Understanding and measuring the impact of in-hospital stress on post-hospital outcomes

This is an exciting opportunity to undertake a PhD within the Yorkshire and Humber Patient Safety Translational Research Centre (Yorkshire and Humber PSTRC), a partnership between the University of Leeds and Bradford Teaching Hospitals Foundation Trust. The Yorkshire and Humber PSTRC is funded by the National Institute for Health Research (NIHR) and is one of three research centres in England funded to ‘pull advances in basic research with potential relevance to patient safety into an applied research setting’. You will also be part of a stimulating and supportive network of students working across the three research centres.

Aims
To understand and measure stressors associated with the in-hospital environment and to investigate individual susceptibility to these stressors.
To evaluate the predictive validity of a tool to assess in-hospital stress.

Project
When a person is a hospital inpatient, they are exposed to many stresses on the body that are directly related to the treatment that they are receiving e.g. the surgical procedure, the medicines they are prescribed. There are also others stresses that are not a function of the treatment per se, but of being in hospital. These have been highlighted in a sentinel article by Goldwater (2018) who identifies five main types of in-hospital stressors associated with nutrition and hydration, mobility restrictions, sleep deprivation, pain and (other environmental factors). The impact of these stressors on post-hospital outcomes is not well understood. However, there is a growing literature that has identified a ‘transient period of vulnerability after hospitalization during which patients are at elevated risk for adverse events from a broad range of conditions’. Many readmissions to hospital happen in the first few weeks after discharge and patients are most likely to die in this period after hospitalisation. For the majority of people however, this period of vulnerability, referred to as post-hospital syndrome, will be experienced as something like extreme fatigue, difficulties in moving and doing the normal activities of daily life etc.

While interest in this area is growing and evidence from a number of surgical studies demonstrate an association between hospital stays pre-surgery and poorer outcomes from surgery, there is, as yet, no formalised measurement of in-hospital stress. Nor do we know the extent to which individuals might vary in their vulnerability to these stressors or what factors are associated with greater individual vulnerability. It is these questions that will be addressed within this scholarship. We anticipate that the scholarship will involve 1) a systematic review of the literature on in-hospital stressors and post-hospital syndrome; 2) the development and user testing of an in-hospital stress index and 3) the evaluation of the predictive validity of the in-hospital stress index in a large scale longitudinal study.

Eligibility
You should hold a first degree equivalent to at least a UK upper second class honours degree, or suitable postgraduate degree in psychology, social science or a health-related subject. You will be enthusiastic, organised and motivated with experience in, or knowledge of healthcare services. Importantly, you will be committed to fully engaging with staff and patients and a wider multi-disciplinary team to conduct high-quality research that is of value to the NHS.

The minimum requirements for candidates whose first language is not English are:

• British Council IELTS - score of 6.5 overall, with no element less than 6.0
• TOEFL iBT - overall score of 92 with the listening and reading element no less than 21, writing element no less than 22 and the speaking element no less than 23.

How to apply
To apply for this project applicants should complete a Faculty Scholarship Application form using the link below https://medicinehealth.leeds.ac.uk/downloads/download/129/faculty_graduate_school_-_application_form) and send this alongside a 300 word research proposal based on the project brief, a full academic CV, degree certificates and transcripts (or marks so far if still studying) to the Faculty Graduate School at [Email Address Removed]

We also require 2 academic references to support your application. Please ask your referees to send these references on your behalf, directly to [Email Address Removed] by no later than Friday 3 April 2020.

If you have already applied for other projects using the Faculty Application Form this academic session you do not need to complete this form again. Instead you should email us to inform us you would like to be considered for this project.