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Background: The National Health Service (NHS) is suffering from a workforce crisis of mental and physical sickness and attrition following the COVID-19 pandemic. An in-depth understanding of healthcare workers' (HCWs) experiences during the pandemic is required to understand the impacts on their mental health in this challenging work environment. This qualitative study explores HCWs' concerns during the COVID-19 pandemic-expressed in real time during an active mental health crisis., Design: This study involved analysis of data from 'Shout', a text message-based, UK-wide mental health support service which, during the pandemic, was advertised to HCWs specifically. Pseudorandom sampling of scripts of anonymised text message conversations between HCWs and Shout Volunteers from April 2020 to March 2021 was undertaken, with data fully anonymised by Shout before researchers accessed them on a secure purpose-built platform. Following application of exclusion and inclusion criteria, 60 conversations were coded to develop a thematic framework and analysed using grounded theory, with subthemes triangulated to create final themes. Quotes extracted from this process were then synthesised for publication., Results: Three themes emerged from the data: (1) poor mental health, subthemes-(a) overwhelming negative feelings or emotional distress experienced, and; (b) active crisis/resurgent symptoms. (2) Negative work experiences, subthemes: (a) negative NHS work culture and expectations; (b) inadequate structures and arrangements for support; (c) trauma at work, and (d) abuse at work. (3) The impact of the COVID-19 pandemic, subthemes: (a) additional work pressure and (b) isolation and risk., Conclusion: This study explores the challenges and mental health concerns in HCWs during an active crisis. Organisational stressors, mental health provision and additional resources for HCWs to recover from the pandemic remain a vital issue in current NHS service provision., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Study Question: What is the prevalence of occupational stress, somatization, and burnout reported by UK and US, embryologists and the impact of work conditions on these well-being outcomes?, Summary Answer: Surveyed UK and US embryologists reported moderate perceived stress, low somatic symptom severity, high levels of burnout, and overall stressful work conditions, but with differences that could be due to country-specific occupational and employment characteristics., What Is Known Already?: Spanish, UK, US, and international surveys have identified high levels of occupational stress, somatization, burnout, and occupational health issues among embryologists. These issues have been attributed to embryologists' occupational challenges and work conditions., Study Design, Size, Duration: A cross-sectional web-based survey was sent to 253 embryologists working in UK ART/IVF clinics and 487 embryologists working in US ART/IVF clinics., Participants/materials, Setting, Methods: Participants self-reported their stress levels, somatization, burnout, and work conditions. Proportions across the Perceived Stress Scale (PSS), Patient Health Questionnaire (PHQ-15), Maslach Burnout Inventory-General Survey (MBI-GS), a single-item work unit grade (A-F), and customized occupational and sociodemographic questionnaires were calculated using descriptive statistics. Welch's t-test was utilized to compare PSS and PHQ-15 scores between groups. Risk ratios were calculated using log-binomial regression for all models except for levels of anxiety related to performing cryostorage tasks, for which Poisson models were used., Main Results and the Role of Chance: In total, 50.6% (128) of the embryologists in the UK and 50.1% (244) in the US completed the survey. Both groups self-reported moderate PSS and low PHQ-15 scores, although fewer UK embryologists scored high on the MBI cynicism dimension than their US colleagues (43% UK vs 60% US embryologists, P < 0.05). The UK and US embryologists did not differ on the MBI exhaustion dimension with both scoring high for exhaustion (59% UK vs 62% US). Although 81% and 80% of UK and US embryologists, respectively, reported working overtime, more embryologists in the UK reported being adequately compensated. Increasing levels of anxiety-related to cryostorage showed a dose-dependent increased risk of burnout on at least two MBI-GS dimensions only in the UK group, and, a dose-dependent likelihood of higher PSS and PHQ-15 scores in both