Aston University-led project finds simple ways to improve the wellbeing of paediatric critical care staff

Jan 28, 2025

4 min

Dr Rachel Shaw



  • The Staff Wellbeing (SWell) project was carried out in conjunction with Birmingham Children’s Hospital and NHS England
  • Paediatric critical care (PCC) staff experience high levels of moral distress, post-traumatic stress disorder and burnout
  • Two simple, low-resource wellbeing sessions can be delivered by staff for staff without specialist training.


The Staff Wellbeing (SWell) project, led by Aston University researchers in collaboration with Birmingham Children’s Hospital and NHS England, has developed two simple, easy-to-deliver sessions to improve the wellbeing of staff in paediatric critical care (PCC) units in UK hospitals.


PCC staff are known to experience high levels of moral distress, symptoms of post-traumatic stress disorder (PTSD) and burnout, but often feel little is offered to help them with their mental health. The SWell team at Aston University, led by Professor Rachel Shaw from the Institute of Health and Neurodevelopment, realised following a literature review that there are no existing, evidence-based interventions specifically designed to improve PCC staff wellbeing. Initial work by SWell identified the ‘active ingredients’ likely to create successful intervention designs.


Together with a team from NHS England, the Aston University researchers set up the SWell Collaborative Project: Interventions for Staff Wellbeing in Paediatric Critical Care, in PCC units across England and Scotland. The aim of the project was to determine the feasibility and acceptability of implementing wellbeing interventions for staff working in PCC in UK hospitals. In total, 14 of the 28 UK PCC units were involved. One hundred and four intervention sessions were run, attended by 573 individuals.


Professor Shaw said:


“The significance of healthcare staff wellbeing was brought to the surface during the COVID-19 pandemic, but it’s a problem that has existed far longer than that. As far as we could see researchers had focused on measuring the extent of the problem rather than coming up with possible solutions. The SWell project was initiated to understand the challenges to wellbeing when working in paediatric critical care, to determine what staff in that high-pressure environment need, and what could actually work day-to-day to make a difference. Seeing PCC staff across half the paediatric critical care units in the UK show such enthusiasm and commitment to make the SWell interventions a success has been one of the proudest experiences in my academic career to date.”


The two wellbeing sessions tested are low-resource and low-intensity, and can be delivered by staff for staff without any specialist qualifications.


In the session ‘Wellbeing Images’, a small group of staff is shown images representing wellbeing, with a facilitated discussion using appreciative inquiry - a way of structuring discussions to create positive change in a system or situation by focusing on what works well, rather than what is wrong.


In the ‘Mad-Sad-Glad’ session, another small group reflective session, participants explore what makes them feel mad, sad and glad, and identify positive actions to resolve any issues raised.


The key ingredients in both sessions are social support – providing a psychologically safe space where staff can share their sensitive experiences and emotions without judgement, providing support for each other; self-belief – boosting staff’s self-confidence and ability to identify and express their emotions in response to work; and feedback and monitoring – encouraging staff to monitor what increases their stress, when they experience challenging emotions, and what might help boost their wellbeing in those scenarios.


Feedback from staff both running and participating in the SWell interventions was very positive, with high satisfaction and feasibility ratings. Participants like that the session facilitated open and honest discussions, provided opportunities to connect with colleagues and offered opportunities for generating solutions and support.


One hospital staff member responsible for delivering the sessions said:


“Our staff engaged really well, and it created a buzz around the unit with members of the team asking if they could be ‘swelled' on shift. A really positive experience and we are keeping it as part of our staff wellbeing package.”


The team concluded that even on busy PCC units, it is feasible to deliver SWell sessions. In addition, following the sessions, staff wellbeing and depression scores improved, indicating their likely positive impact on staff. Further evaluations are needed to determine whether positive changes can be sustained over time following the SWell sessions.


The work was funded by Aston University Proof of Concept Fund and NHS England.


Donna Austin, an advanced critical care practitioner at University Hospital Southampton paediatric intensive care unit, said:


“We were relatively new to implementing wellbeing initiatives, but we recognised the need for measures to be put in place for an improvement in staff wellbeing, as staff had described burnout, stress and poor mood. SWell has enabled our unit to become more acutely aware of the needs of the workforce and adapt what we deliver to suit the needs of the staff where possible. Staff morale and retention has been the greatest outcomes from us participating in the SWell study and ongoing SWell related interventions.”


