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Article ; Online: Do Black, Asian and Minority Ethnic nurses and midwives experience a career delay? A cross-sectional survey investigating career progression barriers.

Johnson, Judith / Mitchinson, Lucy / Parmar, Mayur / Opio-Te, Gail / Serrant, Laura / Grange, Angela

2021 Volume 57, Issue 1-2, Page(s) 99–112

Abstract: Background: Black, Asian and Minority Ethnic nurses and midwives are under-represented in higher and managerial roles.: Aims: This study explored the presence and nature of career progression delays for Black, Asian and Minority Ethnic nurses and ... ...

Abstract	Background: Black, Asian and Minority Ethnic nurses and midwives are under-represented in higher and managerial roles. Aims: This study explored the presence and nature of career progression delays for Black, Asian and Minority Ethnic nurses and midwives and investigated where the barriers to progression were. Design: A secondary analysis of data from a wider cross-sectional survey investigating workplace experiences, burnout and patient safety in nurses and midwives. Methods: 538 nurses and midwives were recruited from four UK hospitals between February and March 2017. A career progression delay was viewed as being present if Black, Asian and Minority Ethnic nurses and midwives had spent longer on the entry level nursing grade and less time on higher grades in the previous 10 years. The analysis included items pertaining to: receipt of professional training, perceived managerial support for progression, likelihood of submitting applications and application success rates. Data were analysed using linear regression, odds ratios and t-tests. Results were reported using the STROBE Checklist. Results: Black, Asian and Minority Ethnic nurses and midwives ( Conclusions: Interventions are needed to improve racial equality regarding career progression in nurses and midwives. Increasing access to professional training and reducing discriminatory practice in job recruitment procedures may be beneficial. Impact statement: Black, Asian and Minority Ethnic nurses and midwives experience career progression inequalities. Interventions should improve transparency in recruitment procedures and enhance training opportunities.
MeSH term(s)	Cross-Sectional Studies ; Ethnicity ; Female ; Humans ; Midwifery ; Minority Groups ; Nurses ; Pregnancy
Language	English
Publishing date	2021-06-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1491361-6
ISSN	1839-3535 ; 1037-6178
ISSN (online)	1839-3535
ISSN	1037-6178
DOI	10.1080/10376178.2021.1927775
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Prognostic decision-making about imminent death within multidisciplinary teams

Nicola White / Patrick Stone / Linda Oostendorp / Steven Bloch / Lucy Mitchinson / Andrea Bruun / Ali-Rose Sisk

BMJ Open, Vol 12, Iss

a scoping review

2022 Volume 4

Keywords	Medicine ; R
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prognostic decision-making about imminent death within multidisciplinary teams: a scoping review.

Bruun, Andrea / Oostendorp, Linda / Bloch, Steven / White, Nicola / Mitchinson, Lucy / Sisk, Ali-Rose / Stone, Patrick

BMJ open

2022 Volume 12, Issue 4, Page(s) e057194

Abstract: Objective: To summarise evidence on how multidisciplinary team (MDTs) make decisions about identification of imminently dying patients.: Design: Scoping review.: Setting: Any clinical setting providing care for imminently dying patients, excluding ...

Abstract	Objective: To summarise evidence on how multidisciplinary team (MDTs) make decisions about identification of imminently dying patients. Design: Scoping review. Setting: Any clinical setting providing care for imminently dying patients, excluding studies conducted solely in acute care settings. Data sources: The databases AMED, CINAHL, Embase, MEDLINE, PsychINFO and Web of Science were searched from inception to May 2021.Included studies presented original study data written in English and reported on the process or content of MDT discussions about identifying imminently dying adult patients. Results: 40 studies were included in the review. Studies were primarily conducted using interviews and qualitative analysis of themes.MDT members involved in decision-making were usually doctors and nurses. Some decisions focused on professionals recognising that patients were dying, other decisions focused on initiating specific end-of-life care pathways or clarifying care goals. Most decisions provided evidence for a partial collaborative approach, with information-sharing being more common than joint decision-making. Issues with decision-making included disagreement between staff members and the fact that doctors were often regarded as final or sole decision-makers. Conclusions: Prognostic decision-making was often not the main focus of included studies. Based on review findings, research explicitly focusing on MDT prognostication by analysing team discussions is needed. The role of allied and other types of healthcare professionals in prognostication needs further investigation as well. A focus on specialist palliative care settings is also necessary.
MeSH term(s)	Adult ; Decision Making ; Health Personnel ; Hospice Care ; Humans ; Prognosis ; Terminal Care
Language	English
Publishing date	2022-04-05
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-057194
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Article ; Online: How best to capture the impact of complementary therapies in palliative care: A systematic review to identify and assess the appropriateness and validity of multi-domain tools.

