Securing the Evidence and Theory-based Design of an Online Intervention Designed to Support Midwives in Work-related Psychological Distress
DOI: https://doi.org/10.29086/JISfTeH.6.e8
Abstract
The psychological wellbeing of midwives can be linked to the safety and quality of maternity care. As such, work-related psychological distress in midwifery populations must be addressed in order to meet the United Nation’s Sustainable Development Goals for maternal health. Earlier research maps out a global vision, using telemedicine and e/mHealth for the design and development of an online intervention designed to support midwives in work-related psychological distress. This paper outlines how the evidence and theory-based design of such an intervention has been secured via a narrative review, a critical realist review, a 2-round Delphi study and a mixed-methods systematic review of the literature. Findings suggest that this online intervention should be designed to provide anonymity and confidentiality for midwives seeking support online. 24-hour mobile access, effective moderation, an online discussion forum, and additional legal, educational, and therapeutic components are also indicated for collation in a ‘One stop shop’ online. Additionally, a simple user assessment may be used to identify those people deemed to be at risk of causing harm. The comprehensive design for this particular intervention is outlined using a validated checklist and guide. This particular design has been informed by the pathways disclosure model and the revised transactional model of occupational stress and coping. This research has been guided by the Medical Research Council’s framework for developing complex interventions. Future research in this field is also suggested. Should this intervention be developed and tested more widely, both midwives and maternity service users may experience safer, more productive and higher-quality maternity care.
References
Health and Safety Executive. Stress and Psychological Disorders in Great Britain. (2016). Available at: http://www.hse.gov.uk/statistics/causdis/stress/stress.pdf accessed 28 September 2017.
Buchan J, Seccombe I, Charlesworth A. Staffing matters; funding counts. Workforce profile and trends in the English NHS. The Health Foundation 2016. (2016). Available at: https://www.health.org.uk/publication/staffing-matters-funding-counts accessed 10 April 2018.
Newman B. Government action on agency use cuts NHS staffing bill. Nurse Manag 2016;22(9):7-7.
NHS Employers. Reducing sickness absence in the NHS using evidence-based strategies. Summary report. (2014). Available at: http://www.nhsemployers.org/~/media/Employers/Publications/Reducing%20sickness%20absence%20in%20the%20NHS.pdf accessed 10 April 2018.
Darzi A. High quality care for all: NHS next stage review final report. London: Department of Health. (2008). Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/228836/7432.pdf accessed 10 April 2018.
West M, Dawson J. Employee engagement and NHS performance. The Kings Fund. (2012). Available at: https://www.kingsfund.org.uk/sites/default/files/employee-engagement-nhs-performance-west-dawson-leadership-review2012-paper.pdf accessed 10 April 2018.
Boorman S. The Final Report of the independent NHS Health and Well-being review. Department of Health. NHS health and well-being review–the government response. (2009). Available at: http://webarchive.nationalarchives.gov.uk/20130124052412/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_108907.pdf accessed 10 April 2018.
The Royal College of Physicians. Work and wellbeing in the NHS: why staff health matters to patient care. (2015). Available at: https://www.rcpsych.ac.uk/pdf/RCP-%20WorkWellbeingNHS.pdf accessed 10 April 2018.
Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PloS One 2016;11(7):e0159015.
Symon A. Summer reading: The NHS Litigation Authority Annual Report. Br J Midwifery 2016;24(9):669-670.
The Lancet. Improving mental health in the workplace. Lancet 2017;390(10107):2015.
Guillaumie L, Boiral O, Champagne J. A mixed‐methods systematic review of the effects of mindfulness on nurses. J Adv Nurs 2016;73(5):1017-1034.
Regehr C, Glancy D, Pitts A, LeBlanc VR. Interventions to reduce the consequences of stress in physicians: a review and meta-analysis. J Nerv Ment Dis 2014;202(5):353-359.
Murray M, Murray L, Donnelly M. Systematic review of interventions to improve the psychological well-being of general practitioners. BMC Fam Pract 2016;17(1):36.
Romppanen J, Häggman‐Laitila A. Interventions for nurses’ well‐being at work: a quantitative systematic review. J Adv Nurs 2016;73(7):1555-1569.
