Recommendations to support the mental wellbeing of nurses and midwives in the United Kingdom: A Delphi study.

AIM: To use the Delphi technique to identify and prioritize recommendations for research and practice to improve the mental wellbeing of nurses and midwives in the United Kingdom (UK). BACKGROUND: Although there is evidence that self-reported mental wellbeing among nurses and midwives in the UK is poor, interventions have not adequately considered the wider context in which they work. The wide range of individual, organizational, occupational and wider sector-level factors that can influence wellbeing requires the involvement of different stakeholders to identify the most pressing actions required. DESIGN: A three-round Delphi technique was conducted in 2019. METHODS: In the first round, 16 subject matter experts generated, reviewed and discussed recommendations from a review of the research evidence with potential to support the mental wellbeing of nurses. A second group with 23 stakeholder representatives then rated and provided feedback on the developed recommendations through two additional rounds. Recommendations that received an 'essential' or 'important' rating from at least 80% of participants were retained and prioritized. RESULTS: In total, 45 recommendations met the consensus agreement and were retained. More than half (57%) involved action at the organizational level, 27% to public policy and 13% to research. Only one recommendation is related to the individual. Collectively, these recommendations highlight the importance of taking direct action to tackle poor mental wellbeing among the workforce and initiating change at the policy and organizational level. CONCLUSION: Our findings emphasize the need to take a systemic approach to improving the mental health of nurses and midwives in the UK with input from different stakeholders. There is a clear consensus that action is needed at the organization and policy levels, rather than at the individual level as is current practice. IMPACT: This study provides a framework, alongside a set of practical recommendations, that provides a starting point for different stakeholders to understand, address and support the mental wellbeing of nurses and midwives. Although UK-focused, it has relevance to healthcare workforces internationally.

Sickness Presenteeism in Prison Officers: Risk Factors and Implications for Wellbeing and Productivity.

Sickness presenteeism involves employees continuing to work while unwell. As presenteeism is influenced by contextual and individual difference factors, it is important to assess its prevalence and implications for wellbeing and productivity in different occupational groups. This study examines these issues in a sample of prison officers working in UK institutions. Data were obtained from a survey of 1956 prison officers. Measures assessed the prevalence of and reasons for presenteeism and the perceived impact on job performance, along with mental health and perceptions of workplace safety climate. More than nine respondents out of ten (92%) reported working while unwell at least sometimes, with 43% reporting that they always did so. Presenteeism frequency was significantly related to mental health symptoms, impaired job performance and a poorer workplace safety climate. The reasons provided for presenteeism explained 31% of the variance in self-reported mental health, 34% in job performance and 17% in workplace safety climate, but the pattern of predictors varied according to the outcome. The findings can be used to inform interventions at the organisational and individual levels to encourage a 'healthier' approach to sickness absence, with likely benefits for staff wellbeing, job performance and workplace safety climate.

Sickness presenteeism at work: prevalence, costs and management.

INTRODUCTION: Presenteeism is defined as continuing to attend work during illness. As a growing health concern, awareness of the factors that encourage presenteeism and the risks of this behaviour is needed. SOURCES OF DATA: A narrative review of research obtained via several databases, including Medline and Psycinfo, was conducted. AREAS OF AGREEMENT: A range of contextual and individual factors is associated with presenteeism. Workers in some sectors, such as healthcare, appear to be at greater risk. Presenteeism may facilitate rehabilitation and recovery but it can exacerbate existing health problems and increase the risk of subsequent illness and absence as well as impair workability. AREAS OF CONTROVERSY: The incidence of sickness presenteeism is rising, alongside reductions in absenteeism. The growing awareness of the costs of presenteeism, especially in safety-critical environments, suggests that it should be considered a risk-taking behaviour and carefully measured and managed. GROWING POINTS AND AREAS FOR DEVELOPING RESEARCH: Measuring presenteeism as well as absenteeism will provide more accurate information about employee health. Raising awareness of the risks of working while sick and the economic, moral, cultural and social pressures on employees to do so appears crucial. Systemic interventions to manage presenteeism based on research evidence are required.

