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Understanding what predicts wellbeing and burnout in those on the frontline.

Understanding what predicts wellbeing and burnout in those on the frontline.

Objectives: Arts on Prescription (AoP) interventions are part of mainstream social prescribing provision in primary health care. Whilst the body of evidence for AoP interventions has been developing, this has primarily focused on wellbeing. \ud Study Design: The present work is an observational longitudinal study on a community-based AoP social prescribing intervention in the South West UK. \ud Method: The present study assessed changes in anxiety, depression, and wellbeing in a cohort of patients participating in up to two eight-week cycles of AoP. The sample consisted of 245 individuals referred into the programme from 2017 to 2019, with a sub-sample of participants (N=110) with identifiable multimorbidity. Outcomes were measured pre- and post-intervention at both initial and re-referral. \ud Results: Anxiety, depression, and wellbeing were all significantly improved after initial referral, re-referral, and overall from initial to post re-referral for this intervention in the whole sample and multimorbid sub-sample. Multivariate analyses revealed that no participant variables appeared to account for the variance in outcome change scores. \ud Conclusion: The research provides further support for AoP interventions, finding associations with reduced anxiety and depression and increased wellbeing. Additionally, these outcomes are evidenced in those with multi-morbidity, as well as across initial- and re-referral cycles.

The literature addressing the potential for nature and natural environments to reduce stress and improve health outcomes has a relative paucity of work regarding interactions with animals, particularly those that are not domestic pets. The present observational study sought to understand whether a brief encounter with non‐domestic animals might reduce stress and improve well‐being of participants, and whether participants' nature relatedness, and their appraisals of the interaction might influence these changes. Participants (N = 86, mean age = 20.8 years, 81.8% women) took part in a brief wildlife encounter at a UK safari park, walking for approximately 11 min around an enclosure with free‐roaming lemurs. Heart rate, cortisol and measures of mood were taken before and after the encounter to understand whether this activity could reduce biological levels of stress and improve psychological well‐being. There was no decrease in participants’ heart rate after their encounter but there was a statistically significant decrease in salivary cortisol. Measures of mood significantly improved immediately after the encounter. Reductions in cortisol were associated with dimensions of an individual's nature relatedness, as well as aspects of the animal encounter (number of lemurs and lemur proximity). The findings contribute to parallel literature on nature–health relationships, with the addition of factors seemingly driving the interaction (individuals' nature relatedness, and the number and proximity of the animals) providing important contributory information. The present study provides new information on how encounters with nature, particularly those involving animals, may be beneficial for health and well‐being. Critically, this study was carried out in a setting where potential impact of visitors on animals is negligible, thereby demonstrating the potential for creating environments where both human and animal well‐being are maximised. A free Plain Language Summary can be found within the Supporting Information of this article.

Registration for a systematic review on social factors in burnout.

Evidence given on 24th August 2021 by Dr Rachel Sumner (UoG) and Dr Elaine Kinsella (UL) to the All Party Parliamentary Group on Coronavirus inquiry on the impact of the pandemic on frontline healthcare workers. Evidence based on work by Dr Rachel Sumner and Dr Elaine Kinsella.

Whilst the Covid-19 pandemic moves into a new phase with the successful roll out of vaccines in adults in the UK, there is an opportunity to reflect, re-evaluate, and reconfigure public health responses. Of importance is the need to defend and protect the frontline workforce who have sacrificed so much over the last 18 months. The present essay summarises key recommendations from frontline workers to policymakers with specific reference to the preparation needed for the Autumn and Winter to come. The participants from the CV19 Heroes Project give voice to concerns over the unique challenges posed by the coming months, and speak of the need to embed evidence into future policy to both compensate existing, and prevent future, occupational exposure to Covid-19, the experience of Long Covid, and the overall psychological and physical scars experienced from what has been a traumatic period of their working lives.

A mixed methods evaluation of the See with Fresh Eyes\ud programme delivered by Look Again in partnership with\ud Create Gloucestershire.

This project has been established to develop and test the theory of Solidarity Appraisal - a concept derived from research with frontline workers during the Covid-19 pandemic. Whilst the concept of solidarity appraisal has been developed through this work, we are keen to see how this may be related to other aspects of occupations and roles, and how this may account for burnout beyond existing models. The project has two current components: (i) theory development; and (ii) testing. The theory development component is initiated with a perspective piece submitted that describes the theory, its origins, and potential applications. The testing component will be broader work including scoping for the potential for meta-ethnography or use of qualitative secondary data, as well as empirical work. Alongside this, the concept of the Hero Contract will also be developed as a key component of supporting the Solidarity Appraisal concept, specifically within work that is often labelled heroic.

The benefits of exposure to nature for health and wellbeing have been demonstrated across multiple disciplines, with empirical data serving as a foundation for conceptual frameworks. However, with fundamental issues apparent even within the definition of what “nature” means, and a general assumption that nature will be beneficial to all in all ways, there remains inconsistencies in empirical findings. Moreover, recent work has sought to establish one dose or type of nature exposure that is universally beneficial, which has proven difficult. With this critical review we argue for a change of focus to look beyond generalised effects, and instead consider the relationship between health and nature as dynamic, changeable, and heavily contextual. We propose a theoretical framework for understanding the nature/health association as a dynamic interaction, and operationalise this within a multidimensional construct of dose to support future work in the medicalisation of nature. By delineating the mechanisms of health benefit derived from nature in terms of the type of interaction (being, doing, or living), it becomes apparent that nature interactions may be highly variable not just between but also within individuals. We describe the ability for nature interactions to be multidimensional, using dose as one element of overall bioavailability; and propose a “green equation” where health benefit is the product of a complex interaction between the individual and the environment with which they engage.