Beacons of Excellence in Stress Prevention

NoThis report describes the work of Robertson Cooper Ltd and UMIST to identify good practice in stress prevention and then identify organisations within the UK that could be called beacons of excellence in comparison to this model. Part one of this report summarises and draws conclusions from all of the substantive academic studies on stress prevention over the last decade and uses this information, as well as advice gained from a panel of international experts, to develop a comprehensive stress prevention model. Part two of the report uses this model to describe examples of stress prevention practices that Robertson Cooper Ltd has identified within a wide range of UK organisations. Case studies are presented for each aspect of the good practice model. Examples of real documentation and organisational practice are presented.Health and Safety Executive (HSE

Demographic, Work Environment and Resilience Characteristics among Registered Nurses

In a caring profession like nursing, the risk of sending newly-graduated nurses with low resilience into the workplace provided impetus for the study to explore the association between demographic, work environment and resilience characteristics among registered nurses employed in acute care setting. Select subscales from the PES-NWI were used to assess Nurse Manager Ability, Leadership and Support of Nurses; Staffing and Resource Adequacy; and Collegial Nurse-Physician Relations (Lake, 2002) and the Resilience Scale was used to measure resilience (Wagnild & Young, 1993). Intent to stay was measured by McCain’s Behavioral Commitment Scale (McCloskey, 1990). One-hundred and thirteen (113) registered nurses completed and returned the survey, giving a response rate of 50.2%. Using SPSS 24 (IBM Corp., 2013) software, descriptive and inferential statistics were used to analyze the data. The p-value for all comparisons was set at p≤0.05. Five (5) out of the twenty-one (21) correlations were statistically significant and were greater than or equal to .33. Resilience scores and Behavioral Commitment scores, or intent-to-stay, had a correlation of only .069. Adequate Staffing was also correlated to positive Nurse-physician relationships and to strong Nurse Management. These factors are clearly related to creating a stable workforce among nurses. The results showed that no factor had strong correlation with the highest level of nursing education received, suggesting that, at this hospital, registered nurses prepared by a four-year degree had no higher or lower resilience and were no more or less likely to stay at their place of work than those who were prepared at the associate degree level. Findings from this study have the potential to mitigate practice work environment stressors and decrease turnover among registered nurses employed in acute care settings

Tracking daily fatigue fluctuations in multiple sclerosis : ecological momentary assessment provides unique insights

The preparation of this manuscript was supported by a UK Economic and Social Research Council (ESRC) PhD studentship (ES/1026266/1) awarded to DP. The study was funded by the Psychology Unit at the University of Southampton. The authors declare that they have no conflict of interest. The authors thank all participants of this study. Open access via Springer Compact Agreement.Peer reviewedPublisher PD

A grounded theory study on work related stress in professionals who provide health & social care for people who exhibit behaviours that challenge

Providing direct health and social care services for people who exhibit behaviours that challenge can be a highly stressful occupation. Existing literature has suggested that there is a need to develop further theoretical understanding of how work related stress can be reduced in professions that consist of providing care for people who exhibit behaviours that challenge. The aim for this study was to use a Classic Grounded Theory approach to develop a theoretical framework to illustrate a common issue that could influence work related stress levels experienced when managing behaviours that challenge in health and social care settings. A series of focus groups and 1:1 semi-structured interviews were conducted to explore the articulated experiences of 47 health/social care professionals who provide care for people who exhibit behaviours that challenge. This led to the development of Therapeutic Engagement Stress Theory (TEST), which illustrates that the perceived capacity to therapeutically engage with people who exhibit behaviours that challenge is an issue that can influence the levels of stress experienced by health/social care professionals. TEST provides a framework that could be applied to identify specific factors that inhibit staff to successfully deliver caring interventions for people who exhibit behaviours that challenge, and also inform bespoke support mechanisms to reduce stress in health/social care professionals

Cumulative Risk and a Call for Action in Environmental Justice Communities

Health disparities, social inequalities, and environmental injustice cumulatively affect individual and community vulnerability and overall health; yet health researchers, social scientists and environmental scientists generally study them separately. Cumulative risk assessment in poor, racially segregated, economically isolated and medically underserved communities needs to account for their multiple layers of vulnerability, including greater susceptibility, greater exposure, less preparedness to cope, and less ability to recover in the face of exposure. Recommendations for evidence-based action in environmental justice communities include: reducing pollution in communities of highest burden; building on community resources; redressing inequality when doing community-based research; and creating a screening framework to identify communities of greatest risk