Emotional Labour and Wellbeing: What Protects Nurses?

Although compassionate care has wide-ranging benefits for patients, it can be emotionally demanding for healthcare staff. This may be a particular problem for those with little experience in a caring role. This study utilises the job demands-resources model to examine links between "emotional labour" and emotional exhaustion in student nurses. In line with the triple-match principle-whereby interactive effects are more likely when job demands, resources, and outcomes are within the same qualitative domain-the protective role of emotional support and emotion-focused coping (i.e., emotional venting) in the relationship between emotional labour and exhaustion is also explored. An online questionnaire was completed by 351 student nurses with experience working in healthcare settings. A strong positive relationship was found between emotional labour and emotional exhaustion, and some support was found for the moderating effects of emotional support and emotion-focused coping. Ways to help student and qualified nurses develop the emotional resilience required to protect their wellbeing, while providing high-quality compassionate care to patients are considered.

Exploring commitment, professional identity, and support for student nurses.

Problems with the recruitment and retention of nurses globally mean that insight into the factors that might increase retention in qualified staff and students is crucial. Despite clear links between work commitment and retention, there is little research exploring commitment in student nurses and midwives. This paper reports the findings of a qualitative study designed to provide insight into commitment using semi-structured interviews conducted with nine pre-registration students and a qualitative survey completed by 171 pre-registration students. Thematic analysis of the data emphasised the impact of placement experiences on commitment via interpersonal relationships. Students typically emphasised their professional identity as the basis for commitment, although many participants also highlighted a lack of acceptance by qualified practitioners, which reduced it. There was evidence that suggested that practitioner workload may impact the student experience due to challenges in making sufficient time to provide support. Implications for retention strategies are discussed.

Academics' experiences of a respite from work: effects of self-critical perfectionism and perseverative cognition on postrespite well-being.

This longitudinal study examined relations between personality and cognitive vulnerabilities and the outcomes of a respite from work. A sample of 77 academic employees responded to week-level measures of affective well-being before, during, and on 2 occasions after an Easter respite. When academics were classified as being either high or low in a self-critical form of perfectionism (doubts about actions), a divergent pattern of respite to postrespite effects was revealed. Specifically, during the respite, the 2 groups of academics experienced similar levels of well-being. However, during postrespite working weeks, the more perfectionistic academics reported significantly higher levels of fatigue, emotional exhaustion, and anxiety. The greater deterioration in well-being experienced by perfectionist academics when first returning to work was mediated by their tendency for perseverative cognition (i.e., worry and rumination) about work during the respite itself. These findings support the view that the self-critical perfectionist vulnerability is activated by direct exposure to achievement-related stressors and manifested through perseverative modes of thinking.

Information satisfaction in breast and prostate cancer patients: implications for quality of life.

OBJECTIVES: This study aimed to assess information needs and levels of information satisfaction in breast and prostate cancer patients. It further examined relationships between information satisfaction and multi-dimensional quality of life (QoL). METHODS: An adapted Information Satisfaction Questionnaire (ISQ, 2004) and the Functional Assessment of Cancer Therapy QoL questionnaire (FACT-G, 1993) were randomly distributed to cancer patients during oncology clinic visits (breast cancer, n=102; prostate cancer, n=112). Hierarchal regression analyses examined information satisfaction as a predictor of global QoL and its four dimensions (i.e. physical, social, emotional, and functional well-being). RESULTS: High levels of information needs and desire for decision involvement were identified, with patients expressing a considerable degree of information satisfaction. After controlling for demographic and illness factors, information satisfaction explained 21% of the variance in global QoL, 12% in physical well-being, 13% in social well-being, 8% in emotional well-being, and 10% in functional well-being (all p<0.001). CONCLUSIONS: This study highlights the importance of information satisfaction for perceived QoL in individuals with cancer. It is clearly important to identify specific information requirements during the diagnosis and treatment process in order to provide information that is congruent with patients' needs.