• promoting and maintaining health and preventing illness,
• understanding how people react to, cope with and recover from illness,
• personalizing treatments and interventions,
• improving health care systems and health policy.

Health psychology asks: What drives health-related behaviours, and how can these behaviours be changed? It also examines how emotions and beliefs are linked with these behaviours and their consequences. Health psychologists, therefore, work across many different environments and groups of people. These include patients, carers and families, individuals in the community, health care professionals, and healthcare systems and institutions. As a result, some basic concepts from the field of health psychology are relevant for anyone working with patients or promoting behavioural changes in practice.

Promoting and maintaining health and preventing illness

While the burden of chronic illness is rapidly increasing worldwide, much of this is preventable. Epidemiological research has demonstrated that primary prevention (e.g., reducing risk factors for cardiovascular disease) is more effective than secondary prevention for reducing deaths from cardiovascular disease. Health psychology has a huge contribution to make in terms of reducing risk factors for illness in populations by identifying specific behaviours (e.g., smoking, poor diet, lack of physical activity, attending medical screening) and targeting them for change.

Health psychology focuses on the psychological mechanisms (e.g., knowledge, attitudes, cognitions) and social influences that may be hindering change and leading to sustained unhealthy behaviour patterns. A better understanding of these processes helps identifying optimal ways to support people to break out of such unhealthy routines and, for example, stop smoking or increase fruit consumption. The development and use of eHealth applications has steadily increased in this area, and the delivery of behaviour change techniques via Apps and devices provides a very interesting opportunity for health psychology.

Understanding how people react to, cope with and recover from illness

Illness has psychological effects that can impact recovery. Individuals may experience stress, anxiety or depression, or struggle with what the illness may mean for their identity. Health psychologists try to better understand how to best support individuals dealing with illness, while also examining the complex links between cognitions, coping, outcomes and important health behaviours (e.g., medication adherence in different populations). Health psychologists critically consider the definition and measurement of key illness behaviours, for example: How can adherence to medication be measured? What is an ‘acceptable’ level of adherence? Theories and models are used to explain and predict illness-related behaviours and outcomes, and form the basis for designing interventions to make positive changes in behaviours. Health psychologists also try to find out how and for whom these interventions are most effective.

Personalizing treatments and interventions

We want to find out how for example a change in goal-setting or social skills may lead to better outcomes, e.g., improved self-management or generating social support; such a finding implies a mediation effect. These findings are important because it will enable us to improve our interventions since it opens the black box of the intervention and shows which ingredients effectively work and have an effect on the outcome when we are able to change them. In addition, it is also very important to know what works best for whom. Suppose a Cognitive Behavioural or Mindfulness intervention helps cancer patients to cope with the implications of the disease, we will see that some individuals do not respond to the treatment they were given. Research techniques enable us to find out whether patients with certain characteristics (like gender, age, or a personality characteristic) respond better or worse to one of these treatments. This is very helpful in determining which treatment works best for whom – a personalized treatment.

Improving health care systems and health policy

The ways in which doctors, nurses and other healthcare professionals interact with a patient can have a significant impact on the patient’s response to illness and treatment. As well as working with patients, carers and families, health psychologists may work with health care professionals. Health psychology has an important role to play in the education of healthcare professionals by promoting patient-centered care that facilitates increased self-management, allowing individuals to have control over their health and helping them make better choices. This includes examining the communication style of healthcare professionals and finding ways to better match the style with patients’ needs in order to improve healthcare outcomes. So, for example in various countries Health Psychology Departments at Academic Hospitals train medical students in the above.

Reaching out to Health Psychologists

If you are dealing in your work with issues described above and you like to be informed about the latest developments in this area, we suggest to keep an eye on our Health Psychology Practical Blog. In addition, if you need practical help, do not hesitate to get in contact with a Health Psychology Department in your own country and to see whether they can help. Could be anything from answering a quick question to collaboration in for example a health promotion project.

