Wellbeing: Overview + SIG resources

Abstract
With increasing gender balance in specialist medical training and employment in Australia, there is a corresponding need to consider how parental leave and subsequent return to work is managed in the workplace. An electronic survey exploring the experiences of pregnancy and return to work following parental leave was distributed by the Australian and New Zealand College of Anaesthetists (ANZCA). The return-to-work component of the survey evaluated parental leave and return-to-work patterns, lactation practices and facilities, supports and resources utilised during the return-to-work process. We report on 391 return-to-work episodes from 219 respondents. One hundred and seventy-two (79%) were specialists at the time of survey completion. Six to 11 months was the most frequent duration of parental leave, and this duration was associated with higher satisfaction levels than shorter durations of leave (odds ratio 5.44, 95% confidence interval 3.18-9.31, P < 0.001). Breastfeeding continued in 246 (63%) return-to-work episodes, and absent or inadequate lactation facilities were reported in 239 (88%). In 227 (58%) return-to-work experiences, respondents received no formal support on returning to work. One hundred and thirty-five (62%) respondents did not utilise any existing return-to-work resources, and family and friends were the main source of support for 113 (52%) respondents. Return-to-work processes should be tailored to meet individual needs. Consistent with existing recommendations, satisfactory lactation facilities must be provided. We recommend that the period of one-to-one supervision be flexible and negotiated, to suit the unique return-to-work trajectory of each worker. Existing ANZCA resources could assist departments in supporting anaesthetists who return to work following parental leave.

Abstract
Introduction: High levels of stress and burnout have been identified among resident anaesthetists in UK training programmes. Factors involving clinical roles, workplace culture and training are known stressors, but in-depth research investigating how to improve wellbeing is limited.

Methods: We used a qualitative design in two phases with participants from across the UK. Phase 1 involved semi-structured interviews of resident anaesthetists in the 2nd-5th years of training, and educational stakeholders. Phase 2 involved additional participants in two focus groups, one each for residents and stakeholders. Interviews and focus groups were conducted online, audio-recorded and transcribed for thematic analysis using a framework approach.

Results: We interviewed 52 participants in phase 1, comprising resident anaesthetists from England, Wales and Scotland and key educational stakeholders. A further 11 resident anaesthetists and stakeholders participated in the phase 2 focus groups. We identified four overarching themes contributing to stress: clinical work; non-clinical work; structure of training; and workplace culture. We also identified supportive features at individual, local, regional and national levels. Stress and burnout were commonplace, particularly during demanding periods of training. Balancing non-clinical commitments alongside busy workloads was difficult. Clinically, intensive care medicine and obstetrics generated the most stress. Frequent rotations and long commutes increased stress, impacting on working and family relationships. Curriculum changes, examinations and competition for higher training posts caused stress and poor morale. Proposed mechanisms to improve wellbeing include: peer-to-peer support; request-based rotas; adoption of 'lead employers'; decreasing rotation frequency and commuting distances; access to less than full-time working and professional support; and adapting the structure of training to improve the stability of the resident anaesthetist workforce.

Discussion: Attention to the factors identified as contributing to stress could improve resident anaesthetists' wellbeing through changes to policy and practice at local, regional and national levels, for which we make research-informed recommendations.

Abstract
Background: Mental health issues among healthcare professionals (HCPs) are rising, impacting individual wellbeing, healthcare systems, and patient safety. This exploratory study aimed to analyse the association between anaesthesia teams' perception of their mental wellbeing, psychosocial work environment, and patient safety culture in a university hospital's anaesthesiology department. Second, to identify types of stressors and strategies to overcome them. Third, to explore differences in perception by profession, gender, and years of experience. Finally, to evaluate the psychometric properties of the questionnaire.

Methods: A questionnaire covering mental wellbeing, teamwork, psychosocial work environment, and patient safety culture was sent to all HCPs in the department in May 2021 via e-mail. The questionnaire consisted of 35 questions, 4 demographic questions, and 2 open text fields.

Results: 293 HCPs responded (73% response rate); 60% agreed their work is emotionally challenging, and 30% experienced weekly emotional strain. Significant differences were seen between professions in terms of stressors. Clinical situations contributed most to doctors' emotional strain, while nurses scored higher on making compromises and being busy. A strong relationship was seen between weekly/daily emotional strain and making compromises in standards, clinical situations, and busyness.

Conclusion: In conclusion, all HCPs experienced emotional strain, with different causes and coping strategies across professions. Support was primarily found among colleagues and networks. Interestingly, low emotional strain correlated positively with coping, teamwork, psychological safety, and patient safety culture, suggesting an interrelation between these dimensions and HCPs' mental health. These findings may inform future conceptualisations of mental health, psychological safety, and safety culture.