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Art Therapy to Address Hospital Clinician Burnout (CHArt)

Primary Purpose

Burnout, Anxiety, Stress

Status
Recruiting
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
Group art therapy
Sponsored by
Barts & The London NHS Trust
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Burnout focused on measuring Art therapy, psychosocial distress, hospital clinicians, burnout

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: • Healthcare professional employed in a patient facing clinical role by Barts Health NHS Trust or Barts Bank partners 18 years or older Willing and able to provide informed consent Able to attend the group intervention sessions Moderate to severe risk scored on any of the three MBI - HSS subscales or on the PSS 10: emotional exhaustion score of ≥17, or depersonalization score of ≥7, or personal accomplishment score of ≤ 38 or perceived stress (≥ 14) Exclusion Criteria: • Unwilling or unable to give consent Diagnosed with or treated for a serious depressive condition, a personality disorder or psychosis in the past 12 months. (Self-reporting through screening.) Attempted suicide or made plans to commit suicide in the past 12 months. (Self-reporting through screening.) Individual does not provide direct patient care for Barts Health NHS Trust

Sites / Locations

  • Barts Health NHS TrustRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Group art therapy

waitlist control group

Arm Description

Participants randomised to the intervention group receive the group art therapy intervention shortly after baseline assessment. Adherence to the intervention will be checked via an adherence questionnaire completed by therapist delivering the intervention after each session. In addition, 20% of sessions will be observed by an independent researcher for adherence checking.

Participants randomised to the waitlist control group will complete outcomes measures at baseline and at the end of a 6 week waiting period. They will then begin the intervention (1-2 weeks after the intervention group has finished).

Outcomes

Primary Outcome Measures

Change in burnout element 'Emotional Exhaustion' assessed using the Emotional Exhaustion scale of The Maslach Burnout Inventory - Human Services Survey (MBI-HSS)
The MBI-HSS assesses three elements of burnout syndrome: emotional exhaustion, depersonalization, and lack of personal accomplishment. Each element is measured by a separate scale. The Emotional Exhaustion (EE) scale assesses feelings of being emotionally over-extended and exhausted at work. It includes 9 items which are scored on a 7-item Likert scale from 0 = never to 6 = every day. The scale has a score range of 0-54 with higher scores corresponding to greater experiences of burnout.

Secondary Outcome Measures

Change in burnout element 'depersonalisation' assessed using the Depersonalisation scale of The Maslach Burnout Inventory - Human Services Survey (MBI-HSS)
Depersonalisation scale of the MBI - HSS The 5-item Depersonalization (DP) scale assesses an emotionally distant / indifferent response toward patients. It includes 6 items which are scored on a 7-item Likert scale from 0 = never to 6 = every day. The scale has a score range of 0-30 with higher scores corresponding to greater experiences of burnout.
Change in burnout element 'personal accomplishment' assessed using the Personal Accomplishment scale of The Maslach Burnout Inventory - Human Services Survey (MBI-HSS)
Personal Accomplishment (PA) scale assesses feelings of competence and achievement in work with people. It includes 8 items which are scored on a 7-item Likert scale from 0 = never to 6 = every day. The scale has a score range of 0-48 with lower scores corresponding to greater experiences of burnout.
Change in anxiety assessed using the Generalised Anxiety Disorder Questionnaire (GAD 7)
The GAD 7 assesses anxiety. It includes 7 items which are scored on a 4-item Likert scale from 0 = not at all to 3 = nearly every day. The scale has a score range of 0-21 with higher scores corresponding to greater levels of anxiety.
Change in depression assessed using the Personal Health Questionnaire Depression Scale (PHQ 8)
The PHQ 8 assesses severity of depression. It includes 8 items which are scored on a 4-item Likert scale from 0 = not at all to 3 = nearly every day. The scale has a score range of 0-24 with higher scores corresponding to greater severity of depression.
Change in perceived stress assessed using the Perceived Stress Scale (PSS-10)
The PSS10 assesses perceived stress. It includes 10 items which are scored on a 5-item Likert scale from 0 = never to 4 = very often. The scale has a score range of 0-40 with higher scores corresponding to greater levels of perceived stress.
CHArt Feedback Questionnaire
This is a participant experience feedback questionnaire. It includes 8 items on themes of perceived helpfulness, perceived behavioural change and attribution of change, barriers and enablers to attendance. Questions include multiple choice and follow - up free text elements. For example Question 6: Were there any barriers / challenges to attending? Yes, definitely; Yes, some; Not really; Not at all If so, what were they and how did you address them? If not, what made attendance possible for you?