Via: https://practicalhealthpsychology.com/

When anger becomes a problem

Anger is natural – we all feel angry from time to time. When expressed in a healthy way and resolved quickly after being triggered, there is nothing inherently wrong with feeling angry or annoyed.

However, intense, ongoing and destructive fits of rage are not healthy and can have a catastrophic effect on your life and the life of those around you. When anger leads to violence, domestic abuse, and criminal charges it is especially devastating.

Unlike depression or anxiety, anger issues aren’t diagnosed as a specific condition.

Signs of an anger problem can include:

• Frequent feeling of anger
• Anger results in violent behaviour, or verbal or emotional abuse
• Work and personal relationships are impacted
• Using aggression and force to get what you want
• Feelings of anger aren’t comparative to the trigger (ie – losing control over something inconsequential)
• Using drugs or alcohol to manage anger problems
• Anger continues long after the triggering event

Often anger has other side effects, like depression, PTSD disorder, or substance abuse issues.

Seeing a psychologist about anger management

If you are dealing with anger issues, speaking with a psychologist can help. They will take you through therapy sessions focused on techniques to control the anger associated known as anger management therapy.

What is Anger Management Therapy?

Anger management therapy can be conducted by a psychologist, therapist, social worker, or counsellor.  During the process you’ll work through understanding your anger, what triggers angry outbursts and learn healthy coping strategies to control them.

Anger treatment can take place in group therapy or one-on-one sessions. Depending on your situation, the sessions may take place over a few weeks or months.

During anger management therapy, your psychologist will use different techniques to help you explore the thoughts and beliefs around your outbursts and introduce new behaviours to cope with them. We explore these techniques further along in this article.

What Anger Management Therapy Can Help With?

Frequent and uncontrolled anger and rage can have a profound effect on your physical and emotional health. It can also cost you intimate, family, social, and professional relationships. 

The benefits of working with a psychologist to help get your anger under control include:

Improved mental health and mood

Unhealthy anger diminishes feelings of wellbeing. This, in turn, can lead to depression; the two issues often go hand in hand. Learning how to express anger in a rational way can have a dramatic impact on overall feelings of life satisfaction, mood and happiness.

Better physical health

Anger triggers a range of physical symptoms; energy pumps through your body and adrenaline enters your bloodstream. Your heart rate and blood flow increase, and your muscles tense up. Over time, unchecked rage can affect your cardiac health, lead to high blood pressure and compromise your immune system. 

Healthier, happier relationships

Relationships with loved ones can be destroyed through episodes of rage and angry outbursts. Processing emotions and learning new coping skills with your psychologist will improve communication with friends and family members. It may even encourage reconciliation for estranged relationships.

 A more fulfilling career and workplace environment

Is your anger sabotaging your career? Explosive outbursts and seething passive aggression towards your co-workers can have a disastrous impact on your career. Strained professional relationships also increase the stress and tension in the office each day.

Through anger management, you’ll find ways to to help improve your work environment and forge productive relationships with your coworkers.

What is the best therapy for anger management?

There isn’t really a definitive ‘best’ therapy for treating anger but the most widely used type of therapy in this area is Cognitive Behavioural Therapy (CBT).

Depending on your situation, there are various techniques and types of therapy a psychologist may employ in your sessions together.

Types of therapy for anger management therapy

Cognitive Behavioural Therapy (CBT)

CBT is based on the idea that if we change our thoughts, we can change how we feel and behave. In anger management, CBT helps identify negative thought patterns and understand why you get angry. Then, you’ll explore new coping skills to deal with triggering situations in a calmer way.

Psychodynamic Therapy

During Psychodynamic therapy, you’ll reflect on the underlying psychological reasons for your anger. When you’ve identified the root of your emotional distress and maladaptive behaviour patterns that follow, new ways to cope can be introduced.

Dialectical Behavioural Therapy (DBT)

Dialectical behaviour therapy blends aspects of cognitive behavioural therapy (CBT)  with concepts like acceptance and mindfulness.

