Keeping the doctor healthy: ongoing challenges

McDonald

2017

Anaesth Intensive Care

This study was designed to investigate levels of stress, anxiety or depression and to identify factors compounding or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists (ANZCA) training scheme. An electronic survey was sent to 999 randomly selected trainees and 428 responses were received. In addition to demographics, psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10) and questions were asked about depression and anxiety, exacerbating factors, personal healthcare and strategies used to manage stress. The majority of respondents (73%) reported being satisfied or very satisfied with their job and training. However, 28% of respondents had K10 scores indicating high or very high distress levels. Eleven percent reported being currently on treatment for anxiety and/ or depression. Twenty-two percent reported having experienced bullying and 14% sexism. Twenty-eight percent reported that they did not have a regular general practitioner (GP), and 41% reported having not visited their GP in the previous year. Fortyseven percent of trainees reported that they self-prescribe medications. Major stressors reported were exams, critical clinical events and fear of making errors. Two stressors previously not identified in similar studies were concern about job prospects in 71% of respondents and workplace-based assessments in 51%. This survey demonstrates significant psychological impairment and poor personal healthcare amongst many trainees. Education, careful continuing assessment of trainees' welfare and a review of current support and remedial measures may be required.

Section: Introductionmentioning

confidence: 99%

Welfare of Anaesthesia Trainees Survey

McDonald

2017

Anaesth Intensive Care

“…7 Training can be a particularly stressful time due to the continual stress of assessments and formal evaluations in the workplace. 8…”

Section: Cultural Aspectsmentioning

confidence: 99%

Psychiatry trainee welfare – from words to action

Kim

Suetani

Forbes

et al. 2018

Australas Psychiatry

Objective: To review selected literature available on trainee welfare and reflect on our own experiences to provide practical advice to our colleagues and suggest strategies to enhance trainee welfare. Conclusions: Promoting the welfare of psychiatry trainees requires a three-pronged approach. We must care for ourselves through individual strategies; we must advocate for optimization of the systems we work in to minimize modifiable factors associated with burnout; and we must continue on the perennial challenge of culture change to reduce stigma around stress and mental illness and promote a healthier workplace.

“…Amidst growing interest in organisational and workplace cultures in healthcare contexts, there is increased understanding of the potential downstream effects of culture on outcomes for both staff (eg, well-being, work-life balance, burnout) and patients (eg, quality of care, mortality, disability) 1–3. The focus on culture in healthcare is particularly important as clinicians have disproportionately high rates of suicidal ideation, depression and burnout compared with other professions 4–11. Such experiences are not only harmful to clinicians personally, but may have effects on patient care through, for example, decreased staff productivity,5 and increased risk of medical errors 12 13.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study investigating the associations of person-organisation and person-group fit with staff outcomes in mental healthcare

et al. 2019

ObjectivesOrganisational and workplace cultures are fundamental determinants of health systems performance; through better understanding of the dimensions of culture there is the potential to influence them, and subsequently improve safety and quality of care, as well as the experiences of both patients and staff. One promising conceptual framework for studying culture in healthcare is person-environment (P-E) fit. Comprising person-organisational (P-O) and person-group (P-G) components, P-E fit is defined as the extent to which individuals are compatible with their work environment. The aim of this study was to examine the associations of P-O and P-G fit with staff outcomes in mental healthcare.Setting and participantsParticipants (n=213) were staff and volunteers at 31 primary mental health facilities across six states of Australia.Primary and secondary outcome measuresStaff outcomes, comprising burnout (depersonalisation and emotional exhaustion), job satisfaction and work stress.DesignA multidimensional survey tool was used to measure P-O and P-G fit, and staff outcomes. Multiple regression analyses were used to test the associations between fit and outcome measures.ResultsThe regression analyses indicated that, based on a Bonferroni adjusted alpha value of α=00417, P-O fit accounted for 36.6% of the variability in satisfaction (F=8.951, p≤0.001); 27.7% in emotional exhaustion (F=6.766, p≤0.001); 32.8% in depersonalisation (F=8.646, p≤0.001); and 23.5% in work stress (F=5.439, p≤0.001). The P-G fit results were less conclusive, with P-G fit accounting for 15.8% of the variability in satisfaction (F=4.184, p≤0.001); 10.0% in emotional exhaustion (F=2.488, p=0.014); 28.6% in depersonalisation (F=8.945, p≤0.001); and 10.4% in work stress (F=2.590, p=0.032). There was no statistically significant increase in the variability accounted for when the interaction term of P-O and P-G fit was added to the regression.ConclusionsThe findings highlight that staff’s perception of their workplace and organisational culture can have implications for staff well-being.