Developing and testing interventions to reduce burnout in healthcare professionals
File(s)
Author(s)
Brazier, Alix
Type
Thesis
Abstract
Burnout is characterised by feelings of exhaustion, cynicism, and reduced professional
efficacy or accomplishment. 33% of UK ‘trainee’ doctors and 40.5% of registered nurses and
midwives report often or always feeling burnt out by their work. Healthcare professional
burnout is associated with negative health outcomes, increased absenteeism and turnover,
and reduced patient care and safety.
Organisational and individual-level interventions have been tested to reduce burnout, but
many suffer from limitations (e.g. high resource or time demands) making them suboptimal
for the NHS context. This thesis aimed to develop and test interventions to reduce burnout in
UK healthcare professionals which could be adopted across the NHS if effective.
Two research programmes were conducted: one in doctors (trainee anaesthetists); one in
adult inpatient nurses. Narrative literature reviews of burnout correlates in doctors and
nurses, and interview studies with each population, enabled development of a burnout
intervention for each group. Interventions were co-developed with trial partners and
members of focus populations.
The text message intervention developed to reduce trainee anaesthetist burnout was
evaluated via randomised controlled trial (with process evaluation through feedback survey
and interviews). The team-based rostering intervention to reduce adult inpatient nurse
burnout was piloted on a ward at a London trust using a comparator ward (process
evaluation through feedback survey). Both evaluations found no impact on burnout.
However, the texts were associated with reduced burnout in those reporting difficult personal
or work circumstances (or a large negative impact from COVID-19) and nurse intervention
participants reported significant improvements in roster satisfaction, shift flexibility,
empowerment, and work-life interference. Both process evaluations indicated intervention
acceptability, and provided suggested improvements.
Intervention adaptation and re-evaluation (especially for the nurse intervention, at larger
scale) would be interesting. More work is required to identify scalable interventions, and
determine if these can reduce burnout.
efficacy or accomplishment. 33% of UK ‘trainee’ doctors and 40.5% of registered nurses and
midwives report often or always feeling burnt out by their work. Healthcare professional
burnout is associated with negative health outcomes, increased absenteeism and turnover,
and reduced patient care and safety.
Organisational and individual-level interventions have been tested to reduce burnout, but
many suffer from limitations (e.g. high resource or time demands) making them suboptimal
for the NHS context. This thesis aimed to develop and test interventions to reduce burnout in
UK healthcare professionals which could be adopted across the NHS if effective.
Two research programmes were conducted: one in doctors (trainee anaesthetists); one in
adult inpatient nurses. Narrative literature reviews of burnout correlates in doctors and
nurses, and interview studies with each population, enabled development of a burnout
intervention for each group. Interventions were co-developed with trial partners and
members of focus populations.
The text message intervention developed to reduce trainee anaesthetist burnout was
evaluated via randomised controlled trial (with process evaluation through feedback survey
and interviews). The team-based rostering intervention to reduce adult inpatient nurse
burnout was piloted on a ward at a London trust using a comparator ward (process
evaluation through feedback survey). Both evaluations found no impact on burnout.
However, the texts were associated with reduced burnout in those reporting difficult personal
or work circumstances (or a large negative impact from COVID-19) and nurse intervention
participants reported significant improvements in roster satisfaction, shift flexibility,
empowerment, and work-life interference. Both process evaluations indicated intervention
acceptability, and provided suggested improvements.
Intervention adaptation and re-evaluation (especially for the nurse intervention, at larger
scale) would be interesting. More work is required to identify scalable interventions, and
determine if these can reduce burnout.
Version
Open Access
Date Issued
2022-12
Date Awarded
2023-07
Copyright Statement
Creative Commons Attribution NonCommercial NoDerivatives Licence
Advisor
Judah, Gaby
Darzi, Ara
Sponsor
National Institute for Health Research (Great Britain)
Publisher Department
Department of Surgery & Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)