182 PMCID: PMC7678358 DOI: 10.1136/bmjopen-2020-038205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Physical inactivity and sedentary behaviour are associated with numerous health problems and increasing risks of premature morbidity and mortality. Workplace health promotion with a focus on increasing physical activity (PA) and reducing sedentary behaviour is of growing interest. The concept of choice architecture with the use of nudges is a promising approach to influence decision making regarding health behaviours. It can help to understand why people often fail to act in their best interest, to follow well-informed preferences or to achieve their set goals. Nudges, the way the choice is presented, can help to overcome these challenges by using the same habits, biases or boundaries to alter our decision-making in favour of the more preferred behaviour. Aims of the scoping review will be to analyse (a) to what extent the concept of choice architecture is used in workplace health promotion to promote PA and/or to reduce sedentary behaviour and (b) which instruments (nudges) are used to archive that. METHODS AND ANALYSES Medline, PsychInfo, Web of Science and CINHAL will be searched from 2009 until June 2020. Applying a two-level screening process, title and abstracts will be screened according to a set of predetermined inclusion and exclusion criteria. Included articles will be screened a second time to determine the extent to which choice architecture has been used. Analyses for publication year, location, setting and target group will be provided. Interventions will be analysed presenting the instruments used, number of studies per instrument, combinations of instruments and alteration of the environment. Outcome measures and results will be reported as they occur. ETHICS AND DISSEMINATION Due to the nature of the scoping review, ethical concerns are minimal. No patient data will be included. Results are published in peer-review journals.
Collapse
Affiliation(s)
- Sarah Forberger
- Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Frauke Wichmann
- Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | | |
Collapse
|
81
|
Edwards KE, Misra SK, Hyman K, Albers A, Kamal AH. Top Ten Tips Palliative Care Clinicians Should Know about Implementing a Team Wellness Program. J Palliat Med 2020; 24:116-121. [PMID: 33146569 DOI: 10.1089/jpm.2020.0628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Palliative care (PC) providers often face challenging and emotional cases while operating in the structures that are not ideally resourced. This combination can lead to burnout and further jeopardize resources from turnover, morale, and decreased productivity. Although many wellness efforts have focused on building personal resilience skills for individuals, programmatic approaches to improve a culture wellness are equally important in supporting clinical teams. This article brings together the perspectives of PC leaders with expertise in wellness to collate practical pearls for interventions that impact the culture of well-being in their organizations. In this article, we use a "Top 10" format to highlight the interventions that PC leaders can implement to support the well-being of clinical staff and promote program sustainability.
Collapse
Affiliation(s)
- Kristin E Edwards
- Center for Geriatrics and Palliative Care, Yale New Haven Health, Bridgeport Hospital, Bridgeport, Connecticut, USA.,Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sumi K Misra
- Division of General Internal Medicine, Veterans Affairs Medical Center, TN Valley GRECC, Nashville, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Katy Hyman
- MemorialCare Long Beach Medical Center, Long Beach, California, USA
| | - Ashley Albers
- Four Seasons, The Care You Trust, Flat Rock, North Carolina, USA
| | - Arif H Kamal
- Duke Cancer Institute, Durham, North Carolina, USA
| |
Collapse
|
82
|
WHIRL Study: Workplace Health Interprofessional Learning in the Construction Industry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186815. [PMID: 32961985 PMCID: PMC7558403 DOI: 10.3390/ijerph17186815] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/22/2022]
Abstract
Interprofessional learning (IPL) is essential to prepare healthcare trainees as the future public health workforce. WHIRL (Workplace Health InteRprofessional Learning) was an innovative IPL intervention that engaged volunteer healthcare trainees (n = 20) in multi-professional teams to deliver health checks (n = 464), including tailored advice and signposting, to employees in the UK construction industry (across 21 events, 16 sites, 10 organisations) as part of an ongoing research programme called Test@Work. Volunteers undertook a four-part training and support package of trainer-led education, observations of practice, self-directed learning and clinical supervision, together with peer mentoring. In a one-group post-test only design, IPL outcomes were measured using the Inventory of Reflective Vignette-Interprofessional Learning (IRV-IPL), and the psychometric properties of the IRV-IPL tool were tested. WHIRL demonstrably improved healthcare trainees' interprofessional skills in all five areas of collaboration, coordination, cooperation, communication, and commendation. The IRV-IPL tool was found to be a valid and reliable measure of interprofessional competencies across three scenarios; before and after health promotion activities, and as a predictor of future health promotion competence. This industry-based workplace IPL programme resulted in the attainment of health check competencies and bridged the gap between research, education and clinical practice.