groups., Limitations, Reasons for Caution: Since the two groups were surveyed 9 months apart and were self-reporting, the study is limited by the differences in responsibilities, scheduling, and workload specific to the time of year., Wider Implications of the Findings: Work-related health issues and occupational challenges shared by UK and US embryologists could be addressed by organizational enhancements and technology. Lower levels of stress and burnout among UK embryologists might be due to the HFEA-provided structure/certainty., Study Funding/competing Interest(s): This study was supported without any external funding by TMRW Life Sciences Inc., which is developing and commercializing an automated platform for embryology. M.G.C. and M.S.L. are full-time employees and stockholders/shareholders with TMRW Life Sciences, and A.M. of Novavax, Inc. was an employee of TMRW Life Sciences. G.P. is a consultant for TMRW Life Sciences. The remaining authors declare no conflict of interest., Trial Registration Number: NCT05326802; NCT05708963., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Problem: UK midwives report high work-related stress, which can negatively impact their health and wellbeing, with many considering leaving the profession., Background: An occupational stress audit guides the implementation of stress management intervention, by identifying which stressors have the most negative impact and why, and highlighting "at risk" groups., Aim: To conduct a concurrent mixed-methods stress audit with UK midwives in an NHS Trust., Methods: Seventy-one midwives (M age = 39 years, SD = 11) completed a survey assessing stressors (e.g., relationships), stress appraisals (i.e., challenge vs. threat), coping strategies (e.g., avoidance-focused), and outcomes (i.e., mental health, performance, and intention to leave). Ten midwives (M age = 42 years, SD = 10) participated in semi-structured interviews., Findings: Quantitative data revealed that more work-related demands, poorer peer support and relationships, and threat appraisals predicted worse mental health. Moreover, less control and more work-related demands predicted poorer performance, while less control, poorer manager support, more change-related demands, and threat appraisals predicted greater intention to leave. Qualitative data generated three themes: organisational pressures exacerbated by unexpected changes; individualised responses but largely debilitative emotions; and personal coping and power of social support., Discussion and Conclusion: This study offered a comprehensive and novel insight into the stress experiences of UK midwives, highlighting targets for future stress management interventions, including key stressors (e.g., manager support), underlying mechanisms (e.g., stress appraisals), and "at-risk" groups (e.g., night shift workers). Practical recommendations are provided for stakeholders operating at multiple levels (e.g., midwife, trust, policy) to better support midwives with work-related stress., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Veterinary professionals experience higher psychological distress and lower wellbeing compared with the general population. Identifying workplace stressors is key to understanding and alleviating these difficulties., Objective: Identify the severity of workplace stressors in veterinary professions across different levels of professional experience., Method: A cross-sectional quantitative design was utilised via administration of a veterinary stressor questionnaire that measured the severity of 93 generic and veterinary-specific workplace stressors., Results: A total of 658 participants reported stressor severity score. Factor analysis revealed four main stressor categories: workload and job demands, client relations stress, performance and accountability, patient care challenges. An inverse relationship was found between experience level and stressor severity scores. Furthermore, the most severe stressors varied as a function of career stage., Findings and Implications: Stressor severity tends to decrease with increasing experience levels. Stressors can be categorised by theme and unique stressor profiles can be derived for practitioners according to experience level. This knowledge can assist in the design and delivery of workplace support initiatives., Conclusions: Identify key stressors across different levels of experience is important in focusing efforts to support people in the workplace., (© 2024 The Author(s). Veterinary Medicine and Science published by John Wiley & Sons Ltd.)