The integrated motivational–volitional model of suicidal behaviour

Suicide is a major public health concern accounting for 800 000 deaths globally each year. Although there have been many advances in understanding suicide risk in recent decades, our ability to predict suicide is no better now than it was 50 years ago. There are many potential explanations for this lack of progress, but the absence, until recently, of comprehensive theoretical models that predict the emergence of suicidal ideation distinct from the transition between suicidal ideation and suicide attempts/suicide is key to this lack of progress. The current article presents the integrated motivational–volitional (IMV) model of suicidal behaviour, one such theoretical model. We propose that defeat and entrapment drive the emergence of suicidal ideation and that a group of factors, entitled volitional moderators (VMs), govern the transition from suicidal ideation to suicidal behaviour. According to the IMV model, VMs include access to the means of suicide, exposure to suicidal behaviour, capability for suicide (fearlessness about death and increased physical pain tolerance), planning, impulsivity, mental imagery and past suicidal behaviour. In this article, we describe the theoretical origins of the IMV model, the key premises underpinning the model, empirical tests of the model and future research directions

The effect of environment on post surgical overall well-being and pain sensitivity in an animal model

With chronic post surgical pain affecting up to one third of patients undergoing surgeries and the price of treatment being astoundingly high there has been a transition in research to investigate and identify risk factors. Through identification of risk factors new preventative measures can be taken to ensure better surgical outcomes. The role that psychosocial factors can play in the development of chronic post surgical pain has long been recognized yet its mechanisms are still unknown. We aim to investigate how environment can play a direct role in pain perception and sensitivity. We used a Chronic Mild Stress (CMS) paradigm to induce depression in 10 adult male mice, we used 10 control mice who were left in standard opti cages, and 10 enriched mice who were placed in large enrichment cages. CMS mice were exposed to a series of stressors and all mice underwent spared nerve injury surgery. During spared nerve injury the common peroneal and tibial branches of the sciatic nerve were severed while the sural branch was left intact. Overall well-being and pain threshold of mice were tested via Von Frey, Hot Plate, Heat Place Preference, Dynamic Weight Bearing, Hole Board, and Social Interaction. It was found that CMS mice experienced thermal hyperalgesia yet normal thermal threshold sensation. CMS mice also spent less time interacting with novel mice in social interaction, and less amount of time exploring the center of the hole board arena than control or enriched mice. While Von Frey results did not change over the course of the experiment, dynamic weight bearing results indicated spared nerve injury surgery was successful and produced chronic pain. Results indicate that environment plays a role in thermal pain perception and CMS affected overall well being of mice as CMS mice exhibited more timid and anxious behavior

Practical approach on frail older patients attended for acute heart failure

Acute heart failure (AHF) is a multi-organ dysfunction syndrome. In addition to known cardiac dysfunction, non-cardiac comorbidity, frailty and disability are independent risk factors of mortality, morbidity, cognitive and functional decline, and risk of institutionalization. Frailty, a treatable and potential reversible syndrome very common in older patients with AHF, increases the risk of disability and other adverse health outcomes. This position paper highlights the need to identify frailty in order to improve prognosis, the risk-benefits of invasive diagnostic and therapeutic procedures, and the definition of older-person-centered and integrated care plans

Differences in Crowding and Stress Experienced by Emergency Medicine Physicians Prior to and During the COVID-19 Pandemic

Burnout in Emergency Medicine physicians has become an increasingly apparent problem in the United States. This psychological syndrome is a result of emotional exhaustion, detachment, and an overwhelming sense of ineffectiveness (Maslach & Leiter, 2016). Work demands within the emergency department are likely to produce chronic exposure to stressors. However, the onset of the COVID-19 pandemic likely contributed to amplifying workplace stressors, suggesting that the rate at which burnout developed was elevated. In the present study, data were collected from Emergency Medicine physicians at Greenville Memorial Hospital in Greenville, South Carolina prior to the start of and during the COVID-19 pandemic. Physicians provided saliva samplesfor salivary cortisol analysis and completed a short assessment of fatigue and shift demands. These data were collected at the beginning and end of each shift, for a total of 116 shifts. Analyses will be done to test whether the average number of stressors reported by physicians, National Emergency Department Overcrowding Scores (NEDOC) scores, and salivary cortisol levels increased in data collected after the start of the pandemic, in comparison to before, for the end-of-shift measures. In order to provide support for these claims, this thesis will begin with an overview of research that has previously been examined on the topic. Firstly, the significance of burnout in healthcare professionals will be described and discussed. The focus will then shift to emergency medicine, highlighting the primary stressors that are faced by healthcare personnel within the emergency department. The consequences of stressors, such as well-being or burnout, on emergency medicine physicians, including the use of salivary cortisol as an objective measure of stress, will be examined. Next, how the COVID-19 pandemic has exacerbated burnout within these settings will be discussed. The introduction will conclude with a presentation of the overview of the study and reveal the hypotheses that are intended to test