1227 The Impact of COVID-19 on the Wellbeing of Surgical Junior Doctors in a Tertiary Referral and Teaching Hospital

Introduction

Protecting the wellbeing of staff in the NHS is becoming ever more critical as we progress through this pandemic. We sought to identify the impact of the pandemic and changes in working pattern on wellbeing of doctors in training in a teaching hospital.

Method

Cross sectional study, with primary data collection using a web-based survey. Questionnaire was designed to identify issues relating to the personal wellbeing before and since the onset of the pandemic (Nov 2019-Feb 2020 vs March 2020- June 2020). Trainees in all surgical specialities were invited to participate.

Results

Thirty-six doctors responded. Across the timepoints there was a marked increase in reports of the following: constant fatigue (+500%), headaches (250%), loss of motivation (+500%), loss of interest in hobbies/friends (+566%), anger (+500%), loss of focus (+320%) and heightened emotional state (+700%). Almost 70% reported difficulty sleeping in the preceding month, with only 50% feeling they received adequate rest between shifts. Feelings of ‘too tired to drive’ increased by 216% with accidents or near misses increasing by 500%. Use of alcohol as coping mechanism increased by 500%, and comfort eating rose by 244%. 50% considered leaving their post.

Conclusions

These findings are significant and point to a dangerous trend if left unchecked. The causes of these outcomes are multi-factorial; changes to working patterns, cancellation of leave, redeployment, and anxieties around career progression were noted. The long-term health implications on the workforce should not be overlooked. This requires a collective response and action by employers, training and regulatory bodies and government.

1215 Training of Surgical Junior Doctors Impacted by COVID-19 in a Tertiary Referral and Teaching Hospital

Introduction

The COVID-19 pandemic continues to cause significant disruption to the working lives, training, and career development for doctors in training. We sought to identify the impact this has had on colleagues and if these issues were in existence before the pandemic.

Method

This was a cross sectional study, with primary data collection using a web-based survey carried out. Trainees in all surgical specialities were invited to participate. The questionnaire was divided into 4 sections which included questions on individual perception of training experiences and support from Clinical/ Educational Supervisors (CS/ES) preceding and since the onset of the pandemic (Nov 2019-Feb 2020 vs March 2020- June 2020).

Results

In total, 36 trainees responded. Those reporting adequate support from relevant supervisors fell across the following domains: education and training (-39%), career support (-52%), overall support (-20%). Adequate support from hospital management fell from 42% pre-pandemic to 22% after. Trainees felt less valued, ranked morale lower and felt less integrated into a team since the onset of the pandemic. 39% said their consultants had no understanding of the issues they faced at work.

Conclusions

This study highlights relevant existing issues including supervision, training, workload, and support that were amplified following the onset of this pandemic. It does also highlight the discrepancy in the understanding of trainees’ role and their workload by supervisors and hospital management. Further studies are required to better understand and address these issues. The importance of representation in organisational decision-making in-service design can help improve workforce and training experience.

The use of finger foods in care settings: an integrative review

BACKGROUND

Reduced food intake is prevalent in people in residential and hospital care settings. Little is known about the use of finger foods (i.e. foods eaten without cutlery) with respect to increasing feeding independence and food intake. The Social Care Institute for Excellence (Malnutrition Task Force: State of the Nation, 2017) recommends the use of finger foods to enable mealtime independence and to prevent loss of dignity and embarrassment when eating in front of others. The aim of this review is to identify and evaluate the existing literature regarding the use and effectiveness of finger foods among adults in health and social care settings.

METHODS

An integrative review methodology was used. A systematic search of electronic databases for published empirical research was undertaken in October 2018. Following screening of titles and abstracts, the full texts of publications, which investigated outcomes associated with the provision of finger foods in adult care settings, were retrieved and assessed for inclusion. Two independent investigators conducted data extraction and quality assessment using Critical Appraisal Skills Programme checklists. Thematic analysis was used to summarise the findings.

RESULTS

Six studies met the inclusion criteria. Four themes were identified: Finger food menu implementation; Importance of a team approach; Effect on nutrition; and Influence on wellbeing. Study designs were poorly reported, with small sample sizes.

CONCLUSIONS

There is some evidence that the provision of finger foods may positively affect patient outcomes in long-term care settings. There is a paucity of research evaluating the use of a finger food menu in acute care settings, including economic evaluation. Future high quality trials are required.