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Our next chat is on Monday 22nd July at 8.30pm BST. It is being hosted by Joe Curtin from the East of England CSP Regional network @CSP_EOE

We as physios are all familiar with the benefits of physical activity for everyone, let alone those who are diagnosed with persistent conditions like arthritis, COPD, cancer, and beyond.

Physical inactivity has been closely linked to increasing the risk and burden of many persistent diseases, and the removal of this behaviour can improve health substantially (Lee et al 2012).

Physical activity has also been acknowledged as the most economically effective intervention or “best buy” for public health, along with reducing the risk of progression of chronic disease, and improve quality of life, and improving overall ability to function physically (US Department of Health and Human Service 2018)

All UK based physios will be familiar with the CSP’s ‘Love Activity’

campaign designed to get the nation moving.

The campaign is designed to offer expert advice and guidance from physiotherapy staff to patients, and gives practical tips for getting started, useful condition-specific insights and inspiring stories to motivate and inspire patients to begin activity. Information like this is best shared, so we at the CSP East of England Regional Network hope to facilitate this talk this evening.

Questions to consider
  • We want to know what area you work in, your most rewarding patient story, and strategies to promote activity in these persistent condition patients.
  • What are your reflections on the challenges of encouraging inactive patients to become more physically active?
  • Could you share your most rewarding patient story of encouraging physical activity?
  • Have you signed up to the Love Activity campaign?
  • What strategies are you using to promote physical activity to patients with persistent conditions?
  • What are you going to bring forward to use with your patient cohort?
Resources

Lee, I.-M., Shiroma, E.J., Lobelo, F., Puska, P., Blair, S.N., Katzmarzyk, P.T. and Group, L.P.A.S.W. (2012) ‘Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy’, The Lancet, 380(9838), 219-229

US Department of Health and Human Services (2018) ‘Physical Activity Guidelines Advisory Committee Scientific Report’. Washington, DC: US Department of Health and Human Services.

Resources for Patients with Specific Persistent Conditions: https://www.csp.org.uk/public-patient/keeping-active-and-healthy/love-activity-hate-exercise-campaign/being-active-long

Your host

Joe Curtin is a Rotational Physiotherapist working at Ipswich Hospital, as part of the East Suffolk and North Essex Foundation Trust. Joe qualified from the University of Limerick in 2018, with a BSc in Physiotherapy. He is also a member of the East of England CSP Regional Network. His research interests include secondary prevention of persistent disease, and mHealth. Through reflecting with his colleagues in the CSP EoERN, and nationally, all AHPs struggle to engage with those decreased activity levels to engage in Physical activity.

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Our next chat is on Monday 22nd July at 8.30pm BST. It is being hosted by Joe Curtin from the East of England CSP Regional network @CSP_EOE

We as physios are all familiar with the benefits of physical activity for everyone, let alone those who are diagnosed with persistent conditions like arthritis, COPD, cancer, and beyond.

Physical inactivity has been closely linked to increasing the risk and burden of many persistent diseases, and the removal of this behaviour can improve health substantially (Lee et al 2012).

Physical activity has also been acknowledged as the most economically effective intervention or “best buy” for public health, along with reducing the risk of progression of chronic disease, and improve quality of life, and improving overall ability to function physically (US Department of Health and Human Service 2018)

All UK based physios will be familiar with the CSP’s ‘Love Activity; Hate Exercise?’, the campaign designed to get the nation moving.

The campaign is designed to offer expert advice and guidance from physiotherapy staff to patients, and gives practical tips for getting started, useful condition-specific insights and inspiring stories to motivate and inspire patients to begin activity. Information like this is best shared, so we at the CSP East of England Regional Network hope to facilitate this talk this evening.

Questions to consider
  • We want to know what area you work in, your most rewarding patient story, and strategies to promote activity in these persistent condition patients.
  • What are your reflections on the challenges of encouraging inactive patients to become more physically active?
  • Could you share your most rewarding patient story of encouraging physical activity?
  • Have you signed up to the Love Activity, Hate Exercise? campaign?
  • What strategies are you using to promote physical activity to patients with persistent conditions?
  • What are you going to bring forward to use with your patient cohort?
Resources

Lee, I.-M., Shiroma, E.J., Lobelo, F., Puska, P., Blair, S.N., Katzmarzyk, P.T. and Group, L.P.A.S.W. (2012) ‘Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy’, The Lancet, 380(9838), 219-229

US Department of Health and Human Services (2018) ‘Physical Activity Guidelines Advisory Committee Scientific Report’. Washington, DC: US Department of Health and Human Services.

