Burnout in UK General Practitioners in the COVID-19 aftermath: Are moral distress, selfcompassion, psychological flexibility, and practice tenure predictors?

Paper one is a literature review that investigates how moral distress can impact the physical, mental, and social wellbeing of nursing professionals and medical doctors. Eleven studies were identified as relevant following a systematic literature search. The review found that higher moral distress was associated with higher anxiety, depression, post-traumatic stress disorder, burnout, higher levels of sickness, reduced engagement at work, and increased intent to leave their jobs. Methodological limitations have been highlighted and evaluated in this review. Clinical and research implications are discussed. The second paper discusses a cross-sectional quantitative study that explored the relationships between burnout in General Practitioners and interpersonal factors such as moral distress, self-compassion, psychological flexibility (including acceptance, avoidance, and harnessing behaviours), and time in practice. Eighty-seven General Practitioners were recruited for the study. Three multiple regression analyses were conducted. The findings suggested that higher levels of moral distress predicted higher levels of emotional exhaustion, and that lower levels of acceptance predicted a reduced sense of personal accomplishment in General Practitioners. The findings also indicated that high avoidance predicted all three domains of burnout, suggesting that avoidance is a key predictor of burnout in General Practitioners. The findings highlighted the importance of addressing moral distress, acceptance, and avoidance, in interventions aimed at preventing or reducing burnout in this population. Further research and clinical implications are discussed. The final report is an executive summary of the study carried out in this thesis. The summary received valuable feedback from two General Practitioners. It was written for General Practitioners as well as for anyone who may be interested in this study.