Collapse
|
83
|
Berlanda S, de Cordova F, Fraizzoli M, Pedrazza M. Risk and Protective Factors of Well-Being among Healthcare Staff. A Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6651. [PMID: 32932588 PMCID: PMC7558609 DOI: 10.3390/ijerph17186651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/04/2022]
Abstract
The purpose of this study was to identify physical and psychosocial working conditions to improve well-being at work among healthcare staff. This is a potent area of inquiry given the relationship between healthcare staff well-being and service quality and other key organizational characteristics. However, while numerous studies in this area have used a quantitative methodology, very few have applied qualitative methodologies gathering subjective descriptions of the sources of well-being, providing in so doing significant data to explore in depth the factors that influence well-being in healthcare systems. We gathered qualitative data analyzing open-ended questions about risk and protective factors of well-being at work. The sample was made of 795 professionals answering an online questionnaire. Answers were coded and analyzed using the thematic analysis with an inductive approach (data-driven). We identified four themes strongly affecting professional well-being in health-care staff: Interactions, Working Conditions, Emotional Responses to Work, and Competence and Professional Growth. Our findings suggest possible strategies and actions that may be effective in helping to calibrate case-specific support and monitoring interventions to improve health and well-being of healthcare staff. We also discuss the implications of the study and suggest possible avenues for future empirical research.
Collapse
Affiliation(s)
- Sabrina Berlanda
- Department of Human Sciences, University of Verona, 37129 Verona, Italy; (F.d.C.); (M.F.); (M.P.)
| | | | | | | |
Collapse
|
84
|
Vallone F, Smith AP, Zurlo MC. Work-related stress and wellbeing among nurses: Testing a multi-dimensional model. Jpn J Nurs Sci 2020; 17:e12360. [PMID: 32803915 DOI: 10.1111/jjns.12360] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/17/2020] [Accepted: 06/23/2020] [Indexed: 11/26/2022]
Abstract
AIM Basing on the Demands-Resources and Individual-Effects (DRIVE) Model developed by Mark and Smith in 2008, the study aims to propose and test a multi-dimensional model that combines work characteristics, individual characteristics, and work-family interface dimensions as predictors of nurses' psychophysical health. METHODS Self-report questionnaires assessing work characteristics (effort; rewards; job demands; job control; social support), individual characteristics (socio-demographic characteristics; coping strategies; Type A behavioral pattern; Type D personality), work-family interface dimensions (work-family interrole conflict; job and life satisfaction), and health outcomes (psychological disease; physical disease) were completed by 450 Italian nurses. Logistic regression analyses and Hayes' PROCESS tool were used to test the proposed model by exploring main, moderating and mediating hypotheses. RESULTS Findings confirmed the proposed theoretical framework including work characteristics, individual characteristics, and work-family interface dimensions as significant predictors of nurses' psychophysical disease. Specific main, moderating and mediating effects were found, providing a wide set of multiple risks and protective factors. CONCLUSIONS The study allowed a broader understanding of nurses' work-related stress process, providing a comprehensive tool for the assessment of occupational health and for the definition of tailored policies and interventions in public healthcare organizations to promote nurses' wellbeing.
Collapse
Affiliation(s)
- Federica Vallone
- Department of Humanities, University of Naples Federico II, Naples, Italy.,Dynamic Psychology Laboratory, University of Naples Federico II, Naples, Italy
| | - Andrew Paul Smith
- Centre for Occupational and Health Psychology, Cardiff University, Cardiff, UK
| | - Maria Clelia Zurlo
- Dynamic Psychology Laboratory, University of Naples Federico II, Naples, Italy.,Department of Political Sciences, University of Naples Federico II, Naples, Italy
| |
Collapse
|
85
|
Allen JD, Shelton RC, Kephart L, Jandorf L, Folta SC, Knott CL. Organizational characteristics conducive to the implementation of health programs among Latino churches. Implement Sci Commun 2020; 1:62. [PMID: 32885217 PMCID: PMC7427941 DOI: 10.1186/s43058-020-00052-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 06/18/2020] [Indexed: 01/16/2023] Open
Abstract
Background Faith-based organizations (FBOs) can be effective partners in the implementation of health interventions to reach underserved audiences. However, little is known about the capacity they have or need to engage in these efforts. We examined inner-setting organizational characteristics hypothesized to be important for program implementation by the Consolidated Framework for Implementation Research (CFIR). Methods This cross-sectional study involved 34 churches with predominantly Latino congregations in Massachusetts. FBO leaders completed a survey assessing inner-setting CFIR organizational characteristics, including organizational readiness, implementation climate, organizational culture, and innovation “fit” with organizational mission. Results There was limited variability in CFIR organizational characteristics, with scores on a scale from 1 to 5 skewed toward higher values, ranging from 3.27 (SD 0.94) for implementation climate to 4.58 (SD 0.54). Twenty-one percent of the FBOs had offered health programs in the prior year. Conclusions FBOs had high scores on most of the organizational factors hypothesized to be important for the implementation of health programs, although relatively few FBOs offered them. While this suggests that FBOs have favorable characteristics for health programming, prospective studies are needed to understand relative salience of inner-setting organizational characteristics versus factors external to the organization (e.g., policies, incentives), as well as the potential direction of relationships between internal organizational characteristics and health program offerings. Trial registration Clinical trials identifier number NCT01740219 (clinicaltrials.gov)