Resources for Patients with Specific Persistent Conditions: https://www.csp.org.uk/public-patient/keeping-active-and-healthy/love-activity-hate-exercise-campaign/being-active-long

Your host

Joe Curtin is a Rotational Physiotherapist working at Ipswich Hospital, as part of the East Suffolk and North Essex Foundation Trust. Joe qualified from the University of Limerick in 2018, with a BSc in Physiotherapy. He is also a member of the East of England CSP Regional Network. His research interests include secondary prevention of persistent disease, and mHealth. Through reflecting with his colleagues in the CSP EoERN, and nationally, all AHPs struggle to engage with those decreased activity levels to engage in Physical activity.

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The next #physiotalk tweet chat will be hosted on Monday 8th July at 8.30pm BST and led by physiotherapy student @_lewadam, who is currently researching as part of his dissertation project, the beliefs and perceptions of bending and lifting in the presence of low back pain.

Following on from the widely engaging chat regarding misinformation in physiotherapy, it seems reasonable to follow-up this up and look more closely at myths and misconceptions surrounding the global burden of low back pain (LBP).

Low back pain costs the UK economy more than £13 billion per year, contributing to 31 million working days being lost in 2016 (Office for National Statistics, 2016). In the NHS alone, back pain accounts for 40% of sickness absence placing further pressure upon stretched healthcare workforces (NHS Employers, 2014).

A recent systematic review uncovered that 79 websites (government, hospitals, universities, professional associations, healthcare organisations) from 6-english speaking countries provide mostly inaccurate information about LBP management which does not reflect current evidence (Ferreira et al. 2019). This is particularly concerning as the internet has rapidly become an easily accessible source for patients to engage with health information so that they can supplement the information provided by their healthcare professional’s in order to self-manage their condition.

Despite the very useful and informative  ‘Back Pain Myth Busters’ guide by the CSP, there still seems to be a divide amongst the beliefs of LBP held within society. Given its socioeconomic burden, healthcare professionals must strive to provide consistent, evidence-based information to patient’s in order to counteract conflicting, and potentially fear-mongering messages influencing poor prognosis (Nolan et al. 2018). Anecdotal evidence can indeed evolve via the media or internet however, the information and advice patients receive from healthcare professionals influences their beliefs for years to come (Darlow et al. 2013).

Discussions surrounding the treatment and management of LBP are commonplace on social media and more often than not generate thought-provoking conversations. Unfortunately, however, it is also not uncommon to stumble across misconceptions and myths that do not reflect contemporary evidence surrounding LBP.

Thus, wouldn’t it be great to discuss and try to dispel such myths on a Monday evening?!

Questions to consider.
  • What do you consider to be the major myths associated with LBP?
  • How do you approach re-educating patients about LBP?
  • What do you consider the core pillars of managing patients with non-specific LBP?
  • Are manual handling recommendations strictly adhered to in your place of work, is this reflected in your advice to patients?
  • How do you approach conversations with colleagues who may behold ‘outdated’ approaches to the treatment/management of non-specific LBP.
Resources. References:

Darlow, B., Dowell, A., Baxter, G., Mathieson, F., Perry, M. and Dean, S. (2013) The enduring impact of what clinicians say to people with low back pain. Annals of Family Medicine, 11 (6), pp. 527-534.

Ferreira, G., Traeger, A., Machado, G., O’Keefe, M. and Maher, C. (2019) Credibility, accuracy, and comprehensiveness of internet-based information about low back pain: a systematic review. Journal of Medical Internet Research, 21 (5), pp. 1-9.

NHS Employers. (2014) Back in work introduction and key messages: Part one of the back in work pack [Internet]. Available from: https://www.nhsemployers.org/-/media/Employers/Documents/Retain-and-improve/Back-in-Work/Back-in-work-part-1.

