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G49 Resilience, Post-Traumatic Stress, Burnout and Coping in Medical Staff on the Paediatric and Neonatal Intensive Care Unit (P/NICU) – A Survey
  1. C Dalia1,
  2. K Abbas2,
  3. G Colville3,
  4. J Brierley2
  1. 1Medical School, St Georges Hospital, London, UK
  2. 2Paediatric and Neonatal Intensive Care Unit, Great Ormond St Hospital, London, UK
  3. 3Dept of Psychology, St Georges Hospital, London, UK

Abstract

Aims Working on intensive care (ICU) can be stressful, Adult-ICU studies demonstrate staff burnout and post-traumatic stress disorder, (PTSD) although resilience is associated with a healthier psychological state in ICU nurses. This study aims to determine whether resilience is related to the prevalence of burnout and PTSD symptoms in PICU/NICU staff, and to establish any differences in coping strategies with varying levels of resilience.

Methods Workplace questionnaire: demographic data, questions on coping strategies and extracts: (1) Brief Resilience Scale 6 items scored on a 5-point scale, higher scores indicate greater resilience) (2) Trauma Screening Questionnaire 10 statements answered ‘yes’ or ‘no’. Score of > 6 predicts PTSD (3) abbreviated Maslach Burnout Inventory – 3 separate subscales: Emotional Exhaustion (EE) = reduced energy and job enthusiasm, Depersonalization (DP) = cynicism, treatment of patients as inanimate, Personal Accomplishment (PA) = Sense of efficacy and effectiveness.

Results 58 respondents (50 female) 32 nurses, 22 doctors, 4 other HCPs. Years qualified: Range 0–32; P/NICU experience: Range 0–28 years.

Mean score for resilience = 3.58 (1.83 –5) 1 = lowest level of resilience and 5 = highest.

Mean burnout measure: PA = 12.5, DP = 2.6 and EE = 8.0 (Scale ‘felt this way’ 0 = never to 18 = everyday).

All staff admitted to symptoms of emotional exhaustion on some level, 22 experienced some depersonalization. Scores for personal achievement ranged from 2–18.

Higher resilience levels were significantly associated with lower PTSD symptoms (r = –0.41, p = 0.001).

10 HCPs met criteria suggestive of PTSD, 38 had lower but concerning scores.

Significant negative correlation between resilience and emotional exhaustion (r = –0.36, p = 0.005) and positive correlation between resilience and personal achievement (r = 0.36, p = 0.005).

No significant difference in coping strategies across different levels of resilience, only one (‘keep professional boundaries’) distinguished between higher and lower resilience levels.

Conclusion Paediatric and Neonatal ICU staff show concerning levels of psychological trauma. Greater resilience is associated with lower levels of PTSD symptomatology and some measures of burnout, indicating a better psychological state.

More research is required to investigate the role of different coping strategies, including techniques, which can influence resilience, and how these may be promoted in staff working in this environment to facilitate staff wellbeing and retention.

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