Collapse
Affiliation(s)
- Jennifer D Allen
- Department of Community Health, Tufts University, 574 Boston Avenue, Medford, MA 02155 USA
| | - Rachel C Shelton
- Department of Socio-medical Sciences, Columbia University Mailman School of Public Health, New York, NY 10032 USA
| | - Lindsay Kephart
- Massachusetts Department of Public Health, 250 Washington Street, Boston, MA 02108 USA
| | - Lina Jandorf
- Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 USA
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave., Boston, MA 02111 USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland School of Public Health, 1234 W SPH Building, College Park, MD 20742 USA
| |
Collapse
|
86
|
Zhang XJ, Song Y, Jiang T, Ding N, Shi TY. Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses. Medicine (Baltimore) 2020; 99:e20992. [PMID: 32590814 PMCID: PMC7328917 DOI: 10.1097/md.0000000000020992] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses. METHODS Researches have been conducted within Cochrane Library, PubMed, Ovid, Scopus, EBSCO, and CINAHL published from inception to 2019. In addition, a manual search for relevant articles was also conducted using Google Scholar and ancestral searches through the reference lists from articles included in the final review. Two reviewers independently selected and assessed, and any disagreements were resolved through a larger team discussion. A data extraction spreadsheet was developed and initially piloted in 3 randomly selected studies. Data from each study were extracted independently using a pre-standardized data abstraction form. The the Risk of Bias in Systematic reviews and assessment of multiple systematic reviews (AMSTAR) 2 tool were used to evaluate risk of bias and quality of included articles. RESULTS A total of 22 studies published from 2014 to 2019 were eligible for analysis. Previous studies have examined burnout among physicians (n = 9), nurses (n = 6) and healthcare providers (n = 7). The MBI was used by majority of studies to assess burnout. The included studies evaluated a wide range of interventions, individual-focused (emotion regulation, self-care workshop, yoga, massage, mindfulness, meditation, stress management skills and communication skills training), structural or organizational (workload or schedule-rotation, stress management training program, group face-to-face delivery, teamwork/transitions, Balint training, debriefing sessions and a focus group) and combine interventions (snoezelen, stress management and resiliency training, stress management workshop and improving interaction with colleagues through personal training). Based on the Risk of Bias in Systematic reviews and AMSTAR 2 criteria, the risk of bias and methodological quality included studies was from moderate to high. CONCLUSIONS Burnout is a complicated problem and should be dealt with by using bundled strategy. The existing overview clarified evidence to reduce burnout of physicians and nurses, which provided a basis for health policy makers or clinical managers to design simple and feasible strategies to reduce the burnout of physicians and nurses, and to ensure clinical safety.
Collapse
Affiliation(s)
- Xiu-jie Zhang
- Department of Nursing, The First affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yingqian Song
- Department of Nursing, The First affiliated Hospital of Dalian Medical University, Dalian, China
| | | | - Ning Ding
- Department of Nursing, The First affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tie-ying Shi
- Department of Nursing, The First affiliated Hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
87
|
Green S, Markaki A, Baird J, Murray P, Edwards R. Addressing Healthcare Professional Burnout: A Quality Improvement Intervention. Worldviews Evid Based Nurs 2020; 17:213-220. [DOI: 10.1111/wvn.12450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Sarah Green
- Children’s Hospital Los Angeles Los Angeles CA USA
- University of Alabama at Birmingham School of Nursing Birmingham AL USA
| | - Adelais Markaki
- PAHO/WHOCC for International Nursing University of Alabama at Birmingham School of Nursing Birmingham AL USA
| | - Jennifer Baird
- Institute for Nursing and Interprofessional Research Children’s Hospital Los Angeles Los Angeles CA USA
| | - Paula Murray
- Institute for Nursing and Interprofessional Research Children’s Hospital Los Angeles Los Angeles CA USA
| | - Rebecca Edwards
- University of Alabama at Birmingham School of Nursing Birmingham AL USA
| |
Collapse
|
88
|
Fitzpatrick C, Buckingham T, Merrell J, McCooey C, Richardson D. Engaging nurses in research and quality improvement is associated with higher job satisfaction and lower rates of unscheduled time off work: A pilot study. Int J STD AIDS 2020; 31:702-704. [DOI: 10.1177/0956462420901989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aim to identify associations that may help support strategies to increase job satisfaction and reduce unscheduled time off work for nurses. Given current concerns regarding nursing workforce and retention, it is vital we identify strategies and factors which maintain job satisfaction, support staff retention and reduce unscheduled time off work. As part of a quality improvement project, we conducted and distributed an online anonymous survey. Likert scales were used to measure job satisfaction, perceived quality of care, wellbeing, and unscheduled time off work. We explored participation in project work of any kind in the preceding 12 months, and captured nursing experience and current area of practice (inpatient/outpatient). A total of 350 complete responses were analysed. Nurses engaged in research or Quality Improvement Projects (QIPs) were more likely to have higher perceived levels of patient care (p = 0.0001), wellbeing (p = 0.0001) and job satisfaction (p = 0.0001) and reported lower levels of unscheduled time off work (p = 0.0001). Nurses engaged in research or quality improvement projects reported higher levels of job satisfaction, wellbeing, perceived higher levels of care in their workplace, and had lower levels of unscheduled time off work. We suggest that involving nurses in research/QIPs may improve workforce instability and job satisfaction.