Nolan, D., O’Sullivan, K., Stephenson, J., O’Sullivan, P. and Luckock, M. (2018) What do physiotherapists and manual handling advisors consider safest lifting posture, and do back beliefs influence their choice? Musculoskeletal Science and Practice,33 (1), pp. 35-40.

Office for National Statistics. (2016) Full report: Sickness absence in the labour market [Internet]. Available from: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/sicknessabsenceinthelabourmarket/2016.

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Due to an unexpected postponement of this weeks original chat (Topic will now be discussed on 24th June) we have now got a new topic to discuss – the role of family on health and rehabilitation. We will be discussing this on Monday 10th June at 8.30pm BST – so same place, same time, just a different topic!

The World Health Organisation has said ‘Family is the fundamental institution of organization in society. Families provide the millieu where individuals are born, nurtured, learn to socialize and where an individual’s behaviour and views take shape‘. We, as health care professionals often cannot view our patients in isolation – they are usually part of some type of family unit and if we do not appreciate this, then our interventions might be lacking in a vital component, or we could miss out on an opportunity for more effective rehabilitation.

We all know how important family is to us all – and when we are ill or in need the importance of family support cannot be over estimated. This support goes from cradle to grave; from the care of neonates through to end of life care. It is support that is often freely and willingly given, but in contrast it can leave family members who support or care for a loved one exhausted from caring or even just from navigating the complexities of the health and social care systems. Is then adding the burden of assisting with rehabilitation a step too far?

In this chat we are going to explore a number of factors linked to family on our health and of course rehabilitation.

Questions to consider

How does family impact on our health?

How important do you feel family is to recovery from illness?

How important do you feel family is to the rehabilitation process – and why?

What strategies do you use to involve family in rehabilitation?

How do you consider family or carer stress during recovery and rehabilitation?

Useful resources and pre-reading

Clinical Implications of Family‐Centered Care in Stroke Rehabilitation

The needs of families of ICU trauma patients: an integrative review

Family Influence in Recovery from Severe Mental Illness

An integrated model of social environment and social context for pediatric rehabilitation

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Our chat on Monday 10th June will be at the usual time of 8.30pm BST and it is hosted by Nicola Laughlan.

She writes that risk is something we encounter daily in our professional and personal lives. It is impossible to eliminate risk entirely from our lives. Even if we wrapped ourselves in cotton wool and remained in bed forever, we would risk pressure sores, muscle wasting, dehydration and malnutrition!

In the same vein, we take risks when we stand up out of bed (falling), exercise (muscle strain), or eat and drink (choking). Our quality of life therefore depends heavily on weighing up the pros and cons, and taking calculated risks.

What, then for our patients? How do we help them balance out those pros and cons, and manage their own level of risk on a daily basis? Particularly when they are sometimes unable to identify the risks themselves or they are under our day to day care in hospital? How do we help them adjust when they move from one environment to another eg from home to hospital and back again?

Questions to consider
  1. What does ‘risk’ look like to you?
  2. How do you assess risk
  3. Do you use particular risk-focused assessments?
  4. What input do your patients have into their own risk assessments?
  5. How do you promote risk enablement within your working environment?
  6. Whose risk is it anyway? Is it only ours until we stop being actively involved in an individuals care or does it continue?
Pre-chat reading and resources

Managing Risk Positively A Guide for Staff in Health and Social Care

Risk enablement and human rights

Older persons’ experiences of adapting to daily life at home after hospital discharge: a qualitative metasummary

What if the NHS changed its approach to risk

Chat host information

I am a Clinical Specialist Physiotherapist in Falls and Osteoporosis working within a community team, but with recent experience working in acute elderly inpatient care.

I have worked in various different roles since qualifying in 1999, however, my main interests are in elderly and mental health care. My experience has been based equally in hospital and community care, and I believe this has enabled me to have a rounded perspective on the transitions between both.

Risk enablement is of particular interest to me in every aspect of healthcare, as I believe we clinicians need to involve people more in making decisions for themselves and taking personal responsibility for their own healthcare.