It focuses on changing unhelpful behaviours and ways of thinking while practising acceptance of who you are. This form of therapy is particularly well suited to those who experience overpowering emotions, such as anger.

Common techniques in therapy sessions

Throughout the sessions, your psychologist will use a series of techniques to treat anger issues.

These techniques can include (but aren’t limited to) the following:

Relaxation-based interventions

As we covered above, anger triggers physical response and relaxation-based interventions are techniques that focus on the body.  You’ll learn to use relaxation techniques to lower the emotional and physiological arousal response to anger.

This may include breathing exercises, progressive muscle relaxation, or rhythmic movement. Exercising these relaxation techniques will blow off steam, and in a more relaxed state, we can think through responses and behaviours with clarity.

Social skills training

Anger issues can result in antagonistic behaviour towards others. Social skills training strengthens listening and conflict management skills and considers the impact of a person’s anger on others.

Social skill development and learning how to communicate calmly can prevent angry emotions and conflict from spiralling into rage or violent behaviour.

Cognitive restructuring

At its essence, cognitive restructuring means changing your thoughts. Through therapy, you’ll learn to recognise flawed thinking patterns and beliefs that can spark anger responses.

For example, feeling angry about a comment that was not intended to be taken personally.

Thoughts are not fact, and our beliefs can often skew our sense of reality, which means we’re likely to respond (in this case, in anger) based on a false reality. Through therapy, you’ll learn to develop more supportive, rational thinking processes to diffuse an aggressive response.

Stress inoculation

This technique involves rehearsing internal dialogue (coping statements) to prepare to handle anger-inducing situations with more self-control,  in advance.

Inaccurate thoughts increase the chance of expressing anger in an explosive, confrontational way while a coping statement can calm the situation. For example:

Inaccurate thought – She’s picking on me with this presentation feedback

Internal coping statement – It’s not personal, it’s work and it is fair to receive feedback

You may create various internal coping statements to help reframe a difficult situation.

No matter what technique is used, the practical coping skills you’ll learn in therapy will equip you to manage anger, frustration, and feelings of rage whenever they arise.

Can anger management issues be cured?

Anger is a normal human emotion that will continue to arise throughout life.  Rather than ‘cure’ it, the aim of therapy is to learn how to manage anger in a healthy way without negative consequences.

Working with a trained mental health professional can help regulate intense emotions and play a key role in shaping appropriate anger responses.

To find out more about dealing with anger issues with one of our experienced psychologists, reach out to our experienced team at Inspire Health and Medical.

Via: https://www.inspirehm.com.au/

The WHO Global recommendations on physical activity for health recommend that people aged 65+ years should do at least 150 minutes of moderate-intensity physical activity, or at least 75 minutes of vigorous-intensity physical activity, or an equivalent combination of moderate- and vigorous-intensity activity throughout the week. It also recommends that older adults perform physical activity to enhance balance and prevent falls on 3 or more days per week, and take part in muscle-strengthening activities at least twice weekly. Despite clear recommendations about the amount of physical activity associated with health gains, around one third of the world’s population is physically inactive, with older people being the most inactive. 

It’s important to note that doing something is better than nothing, even if people can’t quite manage the amount recommended by guidelines. Physical activity can include a range of activity types, from structured exercise classes, to active transport, to gardening and home maintenance. Starting small and building up the amount and intensity of activity and choosing something enjoyable are the best ways to start.  For those who are already participating in more vigorous activities such as running, rowing, or cycling, ageing is no reason to stop if a person’s health allows it. 

Falls are also a common issue in older age, with around 1 in 3 people aged 65 + falling each year. Falls often have lasting, devastating consequences for an older person and their family, and can result in an older person moving into residential aged care. Falls are not inevitable, and can be prevented with regular exercise that challenges balance, such as tandem walking or repeated sit-to-stand exercises.

Older people face particular barriers to being more physically active – these can be financial, physical, social or practical. Some older adults find electronic gadgets that track daily physical activity useful for reminding and motivating them to be more active. 