Collapse
Affiliation(s)
- Colin Fitzpatrick
- Clinic 16, Royal North Shore Hospital, Sydney, Australia
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | | | - Jayne Merrell
- Southern Health and Social Care Trust, Belfast, Northern Ireland
| | | | - Daniel Richardson
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
- Brighton and Sussex Medical School, Brighton, UK
| |
Collapse
|
89
|
Raine G, Thomas S, Rodgers M, Wright K, Eastwood A. Workplace-based interventions to promote healthy lifestyles in the NHS workforce: a rapid scoping and evidence map. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
The health and well-being of staff working in the NHS is a significant issue for UK health care. We sought to identify research relevant to the promotion of healthy lifestyles among NHS staff on behalf of NHS England.
Objectives
To map existing reviews on workplace-based interventions to promote health and well-being, and to assess the scope for further evidence synthesis work.
Design
Rapid and responsive scoping search and evidence map.
Participants
Adult employees in any occupational setting and in any role.
Interventions
Any intervention aimed at promoting or maintaining physical or mental health and well-being. Early intervention initiatives and those addressing violence against staff, workplace bullying or harassment were also included.
Main outcome measures
Any outcome related to the effectiveness, cost-effectiveness or implementation of interventions.
Data sources
A scoping search of nine databases was conducted to identify systematic reviews on health and well-being at work. Searches were limited by publication date (2000 to January/February 2019).
Review methods
The titles and abstracts of over 8241 records were screened and a total of 408 potentially relevant publications were identified. Information on key characteristics were extracted from the titles and abstracts of all potentially relevant publications. Descriptive statistics (counts and percentages) for key characteristics were generated and data from reviews and ‘reviews of reviews’ were used to produce the evidence map.
Results
Evidence related to a broad range of physical and mental health issues was identified across 12 ‘reviews of reviews’ and 312 other reviews, including 16 Cochrane reviews. There also exists National Institute for Health and Care Excellence guidance addressing multiple issues of potential relevance. A large number of reviews focused on mental health, changing lifestyle behaviour, such as physical activity, or on general workplace health/health promotion. Most of the reviews that focused only on health-care staff addressed mental health issues, and stress/burnout in particular.
Limitations
The scoping search process was extensive and clearly effective at identifying relevant publications, but the strategy used may not have identified every potentially relevant review. Owing to the large number of potentially relevant reviews identified from the scoping search, it was necessary to produce the evidence map using information from the titles and abstracts of reviews only.
Conclusions
It is doubtful that further evidence synthesis work at this stage would generate substantial new knowledge, particularly within the context of the NHS Health and Wellbeing Framework[NHS England. Workforce Health and Wellbeing Framework. 2018. URL: www.nhsemployers.org/-/media/Employers/Publications/Health-and-wellbeing/NHS-Workforce-HWB-Framework_updated-July-18.pdf (accessed 10 January 2019)] published in 2018. Additional synthesis work may be useful if it addressed an identifiable need and it was possible to identify one of the following: (1) a specific and focused research question arising from the current evidence map; it may then be appropriate to focus on a smaller number of reviews only, and provide a more thorough and critical assessment of the available evidence; and (2) a specific gap in the literature (i.e. an issue not already addressed by existing reviews or guidance); it may then be possible to undertake further literature searching and conduct a new evidence review.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 18. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Gary Raine
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sian Thomas
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Alison Eastwood
- Centre for Reviews and Dissemination, University of York, York, UK
| |
Collapse
|
90
|
Belrhiti Z, Van Damme W, Belalia A, Marchal B. Unravelling the role of leadership in motivation of health workers in a Moroccan public hospital: a realist evaluation. BMJ Open 2020; 10:e031160. [PMID: 31900266 PMCID: PMC6955542 DOI: 10.1136/bmjopen-2019-031160] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES This study aimed at opening the black box of the relationship between leadership and motivation of health workers by focusing on a high-performance hospital in Morocco. DESIGN We adopted the realist evaluation approach and used the case study design to test the initial programme theory we formulated on the basis of a scoping review on complex leadership. We used the Intervention-Context-Actors-Mechanism-Outcome Configuration as a heuristic tool to identify plausible causal configurations. SETTINGS Since 2000, the Ministry of Health in Morocco initiated many reforms in the frame of the governmental deconcentration process called 'advanced regionalisation'. The implementation of these reforms is hampered by inadequate human resource management capacities of local health system managers. Yet, the National 'Concours Qualité', a national quality assurance programme implemented since 2007, demonstrated that there are many islands of excellence. We explore how leadership may play a role in explaining these islands of excellence. PARTICIPANTS We carried out a document review, 18 individual interviews and 3 group discussions (with doctors, administrators and nurses), and non-participant observations during a 2-week field visit in January-February 2018. RESULTS We confirmed that effective leaders adopt an appropriate mix of transactional, transformational and distributed leadership styles that fits the mission, goals, organisational culture and nature of tasks of the organisation and the individual characteristics of the personnel when organisational culture is conducive. Leadership effectiveness is conditioned by the degree of responsiveness to the basic psychological needs of autonomy, competence and relatedness, perceived organisational support and perceived supervisor support. Transactional and overcontrolling leadership behaviour decreased the satisfaction of the need for autonomy and mutual respect. By distributing leadership responsibilities, complex leaders create an enabling environment for collective efficacy and creative problem solving. CONCLUSIONS We found indications that in the Moroccan context, well-performing hospitals could be characterised by a good fit between leadership styles, organisational characteristics and individual staff attributes.