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Our next chat is on Monday 27th May at 8.30pm BST. It is hosted by @TheACPRC

It is estimated that there are approximately 1.8 million people aged over 60 living with frailty in England, and almost half of these are people are aged over 80 (ELSA 2016). Frailty is not a diagnosis, but it is symptom of patients with multiple chronic conditions, of which many are respiratory in origin.

It is therefore vital that we work across clinical areas, providers, primary and secondary care to ensure these patients get the specialist care they need while considering the impact of frailty on their needs. This Tweet chat is to open up discussions as to how all physiotherapists can best manage respiratory conditions in our frail patients, particularly those who may not be admitted to specialist respiratory areas.

Questions to consider
  • What red flags can we look for that might highlight a frail patient to us?
  • Should we routinely assess for frailty in respiratory services, and what assessment tools can we use?
  • How can respiratory/acute medicine teams work collaboratively to deliver best practice for both respiratory and frailty-related problems?
  • How can we support frail patients with respiratory disease admitted to non-respiratory speciality areas? How do we support the staff working in these areas?
  • How can we support frail patients with their respiratory symptoms and treatment plans?
Our guest hosts

The Association of Chartered Physiotherapists in Respiratory Care is a National Body which promotes health and best practice in Respiratory Physiotherapy for the benefit of all. It is one of the largest professional networks of physiotherapists in the UK . The ACPRC is run by an elected committee of members who support the organisation on a voluntary basis. The committee itself is made up of a wide range of specialist physiotherapists, many of whom are leading figures in their area of expertise.

Chat resources

Frailty Core Capabilities Framework

Research on older people living with frailty in hospital

Safe, compassionate care for frail older people using an integrated care pathway

Fit for frailty

Joining in for the first time?

How to tweetchat

Keeping up with a tweetchat

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Physiotalk have been carrying out research supported by Dr. Cathy Bulley, a Reader at Queen Margaret University, around tweetchats and continuing professional development. Our first research project looked at the impact of participating in a #physiotalk tweetchat and was presented at WCPT congress in 2017 and then published in the European Journal of Physiotherapy


But we know that most of our followers do not actually participate in a tweetchat – in common twitter parlance they ‘lurk’ on the chat. So this became the focus of our next research project – looking to see if people who ‘lurk’ gain anything from that type of participation. We are presenting Stage 1 of this research at WCPT 2019 and will be presenting Stage 2 (based on interviews with ‘lurkers’) at Physiotherapy UK in November 2019 – so watch this space!

Our presentation is on Monday 13th May at 1.45pm (Geneva time!) and this blog post is timed to go out at as Janet starts speaking, to add to the information that will be presented in an WCPT 2019 platform presentation!

Abstract:

This has been enhanced with additional charts showing an overview of the wider results.

Background: Tweetchats are becoming a recognised method of engaging in continuing professional development (CPD). Previous research demonstrated that participants in a Physiotalk tweetchat valued the connectedness and the constructive change gained from participation. The phenomenon of ‘lurking’ on social media has long been recognised but there is little research examining the impact lurking may have on health care professionals CPD
Purpose: This study aimed to explore experiences and views of lurkers in a specific online twitter community in relation to continuing professional development. Lurking is defined as watching a tweetchat in real time or reading tweets or a transcript after the chat, but not posting tweets during the chat.
Methods:
A mixed methods two-stage study was planned to explore the perceived impacts of ‘lurking’ during a Tweetchat on participants’ CPD.
This is a report of Stage one, an online survey incorporating both open and closed questions based on the findings of previous research. Closed questions were analysed using descriptive statistics. Open questions were analysed using open, axial and selective coding developing themes building on those developed in the previous research.
Results: 44 complete responses were submitted. The survey respondents were 77.3% female with the majority in the 41 – 60 age group (40.9%). Whilst the respondents were predominantly from the UK (68.2%) most other global regions were represented.

Gender Age Level of qualification Geographical area

Most chose to look at the tweets after the chat finished (54.5%). Free text responses indicated this was often due to being in a different time zone and availability during a chat. Most did lurk regularly, with 67% engaging at least monthly. The main driver for engagement was the topic of the tweetchat.