Full Information

First Posted
February 1, 2023
Last Updated
March 14, 2023
Sponsor
Barts & The London NHS Trust
Collaborators
Queen Mary University of London
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1. Study Identification

Unique Protocol Identification Number
NCT05728086
Brief Title
Art Therapy to Address Hospital Clinician Burnout
Acronym
CHArt
Official Title
Art Therapy to Address Hospital Clinician Burnout and Psychosocial Distress: a Randomised Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 6, 2023 (Actual)
Primary Completion Date
July 1, 2024 (Anticipated)
Study Completion Date
July 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Barts & The London NHS Trust
Collaborators
Queen Mary University of London

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A structured group art therapy intervention, comprising six 60 - 90-minute weekly workshops.
Detailed Description
The CHArt group art therapy intervention builds on a 6-week art therapy group intervention piloted with Barts Health oncology and palliative care doctors (Tjasink, M. 2019). It incorporates elements of workshops delivered for staff support by Barts art therapists during the Covid-19 pandemic (Tjasink, M., Stevens, P. 2022). The intervention is broadly informed by affective neuroscience and evolutionary psychology theories with an emphasis on compassion-focused and resource-oriented therapeutic practice. Whilst the intervention draws on diverse influences, it aligns with the principles of Compassion Focussed Therapy (CFT), an integrative, bio-physiological psychological model underpinned by evolutionary theory. Intervention elements include psycho-education, individual art making, collaborative group art making, art making in pairs, exploring a range of art materials and techniques (including clay, paint, natural objects and non-traditional mark - making materials), art-based grounding exercises and reflective discussion. The intervention manual was developed by the study's Chief Investigator with input from a group of three art therapy experts (Health and Care Professions Council (HCPC) accredited art therapists working in National Health Service (NHS) medical contexts with experience of delivering art therapy - based staff support) and three experts by experience (Health Care professionals with experience of participating in art therapy - based staff support groups at work). Adherence to the intervention will be monitored through two adherence tools (therapist self reported and independent observer).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Burnout, Anxiety, Stress, Depression
Keywords
Art therapy, psychosocial distress, hospital clinicians, burnout