Collapse
Affiliation(s)
- Zakaria Belrhiti
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Gerontology, Vrije Universiteit Brussel, Brussel, Belgium
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Gerontology, Vrije Universiteit Brussel, Brussel, Belgium
| | | | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|
91
|
Belrhiti Z, Van Damme W, Belalia A, Marchal B. The effect of leadership on public service motivation: a multiple embedded case study in Morocco. BMJ Open 2020; 10:e033010. [PMID: 31900272 PMCID: PMC6955481 DOI: 10.1136/bmjopen-2019-033010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES We aimed at exploring the underlying mechanisms and contextual conditions by which leadership may influence 'public service motivation' of health providers in Moroccan hospitals. DESIGN We used the realist evaluation (RE) approach in the following steps: eliciting the initial programme theory, designing the study, carrying out the data collection, doing the data analysis and synthesis. In practice, we adopted a multiple embedded case study design. SETTINGS We used purposive sampling to select hospitals representing extreme cases displaying contrasting leadership practices and organisational performance scores using data from the Ministry of Health quality assurance programmes from 2011 to 2016. PARTICIPANTS We carried out, on average, 17 individual in-depth interviews in 4 hospitals as well as 7 focus group discussions and 8 group discussions with different cadres (administrators, nurses and doctors). We collected relevant documents (eg, performance audit, human resource availability) and carried out observations. RESULTS Comparing the Intervention-Context-Actor-Mechanism-Outcome configurations across the hospitals allowed us to confirm and refine our following programme theory: "Complex leaders, applying an appropriate mix of transactional, transformational and distributed leadership styles that fit organisational and individuals characteristics [I] can increase public service motivation, organisational commitment and extra role behaviours [O] by increasing perceived supervisor support and perceived organizational support and satisfying staff basic psychological needs [M], if the organisational culture is conducive and in the absence of perceived organisational politics [C]". CONCLUSIONS In hospitals, the archetype of complex professional bureaucracies, leaders need to be able to balance between different leadership styles according to the staff's profile, the nature of tasks and the organisational culture if they want to enhance public service motivation, intrinsic motivation and organisational commitment.
Collapse
Affiliation(s)
- Zakaria Belrhiti
- Ecole Nationale de Sante Publique, Rabat, Morocco
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|
92
|
|
93
|
McLennan S. The Content and Nature of Narrative Comments on Swiss Physician Rating Websites: Analysis of 849 Comments. J Med Internet Res 2019; 21:e14336. [PMID: 31573918 PMCID: PMC6792026 DOI: 10.2196/14336] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/28/2019] [Accepted: 07/15/2019] [Indexed: 11/13/2022] Open
Abstract
Background The majority of physician rating websites (PRWs) provide users the option to leave narrative comments about their physicians. Narrative comments potentially provide richer insights into patients’ experiences and feelings that cannot be fully captured in predefined quantitative rating scales and are increasingly being examined. However, the content and nature of narrative comments on Swiss PRWs has not been examined to date. Objective This study aimed to examine (1) the types of issues raised in narrative comments on Swiss PRWs and (2) the evaluation tendencies of the narrative comments. Methods A random stratified sample of 966 physicians was generated from the regions of Zürich and Geneva. Every selected physician was searched for on 3 PRWs (OkDoc, DocApp, and Medicosearch) and Google, and narrative comments were collected. Narrative comments were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues. Results The selected physicians had a total of 849 comments. In total, 43 subcategories addressing the physician (n=21), staff (n=8), and practice (n=14) were identified. None of the PRWs’ comments covered all 43 subcategories of the categorization framework; comments on Google covered 86% (37/43) of the subcategories, Medicosearch covered 72% (31/43), DocApp covered 60% (26/43), and OkDoc covered 56% (24/43). In total, 2441 distinct issues were identified within the 43 subcategories of the categorization framework; 83.65% (2042/2441) of the issues related to the physician, 6.63% (162/2441) related to the staff, and 9.70% (237/2441) related to the practice. Overall, 95% (41/43) of the subcategories of the categorization framework and 81.60% (1992/2441) of the distinct issues identified were concerning aspects of performance (interpersonal skills of the physician and staff, infrastructure, and organization and management of the practice) that are considered assessable by patients. Overall, 83.0% (705/849) of comments were classified as positive, 2.5% (21/849) as neutral, and 14.5% (123/849) as negative. However, there were significant differences between PRWs, regions, and specialty regarding negative comments: 90.2% (111/123) of negative comments were on Google, 74.7% (92/123) were regarding physicians in Zurich, and 73.2% (90/123) were from specialists. Conclusions From the narrative comments analyzed, it can be reported that interpersonal issues make up nearly half of all negative issues identified, and it is recommended that physicians should focus on improving these issues. The current suppression of negative comments by Swiss PRWs is concerning, and there is a need for a consensus-based criterion to be developed to determine which comments should be published publicly. Finally, it would be helpful if Swiss patients are made aware of the current large differences between Swiss PRWs regarding the frequency and nature of ratings to help them determine which PRW will provide them with the most useful information.
