They took off their uniform when they got home, but couldn’t remove the armour

Although she has conducted research in several areas, Christina Maslach is best known for her pioneering work on ‘burnout’. It’s a concept with great academic and popular appeal as it captures a common experience among employees, especially those working within the helping professions. Gail Kinman and Kevin Teoh interviewed Professor Maslach at the European Academy of Occupational Health Psychology conference in Athens, where she was a keynote speaker

Looking after doctors’ mental wellbeing during the covid-19 pandemic

Kevin Teoh and Gail Kinman share ways that doctors can look after themselves during the covid-19 pandemic

Hospital working conditions, doctors' work-related wellbeing, and the quality of care provided : a multilevel perspective

This thesis aims to examine the relationship between the psychosocial working conditions of hospital doctors in England and the quality of care being provided, with work-related wellbeing as a mediator. It applied the job demands-resources model to this occupational sample, and utilised a multilevel perspective to include trust-level demands and outcomes. In the first of four studies - a systematic review and meta-analysis found that across 21 studies, 62% of the reported relationships between job demands and 64% of job resources’ relationships with quality of care were significant; the presence of these relationships varied by the type of outcome measure used. A lack of theoretical grounding within these studies emphasised the need to frame these relationships within a theoretical framework. The three subsequent empirical studies drew on composite scales from the 2014 NHS Staff Survey in England. Across these multilevel studies, job demands (insufficient work resources, workplace aggression) predicted negative work-related wellbeing (presenteeism, work-related stress), while job resources (manager support, job control, effective teams) predicted work engagement. Trust-level demands (number of emergency admission, bed occupancy rate) also predicted hospital doctors’ work-related wellbeing. No interactions were observed between job demands and resources. Work-related wellbeing mediated most relationships between job demands and resources with individual self-rated quality-of-care measures. Some mediations involving patient satisfaction with doctors were found, but not for hospital mortality or patient safety incidents. The research reported in this thesis highlights the complexity of work-related predictors to hospital doctors’ work-related wellbeing and the quality of care provided. It further demonstrates that these outcomes are a product of their wider work context. Successful interventions should target the appropriate antecedent pathway, and recognise trust and system factors. The job demands-resources model can be useful in explaining individual-level relationships, but is limited when including trust-level measures. Further implications on research, practice, and policy are discussed

Doctors’ perceived working conditions and the quality of patient care: A systematic review

Numerous reports advocate improving doctors’ working conditions as an important part of initiatives to enhance the quality of patient care. However, the research literature is not clear on this underlying relationship. This systematic review examines the evidence on the relationship between the working conditions perceived by doctors and the quality of patient care. Seven electronic databases were searched, with 21 studies from six countries included in the review. The findings highlight the questions how quality of care is constructed and measured as the presence of these relationships varied by the outcome measure used. A greater number of significant relationships were observed for clinical excellence and patient safety than patient experience. The reviewed literature reflects a lack of theoretical underpinning and consideration of the mechanisms underlying pathways between doctors’ perceived working conditions and quality of care. It also does not capture the complexities within the healthcare sector, nor the wider theoretical and empirical developments in the field. Therefore, a definitive relationship between doctors’ perceived working conditions and the quality of patient care should be considered with caution. Future research should account for the observed methodological and theoretical limitations to better understand the nuances within this complex, but important relationship