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Yannamani P, Gale NK. The ebbs and flows of empathy: a qualitative study of surgical trainees in the UK. BMC MEDICAL EDUCATION 2024; 24:131. [PMID: 38336765 PMCID: PMC10858458 DOI: 10.1186/s12909-024-05105-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Empathy is widely recognised as an important element of medical practice contributing to patient outcomes and satisfaction. It is also an important element of collaborative work in a healthcare team. However, there is evidence to suggest that empathy towards patients declines over time, particularly in surgical specialities. There is little qualitative research on this decline in surgical trainees, particularly in the UK. Therefore, the aim of this study was to explore how trainee surgeons experience empathy over the course of their career, both towards patients and colleagues and how they perceive it in others. METHODS 10 semi-structured interviews were carried out with surgical trainees of different grades and specialties in January and February 2022. Framework analysis was used to interpret the data. RESULTS Participants experienced an evolution in empathy over their career as their personal and professional experience was added to. They drew a distinction between desensitisation and actual decline in empathy and identified more with experiencing the former in their careers. Participants also felt interprofessional relationships require empathy, and this could be improved upon. Finally, they highlighted specific impacts of the COVID-19 pandemic upon their training, including reduced theatre time. CONCLUSIONS Participants felt training could be improved in regard to accessing training opportunities and relationships with colleagues, although many felt empathy between colleagues is better than it has been in the past. This project highlighted areas for future research, such as with surgeons in later stages of their careers, or mixed-methods projects.
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Affiliation(s)
| | - Nicola Kay Gale
- Health Policy and Sociology, Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK
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Evans TR, Burns C, Essex R, Finnerty G, Hatton E, Clements AJ, Breau G, Quinn F, Elliott H, Smith LD, Matthews B, Jennings K, Crossman J, Williams G, Miller D, Harold B, Gurnett P, Jagodzinski L, Smith J, Milligan W, Markowski M, Collins P, Yoshimatsu Y, Margalef Turull J, Colpus M, Dayson ML, Weldon S. A systematic scoping review on the evidence behind debriefing practices for the wellbeing/emotional outcomes of healthcare workers. Front Psychiatry 2023; 14:1078797. [PMID: 37032950 PMCID: PMC10080145 DOI: 10.3389/fpsyt.2023.1078797] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/13/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Debriefings give healthcare workers voice through the opportunity to discuss unanticipated or difficult events and recommend changes. The typical goal of routine debriefings has been to improve clinical outcomes by learning through discussion and reflection of events and then transferring that learning into clinical practice. However, little research has investigated the effects of debriefings on the emotional experiences and well-being of healthcare workers. There is some evidence that debriefings are a multi-faceted and cost-effective intervention for minimising negative health outcomes, but their use is inconsistent and they are infrequently adopted with the specific intention of giving healthcare workers a voice. The purpose of this systematic scoping review is therefore to assess the scope of existing evidence on debriefing practices for the well-being and emotional outcomes of healthcare workers. Methods Following screening, 184 papers were synthesised through keyword mapping and exploratory trend identification. Results The body of evidence reviewed were clustered geographically, but diverse on many other criteria of interest including the types of evidence produced, debriefing models and practices, and outcomes captured. Discussion The current review provides a clear map of our existing understanding and highlights the need for more systematic, collaborative and rigorous bodies of evidence to determine the potential of debriefing to support the emotional outcomes of those working within healthcare. Systematic Review Registration https://osf.io/za6rj.
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Affiliation(s)
- Thomas Rhys Evans
- School of Human Sciences, University of Greenwich, London, United Kingdom
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
- *Correspondence: Thomas Rhys Evans,
| | - Calvin Burns
- School of Human Sciences, University of Greenwich, London, United Kingdom
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
| | - Ryan Essex
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
| | - Gina Finnerty
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Ella Hatton
- School of Psychology, Arden University, Coventry, United Kingdom
| | | | - Genevieve Breau
- School of Human Sciences, University of Greenwich, London, United Kingdom
| | - Francis Quinn
- School of Applied Social Studies, Robert Gordon University, Aberdeen, United Kingdom
| | - Helen Elliott
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Lorraine D. Smith
- School of Education, University of Greenwich, London, United Kingdom
| | - Barry Matthews
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Kath Jennings
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Jodie Crossman
- School of Sport and Health Sciences, University of Brighton, Brighton, United Kingdom
| | - Gareth Williams
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Denise Miller
- School of Education, University of Greenwich, London, United Kingdom
| | - Benjamin Harold
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Philip Gurnett
- School of Health Sciences, University of Greenwich, London, United Kingdom
- Greenwich Learning and Simulation Centre, University of Greenwich, London, United Kingdom
| | - Lee Jagodzinski
- School of Health Sciences, University of Greenwich, London, United Kingdom
- Greenwich Learning and Simulation Centre, University of Greenwich, London, United Kingdom
| | - Julie Smith
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Wendy Milligan
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Marianne Markowski
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Peter Collins
- School of Human Sciences, University of Greenwich, London, United Kingdom
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
| | - Yuki Yoshimatsu
- School of Human Sciences, University of Greenwich, London, United Kingdom
- Lewisham and Greenwich NHS Trust, London, United Kingdom
| | | | - Mark Colpus
- School of Human Sciences, University of Greenwich, London, United Kingdom
| | - Mark L. Dayson
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
- School of Health Sciences, University of Greenwich, London, United Kingdom
| | - Sharon Weldon
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
- School of Health Sciences, University of Greenwich, London, United Kingdom
