Building evidence-based interventions to improve staff well-being in paediatric critical care using the behaviour change wheel

Background: Research has demonstrated that staff working in Paediatric Critical Care (PCC) experience high levels of burnout, post-traumatic stress and moral distress. There is very little evidence of how this problem could be addressed.

Aim: To develop evidence-based, psychologically informed interventions designed to improve PCC staff well-being that can be feasibility tested on a large scale.

Study design: The Behaviour Change Wheel (BCW) framework guided systematic development of the interventions. This process was informed by a review of existing well-being initiatives and a survey of PCC staff's awareness and uptake of initiatives identified.

Results: Together with empirical evidence, the BCW process produced two bespoke 'SWell' (Staff Wellbeing) interventions tailored for delivery in UK PCC units. The two group-based interventions, Mad-Sad-Glad and Wellbeing Images involve the Behaviour Change Techniques (BCTs) of self-belief, social support, feedback and monitoring. These BCTs align closely with the psychological concepts of self-efficacy, self-regulation and the psychological theory of how to thrive.

Conclusions: Tailored, evidence-based, psychologically informed SWell (Staff Wellbeing) interventions are likely to be feasible and have the potential of making significant differences to individual staff members and the PCC workforce as a whole. Associated investments in the psychological health of the workforce and time to prioritize well-being interventions are required for change to occur and be maintained.

Relevance to clinical practice: The SWell (Staff Wellbeing) interventions could impact directly on the well-being of PCC staff and their ability to thrive in the workplace. Indirectly, they could reduce staff attrition, sickness absence and improve patients' and families' experiences of care.