Some people require a more supported approach to stay on track and reach their physical activity goals. Health coaching is a person-centred approach that commonly includes motivational interviewing techniques and solution-focused goal setting as strategies for promoting behaviour change. A recent systematic review of the effect of health coaching on physical activity among people aged 60+ demonstrated significant improvements in physical activity with this approach.

Goal setting is another strategy that promotes physical activity behaviour change. Goals encourage people to create a sense of urgency and motivation to invest time and energy to make the desired change. To maximise effectiveness, goals should be self-directed and meet S.M.A.R.T  criteria: Specific, Measurable, Attainable, Relevant and Timely.

The social benefits of physical activity participation are often particularly important to older people. There are many options for people who prefer to exercise in organised groups. Many local councils organise free walking groups – these are a way of keeping active in a fun and sociable way. Or for a bit more of a challenge, Parkrun is a free, weekly 5km timed running (or walking) event in more than 1,700 locations across the globe.

At any age the message around physical activity is simple- be as active as you can, in as many ways as possible, as often as you can. Doing something is better than doing nothing, and every little bit counts towards better health.

Via: https://practicalhealthpsychology.com/

Lifestyle medicine is the clinical application of healthy behaviors to prevent, treat and reverse disease. More than ever, research underscores that the “pills” today’s physician should be prescribing for patients are the six domains of lifestyle medicine: whole food plant-based eating, regular physical activity, restorative sleep, stress management, addiction reduction or elimination, and positive psychology and social connection.

We are a primary care preventive medicine physician and a computational immunologist, both committed to applying state-of-the-art research to inform the clinical practice of lifestyle medicine. Our findings and recommendations were just published. We highlight the key take-home points for each of the areas below.

Whole-food, plant-based eating

Diets high in fruits, vegetables and whole grains and lower in animal products and highly processed foods have been associated with prevention of many diseases. These diets have also improved health and even reversed common cardiovascular, metabolic, brain, hormonal, kidney and autoimmune diseases as well as 35% of all cancers.

We believe that future research should include larger trials or new research methods with emphasis on quality of diet. This would include more data on the micronutrient composition and protein sources of plant versus animal-based foods – not just proportion of fat, carbohydrates and protein. Such trials should include children, as many adult disorders are seeded as early as infancy or in utero.

Regular physical activity

For decades, surgeon generals’ guidelines have emphasized that daily moderate-to-vigorous aerobic physical activity has both immediate and long-term health benefits. For example, why we age and the rate at which we age – chronological age versus biological age – is determined by multiple molecular processes that are directly influenced by physical activity. And now scientists are gaining a better understanding of the cellular and molecular changes that exercise induces to reduce disease risk.

Research priorities for scientists and physicians include obtaining a deeper understanding of the type, intensity and frequency of activity, and better insights into the molecular and cellular alterations that occur with exercise.

Restorative sleep

Sleep helps the cells, organs and entire body to function better. Regular uninterrupted sleep of seven hours per night for adults, eight to 10 hours for teenagers and 10 or more for children is necessary for good health.

Though understudied, there is evidence that high-quality sleep can reduce inflammation, immune dysfunction, oxidative stress, and epigenetic modification of DNA, all of which are associated with or cause chronic disease.

Therefore, research into the biological mechanisms that underlie the restorative properties of sleep could lead to environmental or population-based and policy approaches to better align our natural sleep patterns with the demands of daily life.

Stress management

Though some stress is beneficial, prolonged or extreme stress can overwhelm the brain and body. Chronic stress increases the risk of cardiovascular disease, irritable bowel disease, obesity, depression, asthma, arthritis, autoimmune diseases, cardiovascular disease, cancer, diabetes, neurological disorders and obesity.

One of the most powerful mechanisms to reduce stress and enhance resilience is by eliciting a relaxation response using mind-body therapies and cognitive behavioral therapy.

More research is need to gain a better understanding of how these therapies work.

Addiction reduction and elimination

Many social, economic and environmental factors have fueled the national rise in substance abuse generally and, most tragically, the opioid epidemic.