Aims: Police employees may experience high levels of stress due to the challenging nature of their work which can then lead to sickness absence. To date, there has been limited research on sickness absence in the police. This exploratory analysis investigated sickness absence in UK police employees., Methods: Secondary data analyses were conducted using data from the Airwave Health Monitoring Study (2006-2015). Past year sickness absence was self-reported and categorised as none, low (1-5 days), moderate (6-19 days) and long-term sickness absence (LTSA, 20 or more days). Descriptive statistics and multinomial logistic regressions were used to examine sickness absence and exploratory associations with sociodemographic factors, occupational stressors, health risk behaviours, and mental health outcomes, controlling for rank, gender and age., Results: From a sample of 40,343 police staff and police officers, forty-six per cent had no sickness absence within the previous year, 33% had a low amount, 13% a moderate amount and 8% were on LTSA. The groups that were more likely to take sick leave were women, non-uniformed police staff, divorced or separated, smokers and those with three or more general practitioner consultations in the past year, poorer mental health, low job satisfaction and high job strain., Conclusions: The study highlights the groups of police employees who may be more likely to take sick leave and is unique in its use of a large cohort of police employees. The findings emphasise the importance of considering possible modifiable factors that may contribute to sickness absence in UK police forces.

Objectives: Evaluate the implementation of Hubs providing access to psychological support for health and social care keyworkers affected by the COVID-19 pandemic., Design: Qualitative interviews informed by normalisation process theory to understand how the Hub model became embedded into normal practice, and factors that disrupted normalisation of this approach., Setting: Three Resilience Hubs in the North of England., Participants: Hub staff, keyworkers who accessed Hub support (Hub clients), keyworkers who had not accessed a Hub, and wider stakeholders involved in the provision of staff support within the health and care system (N=63)., Results: Hubs were generally seen as an effective way of supporting keyworkers, and Hub clients typically described very positive experiences. Flexibility and adaptability to local needs were strongly valued. Keyworkers accessed support when they understood the offer, valuing a confidential service that was separate from their organisation. Confusion about how Hubs differed from other support prevented some from enrolling. Beliefs about job roles, unsupportive managers, negative workplace cultures and systemic issues prevented keyworkers from valuing mental health support. Lack of support from managers discouraged keyworker engagement with Hubs. Black, Asian and minority ethnic keyworkers impacted by racism felt that the Hubs did not always meet their needs., Conclusions: Hubs were seen as a valuable, responsive and distinct part of the health and care system. Findings highlight the importance of improving promotion and accessibility of Hubs, and continuation of confidential Hub support. Policy implications for the wider health and care sector include the central importance of genuine promotion of and value placed on mental health support by health and social care management, and the creation of psychologically safe work environments. Diversity and cultural competency training is needed to better reach under-represented communities. Findings are consistent with the international literature, therefore, likely to have applicability outside of the current context., Competing Interests: Competing interests: PF has previously been a member of NIHR HTA Prioritisation Committee and is a current member of NIHR HTS Clinical Evaluation and Trials funding Committee. DH has previously been a member of NIHR Research for Patient Benefit, Yorks & NE Regional Advisory Committee, and is a current member of NIHR Health Technology Assessment Clinical Evaluation and Trials Funding Committee (2019-2024). FV has received an NIHR Advanced Fellowship in a clinical research area unrelated to the Resilience Hubs. FV, PF, DH, and GB are Investigators/Co-Investigators in several other NIHR projects funded by various funding streams (RfPB, HTA, EME, HS&DR). AB is an honorary member of the National Mental Health & Wellbeing expert reference group at NHS England and NHS Improvement. AB, JW, KM and FV are members of the Greater Manchester Psychosocial Board, and JW, RW and KM are members of the Greater Manchester Expert Reference Group. GB is Interim co-chair of the National Institute of Health & Care Excellence (NICE) Quality Standards Advisory Committee. PF is clinical advisor to National Clinical Audit of Psychosis at Royal College of Psychiatry and Board member of International Early Psychosis