Read the paper about the SWell interventions in the journal Nursing in Critical Care at https://onlinelibrary.wiley.com/doi/10.1111/nicc.13228.


For more information about SWell, visit the website.

Connect with:
Dr Rachel Shaw

Dr Rachel Shaw

Reader, School of Psychology

Dr Shaw studies the synthesis of diverse evidence and the use of different ways of knowing in healthcare practice.

Qualitative ResearchHealth PsychologyMethodologyDementiaBody Dysmorphia

You might also like...

Check out some other posts from Aston University

4 min

Aston University collaboration to develop injectable paste which could treat bone cancer

A £110k grant from Orthopaedic Research UK is to help to conduct the work Study is a collaboration with The Royal Orthopaedic Hospital Researchers to use gallium-doped bioglass to produce a substance with anticancer and bone regenerative properties. Professor Richard Martin Aston University is collaborating in research to develop an injectable paste which could treat bone cancer. The Royal Orthopaedic Hospital has secured a £110,000 grant from Orthopaedic Research UK to conduct the work. The project will see researchers at the hospital and the University use gallium-doped bioglass to produce a substance with anticancer and bone regenerative properties. If proved effective it could be used to treat patients with primary and metastatic cancer. Gallium is a metallic element that when combined with bioactive glass can kill cancerous cells that remain when a tumour is removed. It also accelerates the regeneration of the bone and prevents bacterial contamination. A recent study led by Aston University found that bioactive glasses doped with the metal have a 99 percent success rate of eliminating cancerous cells. Dr Lucas Souza, research lab manager at the hospital’s Dubrowsky Lab is leading the project. He said : “Advances in treatment of bone cancer have reached a plateau over the past 40 years, in part due to a lack of research studies into treatments and the complexity and challenges that come with treating bone tumours. Innovative and effective therapeutic approaches are needed, and this grant provides vital funds for us to continue our research into the use of gallium-doped bioglass in the treatment of bone cancer.” Professor Richard Martin who is based in Aston University’s College of Engineering and Physical Sciences added: “The injectable paste will function as a drug delivery system for localised delivery of anticancer gallium ions and bisphosphonates whilst regenerating bone. Our hypothesis is that this will promote rapid bone formation and will prevent cancer recurrence by killing residual cancer cells and regulating local osteoclastic activity.” It is hoped the new approach will be particularly useful in reducing cancer recurrence and implant site infections. It is also thought that it will reduce implant failure rates in cases of bone tumours where large resections for complete tumour removal is either not possible, or not recommended. This could include incidents when growths are located too close to vital organs or when major surgery will inflict more harm than benefit. It could also be used in combination with minimally invasive treatments such as cryoablation or radiofrequency ablation to manage metastatic bone lesions. Dr Souza added: “The proposed biomaterial has the potential to drastically improve treatment outcomes of bone tumour patients by reducing cancer recurrence, implant-site infection rates, and implant failure rates leading to reduced time in hospital beds, less use of antibiotics, and fewer revision surgeries. Taken together, these benefits could improve survival rates, functionality and quality of life of bone cancer patients.” Other members of the team include the hospital’s Professor Adrian Gardner, director of research and development and Mr Jonathan Stevenson, orthopaedic oncology and arthroplasty consultant, Dr Eirini Theodosiou from Aston University and Professor Joao Lopes from the Brazilian Aeronautics Institute of Technology. ENDS About the Royal Orthopaedic Hospital NHS Foundation Trust The Royal Orthopaedic Hospital NHS Foundation Trust is one of the largest specialist orthopaedic units in Europe, offering planned orthopaedic surgery to people locally, nationally, and internationally. The Trust is an accredited Veteran Aware organisation and a Disability Confident Leader. Ranked 8th in the 2024 UK Inclusive Top 50 Employers list, the Royal Orthopaedic Hospital is the highest-ranking NHS organisation for its commitment to diversity and inclusion. The Royal Orthopaedic Hospital has a vibrant research portfolio of clinical trials, observational studies and laboratory studies exploring new treatment options, new approaches in rehabilitation and therapy, and new medical devices. This research is delivered by our researchers and clinicians spread across the Knowledge Hub, our home for education and research, and the Dubrowsky Regenerative Medicine Laboratory, a state-of-the-art lab opened in 2019. About Aston University For over a century, Aston University’s enduring purpose has been to make our world a better place through education, research and innovation, by enabling our students to succeed in work and life, and by supporting our communities to thrive economically, socially and culturally. Aston University’s history has been intertwined with the history of Birmingham, a remarkable city that once was the heartland of the Industrial Revolution and the manufacturing powerhouse of the world. Born out of the First Industrial Revolution, Aston University has a proud and distinct heritage dating back to our formation as the School of Metallurgy in 1875, the first UK College of Technology in 1951, gaining university status by Royal Charter in 1966, and becoming The Guardian University of the Year in 2020. Building on our outstanding past, we are now defining our place and role in the Fourth Industrial Revolution (and beyond) within a rapidly changing world. For media inquiries in relation to this release, contact Nicola Jones, Press & Communications Manager on 07941194168 or email: n.jones6@aston.ac.uk