Physicians and researchers are beginning to understand the underlying physiology and psychology of addiction.

Yet the continued stigma and disjointed or absent access to services remains a challenge. Clinicians and scientists need to explore how to predict who is more vulnerable to addiction and find ways of preventing it. Treatment that incorporates integrated care focused on all the patient’s needs should be prioritized.

Positive psychology and social connection

Maintaining a positive mindset through the practice of gratitude and forgiveness has a significant impact on psychological and subjective well-being, which are, in turn, associated with physical health benefits.

Social connectivity, namely the quantity and quality of our relationships, has perhaps the most powerful health benefits.

Conversely, social isolation – such as living alone, having a small social network, participating in few social activities, and feeling lonely – is associated with greater mortality, increased morbidity, lower immune system function, depression and cognitive decline.

Further study is needed to uncover how an individual’s biology and chemistry change for the better through more social interactions.

Inflammation’s role in lifestyle-related diseases

Unhealthy lifestyle behaviors produce a vicious cycle of inflammation. While inflammation is a healthy, natural way the body fights infections, injury, and stress, too much inflammation actually promotes or exacerbates the diseases described above.

The inflammatory response is complex. We have been using machine learning and computer modeling to understand, predict, treat and reprogram inflammation – to retain the healing elements while minimizing the detrimental more chronic ones. Scientists are unraveling new mechanisms that explain how chronic stress can turn genes on and off.

Overcoming challenges and barriers

We and others who study lifestyle medicine are now discussing how we can leverage all of these approaches to improve clinical studies on the impacts of lifestyle interventions.

At the same time we and our colleagues realize that there are environmental challenges and barriers that prevent many people from embracing these lifestyle fixes.

There are food deserts where healthier foods are not available or affordable. Unsafe neighborhoods, harmful chemicals and substances create constant stress. Poor education, poverty, cultural beliefs and racial and ethnic disparities and discrimination must be addressed for all people and patients to appreciate and embrace the six “pills.”

The application of lifestyle medicines is particularly important now because unhealthy lifestyles have caused a pandemic of preventable chronic diseases that is now exacerbating the COVID-19 pandemic, which disproportionately afflicts those with these conditions.

Ask your doctor to “prescribe” these six “pills” for a longer and better life. After all, they’re free, work better than or as well as medications and have no side effects!

Via: https://theconversation.com/

“It blows my mind how much attention, money, and energy people put into their gear but then don’t put into the thing that uses the gear,” says Nicole Haas, a physical therapist based in Boulder, Colorado. “Everyone knows you need to tune your skis and tune your bike. PTs are quite literally the mechanics of humans.”

Nicole Haas

There are a lot of misconceptions about physical therapy: it’s a long and expensive process, it’s only for severe injuries, you’ll have to stop doing what you love. But often it takes just a session or two to get back on the right track, and plenty of PTs encourage their patients to keep doing their sport (with modifications) during the recovery process. The faster you seek help, the faster you’ll likely be back in action.

Deciding to see a medical professional is the first and hardest step. Once you’ve committed, follow Haas’s advice, below, on how to make the most of physical therapy.

Recognize When You Need Help 

Chronic overuse injuries can be challenging to recognize and accept. If something has been lingering for two weeks or longer and isn’t getting better, Haas recommends seeing a medical professional for an evaluation. The discomfort doesn’t need to be consistent throughout the day, Haas adds. “If the pain shows up whenever you do a particular sport or activity, there’s a biomechanical problem,” she says.

Whether you should see a PT or your primary-care physician first is another consideration. The direct access law allows patients in all 50 states to see a licensed PT without a prescription or referral from a physician, according to the American Physical Therapy Association. However, there are limitations in certain states. If you think your injury is biomechanical and doesn’t stem from any underlying medical issues, going directly to a PT can save you valuable time, not to mention co-pays. If your PT has any concerns, they can always refer you back to your doctor.