Mitchinson, Lucy / Chu, Christina / Bruun, Andrea / Sisk, Ali-Rose / Armstrong, Megan / Vindrola-Padros, Cecilia / Kupeli, Nuriye / Candy, Bridget / Stone, Patrick

Palliative medicine

2022 Volume 36, Issue 9, Page(s) 1320–1335

Abstract: Background: Complementary therapies are widely used in palliative care settings. Qualitative research found that people with advanced disease report a range of physical and psychological benefits from complementary therapies, however evidence of their ... ...

Abstract	Background: Complementary therapies are widely used in palliative care settings. Qualitative research found that people with advanced disease report a range of physical and psychological benefits from complementary therapies, however evidence of their effectiveness from clinical trials is inconclusive. This may be because trials are limited by use of inappropriate outcome measures. Aims: To identify tools which capture the impact of massage, reflexology and aromatherapy in people with advanced disease. We (1) identified multi-domain tools used to evaluate these therapies in populations with any chronic health condition and (2) assessed whether tools were valid and psychometrically robust in populations with advanced disease. Design: A two-stage systematic review was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines (PROSPERO: CRD42020161199). Data sources: Six databases were searched (August 2021). Study methodological quality, tool psychometric properties and evidence quality were assessed. A global comparison score was generated. Results: Stage 1: 66 trials using 40 different multi-domain tools were identified. Stage 2: Of these tools, we identified papers for seven tools regarding development or validation in advanced disease populations. The majority of psychometric data were inconsistent or inconclusive. Data were mostly of low quality due to methodological issues. Conclusion: Of the tools identified, 'Functional Assessment of Cancer Therapy - General' appears to be the most suitable alternative tool against COMSIN criteria, for trials of massage, reflexology and aromatherapy in palliative care. Further tool validation is required before firm recommendations can be made. Co-development of a core outcome set could ensure relevant domains are assessed.
MeSH term(s)	Humans ; Palliative Care ; Aromatherapy ; Hospice and Palliative Care Nursing ; Psychometrics ; Massage
Language	English
Publishing date	2022-09-07
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	639247-7
ISSN	1477-030X ; 0269-2163
ISSN (online)	1477-030X
ISSN	0269-2163
DOI	10.1177/02692163221122955
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Article ; Online: Re-ordering connections: UK healthcare workers' experiences of emotion management during the COVID-19 pandemic.

Dowrick, Anna / Mitchinson, Lucy / Hoernke, Katarina / Mulcahy Symmons, Sophie / Cooper, Silvie / Martin, Sam / Vanderslott, Samantha / Vera San Juan, Norha / Vindrola-Padros, Cecilia

Sociology of health & illness

2021 Volume 43, Issue 9, Page(s) 2156–2177

Abstract: This paper examines the impact of disruptions to the organisation and delivery of healthcare services and efforts to re-order care through emotion management during the COVID-19 pandemic in the UK. Framing care as an affective practice, studying ... ...

Abstract	This paper examines the impact of disruptions to the organisation and delivery of healthcare services and efforts to re-order care through emotion management during the COVID-19 pandemic in the UK. Framing care as an affective practice, studying healthcare workers' (HCWs) experiences enables better understanding of how interactions between staff, patients and families changed as a result of the pandemic. Using a rapid qualitative research methodology, we conducted interviews with frontline HCWs in two London hospitals during the peak of the first wave of the pandemic and sourced public accounts of HCWs' experiences of the pandemic from social media (YouTube and Twitter). We conducted framework analysis to identify key factors disrupting caring interactions. Fear of infection and the barriers of physical distancing acted to separate staff from patients and families, requiring new affective practices to repair connections. Witnessing suffering was distressing for staff, and providing a 'good death' for patients and communicating care to families was harder. In addition to caring for patients and families, HCWs cared for each other. Infection control measures were important for limiting the spread of COVID-19 but disrupted connections that were integral to care, generating new work to re-order interactions.
MeSH term(s)	COVID-19 ; Emotions ; Health Personnel ; Humans ; Pandemics ; SARS-CoV-2 ; United Kingdom
Language	English
Publishing date	2021-10-27
Publishing country	England
Document type	Journal Article
ZDB-ID	795552-2
ISSN	1467-9566 ; 0141-9889
ISSN (online)	1467-9566
ISSN	0141-9889
DOI	10.1111/1467-9566.13390
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Article ; Online: Missing the human connection: A rapid appraisal of healthcare workers' perceptions and experiences of providing palliative care during the COVID-19 pandemic.