Association. GB, AB, HTC, KM, FH, MS, RW and JW have all held senior clinical and/or operational roles at the Hub sites involved in this study. PF has previously led research to evaluate the original Resilience Hub service set up to support those affected by the 2017 Manchester Arena bombing, in which DH and KA were also involved. KA has also held a research and evaluation role at a second Hub involved in this project., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49-2.95), nurse (OR 1.38; 95% CI 1.04-1.84), and 'other clinical' (OR 2.02; 95% CI 1.45-2.82); being redeployed (OR 1.27; 95% CI 1.02-1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98-2.99), anxiety (OR 4.87; 95% CI 3.92-6.06) and depression (OR 4.06; 95% CI 3.04-5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51-0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22-0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers., Competing Interests: JK has received an educational grant from Johnson and Johnson. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

COVID-19 research from China suggests health care workers are at risk of distress, have specific concerns, and need support. It remains unknown whether findings are applicable to UK health care staff and whether psychological support based on generic approaches is effective. We administered an online survey at a leading neuroscience hospital in the UK to examine how individual staff characteristics contribute to distress, concerns, and interventions most valued during the COVID-19 pandemic. We found a high incidence of distress, particularly in females and staff with previous mental health history. Concerns fell into three factors: 'risk of infection', 'work challenges', and 'social change', and were affected by professional role and contact with COVID-19 patients. These three factors predicted distress. Psychological support and clear updates were deemed most useful, with specific needs affected by age, professional role, and contact with COVID-19 patients. This is the first documentation of a high incidence of psychological distress predicted by three types of concerns in health care workers of a neuroscience hospital. Distress, concerns, and interventions most valued were all affected by individual staff characteristics. These findings highlight the importance of providing stratified, one to one support interventions, tailored to professional group, and background, rather than more generic approaches. PRACTITIONER POINTS: The COVID-19 pandemic has resulted in a high incidence of psychological distress in UK health care staff. Distress, concerns, and interventions most valued are influenced by individual staff characteristics. Stratified, one-to-one support interventions, tailored to professional group, and background, rather than more generic approaches for stress reduction and resilience, are crucial., (© 2020 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Sam Foster , Chief Nurse, Oxford University Hospitals, reflects on ways in which nurse leaders can help their staff recover from the stresses of working during the COVID-19 pandemic.

Purpose: Occupational stress in police call handlers is researched less frequently than in operational or frontline police, despite the role's unique challenges. Occupational stress is potentially manageable, thus improved understanding of its contributors and consequences is important for effective intervention. We aimed to compare levels and sources of organisational stress in police contact and dispatch personnel with UK benchmarks. Second, to test whether different typologies of stress were associated with physical health, mental health and substance use. Finally, to examine whether non-organisational factors (socio-demographic factors and family interference with work (FIW)) predicted organisational stress typologies., Methods: A sample (n = 720) of police and civilian staff in a UK police call and dispatch centre were surveyed., Results: The strongest sources of stress were competing and high demands, low control, insufficient managerial support and ambiguity surrounding workplace change-all of which indicated need for 'urgent action' according to UK benchmarks. Substance use and particularly mental health difficulties were higher than published norms. A latent profile analysis grouped respondents into a low-stress group and two high-stress profiles. As stress increased across profiles, this corresponded with worse physical and mental health and higher substance use. FIW predicted membership of both high-stress profiles., Conclusion: Despite non-operational roles, police contact and despatch personnel can experience high occupational stress which is associated with physical and mental health difficulties and substance use. Organisational-level interventions which address lack of control, conflicting role demands as well as enhance management support and communication around change might be most effective in this group.