You might be inclined to just take a few weeks off, but passive rest won’t correct the underlying issues that led to the injury in the first place. Early intervention means quicker recovery, potentially fewer visits, and higher odds that you’ll be able to continue doing your sport (with modifications) during the recovery period.

Choose the Right PT

Physical therapists span a broad spectrum of approaches, training, philosophies, and experience. Research a PT’s education, specialization, and experience, and ask around for recommendations. Physical therapists who work with athletes frequently—and, ideally, are athletes themselves—will better understand your passion and goals.

If your PT is part of a larger practice, ensure you’ll get to see the same person each time, rather than a rotating cast. It’s useful to ask how much face-to-face time you’ll get during each session, too. If the PT keeps an open line of communication between visits, responding to calls, texts, or emails, you may see faster progress and more personalized care.

Be a Good Historian

Your PT is a detective. During your initial evaluation, they need as much information as possible to create a treatment plan. Create a timeline of your injury in advance, including how it has progressed or changed over time, what aggravates the pain, and what makes it feel better. Note when the pain showed up and whether anything in particular provoked it, like a crash or a tweaky movement. If there wasn’t a specific incident, think about when you first started to feel symptoms. What else was going on? Did you increase or change your training? Even simple things like new running shoes or ski boots or long hours at your desk can trigger a problem. 

Use Physical Therapy as an Educational Opportunity

Haas sees two types of patients: those who treat their appointment like an obligation and move disinterestedly through a laundry list of exercises, and those who show up curious to learn about their body and how to care for it. “The success of therapy isn’t just about doing the exercises but understanding the issue and the things that can be done throughout one’s daily life,” says Haas. Come with an open mind, and ask questions.

Overcommunicate

Tell your PT what you’re feeling throughout your appointment, whether you think it’s important information or not. “If I have you move in a certain way, I’m not just looking for pain, I might be looking for tightness or other sensations.” Haas says. 

Healthy Conversation Skills is a training programme based on social cognitive theory and behaviour change techniques, which promotes empowerment and patient-centred care. It was developed by a multi-disciplinary team at the University of Southampton in consultation with local health and social care organisations. Healthy Conversation Skills is an effective, evidence-based approach that uses practical, easy-to-apply skills to help people identify their own important behaviour change challenges and solutions. All health care professionals can use Healthy Conversation Skills, even within brief consultations.

People do not adopt or change behaviours in isolation. They are influenced by their social world, their physical environment and by other elements outside their control. We need to understand these factors in order to support effective behaviour change. By focusing on finding out more about people’s lives and circumstances, you will be better placed to offer appropriate support and effectively promote health behaviour changes. One tenet of Healthy Conversation Skills is therefore to start by asking people about their priorities, understand their motivation and challenges, and what they feel is the most important thing to focus on.

The programme also encourages practitioners to reflect on the value of asking questions, listening and supporting goal-setting, as opposed to telling people what to do, giving advice or providing information. We can make more effective use of the time we have available to support individuals to improve their health and well-being by using supportive conversations that take the time to listen, learn about and explore people’s worlds, and using this shared understanding to plan first steps to behaviour change. Below are some practical takeaways from Healthy Conversation Skills that you can put to use today.

Practical recommendations

1. Ask open discovery questions. These questions generally begin with “What” or “How”, and invite someone to reflect on their own issues, barriers, solutions and first steps for change. For example, “What would you like to change? What is getting in the way of you making that change? How could you overcome that? What would be a good first step for you?” By asking these questions you can find out a lot about someone and support them to identify the skills and resources they need to make a change.
2. Avoid giving advice or telling people what to do. Just giving advice assumes that people do not already know what you are telling them about the importance of health lifestyle behaviours. This can feel patronising and be disempowering if the individual does not feel capable of changing.
3. Listen and embrace silence. People need time to think, so once you have asked a question, do not rush to fill any silence. Instead, give the person space to formulate their answer, and see silence as thinking. Simply allowing someone the opportunity to speak their mind can be hugely beneficial. It might be the first time they have been listened to in a while, which can feel supportive and empowering. Listening shows that you value their views, and you will learn lots about them, which can help you to help them.
4. Support SMARTER goal-setting (Specific, Measurable, Actionable, Realistic, Timed, Evaluated and Reviewed). People frequently set themselves goals with limited planning as to how they will achieve these. We say, “a goal without a plan is just a wish”! If you try and fail, you are likely to give up. If you try to achieve something smaller and succeed, you are likely to stick with it.
5. Reflect on your conversations and how empowering these are. Taking just a few minutes to look back on how we interact with people, what works and what does not, is a valuable use of time. It helps identify what we do well and where we could improve, and ensures that we are giving our best every day.