How often respondents lurked on a #physiotalk chat Methods respondents used to access a #physiotalk chat The respondents preferred method of following a #physiotalk chat The prompts to engage with a #physiotalk chat Connectedness
52.2% felt at least ´somewhat´ part of the community and 76.7% answered that it allowed connections with other physiotherapists around the world. This was reported as finding new people to follow especially those who they perceived as experts. Do you feel part of a Physiotalk community? Does engaging with #physiotalk enable you to feel connected with other physiotherapists wherever they are in the world? Has engaging with #physiotalk allowed you to make connections with other physiotherapists? Constructive change

Whilst 52.3% of respondents reported that they used Physiotalk very little or not at all to access CPD, 75% did respond that they were prompted to look further into a topic, 81.8% said it had added to their knowledge and 65.9% said it had changed their views on a topic to a certain extent.

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Our next #physiotalk tweetchat will be on Monday 29th April at 8.30pm BST

The topic is on Misinformation in physiotherapy – so what’s that and what can we do about it?

Most physiotherapists profess to be using evidence based practice – or at the very least aspire to being practitioners who use the best evidence we can find. We live in a 24 hour society and sometimes it seems that the latest evidence is coming at us from multiple sources: we can’t possibly still be using outdated, misinformed or plain wrong practices – or can we? Is there just too much information coming at us that we can’t possibly sort out what is useful from what is misinformed?

The chat on Monday night will focus on:

  • How to identify misinformation
  • Understanding why might misinformation get shared
  • How do we make sure our practice is evidence based
  • How do we ensure the correct information is disseminated

This will be looking from two angles – firstly how we as practitioners can be misinformed or outdated and secondly, how do we go about correcting the misinformation held by the public at large.  We know this is a tough ask – some campaigns such as the CSP’s ‘Back Pain Myth Busters‘ have been needed to try and correct some very strong beliefs that are held by the public at large and of course potentially by some professionals as well. This is nothing new of course – a paper in 1993 proposed that Chronic Low Back Pain might be a product of incorrect information given to acute low back pain patients.

Questions to consider
  1. What do you consider to be the major ‘myths’ in physiotherapy?
  2. How do you identify that a practice or intervention might be based on misinformation?
  3. Why does misinformation seem to be shared more widely that EBP – or is it?
  4. How can we become better at appraising the new (and relinquishing the outdated)?
  5. What can we do to ensure correct information only is disseminated to the public?
Resources

Thanks to Tom Jesson who compiled a long list of myths and misconceptions for students

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Our tweetchat on Monday 15th April at 8.30pm (BST) will be hosted by @KatiePwork @RtHPhysio and @HeneghanNicola and will focus on getting your abstract ready for Physiotherapy UK.

Physiotherapy UK 2019 is the flagship scientific conference hosted by the Chartered Society of Physiotherapy for those with an interest in physiotherapy and rehabilitation. It is aimed at all sectors, settings, specialities and seniorities (including students and support workers) and is a fantastic opportunity to share, learn and network. This year’s themes are innovation in rehabilitation, managing complexity, fit for work and the next generation.

The call for abstracts for the programme is open until 24 April. Submitting an abstract is a great opportunity to share your innovations and achievements with the physiotherapy community. In 2018 30% of the programme was made up of abstracts. Every abstract that is accepted is published in an online supplement of physiotherapy and may also be selected for the CSP Innovations in Physiotherapy database which is great for your CV.

We are going to chat about submitting abstracts to find out how everyone is getting on and to share information about the support on offer.

Feedback on your experience of getting involved with Physiotherapy UK will be invaluable to help others and to improve the abstract submission process in the future.

The chat hosts are all involved in organising Physiotherapy UK as follows:

Ruth’s role is to lead the development of content for the #physio19 programme, including working with networks, theme leads and other contributors. This year, that includes partnering with lots of professional networks APCP, ACPOHE and MACP.

Nicola is Chair of MACP, partners for the managing musculoskeletal complexity theme.

Katie works on abstract submission and review.

Questions to consider

Q 1. Do you feel sharing your work at Physio UK is achievable?

Q2. What support networks could you use (or have you used in the past) to help?

Q3. How do you decide what is most important to include or what to leave out?