Collapse
Affiliation(s)
- Stuart McLennan
- Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany.,Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| |
Collapse
|
94
|
Vuong W, Ledi D, Kelland J, Hunter D, Boffa E, Agyapong VIO. Promoting Staff and Physician Well-Being With a Single-Day Event: Event Satisfaction and Perceived Well-Being Benefits of an Addiction and Mental Health Sports Day. Workplace Health Saf 2019; 68:6-12. [DOI: 10.1177/2165079919875731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Addiction and mental health (AMH) professionals often experience high levels of burnout, which can lead to detrimental outcomes for patient care and safety and the AMH professional themselves. Interventions aimed at improving well-being can be useful to tackle the issues surrounding burnout. Specifically, implementing activity-based events (ABEs), which encourages individuals to be more physically active, can be useful in improving physical, mental, and social well-being. Alberta Health Services AMH, Edmonton Zone, implemented a Sports Day event to promote well-being as a way to help offset the risk of burnout. Methods: This was an online anonymous cross-sectional, postsurvey evaluation. The postsurvey was administered to 243 AMH staff and physicians who registered for Sports Day. Findings: The responses from 66 AMH staff and physician attendees indicated that individuals were highly satisfied with the event and felt that Sports Day promoted positive mental and physical well-being, helped to develop a sense of community, and strengthened colleague relationships. Conclusions/Application to Professional Practice: The results build on the literature examining the effects of single-day ABEs and can be implemented by health care organizations to promote staff and physician well-being via increased physical activity. Single-day ABEs, like Sports Day, can promote mental, physical, and social well-being. Organizing a sports day event is a feasible way to help offset the risk of burnout and is generally well received by individuals.
Collapse
Affiliation(s)
| | | | | | | | - Ernie Boffa
- Alberta Health Services
- University of Alberta
| | | |
Collapse
|
95
|
Mayer DK, Alfano CM. Personalized Risk-Stratified Cancer Follow-Up Care: Its Potential for Healthier Survivors, Happier Clinicians, and Lower Costs. J Natl Cancer Inst 2019; 111:442-448. [PMID: 30726949 PMCID: PMC6804411 DOI: 10.1093/jnci/djy232] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/03/2018] [Accepted: 12/20/2019] [Indexed: 12/16/2022] Open
Abstract
The growth in the number of cancer survivors in the face of projected health-care workforce shortages will challenge the US health-care system in delivering follow-up care. New methods of delivering follow-up care are needed that address the ongoing needs of survivors without overwhelming already overflowing oncology clinics or shuttling all follow-up patients to primary care providers. One potential solution, proposed for over a decade, lies in adopting a personalized approach to care in which survivors are triaged or risk-stratified to distinct care pathways based on the complexity of their needs and the types of providers their care requires. Although other approaches may emerge, we advocate for development, testing, and implementation of a risk-stratified approach as a means to address this problem. This commentary reviews what is needed to shift to a risk-stratified approach in delivering survivorship care in the United States.
Collapse
Affiliation(s)
- Deborah K Mayer
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health
- School of Nursing, UNC Lineberger Comprehensive Cancer Center, University of North Carolina
| | | |
Collapse
|
96
|
Raman R, McClelland L. Bringing compassion into information systems research: A research agenda and call to action. JOURNAL OF INFORMATION TECHNOLOGY 2019. [DOI: 10.1177/0268396218815989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In this article, we assert that compassion-driven approaches are the sustainable way for information and communication technologies to contribute to economic value. We urge future information systems research to emphasize, with equal vigor, the joint goals of compassion and financial gains from information and communication technologies. We present a broad agenda for future information systems research based on this premise. We also discuss how certain core assumptions underlying traditional information systems research—so far, driven primarily by economic value as outcome—would need to change in order to support this new agenda emphasizing compassion and economic value as complementary and synergistic outcomes. We provide a brief concrete illustration of this proposed agenda, and its underlying revised assumptions, by drawing on the example of a prominent field of study in information systems research, namely health information systems research.