Ruotsalainen JH, Verbeek JH, Mariné A, Serra C. Preventing occupational stress in healthcare workers. The Cochrane Library. (2015). Available at: http://www.cochrane.org/CD002892/OCCHEALTH_preventing-occupational-stress-in-healthcare-workers accessed 10 April 2018.
Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;29;337:a1655.
Cumberlege J. Better births. Improving outcomes of maternity services in England: A Five Year Forward View for maternity care. The National Maternity Review. London: NHS England; 2016. Available at: https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf accessed 10 April 2018.
Department of Health. Managing the supply of NHS clinical staff in England. (2016). Available at: https://www.nao.org.uk/wp-content/uploads/2016/02/Managing-the-supply-of-NHS-clinical-staff-in-England.pdf accessed 10 April 2018.
Lewis R, Donaldson-Feilder E, Tharani T. Managing for sustainable employee engagement: Developing a behavioural framework. CIPD. (2012). Available at: http://www.mas.org.uk/uploads/artlib/managing-for-sustainable-employee-engagement.pdf accessed 10 April 2018.
Edwards N, Gilbert A, Mander R, et al. Are staffing shortages changing the culture of midwifery? Pract Midwife 2016;19(3):12-14.
Pezaro S, Clyne W, Turner A, Fulton EA, Gerada C. ‘Midwives Overboard!’ Inside their hearts are breaking, their makeup may be flaking but their smile still stays on. Women Birth 2015;29(3):59-66.
The Royal College of Midwives. Caring for You Campaign: Survey Results RCM campaign for healthy workplaces delivering high quality care. RCM. (2017) Available at: https://www.rcm.org.uk/sites/default/files/Caring%20for%20You%20-%20Survey%20Results%202016%20A5%2084pp_5%20spd.pdf accessed 10 April 2018.
Pezaro S, Clyne W, Gerada C. Confidentiality, anonymity and amnesty for midwives in distress seeking online support - Ethical? Nurs Ethics 2016;pii: 0969733016654315. [Epub ahead of print].
Pezaro S, Clyne W. Achieving consensus for the design and delivery of an online intervention to support midwives in work-related psychological distress: results from a Delphi Study. JMIR Mental Health 2016;3(3):e32.
Pezaro S, Clyne W. Achieving consensus in the development of an online intervention designed to effectively support midwives in work-related psychological distress: protocol for a Delphi Study. JMIR Res Prooct 2015;4(3):e107.
Sandelowski M, Voils CI, Barroso J. Defining and designing mixed research synthesis studies. Res Sch 2006;13(1):29.
Pezaro S, Clyne W, Fulton EA. A systematic mixed-methods review of interventions, outcomes and experiences for midwives and student midwives in work-related psychological distress. Midwifery 2017;50:163-173.
Cooper G. Exploring and understanding online assistance for problem gamblers: The pathways disclosure model. Int J Ment Health Addict 2004;1(2):32-38.
Lazarus RS, Folkman S. Stress, Appraisal, and Coping. New York. Springer 1986.
Karasek Jr RA. Job demands, job decision latitude, and mental strain: Implications for job redesign. Adm Sci Q 1979:24(2):285-308.
Goh YW, Sawang S, Oei TP. The Revised Transactional Model (RTM) of occupational stress and coping: An improved process approach. Austral J Org Psych 2010;3:13-20.
Ryan C, Bergin M, Chalder T, et al. Web-Based interventions for the management of stress in the workplace: focus, form, and efficacy. J Occup Health 2017;59(3):215–236.
Ebert DD, Heber E, Berking M, et al. Self-guided internet-based and mobile-based stress management for employees: results of a randomised controlled trial. Occup Environ Med 2016;73(5):315-323.
Ebert DD, Lehr D, Heber E, et al. Internet- and mobile-based stress management for employees with adherence-focused guidance: efficacy and mechanism of change. Scand J Work Environ Health 2016;42(5):382-394.
Heber E, Lehr D, Ebert DD, et al. Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial. J Med Internet Res 2016;18(1):e21.
Williams A, Hagerty BM, Brasington SJ, et al. Stress gym: Feasibility of deploying a web-enhanced behavioral self-management program for stress in a military setting. Mil Med 2010;175(7):487-493.
