Addressing Healthcare Provider Well-being in a Conflict Zone: A Mixed-Method Study of Vital Anesthesia Simulation Training Wellbeing.

Abstract

Burnout among healthcare providers can adversely impact their performance and patient care. Vital Anaesthesia Simulation Training (VAST) Wellbeing is a 1-day course designed to promote personal and professional well-being and to reduce burnout for healthcare providers in low-resource settings. VAST Wellbeing has demonstrated benefits in this context but has never been evaluated in a conflict zone. This study assessed the influence of VAST Wellbeing among healthcare workers practicing in the EMERGENCY-NGO Salam Centre for Cardiac Surgery in Sudan amidst a conflict. This mixed-methods study was designed to explore participants' experience of VAST Wellbeing offered in Sudan to learn about benefits and challenges to this training in a conflict zone. Our team used in-depth qualitative interviews with purposively selected course participants. Perceived social stigma of receiving mental health support and attitudes toward help seeking for mental health were also quantitatively assessed using the Stigma Scale for Receiving Psychological Help and the General Help-Seeking Questionnaire, respectively. Sixty healthcare providers attended the course; 35 completed quantitative measures, and 12 were interviewed. Stigma for receiving mental health support decreased comparing median [interquartile range {IQR}] precourse to postcourse scores (8.0 [6-9] versus 6.0 [3-8], P =.005). Willingness to seek help in the event of a mental health concern significantly increased when comparing precourse to postcourse scores (3.4 [2.6 to 3.9] versus 4.6 [3.9 to 5.0], P >.001). Three major themes and nine subthemes were identified during qualitative data analysis. Theme 1: The influence of conflict manifested as participants reporting persistent fear and stress and that the workplace was extremely strained. Theme 2: In social context it was noted that the training reduced social stigma, strengthened of a sense of community, and led to subtle changes in the workplace environment. Theme 3: The training contributed to new learning and practices, such as greater recognition of burnout and engaging in personal well-being practices. Acceptance of mindfulness was mixed, albeit with recognition of its positive effects. Despite many contextual challenges, participants reported the course to be needed and relevant. The findings suggest that VAST Wellbeing was pertinent and impactful in a conflict zone. It helped to foster a stronger sense of community, reduce stigma around mental health discussions, increase the acceptability of help-seeking, and encourage participants to adopt strategies for self-care and well-being.