Objectives: To gain insight into the experiences and concerns of front-line National Health Service (NHS) workers while caring for patients with COVID-19., Design: Qualitative analysis of data collected through an anonymous website (www.covidconfidential) provided a repository of uncensored COVID-19 experiences of front-line NHS workers, accessed via a link advertised on the Twitter feed of two high profile medical tweeters and their retweets., Setting: Community of NHS workers who accessed this social media., Participants: 54 healthcare workers, including doctors, nurses and physiotherapists, accessed the website and left a 'story'., Results: Stories ranged from 1 word to 10 min in length. Thematic analysis identified common themes, with a central aspect being the experience and psychological consequence of trauma. Specific themes were: (1) the shock of the virus, (2) staff sacrifice and dedication, (3) collateral damage ranging from personal health concerns to the long-term impact on, and care of, discharged patients and (4) a hierarchy of power and inequality within the healthcare system., Conclusions: COVID-19 confidential gave an outlet for unprompted and uncensored stories of healthcare workers in the context of COVID-19. In addition to personal experiences of trauma, there were perceptions that many operational difficulties stemmed from inequalities of power between management and front-line workers. Learning from these experiences will reduce staff distress and improve patient care in the face of further waves of the pandemic., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: The coronavirus 2019 (COVID-19) pandemic has overwhelmed health care systems and disrupted routine care internationally. Health care workers face disruption to their work routines and professional development, as well as an elevated risk of infection and morbidity. We sought to establish the impact of the COVID-19 pandemic on the well-being, practice, and progression of all trainees in cardiothoracic surgery in the United Kingdom., Methods: A 31-item questionnaire was designed, validated, and disseminated via e-mail and an instant-messaging platform., Results: In total, 76 (of 118, 64%) cardiothoracic surgical trainees responded, representing all training grades and programs nationally; 48 (63%) and 24 (32%) were concerned about their physical and mental health, respectively, 25 (33%) had taken time off work due to COVID-19, 65 (86%) had treated patients with COVID-19, 36 of whom (55%) were wearing satisfactory personal protective equipment at the time, 41 (54%) remain concerned about personal protective equipment provision at their institution, 42 (55%) had been redeployed to cover other specialties, and 23 (30%) had encountered ethical dilemmas related to care of patients. There was a significant impact on time spent in outpatient clinics (44% reduction), multidisciplinary team meetings (79% reduction), and operating theaters (78% reduction). In total, 67 (88%) of respondents were concerned about the impact on their training, and 54 (71%) felt that the deviation may require an extension in their planned training time., Conclusions: The duration and impact of the current pandemic is, as yet, uncertain. Timely sharing of experiences, concerns, and expectations will inform health care and education policy and influence practice in the pandemic era and beyond., (Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Surgeon Henry Marsh begins his autobiography, Do No Harm , with a quotation from the French practitioner René Leriche, "Every surgeon carries within himself a small cemetery, where from time to time he goes to pray-a place of bitterness and regret, where he must look for an explanation for his failures". This article uses memoirs and oral history interviews to enter the operating theatre and consider the contemporary history of surgeons' embodied experiences of patient death. It will argue that these experiences take an under-appreciated emotional toll on surgeons, but also that they are deployed as a narrative device through which surgeons construct their professional identity. Crucially, however, there is as much forgetting as remembering in their accounts, and the 'labour' of death has been increasingly shifted out of the operating theatre, off the surgeons' hands and into the laps of others. The emotional costs of surgical care remain understudied. Indeed, while many researchers agree that undergoing surgery can be a troubling emotional experience for the patient, less scholarly attention has been paid to the emotional demands performing surgery makes on surgical practitioners. Is detachment the modus operandi of the modern surgeon and if so, is it tenable in moments of emotional intensity-like patient death?, Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

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., Competing Interests: The authors have declared that no competing interests exist.

Emeritus Professor Alan Glasper , from the University of Southampton, discusses the ongoing NHS Employers initiative which is designed to support the NHS employees' emotional health.

