3.2 and 4.2 Wellbeing for self

clinical wellbeing

Experiencing satisfaction and engagement with work while also having a feeling of professional fulfilment and a sense of meaning in work.

stress

physiological or psychological response to internal or external stressors.

Burnout

Physical, emotional, or mental exhaustion accompanied by decreased motivation, lowered performance, and negative attitudes toward oneself and others.

Trauma

Any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behaviour, and other aspects of functioning.

when wellbeing goes down what is affected

service delivery

job performance

job satisfaction

personal life

stressor

any event, force or condition that results in physical or emotional stress.

Stressors may be internal or external forces.

internal stressors vs external stressors

Internal e.g. memories, worries about future, stressful or unwanted thoughts etc.

 

External e.g. conflict with colleagues, financial problems, busy schedule etc.

five types of stressors

life events

chronic stressors

daily stressors

trauma

non events

differentiating in duration and intensity

life events

death of someone you know

divorce

job loss

chronic stressors

threats eg abuse risk of crime

high demands

lack of resources

ongoing conflict with partner or at home

trauma

accidents

abuse

sexual assault

robbery

non events

not married in time

not getting good job

not buying a house

stress is essentially a

survival mechanism.

Respond to physical threats for a short period of time.

Less adaptive in many modern parts of life.

what are physiological changes caused by stress

heart beats faster

bp and pulse go up

sight hearing and other senses become sharper

blood sugar released from stores to increase available energy for body

stress useful when active for

short periods

chronic activation of stress can lead to

-          Tension headaches and chronic painful conditions

 

-          Respiratory issues

 

-          Heart problems

 

-          Burnout

how we respond to stress is individually and culturally defined by

-          Personality

 

-          Past experiences (e.g., trauma, childhood attachment, etc.).

 

-          Self-beliefs (e.g., confidence, skills, etc.).

 

-          Coping styles

-          Cultural norms and expectations (e.g., culturally appropriate behaviours etc.).

lazurus and folman appraisal theory

highlights relationship between stressors and the way we cope with stress

summarise steps of stress coping according to LFAT

step 1 perception filter or selection

step 2 primary appraisal

step 3 secondary appraisal

step 4 coping with stress and reappraisal

perception filter or selection

Our brains filter information from the environment to decide what to attend to.

primary appraisal

Once something passes the filter, we then predict the potential impact of it.

Interpretation of stressors as:

-          Positive

-          Dangerous (challenge, threat, harm or loss)

-          Irrelevant

secondary appraisal

-          If something is viewed as dangerous then we consider our resources for the situation

Insufficient

Or

Sufficient

people implement coping strategies and reappraise

overcoming of stress is either

• Problem focused- change situation itself

• Emotion focused- change relation to situation

factors that shape stress reactions

biological individual and cultural factors

summarise coping mechanism of stress according to LFAT theory

Individuals identify potential stressors in their environment, appraise whether the potential stressor poses a risk, and whether they have the resources to meet the risk. They then activate coping resources. 

Burnout is multidimensional or meta construct with 3 domains:

emotional exhaustion

depersonalisation- increased mental distance from one’s job or feelings of negativism or cynicism related to one’s job

reduced sense of personal accomplishment leading to reduced professional self efficacy

what are the 3 types of burnout

frenetic burnout

underchallenged burnout

worn out burnout

frenetic burnout

Characterise by ambition.

Overload and overinvolment at work.

Putting self second to meeting work goals.

Strongly associated with exhaustion.

Problems solvers often found in this group.

Inability to recognise own limitations.

Under-challenged burnout

Characterised by indifference.

Lack of development and interest in tasks.

Work at a superficial level.

Boredom and monotony.

Worn out burnout

Characterised by neglect, inattentiveness and careless toward responsibilities.

Perceived lack of acknowledgement of efforts.

Perceived lack of control over work.

Behavioural disengagement from tasks and duties.

Too much stress and demand basically.

Under challenged burnout is too little stimulation and challenge.

compassion fatigue

inability to care through stress.

diminished capacity to care because of repeated exposure to suffering of patients and form knowledge of patient’s traumatic experiences

impact of compassion fatigue on work

•       Erodes capacity to connect with others by decreasing compassion and empathy.

•       Considered a cost of caring for others in distress, and an occupational hazard in caring professions.

physical symptoms of compassion fatigue

•       Exhaustion.

•       Insomnia.

•       Headaches.

•       Stomach aches.

behavioural symptoms of compassion fatigue

•       Anger and irritability.

•       Strained personal relationships (contributing to toxicity at work).

•       Avoidance of patients.

•       Silencing response.

psychological symptoms of compassion fatigue

•       Relational distancing.

•       Negative self-image.

•       Depression.

•       Reduced ability to feel sympathy and empathy.

•       Cynicism.

•       Resentment.

•       Dread of working with certain patients.

•       Professional helplessness.

•       Diminished enjoyment/career satisfaction.

•       Loss of hope.

how to address frenetic burnout

-          Minimise overload and stressors

 

-          Emotion focused coping to:

 

o   Help address issues such as perfectionism

o   Regulate emotions with breathing and relaxation

how to address underchallenged burnout

-          Identify development needs

-          Activities that support presence and engagement at work such as mindfulness

how to address wornout burnout

-          Address neglect issue

-          May require specialised services such as psychologist or counsellor to work through issues.

what are evidence driven strategies for compassion fatigue?

1.Breathing and meditation.

2.Snack and relax (didn’t work).

3.Educational programs (e.g., learning about
compassion fatigue).

what are broader approaches for compassion fatigue

Therapy and therapeutic tools (e.g., CBT, ACT, etc.).

The basics: Sleep, good nutrition, and exercise.

Social support.

Regular breaks.

General self-care activities.

Peer support and debriefing (supervision).

how can reflective practice help with addressing burnout etc

Good mental health and wellbeing require ongoing reflective practice to identify when problems are occurring and which strategies are effective in addressing the problem.

key to managing difficult situations, emotions, and the potential negative effects of long-term stress.

structured reflective practice

What, where, and who—the situation

How did it make you feel—your emotional state

Why did it happen—making sense of the situation

Could you have done anything differently—critical review and development of insight

What will you do differently in the future—how will this change your practice

Re-enforcement—what happens when you put this into practice

stress impacts our biological processes increasing

stress hormones like cortisol and adrenaline

body needs to move out of stress cycle.

ways of managing stress

physical activity

crying

creative endeavours

laughter

deep breathing and mindfulness

common stressors for audiologists

lack of time to complete tests and heavy workload.

patient issues: inability to completely solve issues or dealing with difficult patients.

admin and financial: underpayment for work.

lack of support

colleagues: conflict fixing others mistakes

work life balance: struggle meeting heavy workload in available hours impacting family life

similarities and differences between burnout and compassion fatigue

burnout relates to how you feel about your contribution at work.

compassion fatigue is your capacity to care for others.