Stansfeld SA, Kerry S, Chandola T, et al. Pilot study of a cluster randomised trial of a guided e-learning health promotion intervention for managers based on management standards for the improvement of employee well-being and reduction of sickness absence: GEM Study. BMJ Open 2015;5(10):e007981,2015-007981.
Ebert DD, Berking M, Thiart H, et al. Restoring depleted resources: Efficacy and mechanisms of change of an internet-based unguided recovery training for better sleep and psychological detachment from work. Health Psych 2015;34(S):1240.
Hoffmann TC, Glasziou PP, Boutron I, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 2014;348:g1687.
Foureur M, Besley K, Burton G, Yu N, Crisp J. Enhancing the resilience of nurses and midwives: Pilot of a mindfulness based program for increased health, sense of coherence and decreased depression, anxiety and stress. Contemp Nurse 2013;45(1):114-125.
Warriner S, Hunter L, Dymond M. Mindfulness in maternity: Evaluation of a course for midwives. Br J Midwifery 2016;24(3):188-195.
van der Riet P, Rossiter R, Kirby D, Dluzewska T, Harmon C. Piloting a stress management and mindfulness program for undergraduate nursing students: Student feedback and lessons learned. Nurse Educ Today 2015;35(1):44-49.
Huang H. Examining the beneficial effects of individual's self-disclosure on the social network site. Comput Human Behav 2016;57:122-132.
Li S, Feng B, Li N, Tan X. How social context cues in online support-seeking influence self-disclosure in support provision. Commun Q 2015;63(5):586-602.
Oh HJ, Ozkaya E, LaRose R. How does online social networking enhance life satisfaction? The relationships among online supportive interaction, affect, perceived social support, sense of community, and life satisfaction. Comput Human Behav 2014;30:69-78.
Lehr D, Geraedts A, Asplund RP, et al. Occupational e-Mental Health: Current Approaches and Promising Perspectives for Promoting Mental Health in Workers. In: Healthy at Work. Springer; 2016;257-281.
Cheng S, Tsui PK, Lam JH. Improving mental health in health care practitioners: Randomized controlled trial of a gratitude intervention. J Consult Clin Psychol 2015;83(1):177.
Billings DW, Cook RF, Hendrickson A, Dove DC. A web-based approach to managing stress and mood disorders in the workforce. J Occup Environ Med 2008;50(8):960-968.
Feicht T, Wittmann M, Jose G, et al. Evaluation of a seven-week web-based happiness training to improve psychological well-being, reduce stress, and enhance mindfulness and flourishing: a randomized controlled occupational health study. Evid Based Complementary Altern Med 2013;2013:676953.
McDonald G, Jackson D, Wilkes L, Vickers MH. Personal resilience in nurses and midwives: Effects of a work-based educational intervention. Contemp Nurse 2013;45(1):134-143.
McDonald G, Jackson D, Wilkes L, Vickers MH. A work-based educational intervention to support the development of personal resilience in nurses and midwives. Nurse Educ Today 2012;32(4):378-384.
Wallbank S. Effectiveness of individual clinical supervision for midwives and doctors in stress reduction: findings from a pilot study. Evid Based Midwifery 2010;8(2):65-70.
Bianchi EF, Bhattacharyya MR, Meakin R. Exploring senior doctors' beliefs and attitudes regarding mental illness within the medical profession: a qualitative study. BMJ Open 2016;6(9):e012598,2016-012598.
Lazarus RS. Stress and emotion: A new synthesis. Springer Publishing Company; 2006.
Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;337:a1655.
Wright EM. Evaluation of a web-based holistic stress reduction pilot program among nurse-midwives. J Holist Nurs 2017:0898010117704325 [Epub ahead of print].
Watson J. The theory of human caring: retrospective and prospective. Nurs Sci Q 1997;10(1):49-52.
England N. NHS five year forward view. London: NHS England. (2014). Available at: https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf accessed 10 April 2018.
Burton A, Burgess C, Dean S, Koutsopoulou GZ, Hugh‐Jones S. How effective are mindfulness‐based interventions for reducing stress among healthcare professionals? A systematic review and meta‐analysis. Stress Health 2016;33(1):3-13.
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