Collapse
|
97
|
Psychiatric and psychological follow-up of undergraduate and postgraduate medical students: Prevalence and associated factors. Results from the national BOURBON study. Psychiatry Res 2019; 272:425-430. [PMID: 30611959 DOI: 10.1016/j.psychres.2018.12.174] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/22/2018] [Accepted: 12/28/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Physicians are at risk of burnout, anxiety and depression. Prevention is needed from the beginning of the medical studies to detect early poor mental health outcomes. OBJECTIVE To determine the prevalence and associated of psychiatric or psychological follow-up in a national sample of undergraduate and postgraduate medical students (UPMS). METHODS UPMS of the 35 French Medicine faculties were recruited through mailing lists and social networks between December 2016 and May 2017 and fulfilled Internet anonymised questionnaires. RESULTS Overall, 10,985 UPMS were included in the present study (2165 (19.7%) postgraduate, 31.6% males, mean aged 21.8 years). Overall, 1345 (12.2%) were followed-up by a psychiatrist and/or a psychologist, 20.5% of them were regular anxiolytic consumers and 17.2% of them were regular antidepressant consumers. In multivariate analyses, being followed-up by a psychiatrist and/or psychologist was associated with older age (aOR = 1.2[1.2-1.2], p < 0.0001), female gender (aOR = 0.5[0.5-0.7], p < 0.0001), current alcohol use disorder (aOR = 1.3[1.3-1.5], p < 0.0001), higher anxiolytic (aOR = 3.1[2.5-3.7],p < 0.0001) and antidepressant (aOR = 11.7[7.6-18.0],p < 0.0001) consumption, and with lower self-reported general health, social functioning and mental health quality of life (all aORs = 0.9, all p < 0.05). The UPMS followed-up by psychiatrist and/or psychologist reported to have been more frequently exposed to sexual assault (5.1% vs. 0.9%, aOR = 2.5[1.3-4.7], p < 0.0001), domestic violence (3.3% vs. 0.8% aOR = 2.1[1.2-4.0], p = 0.01) and parents divorce (11% vs. 6.4%, aOR = 1.5[1.2-1.9], p = 0.001). Students followed-up by a psychiatrist and/or psychologist reported more frequently to seek alleviating anxiety (aOR 1.9[1.6-2.3], p < 0.0001), depression (aOR 1.7[1.3-2.1],p < 0.0001), coping with studies difficulties (aOR 1.5[1.2-1.8],p < 0.0001), experiencing more stress at hospital (aOR = 2.3[1.6-3.5],p < 0.001) and more burnout syndrome (aOR = 1.4[1.1-1.8], p = 0.03). CONCLUSIONS Around 12% of UPMS are followed-up by a psychiatrist and/or a psychologist. These students reported higher antidepressant and anxiolytic consumption, psychic suffering and altered quality of life, associated with professional pressure and personal issues. Public health programs should be developed to help these students through their studies to prevent later mental /addictive issues and professional suffering. Improving UPMS mental health may also improve the later quality of care of their patients and global stress at hospital.
Collapse
|
98
|
Yeh TL, Chen HH, Chiu HH, Chiu YH, Hwang LC, Wu SL. Morbidity associated with overweight and obesity in health personnel: a 10-year retrospective of hospital-based cohort study in Taiwan. Diabetes Metab Syndr Obes 2019; 12:267-274. [PMID: 30881069 PMCID: PMC6410747 DOI: 10.2147/dmso.s193434] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To investigate morbidity associated with overweight and obesity in health personnel and compare the differences among work roles. MATERIALS AND METHODS This retrospective cohort study examined measurements obtained during employee medical checkups between 2007 and 2016 in a Taiwan medical center. BMI was used to define overweight (≥24 and <27 kg/m2) and obesity (≥27 kg/m2). Morbidity refers to prevalence, period incidence proportion, and incidence rate. Multivariable Cox model was used to estimate the HRs and 95% CI of the incidence proportion across work roles. RESULTS Ten thousand six hundred fifty-one health personnel with 24,295 BMI measurements were recruited. Mean age was 33.4±10.7 years and 72.4% was female. In total, 1,992 (8.2%) health personnel were underweight, 13,568 (55.8%) had a normal BMI, 5,097 (21%) were overweight, and 3,638 (15%) were obese. Five thousand nine hundred one health personnel with 31,172 different interval-year arrangement combinations were obtained. The incidence proportion of overweight and obesity was 1,947 (6.2%) and 1,494 (4.8%), respectively. The incidence rate was 37/1,000 and 15/1,000 person-years, respectively. Compared with that in supporting staff, the HR of overweight in doctors, nurses, and allied health professionals was 0.93 (95% CI =0.73-1.18, P=0.553), 0.92 (95% CI =0.73-1.16, P=0.491), and 0.85 (95% CI =0.67-1.09, P=0.202), respectively. Similarly, the HR of obesity was 0.86 (95% CI =0.66-1.14, P=0.301), 0.89 (95% CI =0.67-1.18, P=0.430), and 0.84 (95% CI =0.63-1.13, P=0.248), respectively. CONCLUSION In health personnel, the prevalence of overweight and obesity was 21% and 15%, respectively. The incidence proportion was 6.2% and 4.8%, respectively. Morbidity across the four health work roles examined was not significantly different.