Background: There is evidence that firefighters are at risk of work-related stress and mental health problems, but little is known about the organizational hazards they experience. Insight is needed into the work-related factors that are most likely to threaten or protect their work-related well-being., Aims: To identify levels of job demands and resources (including demands relating to workload, work patterns and the working environment, relationship conflicts, control, support, role clarity and change management) among firefighters, and to use a job demands-resources framework to examine their impacts on work-related well-being. The role played by recovery strategies in predicting work-related well-being was also considered., Methods: Job demands and resources were assessed by the Health & Safety Executive (HSE) Management Standards Indicator Tool. Validated scales measured recovery strategies (detachment, affective rumination and problem-solving pondering) and work-related well-being (anxiety-contentment and depression-enthusiasm). The impact of job demands, resources and recovery strategies was tested by multiple linear regression., Results: The sample comprised 909 firefighters across seven Fire and Rescue Services in the UK (85% male). Levels of job demands and resources did not meet HSE benchmarks. The main risk factors for poor work-related well-being were relationship conflicts and affective rumination, but resources such as role clarity and job control and the use of problem-solving pondering and detachment were beneficial., Conclusions: Interventions that aim to reduce relationship conflicts at work and promote problem-solving rather than affective rumination, and detachment from work when off-duty, are likely to improve work-related well-being. Attention to enhancing job resources may also be beneficial., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: There may be ongoing psychological problems associated with military service later in life; yet as the elderly in the general population also suffer from mental health problems, whether such issues can be attributed to military service or are a feature of ageing remains unclear. This study aimed to explore veteran and nonveteran perceptions of the impact of their occupation on their psychological well-being later in life., Methods: Twenty-five veterans (≥65 y); 25 nonveterans (≥65 y); 10 veterans with diagnoses of mental health issues (≥65 y); and a close companion of all participants (≥18 y, spouse, child, and close friend) were recruited. Using a qualitative approach, participants completed semistructured qualitative interviews with measures of psychological adjustment used to describe the sample., Results: Veterans were found to experience higher levels of workplace stress and trauma exposure compared with nonveterans. When such challenges were positively appraised, veterans described increased confidence and resilience. Social support in response to occupational stress was central to veteran and nonveteran well-being, especially for those with mental health problems. Nonetheless, providing support was challenging for close companions, with many feeling overwhelmed and requiring additional guidance from the veteran's clinical care team., Conclusions: The findings delineate the impact of occupation on the well-being of older veterans and nonveterans. The results illustrated the psychological support needs and formal guidance desired by veterans, nonveterans, and their families, which could ultimately improve coping of both the individual and family., (© 2019 John Wiley & Sons, Ltd.)

Doctors in training are particularly vulnerable to stress and burnout, with the transition into the early parts of training being a period of acute anxiety. Supervisors and mentors have a key role to play in helping trainees make the transition from medical student to practising doctor. This often involves professional conversations, ranging from the relatively routine to difficult issues. The Swansea 6D model has been designed as a guidance tool which provides a simple, memorable framework around which conversations can be structured in terms of identifying meaningful expectations, providing explanations and reframing situations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Although there is currently little research data to support the contention, concerns have been raised about possible traumatic stressors inherent to Remotely Piloted Aircraft System (RPAS) operator roles. Factors such as exposure to visually traumatic events compounded by long working hours and blurred boundaries between military and civilian life have been cited as potential stressors. Robust research into the well-being of RPAS operators is scarce and mostly samples US personnel., Aims: To provide mental health and well-being data relating to UK RPAS operators., Methods: UK RPAS operators completed mental health questionnaires to assess levels of post-traumatic stress disorder (PTSD), anxiety and depression symptoms, alcohol use and occupational functioning. Respondents were also asked about work patterns., Results: Forty-one per cent of the sample reported potentially hazardous alcohol use. Ten per cent met psychiatric symptom criteria for moderate or severe anxiety, and 20% for moderate depressive symptoms. While there were no cases of probable PTSD, 30% of the sample reported sub-clinical PTSD symptoms likely to impair occupational functioning. Overall, 70% of the sample reported that psychological symptoms significantly impaired their functioning., Conclusions: Compared to UK military sub-groups, RPAS operators were not at increased risk of