Mitchinson, Lucy / Dowrick, Anna / Buck, Caroline / Hoernke, Katarina / Martin, Sam / Vanderslott, Samantha / Robinson, Hannah / Rankl, Felicia / Manby, Louisa / Lewis-Jackson, Sasha / Vindrola-Padros, Cecilia

Palliative medicine

2021 Volume 35, Issue 5, Page(s) 852–861

Abstract: Background: During infectious epidemics, healthcare workers are required to deliver traditional care while facing new pressures. Time and resource restrictions, a focus on saving lives and new safety measures can lead to traditional aspects of care ... ...

Abstract	Background: During infectious epidemics, healthcare workers are required to deliver traditional care while facing new pressures. Time and resource restrictions, a focus on saving lives and new safety measures can lead to traditional aspects of care delivery being neglected. Aim: Identify barriers to delivering end-of-life care, describe attempts to deliver care during the COVID-19 pandemic, and understand the impact this had on staff. Design: A rapid appraisal was conducted incorporating a rapid review of policies from the United Kingdom, semi-structured telephone interviews with healthcare workers, and a review of mass print media news stories and social media posts describing healthcare worker's experiences of delivering care during the pandemic. Data were coded and analysed using framework analysis. Setting/participants: From a larger ongoing study, 22 interviews which mentioned death or caring for patients at end-of-life, eight government and National Health Service policies affecting end-of-life care delivery, eight international news media stories and 3440 publicly available social media posts were identified. The social media analysis centred around 274 original tweets with the highest reach, engagement and relevance. Incorporating multiple workstreams provided a broad perspective of end-of-life care during the COVID-19 pandemic in the United Kingdom. Results: Three themes were developed: (1) restrictions to traditional care, (2) striving for new forms of care and (3) establishing identity and resilience. Conclusions: The COVID-19 pandemic prohibited the delivery of traditional care as practical barriers restricted human connections. Staff prioritised communication and comfort orientated tasks to re-establish compassion at end-of-life and displayed resilience by adjusting their goals.
MeSH term(s)	COVID-19 ; Health Personnel ; Humans ; Palliative Care ; Pandemics ; Perception ; SARS-CoV-2 ; State Medicine ; United Kingdom
Language	English
Publishing date	2021-03-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	639247-7
ISSN	1477-030X ; 0269-2163
ISSN (online)	1477-030X
ISSN	0269-2163
DOI	10.1177/02692163211004228
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Article ; Online: An investigation into the relationships between bullying, discrimination, burnout and patient safety in nurses and midwives: is burnout a mediator?

Johnson, Judith / Cameron, Lorraine / Mitchinson, Lucy / Parmar, Mayur / Opio-Te, Gail / Louch, Gemma / Grange, Angela

Journal of research in nursing : JRN

2019 Volume 24, Issue 8, Page(s) 604–619

Abstract: Background: Bullying and discrimination may be indirectly associated with patient safety via their contribution to burnout, but research has yet to establish this.: Aims: The aims of this study were to investigate the relationships between workplace ... ...

Abstract	Background: Bullying and discrimination may be indirectly associated with patient safety via their contribution to burnout, but research has yet to establish this. Aims: The aims of this study were to investigate the relationships between workplace bullying, perceived discrimination, levels of burnout and patient safety perceptions in nurses and midwives and to assess whether bullying and discrimination were more frequently experienced by Black, Asian and minority ethnic than White nurses and midwives. Methods: In total, 528 nurses and midwives were recruited from four hospitals in the United Kingdom to complete a cross-sectional survey between February and March 2017. The survey included items on bullying, discrimination, burnout and individual level and ward level patient safety perceptions. Data were analysed using path analysis. Results: The results were reported according to the STROBE checklist. Bullying and discrimination were significantly associated with higher burnout. Higher burnout was in turn associated with poorer individual- and ward-level patient safety perceptions. Experiences of discrimination were three times more common among Black, Asian and minority ethnic than White nurses and midwives, but there was no significant difference in experiences of bullying. Conclusions: Bullying and discrimination are indirectly associated with patient safety perceptions via their influence on burnout. Healthcare organisations seeking to improve patient care should implement strategies to reduce workplace bullying and discrimination.
Language	English
Publishing date	2019-12-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2173772-1
ISSN	1744-988X ; 1744-9871
ISSN (online)	1744-988X
ISSN	1744-9871
DOI	10.1177/1744987119880329
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Article: Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice.