Collapse
Affiliation(s)
- Tzu-Lin Yeh
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hsin-Hao Chen
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan
| | - Hsiao-Hui Chiu
- Department of Nursing, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Yu-Hua Chiu
- Occupational Safety and Health Office, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Lee-Ching Hwang
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Shang-Liang Wu
- School of Medicine, Griffith University, Gold Coast Campus, QLD, Australia,
| |
Collapse
|
99
|
Abstract
There is a continued mandate for practicing evidence-based medicine and the prerequisite rigorous analysis of the comparative effectiveness of alternative treatments. There is also an increasing emphasis on delivering value-based health care. Both these high priorities and their related endeavors require correct information about the outcomes of care. Accurately measuring and confirming health care outcomes are thus likely now of even greater importance. The present basic statistical tutorial focuses on the germane topic of psychometrics. In its narrower sense, psychometrics is the science of evaluating the attributes of such psychological tests. However, in its broader sense, psychometrics is concerned with the objective measurement of the skills, knowledge, and abilities, as well as the subjective measurement of the interests, values, and attitudes of individuals-both patients and their clinicians. While psychometrics is principally the domain and content expertise of psychiatry, psychology, and social work, it is also very pertinent to patient care, education, and research in anesthesiology, perioperative medicine, critical care, and pain medicine. A key step in selecting an existing or creating a new health-related assessment tool, scale, or survey is confirming or establishing the usefulness of the existing or new measure; this process conventionally involves assessing its reliability and its validity. Assessing reliability involves demonstrating that the measurement instrument generates consistent and hence reproducible results-in other words, whether the instrument produces the same results each time it is used in the same setting, with the same type of subjects. This includes interrater reliability, intrarater reliability, test-retest reliability, and internal reliability. Assessing validity is answering whether the instrument is actually measuring what it is intended to measure. This includes content validity, criterion validity, and construct validity. In evaluating a reported set of research data and its analyses, in a similar manner, it is important to assess the overall internal validity of the attendant study design and the external validity (generalizability) of its findings.
Collapse
Affiliation(s)
- Thomas R. Vetter
- Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
| | - Catherine Cubbin
- Steve Hicks School of Social Work at the University of Texas at Austin, Austin, Texas
| |
Collapse
|
100
|
Quirk H, Crank H, Carter A, Leahy H, Copeland RJ. Barriers and facilitators to implementing workplace health and wellbeing services in the NHS from the perspective of senior leaders and wellbeing practitioners: a qualitative study. BMC Public Health 2018; 18:1362. [PMID: 30526543 PMCID: PMC6288890 DOI: 10.1186/s12889-018-6283-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 11/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The National Health Service (NHS) seems appropriately placed to be an exemplar employer in providing effective and proactive workplace health and wellbeing services for its staff. However, NHS staff sickness absence costs an estimated £2.4 billion. Evidence suggests staff health and wellbeing services delivered in the NHS can improve health, productivity and sickness absence and yet the adoption of these services remains a challenge, with few examples nationally. This research aimed to explore the perceptions of NHS senior leaders and health and wellbeing practitioners regarding barriers and facilitators to implementing workplace health and wellbeing services for staff in the NHS. METHODS Semi-structured interviews were conducted with NHS staff, consisting of four senior leaders, four heads of department and three health and wellbeing practitioners in one region of the UK. Interviews were transcribed verbatim and analysed using thematic analysis. RESULTS Themes describe the experience of delivering workplace health and wellbeing services in the NHS, and barriers and facilitators to implementation from senior decision makers. Barriers to implementation of services include; a busy and pressurised environment, financial constraints and reluctance to invest in staff health and wellbeing. Barriers to staff engagement were also reported and include difficulty of access to health and wellbeing services and lack of time. Initiating services were facilitated by financial incentives, a supportive organisational structure and culture that takes a preventative, rather than reactive, approach to staff health and wellbeing. Facilitators to implementing health and wellbeing services include a coherent, strategic approach to implementation, effective communication and advertisement, being creative and innovative with resources and conducting a needs analysis and evaluation before, during and after implementation. CONCLUSIONS Barriers to the successful initiation and implementation of health and wellbeing services in the NHS are numerous and range from front-line logistical issues with implementation to high-level strategic and financial constraints. Adopting a strategic and needs-led approach to implementation and ensuring thorough staff engagement are amongst a number of factors that facilitate implementation and help overcome barriers to initiation of wellbeing programmes in the NHS. There is a need for a culture that supports staff health and wellbeing in the NHS.
Collapse
Affiliation(s)
- Helen Quirk
- Centre for Sport and Exercise Science, Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Hall, Collegiate Crescent, Sheffield, S10 2BP UK
| | - Helen Crank
- Centre for Sport and Exercise Science, Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Hall, Collegiate Crescent, Sheffield, S10 2BP UK
| | - Anouska Carter
- Centre for Sport and Exercise Science, Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Hall, Collegiate Crescent, Sheffield, S10 2BP UK
| | - Hanna Leahy
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QU UK
| | - Robert J. Copeland
- Centre for Sport and Exercise Science, Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Hall, Collegiate Crescent, Sheffield, S10 2BP UK
- The National Centre for Sport and Exercise Medicine, Sheffield, UK
| |
Collapse
|