mental health problems. However, a high proportion of the sample reported significant functional impairment, which has not been explored in other comparable studies. The most frequently highlighted work-related stressors were timing of RPAS work and operator shift patterns., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The veterinary profession recognises the importance of addressing work-related stress for veterinary surgeons' wellbeing. Identifying aspects of veterinarians' work that are sources of stress is a key step in implementing appropriate stress management interventions for the profession. However, little systematic research on the causes of stress in veterinary work has been carried out. A qualitative interview study was conducted with 18 veterinarians practising in the UK to explore aspects of their work that are stressful. Thematic analysis revealed principal stressors to be poor work-life balance, interaction with animal owners, specific aspects of euthanasia, dealing with poor animal welfare and staff management responsibilities. Injury risk, supervision arrangements for newly qualified veterinarians and lack of control over work were stressors for some. The practical implications of the findings for stress management in veterinary work are considered. Comments by several participants indicated a strong achievement focus and possible perfectionism. It is proposed that veterinarians with perfectionist traits might experience greater psychological distress in the face of some specific stressors in veterinary practice, and further investigation of possible interactive effects of work stressors and perfectionism on veterinarians' wellbeing is merited., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

We investigated whether a mindfulness meditation program delivered via a smartphone application could improve psychological well-being, reduce job strain, and reduce ambulatory blood pressure during the workday. Participants were 238 healthy employees from two large United Kingdom companies that were randomized to a mindfulness meditation practice app or a wait-list control condition. The app offered 45 prerecorded 10- to 20-min guided audio meditations. Participants were asked to complete one meditation per day. Psychosocial measures and blood pressure throughout one working day were measured at baseline and eight weeks later; a follow-up survey was also emailed to participants 16 weeks after the intervention start. Usage data showed that during the 8-week intervention period, participants randomized to the intervention completed an average of 17 meditation sessions (range 0-45 sessions). The intervention group reported significant improvement in well-being, distress, job strain, and perceptions of workplace social support compared to the control group. In addition, the intervention group had a marginally significant decrease in self-measured workday systolic blood pressure from pre- to post-intervention. Sustained positive effects in the intervention group were found for well-being and job strain at the 16-week follow-up assessment. This trial suggests that short guided mindfulness meditations delivered via smartphone and practiced multiple times per week can improve outcomes related to work stress and well-being, with potentially lasting effects. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Competing Interests: Competing interests: I am a former chair of the Royal College of General Practitioners, a partner of the Hurley Group, and shareholder of eConsult. I am also a non-executive director at University College London Hospitals and a member of the General Medical Council’s independent inquiry on gross negligence manslaughter.

Competing Interests: Competing interests: Ipsos MORI provides research services to the Department of Health and Social Care, the Care Quality Commission, Public Health England, the King’s Fund, and HM Government, as well as numerous charities, public bodies, and private companies in the UK and worldwide.

Background: The UK education sector has among the highest level of stress sickness absence of all occupations. However, investigations of psychosocial working conditions which contribute to stress, including behaviour of students and parents, has not been conducted., Aims: To investigate the psychosocial working conditions and prevalence of negative parental and student behaviour in a large sample of school teachers and college lecturers based in England. In addition, to assess the influence of working conditions, student behaviour and parental behaviour on perceived stress., Methods: A cross-sectional survey of teachers in England. Respondents completed the Management Standards Indicator Tool (MSIT), Perceived Stress Scale (PSS-4), Student Behaviour Scale and a two-item measure of parental behaviour. Differences in these measures across different teaching roles were assessed using analysis of variance. Regression analyses were used to evaluate the association of MSIT, student and parental behaviour on PSS outcomes., Results: Compared to UK benchmark scoring, psychosocial working conditions were at a poor level, with primary teachers in particular exposed to negative parental behaviours, and secondary teachers to poor student behaviour. Demands were consistently associated with perceived stress outcomes across job roles, although management support and relationships with peers also played a part., Conclusions: Demands faced by teachers in England played an important part in the experience of stress. Interventions to reduce these demands, and the high frequencies of negative pupil and parental behaviours, should be considered.