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


Key facts

Type of research degree
Application deadline
Friday 3 April 2020
Project start date
Thursday 1 October 2020
Country eligibility
UK and EU
Source of funding
External organisation
Professor Rebecca Lawton and Professor Daryl O'Connor
School of Psychology
<h2 class="heading hide-accessible">Summary</h2>

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 &lsquo;pull advances in basic research with potential relevance to patient safety into an applied research setting&rsquo;. This is one of six patient safety scholarships currently hosted by the PSTRC. You will also be part of a stimulating and supportive network of students working across the three research centres.

<h2 class="heading hide-accessible">Full description</h2>

<h6>Aim</h6> <p>To understand and measure stressors associated with the in-hospital environment and to investigate individual susceptibility to these stressors</p> <p>To evaluate the predictive validity of a tool to assess in-hospital stress.</p> <p>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 &lsquo;transient period of vulnerability after hospitalization during which patients are at elevated risk for adverse events from a broad range of conditions&rsquo;. 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. &nbsp;</p> <p>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.&nbsp;</p> <h6>Environment</h6> <p>Working with Professors Daryl O&rsquo;Connor and Rebecca Lawton in School of Psychology, University of Leeds the successful applicant will also be supported by Clinical Leaders in relevant clinical specialties in the Yorkshire and Humber region. The holder of this prestigious PhD Fellowship will also be embedded within the NIHR Yorkshire and Humber Patient Safety Translational Research Centre (, a research team at the forefront of patient safety research in the UK. The University of Leeds, a member of the Russell Group of research-intensive universities, is one of the top 10 Universities in the UK and is ranked in the top 100 universities in the QS World University Rankings 2019.&nbsp;</p> <p>For more&nbsp;information about the <a href="">Patient Safety Translational Research Centres</a>&nbsp;and the <a href="">Yorkshire and Humber PSTRC</a> where this scholarship will be hosted please click the relevent links above.</p>

<h2 class="heading">How to apply</h2>

<p>To apply for this project applicants should complete a<a href=""> Faculty Application Form</a> and send this alongside a 300 word research proposal based on the project brief, a full academic CV, degree transcripts (or marks so far if still studying) and degree certificates to the Faculty Graduate School <a href=""></a>&nbsp;</p> <p>We also require 2 academic references to support your application. Please ask your referees to send these <a href="">references</a> on your behalf, directly to <a href=""></a>&nbsp;by no later than Friday 3 April 2020.</p> <p>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 fmhgrad to inform us you would like to be considered for this project.</p> <p>If English is not your first language, you must provide evidence that you meet the University&#39;s minimum English language requirements (below).</p> <p><em>We welcome applications from all suitably-qualified candidates, but UK black and minority ethnic (BME) researchers are currently under-represented in our Postgraduate Research community, and we would therefore particularly encourage applications from UK BME candidates. All scholarships will be awarded on the basis of merit.</em></p>

<h2 class="heading heading--sm">Entry requirements</h2>

This prestigious award is available to an exceptional candidate who can demonstrate excellent academic ability, an enthusiasm for healthcare safety, the drive and determination to undertake a PhD and an ambition to work in a multi-disciplinary team to deliver research that makes healthcare safer. 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.

<h2 class="heading heading--sm">English language requirements</h2>

Applicants whose first language is not English must provide evidence that their English language is sufficient to meet the specific demands of their study. The Faculty of Medicine and Health minimum requirements in IELTS and TOEFL tests for PhD, MSc, MPhil, MD are: &bull; British Council IELTS - score of 6.5 overall, with no element less than 6.0 &bull; 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.

<h2 class="heading">Funding on offer</h2>

<p>This PhD scholarship will attract an annual tax-free stipend of &pound;15,009, increasing in line with UK Research Council guidelines each year, subject to satisfactory progress, and will cover the UK/EU tuition fees.&nbsp;This project is supported by the National Institute for Health Research.&nbsp;</p>

<h2 class="heading">Contact details</h2>

<p>For further information please contact the Graduate School Office<br /> e:&nbsp;<a href=""></a>, t: +44 (0)113 343 8221.</p>