Attoe, Christopher Robert Michael (2025) Understanding and supporting the return-to-work needs of medical doctors : A systematic review, cross-sectional study, and randomised control trial. Doctoral thesis, Birkbeck, University of London.
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Chris Attoe_thesis submission_DrOHPM_Doctors RTW_Final 14 Apr 2025_Library copy-1.pdf - Full Version Download (8MB) |
Abstract
The working lives of UK doctors are under scrutiny, with unprecedented industrial action alongside negative trends for satisfaction levels, burnout rates, and leaver rates. Return-to-work (RTW) is a priority for medical and NHS leaders, with 84,000 UK doctors eligible to return to clinical work, underlining RTW’s importance for workforce growth targets and population health needs. However, limited research has investigated doctors’ RTW, preventing evidence-based policy and practice. This thesis investigates the needs of UK doctors returning to clinical work, how needs differ based on the nature of the individual and the absence, and the efficacy of a needs self-assessment tool. A systematic review found 11 prominent factors for returning doctors’ needs, from twenty-four included studies presenting data from 92,692 doctors across 14 quantitative and 10 qualitative studies. All 24 studies identified personal needs, 17 highlighted social needs, and 22 found organisational needs, alongside practical recommendations and resources. A cross-sectional mixed methods study employed factor analyses and structural equation modelling to develop a well-fitting structural model of returning doctors’ needs, identifying five main factors and their relationships: organisational support; social support; job demands; self-image; emotional needs. One-way ANOVAs found statistically significant differences for absence reason and gender, alongside limited differences for absence length, career stage, return stage, age, and ethnicity. A randomised control trial found no significant effect for the needs self-assessment intervention on RTW self-efficacy, work-related quality of life, and work engagement. A potential effect of time was identified through improved post-test scores for RTW self-efficacy and job satisfaction, stress, absorption, and dedication subscales. This thesis presents a foundational theoretical and empirical model of returning doctors’ needs drawing from occupational stress, biopsychosocial, educational, and management theory. Knowledge was added on the needs and resources of returning doctors, relationships between these, and group differences, highlighting further research and practice directions.
Metadata
| Item Type: | Thesis |
|---|---|
| Copyright Holders: | The copyright of this thesis rests with the author, who asserts his/her right to be known as such according to the Copyright Designs and Patents Act 1988. No dealing with the thesis contrary to the copyright or moral rights of the author is permitted. |
| Depositing User: | Acquisitions And Metadata |
| Date Deposited: | 02 May 2025 16:21 |
| Last Modified: | 18 Sep 2025 08:25 |
| URI: | https://eprints.bbk.ac.uk/id/eprint/55522 |
| DOI: | https://doi.org/10.18743/PUB.00055522 |
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