Q4. How can you improve the quality of your abstract?

Q5. Do you have any last minute tips for anyone still working on an abstract?

Pre-chat resources
  • Frontline articles:

https://www.csp.org.uk/frontline/article/developing-research-profile

http://www.csp.org.uk/frontline/article/cpd-ptuk-art-abstracts http://www.csp.org.uk/frontline/article/getting-research.

CAHPR top tips on getting an abstract accepted: https://cahpr.csp.org.uk/content/cahpr-top-ten-tips

Post chat

The chat transcript will be posted here after the chat

The chat hosts

Ruth ten Hove is interim Assistant director in Practice and Development at the CSP. Ruth has worked for many years for improvements in the access to and quality of rehabilitation for the population who have multiple conditions. She has led, on behalf of the CSP with the RCP, a national audit of physiotherapy and hip fracture (Hipsprint). Ruth is currently leading work with NHSE and the Joint Work and Health Unit to evaluate the impact of First Contact Physiotherapists in General Practice.

This year she is leading the programme for Physiotherapy UK 2019.  With the increasing quantity and quality of the abstracts for Physiotherapy UK, Ruth has shifted the programme content development to a competitive process to submit Focus Symposia, based on the WCPT model.

Nicola Heneghan is a Lecturer/Researcher in Musculoskeletal Rehabilitation Sciences in the Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, Birmingham. Nicola leads CPR Spine Education and Patient and Public Involvement, as well as the MACP approved MSc Advanced Manipulative Physiotherapy programme. Nicola’s specific research interest is assessment and management of thoracic pain and dysfunction in different patient populations as well as collaborating on research in patients following spinal surgery, with low back and neck pain, and following trauma. Nicola has published >50 articles in high impact journals including BMJ Open, PlosOne etc. She has supported >100 students to successful completion of postgraduate degrees (MSc, MRes and PhD) and currently supervises students on all programmes. External to her academic commitments she is currently the Chair of the MACP and IFOMPT MO delegate.

Katie Prangle works at the CSP as Council for AHP Research Support Officer. Katie runs the abstract submission and review processes for Physiotherapy UK every year and enjoys working to promote AHP research and supporting physiotherapists to showcase their work at a scientific conference.

Katie has worked at the CSP for about five years and has a background in charity project monitoring and administration.

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Physiotherapists are becoming increasingly involved in delivering exercise-based mental health interventions to patients, and more conversations are opening up about applying and developing our skills to help individuals with poor mental health. However, how often do we turn the focus to ourselves and discuss our own mental and emotional health?

Maintaining positive mental health, both in work and at home, is equally important as physical health.  Each occupation has a unique set of factors which can act as supports and barriers to positive mental health and ours is no different.  Promoting positive mental health in staff is essential for healthcare organisations, and tools such as ‘How are you feeling today NHS?’ are available to help staff talk openly and regularly about emotional health.

Many strategies for maintaining positive mental health are well reported – most people are aware that it helps to keep physically active, eat a balanced diet, discuss your feelings with others and ask for help when needed.  What are the other factors can help, both in work and at home? Do we have opportunities to apply these strategies in our professional lives? And how can we help create a workplace that prioritises emotional wellbeing?

Questions to consider
  1. Why is supporting positive mental health important in physiotherapy staff?
  2. What are the barriers to positive mental health in physiotherapy staff?
  3. What does a workplace which supports positive mental health look like? What features and characteristics are key?
  4. What can we do outside of work to maintain our own positive mental health?
  5. How can we support the mental health of our colleagues? How can we identify if someone needs additional support?

Missed the chat? We’ll post the transcript right here afterwards!

Resources Background reading:

Brand 2017 Whole-system approaches to improving the health and wellbeing of healthcare workers_a systematic review

Brand 2017 Whole-system approaches to improving the health and wellbeing of healthcare workers_a systematic reviewCampo

2009 Job Strain in Physical Therapists

Wellbeing in work

Eight elements of workplace wellbeing

Discussing wellbeing in work – How Are You Feeling NHS?

Strategies for positive mental health

Mind.org.uk Five Ways to Wellbeing

Tips for maintaining good mental health – College of Psychiatrists of Ireland

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