The psychological impact of working in paediatric intensive care. A UK-wide prevalence study.
File(s)
Accepted version
Author(s)
Inwald, David
Jones, Gareth
Type
Journal Article
Abstract
Objective
To determine the prevalence of work related psychological distress in staff working in UK paediatric intensive care units (PICUs).
Design
Online (Qualtrics LLC) staff questionnaire, conducted April – May 2018.
Setting
Staff working in 29 PICUs and 10 PICU transport services were invited to participate.
Participants
1656 staff completed the survey: 1194 nurses, 270 physicians and 192 others. 234 (14%) respondents were male. Median age was 35 (IQR 28-44).
Main outcome measures
The Moral Distress Scale (Revised) (MDS-R) was used to look at moral distress, the abbreviated Maslach Burnout Inventory (aMBI) to examine the depersonalisation (DP) and emotional exhaustion (EE) domains of burnout, and the Trauma Screening Questionnaire (TSQ) to assess risk of PTSD.
Results
435/1194 (36%) nurses, 48/270 (18%) physicians and 19/192 (10%) other staff scored above the study threshold for moral distress (≥90 on MDS-R) (Chi-square test, p<0.00001). 594/1194 (50%) nurses, 99/270 (37%) physicians and 86/192 (45%) other staff had high burnout scores (Chi-square test, p=0.0004). 366/1194 (31%) nurses, 42/270 (16%) physicians and 21/192 (11%) other staff scored at risk for PTSD (Chi-square test, p<0.00001). Junior nurses were at highest risk of moral distress and PTSD, and junior doctors of burnout. Larger unit size was associated with higher MDS-R, burnout and TSQ scores.
Conclusions
These results suggest that UK PICU staff are experiencing work-related distress. Further studies are needed to understand causation and to develop strategies for prevention and treatment.
To determine the prevalence of work related psychological distress in staff working in UK paediatric intensive care units (PICUs).
Design
Online (Qualtrics LLC) staff questionnaire, conducted April – May 2018.
Setting
Staff working in 29 PICUs and 10 PICU transport services were invited to participate.
Participants
1656 staff completed the survey: 1194 nurses, 270 physicians and 192 others. 234 (14%) respondents were male. Median age was 35 (IQR 28-44).
Main outcome measures
The Moral Distress Scale (Revised) (MDS-R) was used to look at moral distress, the abbreviated Maslach Burnout Inventory (aMBI) to examine the depersonalisation (DP) and emotional exhaustion (EE) domains of burnout, and the Trauma Screening Questionnaire (TSQ) to assess risk of PTSD.
Results
435/1194 (36%) nurses, 48/270 (18%) physicians and 19/192 (10%) other staff scored above the study threshold for moral distress (≥90 on MDS-R) (Chi-square test, p<0.00001). 594/1194 (50%) nurses, 99/270 (37%) physicians and 86/192 (45%) other staff had high burnout scores (Chi-square test, p=0.0004). 366/1194 (31%) nurses, 42/270 (16%) physicians and 21/192 (11%) other staff scored at risk for PTSD (Chi-square test, p<0.00001). Junior nurses were at highest risk of moral distress and PTSD, and junior doctors of burnout. Larger unit size was associated with higher MDS-R, burnout and TSQ scores.
Conclusions
These results suggest that UK PICU staff are experiencing work-related distress. Further studies are needed to understand causation and to develop strategies for prevention and treatment.
Date Issued
2020-04-17
Date Acceptance
2019-11-07
Citation
Archives of Disease in Childhood, 2020, 105, pp.470-475
ISSN
0003-9888
Publisher
BMJ Publishing Group
Start Page
470
End Page
475
Journal / Book Title
Archives of Disease in Childhood
Volume
105
Copyright Statement
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. This article has been accepted for publication in Archives of Disease in Childhood following peer review. The definitive copyedited, typeset version
Jones GAL, Colville GA, Ramnarayan P, et alPsychological impact of working in paediatric intensive care. A UK-wide prevalence studyArchives of Disease in Childhood 2020;105:470-475.
is available online at: http://dx.doi.org/10.1136/archdischild-2019-317439
Jones GAL, Colville GA, Ramnarayan P, et alPsychological impact of working in paediatric intensive care. A UK-wide prevalence studyArchives of Disease in Childhood 2020;105:470-475.
is available online at: http://dx.doi.org/10.1136/archdischild-2019-317439
Identifier
https://adc.bmj.com/content/105/5/470
Subjects
burnout
intensive care
moral distress
paediatric staffing
post traumatic stress
Pediatrics
1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
1117 Public Health and Health Services
Publication Status
Published online
Date Publish Online
2020-04-17