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Chambers CNL, Frampton CMA. Burnout, stress and intentions to leave work in New Zealand psychiatrists; a mixed methods cross sectional study. BMC Psychiatry 2022; 22:380. [PMID: 35668372 PMCID: PMC9169591 DOI: 10.1186/s12888-022-03980-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Demand for mental health services in New Zealand and internationally is growing. Little is known about how psychiatrists are faring in this environment. This study aimed to investigate wellbeing of psychiatrists working in the public health system in New Zealand, identify the main risk factors for work-related stress, gauge perceptions of how workload has changed over time, assess job satisfaction and whether individuals intend or desire to leave their work. METHODS Psychiatrists working in New Zealand who were also members of the Association of Salaried Medical Specialists were invited to participate in an online survey. Main outcome measures were degree of burnout and stress experienced at work. Supplementary measures included perceived workplace demands and levels of support. Predictor variables included perceptions of changes to workloads over time, degree of job satisfaction and intentions to leave work. Logistic regression assessed characteristics associated with burnout and job satisfaction as well as intentions to leave work. Free text comments were analysed thematically alongside quantitative trends. RESULTS 368/526 responded (70% response rate). 34.6% met the criteria for burnout and 35.3% scored with high work stress. There were no significant patterns of association with demographic variables but significant correlation with all but one predictor variable; having experienced a change to the demands of the on-call workload. 45% agreed they would leave their current job if able and 87% disagreed that they are working in a well-resourced mental health service. Respondents emphasised the impact of growing workloads and expressed concerns about their ability to provide optimal care in these circumstances. CONCLUSIONS High burnout appears to affect one in three psychiatrists in New Zealand. Many attribute their feelings of burnout to demand for their services. These findings may assist with better workforce planning for psychiatry and emphasises potential consequences of demand for and poor resourcing of mental health services for the retention and wellbeing of doctors in psychiatry worldwide.
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Affiliation(s)
- Charlotte N. L. Chambers
- Director, Policy and Research, Association of Salaried Medical Specialists, PO Box 10763, Wellington, 6143 New Zealand
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Health Occupation and Job Satisfaction: The Impact of Psychological Capital in the Management of Clinical Psychological Stressors of Healthcare Workers in the COVID-19 Era. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106134. [PMID: 35627671 PMCID: PMC9140562 DOI: 10.3390/ijerph19106134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 01/05/2023]
Abstract
The COVID-19 pandemic greatly impacted global health. Frontline healthcare workers involved in the response to COVID-19 faced physical and psychological challenges that threatened their wellbeing and job satisfaction. The pandemic crisis, alongside pre-existing critical issues, exposed healthcare workers to constant emotional fatigue, creating an increased workload and vulnerability to stress. Maintaining such stress levels increased their levels of anxiety, irritability and loneliness. Evidence shows that the Psychological Capital (PsyCap) was a strong protective factor against these stressors. The aim of this study was to analyze the level of job satisfaction among health workers facing the COVID-19 pandemic. The possible antecedent factors to satisfaction and the role that PsyCap plays in preserving and fostering higher levels of job satisfaction were investigated. A total of 527 healthcare workers from different areas of Italy were recruited for the study. The results revealed that psychological stress factors have a considerable impact on job satisfaction. All four predictors (Stress Vulnerability, Anxiety Symptoms, Loneliness and Irritability) had the potential to decrease job satisfaction. Loneliness had a more significant effect than other factors assessed in this study. Moreover, the results showed how PsyCap could decrease the effects of psychological stressors on job satisfaction. Consistent with previous studies, our findings show that PsyCap could alleviate negative impacts in work-related circumstances.
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Edet BE, Olasubulu OA, Essien EA, Olose EO, Ekereuke WE, Okon AG. Pattern and Sociodemographic Correlates of Job Stress among Staff in a Nigerian Psychiatric Hospital. Indian J Occup Environ Med 2022; 26:21-25. [PMID: 35571536 PMCID: PMC9106122 DOI: 10.4103/ijoem.ijoem_277_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 12/02/2022] Open
Abstract
CONTEXT Globalization and technological advances are associated with rapid social and economic changes which are accompanied by increased pressures in the work environment. Job stress is a hidden pandemic, especially in developing countries where it remains largely unaddressed. AIMS The objective is to determine the pattern and sociodemographic correlates of job stress among staff in a Nigerian psychiatric hospital using the Health and Safety Executive (HSE) indicator tool. METHODS AND MATERIAL This is a cross-sectional study conducted among 292 full-time staff who were randomly selected across hospital units. Informed consent was obtained and the study questionnaires which included a sociodemographic questionnaire and the HSE indicator tool were administered. Statistical analysis was done using IBM SPSS version 22 and the level for statistical significance was set at P < 0.05. RESULTS The study sample comprised of 133 (45.5%) men and 159 (54.5%) women. The mean age was 35.03 and (SD = 7.45). A high level of stress (<20th percentile) was found in the demands, control, and relationships domains. Sociodemographic correlates of stress in domain analysis included age, marital status, staff level, parenthood, and being a clinical worker. CONCLUSIONS This study demonstrates a high level of stress in domains of the HSE indicator among respondents. More research is needed to further examine the stress levels of hospital workers.
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Affiliation(s)
- Bassey E. Edet
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Calabar, Nigeria
| | - Olaolu A. Olasubulu
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Calabar, Nigeria
| | - Emmanuel A. Essien
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Calabar, Nigeria,Address for correspondence: Dr. Emmanuel A. Essien, Federal Neuropsychiatric Hospital, 123 Calabar Road, Calabar, Cross River State, Nigeria. E-mail:
| | | | - Wisdom E. Ekereuke
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Calabar, Nigeria
| | - Anthony G. Okon
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Calabar, Nigeria
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