Impact of Work on Emotional Well-being Results of a Survey of

NHS


Introduction
Well-being is a state of positive feeling and meeting one's full potential.It can be measured subjectively and objectively. 1he hedonistic term 'positive feelings and the eudemonic term 'meeting full potential as a member of society' are inclusive, free from cultural bias and should be included in such a definition.While overlapping with health, wellness, welfare and quality of life, wellbeing is separate from these.
Occupational stressors at work increase the risk for mental health dysfunction.Poor mental well-being is harmful to the individual and can affect professionalism, organisational effectiveness, and public safety. 2It is recognised that working conditions affect worker's well-being (Occupational well-being), including job demands (role conflict and emotional demands) and job resources (influence at work and social community at work) among other factors.The organisational stressors most often demonstrating consistently significant associations with mental health outcomes included lack of support, demand, job pressure, administrative/organisational pressure, and long working hours. 2 Occupational stress impairs psychosomatic well-being, which includes anxiety, depression, sleep quality, and somatic symptoms.The subdimensions of occupational stressworkload and time pressure, professional and career issues, patient care and interaction, interpersonal relationships and management problems, but not resource and environment problems impact occupational well-being. 3Doctors' poor rota design and inhumane working hours or work-life conflict are the key contributors to burnout.
Ideally, employers want their employees to be happy-productive, yet over half tend to be either unhappy-productive or happyunproductive-both of which are not desirable. 4Employees report that "feeling happier at work" is the most important factor promoting their health and wellbeing. 5Other factors include a good understanding of the role, being able to manage the role without being physically or mentally stressed, having access to breaks and feeling valued are also important factors.Individual factors (i.e., personal feelings, behaviours, and health) are determinants of an individual's perceived work-life balance, along with the quality and quantity of personal time. 6 is important for organisations to explore and understand the specific determinants of occupational well-being for their employees on a regular basis and invest in measures that improve conditions working towards a happy-productive employee model.This is ultimately likely to lead to better recruitment and retention as well as patient safety and organisational efficiency.

Methods
Instruments that measure occupational well-being with the greatest number of positively rated measurement properties include the Personal Growth and Development Scale, The University of Tokyo Occupational Mental Health Wellbeing 24 scale, and the Employee Wellbeing scale.However, none of these worker well-being instruments meet the criteria for adequate instrument design. 7We designed an occupational well-being survey of doctors in a Yorkshire NHS Trust.Our survey used an anonymised, online questionnaire (using Google Forms on multiple digital platforms) based on the Management Standards Indicator Tool developed by the Health and Safety Executive (HSE). 8The survey was designed to capture the multifaceted nature of workrelated emotional impact on United Kingdom National Health Service (NHS) Trust employees.

SUSHRUTA JOURNAL OF HEALTH POLICY
Respondents reported being consulted about change at work (66.3%, fig 16) and felt that their colleagues were willing to listen to work-related problems (68.1%, fig 17).They reported feeling warm at work (59.6%, fig 18).They reported that work did not affect them (65%, fig 19) or their families negatively (65.7%, fig 20).
Sixty-nine per cent of respondents felt happy at work, while the remaining were apprehensive, unhappy, anxious, or depressed.

Discussion
The results from the current survey provide perspective into the emotional well-being and work-related experiences of NHS employees in Yorkshire, a vast proportion of whom were doctors belonging to a minority background.Responses to the questions illuminate how various aspects of the job environment can impact healthcare professionals.Our findings, combined with previous studies, underscore the complexity of the factors contributing to emotional well-being at work.
It is important that employees understand the nature of their work and are clear on what is expected of them.Our findings are in line with findings from a 2019 national NHS staff survey that reported that over 70% of NHS workers felt they knew what was expected from them at work. 9 In this survey majority of respondents did not report concerns related to their work, which aligns with the findings by Alarcon that healthcare professionals often exhibit a high level of dedication and commitment to their work 10 , despite the presence of underlying issues potentially related to stress, workload, or interpersonal dynamics 11 .
Most of the respondents demonstrated confidence in being equipped to deliver their work, which is consistent with reports that healthcare professionals tend to report high levels of expertise and confidence in their abilities 12 and adaptability. 13e proportion who reported experiencing workplace harassment reflected the persistent reports from NHS staff surveys and Workforce Race and Equality Standards (WRES) proportions. 14Despite the reports of harassment, most respondents believe that colleagues would lend help if needed, findings are consistent with the literature on teamwork and camaraderie in healthcare settings. 15st respondents disagreed with the statement about having to work more intensively than expected.This might reflect the often-demanding nature of healthcare jobs, which could set higher expectations of workload intensity.This finding contrasts with the increasing concern about burnout in healthcare professionals due to high workload demands. 16In terms of autonomy at work, most respondents felt they had a choice in deciding their tasks, which is associated with higher job satisfaction. 17

SUSHRUTA JOURNAL OF HEALTH POLICY
A significant proportion agreed that they were unable to take enough breaks.This could contribute to fatigue and burnout and is worth attention. 18Most respondents felt they received the respect they deserved from their colleagues, indicating a generally positive work environment. 19ost respondents reported that they could discuss upsetting or annoying workrelated matters with their line managers.This is a promising finding, as open communication with superiors can contribute to better job satisfaction and well-being. 20Almost half of the respondents felt supported through emotionally demanding work, which is vital in healthcare settings where emotional stress is prevalent 21 and agreed that their colleagues were willing to listen to their work-related problems.This is positive, as peer support is known to help mitigate work-related stress. 22e response to the question about a warm feeling towards the workplace was almost evenly split.This could be indicative of varying levels of job satisfaction, workplace culture, and engagement. 23Negative emotions about the workplace can impact job satisfaction and productivity, so this warrants further investigation. 24Many disagreed that work was negatively impacting their personal and family life.This is an encouraging finding, given the known risks of work-life conflict in healthcare professions.However, the sizeable minority who agreed suggests a need for continued efforts to promote work-life balance.

Limitations
This methodology, despite its limitations, has provided a foundation for understanding the work-related emotional impact on NHS employees.By building upon this study's methodology in future research, we can continue to generate insights into these important issues, driving forward initiatives to improve the working lives of those at the heart of our healthcare system: the employees of the NHS.

Conclusions
The results from this survey provide important insights into the emotional wellbeing of NHS employees, particularly those from a minority ethnic background.It's clear that there are several positive aspects, including clarity of roles, support from colleagues, and perceived respect.However, there are also areas for improvement, such as managing workload intensity, improving job autonomy, promoting mutual respect, facilitating open communication with line managers, and promoting work-life balance.These findings can inform strategies to improve the work environment and support the emotional well-being of NHS employees.
Fig 2), having no concerns at work (73%; Fig 3), and knowing how to get their work done (73%, figure 4) and did not report having too many demands on them from different quarters (73%, fig 5).Most respondents did not report facing harassment or rarely (58.2%; 15.4%, fig 6), and believed that if the work was tough, they would receive help from colleagues (72%, fig 7).SUSHRUTA JOURNAL OF HEALTH POLICY Respondents reported not having to work more intensely than expected (65%, fig 8), that they have a choice in what they do at work (65%, fig 9) as well as being clear on their responsibilities (70%, fig 10) and understanding the aims and objectives of their team or department (77%; fig 11).