Via: https://practicalhealthpsychology.com/

Missed breaks have a range of negative consequences – from the practical discomfort of being unable to go to the toilet and the lack of opportunity to eat healthily to the feelings of demoralisation and dissatisfaction and cognitive changes that lengthy work periods with inadequate breaks can produce.

The cognitive changes that occur when working for lengthy periods without a break are one of the key arguments in support of regular breaks. We are all familiar with the experience of feeling tired and drained at the end of a long working day, struggling to make decisions or unable to concentrate on the task in front of us. This drop in cognitive performance is entirely natural, and reflects the fact that human cognition is simply not designed to focus continuously on the same task for long periods of time. In fact, in cognitive terms, fatigue is an adaptive signal – a sign that we have spent too long ‘on task’ and need to take a break before mistakes start to be made.

More than a century ago, the negative effects of working continuously without a break were clear.  In one of the most heroic examples, Tsuro Arai, the first Japanese woman ever to earn a PhD, forced herself to complete a work task that required concentration (solving complex multiplication problems) continuously for 12-hours over several consecutive days without rest. Unsurprisingly, as time on task increased, her performance became slower and less accurate; demonstrating empirically for the first time that optimal cognitive performance cannot be maintained over 12 hour periods without a break. Despite this, modern healthcare workers often spend this kind of period working without adequate rest breaks. A landmark study of  around 400 nurses over more than 5,000 shifts showed that in line with Arai’s experiment, nurses who worked more than 12 hours at a time (around 40% of sampled shifts) made significantly more errors.

In addition to errors related to slips of attention and memory, there is a growing body of evidence suggesting that decision making changes predictably over lengthy periods of work -a phenomenon referred to as ‘decision fatigue’. As people make more and more consecutive decisions without a break, they start to progressively shift towards decisions that are in some way cognitively easier (e.g., going along with the default option, passing a decision on to someone else, or using rules of thumb or shortcuts). In healthcare, we see clear evidence of this over working shifts. For example, GPs are more likely to prescribe unnecessary antibiotics towards the end of clinics and nurses become progressively more likely to refer patients on to other healthcare professionals as time since last break increases. The last example raises a key point. Cognitively, it is not the overall amount of work that is the problem –it is the amount of work completed without a break. In other words, it is the timing and presence (or absence) of breaks within the work period, rather than overall workload which is critical in maintaining optimal cognitive functioning over time.

Ensuring that healthcare staff take rest breaks in a busy health service is of course easier said than done. But here, the evidence is clear: any break is better than none and regular breaks should be considered an essential and non-negotiable part of the working day. Even when there is no time to take a proper break, the evidence suggests that taking a couple of minutes to step away from your task, stretch and breathe deeply is beneficial. ‘Microbreaks’, breaks of a few minutes’ duration, appear to be enough during demanding activities to mitigate some of the negative effects of long periods of unbroken work. Studies show for example that surgeons who take regular, brief microbreaks during operations (of 90 seconds to 5 minutes) report; better physical and mental performance, reduced stress, and fewer intraoperative events. Importantly, the operations which included these microbreaks took no longer than standard operations, suggesting that the breaks ‘pay for themselves’ by counteracting normal reductions in speed and efficiency over time.

In short, breaks are an essential part of the working day for healthcare (and other!) workers.

Via: https://practicalhealthpsychology.com/