Vera San Juan, Norha / Aceituno, David / Djellouli, Nehla / Sumray, Kirsi / Regenold, Nina / Syversen, Aron / Mulcahy Symmons, Sophie / Dowrick, Anna / Mitchinson, Lucy / Singleton, Georgina / Vindrola-Padros, Cecilia

BJPsych open

2020 Volume 7, Issue 1, Page(s) e15

Abstract: Background: Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well- ... ...

Abstract	Background: Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well-being and the evidence base behind such guidelines remain unclear. Aims: The aims of the study are to assess the applicability of well-being guidelines in practice, identify unaddressed healthcare workers' needs and provide recommendations for supporting front-line staff during the current and future pandemics. Method: This paper discusses the findings of a qualitative study based on interviews with front-line healthcare workers in the UK (n = 33), and examines them in relation to a rapid review of well-being guidelines developed in response to the COVID-19 pandemic (n = 14). Results: The guidelines placed greater emphasis on individual mental health and psychological support, whereas healthcare workers placed greater emphasis on structural conditions at work, responsibilities outside the hospital and the invaluable support of the community. The well-being support interventions proposed in the guidelines did not always respond to the lived experiences of staff, as some reported not being able to participate in these interventions because of understaffing, exhaustion or clashing schedules. Conclusions: Healthcare workers expressed well-being needs that aligned with socio-ecological conceptualisations of well-being related to quality of life. This approach to well-being has been highlighted in literature on support of healthcare workers in previous health emergencies, but it has not been monitored during this pandemic. Well-being guidelines should explore the needs of healthcare workers, and contextual characteristics affecting the implementation of recommendations.
Language	English
Publishing date	2020-12-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2829557-2
ISSN	2056-4724
ISSN	2056-4724
DOI	10.1192/bjo.2020.148
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Article ; Online: Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK

Cecilia Vindrola-Padros / Samantha Vanderslott / Nehla Djellouli / Lily Andrews / Sasha Lewis-Jackson / Louisa Manby / Sam Martin / Anna Dowrick / Harrison Fillmore / Elysse Bautista Gonzalez / Lucy Mitchinson / Sophie Mulcahy Symmons / Nina Regenold / Hannah Robinson / Kirsi Sumray / Georgina Singleton / Aron Syversen / Ginger Johnson

BMJ Open, Vol 10, Iss

2020 Volume 11

Keywords	Medicine ; R
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Healthcare Workers′ Mental Health and Wellbeing During the COVID-19 Pandemic in the UK: Contrasting Guidelines with Experiences in Practice

medRxiv

Abstract: Background Substantial evidence has highlighted the importance of considering healthcare workers′ (HCW) mental health during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of ... ...

Abstract	Background Substantial evidence has highlighted the importance of considering healthcare workers′ (HCW) mental health during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of wellbeing and the evidence-base behind such guidelines remains unclear. Objectives Assessing the applicability of wellbeing guidelines in practice; identify unaddressed HCWs′ needs; and provide recommendations for supporting frontline staff during the current and future pandemics. Methods and Design This paper discusses the findings of a qualitative study based on interviews with frontline healthcare staff in the UK and examines them in relation to a rapid review of wellbeing guidelines developed in response to the COVID-19 pandemic. Results 14 guidelines were included in the rapid review and 33 interviews with HCWs were conducted in the qualitative study. As a whole, the guidelines placed greater emphasis on wellbeing at an individual level, while HCWs placed greater emphasis on structural conditions at work, such as understaffing and the invaluable support of the community. This in turn had implications for the focus of wellbeing intervention strategies; staff reported an increased availability of formal mental health support, however, understaffing or clashing schedules prevented them from participating in these activities. Conclusion HCWs expressed wellbeing needs which align with social-ecological conceptualisations of wellbeing related to quality of life. This approach to wellbeing has been highlighted in literature about HCWs support in previous health emergencies, yet it has not been monitored during this pandemic. Wellbeing guidelines should explore staff′s needs and contextual characteristics affecting the implementation of recommendations.
Keywords	covid19
Language	English
Publishing date	2020-07-26
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.07.21.20156711
Database	COVID19

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