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Waitlist randomized controlled trial (RCT) design comprising an intervention group and a waitlist-control group
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
125 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Group art therapy
Arm Type
Experimental
Arm Description
Participants randomised to the intervention group receive the group art therapy intervention shortly after baseline assessment. Adherence to the intervention will be checked via an adherence questionnaire completed by therapist delivering the intervention after each session. In addition, 20% of sessions will be observed by an independent researcher for adherence checking.
Arm Title
waitlist control group
Arm Type
No Intervention
Arm Description
Participants randomised to the waitlist control group will complete outcomes measures at baseline and at the end of a 6 week waiting period. They will then begin the intervention (1-2 weeks after the intervention group has finished).
Intervention Type
Other
Intervention Name(s)
Group art therapy
Intervention Description
The intervention is a manualised programme of group art therapy based on a bio-psychosocial therapeutic model. The programme is made up of six 60 - 90-minute art therapy group sessions facilitated by an experienced HCPC (Health and Care Professions Council) registered Art Therapists trained in the intervention.
Primary Outcome Measure Information:
Title
Change in burnout element 'Emotional Exhaustion' assessed using the Emotional Exhaustion scale of The Maslach Burnout Inventory - Human Services Survey (MBI-HSS)
Description
The MBI-HSS assesses three elements of burnout syndrome: emotional exhaustion, depersonalization, and lack of personal accomplishment. Each element is measured by a separate scale. The Emotional Exhaustion (EE) scale assesses feelings of being emotionally over-extended and exhausted at work. It includes 9 items which are scored on a 7-item Likert scale from 0 = never to 6 = every day. The scale has a score range of 0-54 with higher scores corresponding to greater experiences of burnout.
Time Frame
Baseline [T1], post 6-week intervention / post 6-week wait [T2], 12 week post intervention follow up [T3]
Secondary Outcome Measure Information:
Title
Change in burnout element 'depersonalisation' assessed using the Depersonalisation scale of The Maslach Burnout Inventory - Human Services Survey (MBI-HSS)
Description
Depersonalisation scale of the MBI - HSS The 5-item Depersonalization (DP) scale assesses an emotionally distant / indifferent response toward patients. It includes 6 items which are scored on a 7-item Likert scale from 0 = never to 6 = every day. The scale has a score range of 0-30 with higher scores corresponding to greater experiences of burnout.
Time Frame
Baseline [T1], post 6-week intervention / post 6-week wait [T2], 12 week post intervention follow up [T3]
Title
Change in burnout element 'personal accomplishment' assessed using the Personal Accomplishment scale of The Maslach Burnout Inventory - Human Services Survey (MBI-HSS)
Description
Personal Accomplishment (PA) scale assesses feelings of competence and achievement in work with people. It includes 8 items which are scored on a 7-item Likert scale from 0 = never to 6 = every day. The scale has a score range of 0-48 with lower scores corresponding to greater experiences of burnout.
Time Frame
Baseline [T1], post 6-week intervention / post 6-week wait [T2], 12 week post intervention follow up [T3]
Title
Change in anxiety assessed using the Generalised Anxiety Disorder Questionnaire (GAD 7)
Description
The GAD 7 assesses anxiety. It includes 7 items which are scored on a 4-item Likert scale from 0 = not at all to 3 = nearly every day. The scale has a score range of 0-21 with higher scores corresponding to greater levels of anxiety.
Time Frame
Baseline [T1], post 6-week intervention / post 6-week wait [T2], 12 week post intervention follow up [T3]
Title
Change in depression assessed using the Personal Health Questionnaire Depression Scale (PHQ 8)
Description
The PHQ 8 assesses severity of depression. It includes 8 items which are scored on a 4-item Likert scale from 0 = not at all to 3 = nearly every day. The scale has a score range of 0-24 with higher scores corresponding to greater severity of depression.
Time Frame
Baseline [T1], post 6-week intervention / post 6-week wait [T2], 12 week post intervention follow up [T3]
Title
Change in perceived stress assessed using the Perceived Stress Scale (PSS-10)
Description
The PSS10 assesses perceived stress. It includes 10 items which are scored on a 5-item Likert scale from 0 = never to 4 = very often. The scale has a score range of 0-40 with higher scores corresponding to greater levels of perceived stress.
Time Frame
Baseline [T1], post 6-week intervention / post 6-week wait [T2], 12 week post intervention follow up [T3]
Title
CHArt Feedback Questionnaire
Description
This is a participant experience feedback questionnaire. It includes 8 items on themes of perceived helpfulness, perceived behavioural change and attribution of change, barriers and enablers to attendance. Questions include multiple choice and follow - up free text elements. For example Question 6: Were there any barriers / challenges to attending? Yes, definitely; Yes, some; Not really; Not at all If so, what were they and how did you address them? If not, what made attendance possible for you?
Time Frame
post 6-week intervention [T2]

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: • Healthcare professional employed in a patient facing clinical role by Barts Health NHS Trust or Barts Bank partners 18 years or older Willing and able to provide informed consent Able to attend the group intervention sessions Moderate to severe risk scored on any of the three MBI - HSS subscales or on the PSS 10: emotional exhaustion score of ≥17, or depersonalization score of ≥7, or personal accomplishment score of ≤ 38 or perceived stress (≥ 14) Exclusion Criteria: • Unwilling or unable to give consent Diagnosed with or treated for a serious depressive condition, a personality disorder or psychosis in the past 12 months. (Self-reporting through screening.) Attempted suicide or made plans to commit suicide in the past 12 months. (Self-reporting through screening.) Individual does not provide direct patient care for Barts Health NHS Trust
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Megan Tjasink
Phone
0207 540 4210
Email
m.tjasink@qmul.ac.uk
First Name & Middle Initial & Last Name or Official Title & Degree
Stefan Priebe
Phone
0207 540 4210
Email
s.priebe@qmul.ac.uk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stefan Priebe
Organizational Affiliation
Queen Mary University of London
Official's Role
Study Chair
Facility Information:
Facility Name
Barts Health NHS Trust
City
London
ZIP/Postal Code
E13 8SP
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Megan Tjasink
Phone
07866602738
Email
m.tjasink@qmul.ac.uk

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
Citation
Tjasink, M., G. Soosaipillai (2019) Art therapy to reduce burnout in oncology and palliative care doctors: a pilot study.
Results Reference
background
Citation
Tjasink, M, Stevens, P. (2022). The innovative use of art psychotherapy with NHS clinicians in Jury, H. and Coles, A., 'Art Psychotherapy and Innovation: New Territories, Techniques and Technologies'. Jessica Kingsley, London: 83 - 103.
Results Reference
background
Citation
Maslach, C. et al. (2018). Maslach burnout inventory: manual. [Menlo Park, Calif.], Mind Garden.
Results Reference
background

Learn more about this trial

Art Therapy to Address Hospital Clinician Burnout

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