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Qualitative interview study of strategies to support healthcare personnel mental health through an occupational health lens

Por: Brown-Johnson · C. · DeShields · C. · McCaa · M. · Connell · N. · Giannitrapani · S. N. · Thanassi · W. · Yano · E. M. · Singer · S. J. · Lorenz · K. A. · Giannitrapani · K.
Background

Employee Occupational Health (‘occupational health’) clinicians have expansive perspectives of the experience of healthcare personnel. Integrating mental health into the purview of occupational health is a newer approach that could combat historical limitations of healthcare personnel mental health programmes, which have been isolated and underused.

Objective

We aimed to document innovation and opportunities for supporting healthcare personnel mental health through occupational health clinicians. This work was part of a national qualitative needs assessment of employee occupational health clinicians during COVID-19 who were very much at the centre of organisational responses.

Design

This qualitative needs assessment included key informant interviews obtained using snowball sampling methods.

Participants

We interviewed 43 US Veterans Health Administration occupational health clinicians from 29 facilities.

Approach

This analysis focused on personnel mental health needs and opportunities, using consensus coding of interview transcripts and modified member checking.

Key results

Three major opportunities to support mental health through occupational health involved: (1) expanded mental health needs of healthcare personnel, including opportunities to support work-related concerns (eg, traumatic deployments), home-based concerns and bereavement (eg, working with chaplains); (2) leveraging expanded roles and protocols to address healthcare personnel mental health concerns, including opportunities in expanding occupational health roles, cross-disciplinary partnerships (eg, with employee assistance programmes (EAP)) and process/protocol (eg, acute suicidal ideation pathways) and (3) need for supporting occupational health clinicians’ own mental health, including opportunities to address overwork/burn-out with adequate staffing/resources.

Conclusions

Occupational health can enact strategies to support personnel mental health: to structurally sustain attention, use social cognition tools (eg, suicidality protocols or expanded job descriptions); to leverage distributed attention, enhance interdisciplinary collaboration (eg, chaplains for bereavement support or EAP) and to equip systems with resources and allow for flexibility during crises, including increased staffing.

Lived experience of recurrent miscarriage: women and their partners experience of subsequent pregnancy and support within an NHS specialist clinic - a qualitative study

Por: Hawkes · A. · Shields · R. C. · Quenby · S. · Bick · D. · Parsons · J. · Harris · B.
Objective

This study aims to describe the lived experiences of couples with a history of recurrent miscarriage in subsequent pregnancies and their perception of clinic support and cytogenetic investigations.

Design

A qualitative interview study with a phenomenological approach. Semistructured interviews were conducted using video conferencing software. Two researchers coded the transcripts and developed themes.

Setting

A National Health Service (NHS) hospital in central England between May 2021 and July 2021, during the COVID-19 pandemic.

Participants

Patients attending a specialist recurrent miscarriage clinic and their partners. This clinic accepts referrals from all over the UK for couples who have suffered two or more miscarriages.

Results

Seventeen participants were interviewed: 14 women and 3 male partners. Six main themes were identified from the data. Three related to the women’s lived experience of recurrent miscarriage (emotions in pregnancy, confidence in their bodies, expectations and coping strategies) and three related to the clinical support offered by the NHS service (impact of early pregnancy scanning, effect of the COVID-19 pandemic and cytogenetic investigations).

Conclusions

Pregnancy following recurrent miscarriage is extremely difficult. Recurrent miscarriage specialist services can provide couples with support and access to early pregnancy scanning, which can make the first trimester of pregnancy manageable. Partners should not be excluded from the clinic as it can result in a feeling of disconnect. Cytogenetic testing of pregnancy tissue can offer couples with recurrent miscarriage closure after pregnancy loss and is a desired investigation.

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