4 min

Babies respond positively to smell of foods experienced in the womb according to study co-led at Aston University

Babies whose mothers took kale or carrot capsules when pregnant responded more favourably to these smells The research shows that the process of developing food preferences begins in the womb, much earlier than previously thought The research follows up on an earlier study Babies show positive responses to the smell of foods they were exposed to in the womb after they are born, according to a new study. The findings, led by Durham University, UK, could have implications for understanding how healthy eating habits might be established in babies during pregnancy. The research included scientists from Aston University, UK, and the Centre national de la recherche scientifique (CNRS) and University of Burgundy, France. It is published in the journal Appetite. Researchers analysed the facial expressions of babies who had been repeatedly exposed to either kale or carrot in the womb after birth. Newborns whose mothers had taken carrot powder capsules when pregnant were more likely to react favourably to the smell of carrot. Likewise, babies whose mothers had taken kale powder capsules while pregnant reacted more positively to the kale scent. Research co-lead author and supervisor Professor Nadja Reissland, of the Fetal and Neonatal Research Lab, Department of Psychology, Durham University, said: “Our analysis of the babies’ facial expressions suggests that they appear to react more favourably towards the smell of foods their mothers ate during the last months of pregnancy. Potentially this means we could encourage babies to react more positively towards green vegetables, for example, by exposing them to these foods during pregnancy. “In that respect, the memory of food the mother consumes during pregnancy appears to establish a preference for those smells and potentially could help to establish healthy eating habits at a young age.” This study is a follow-up to a 2022 research paper where the researchers used 4D ultrasound scans at 32 and 36 gestational weeks to study foetal facial expressions after their pregnant mothers had ingested a single dose of either 400mg of carrot or kale capsules. Foetuses exposed to carrot showed more “laughter-face” responses while those exposed to kale showed more “cry-face” responses. For the latest study, the researchers followed up 32 babies from the original research paper – 16 males and 16 females – from 36 weeks gestation until approximately three weeks after birth. Mothers consumed either carrot or kale capsules every day for three consecutive weeks until birth. When the babies were about three weeks old, the research team tested newborns’ reactions to kale, carrot, and a control odour. Separate wet cotton swabs dipped in either carrot or kale powders, or water as the control, were held under each infant’s nose and their reaction to the different smells was captured on video. The babies did not taste the swabs. Scientists then analysed the footage to see how the newborns reacted and compared these reactions with those seen before the babies were born to understand the effects of repeated flavour exposure in the last trimester of pregnancy. The research team found that, from the foetal to newborn period, there was an increased frequency in “laughter-face” responses and a decreased frequency in “cry-face” responses to the smell the babies had experienced before birth. Humans experience flavour through a combination of taste and smell. In foetuses, this happens through inhaling and swallowing the amniotic fluid in the womb. Research co-lead author Dr Beyza Ustun-Elayan carried out the research while doing her PhD at Durham University. Dr Ustun-Elayan, who is now based at the University of Cambridge, said: “Our research showed that foetuses can not only sense and distinguish different flavours in the womb but also start learning and establish memory for certain flavours if exposed to them repeatedly. This shows that the process of developing food preferences begins much earlier than we thought, right from the womb. By introducing these flavours early on, we might be able to shape healthier eating habits in children from the start.” The researchers stress that their findings are a baseline study only. They say that longer follow-up studies are needed to understand long-term impacts on child eating behaviour. They add that further research would also need to be carried out on a larger group of infants, at different points in time. They say that the absence of a control group not exposed to specific flavours makes it challenging to fully disentangle developmental changes in the babies from the effects of repeated flavour exposure. Future research should also factor in post-birth flavour experiences, such as some milk formulas known to have a bitter taste, which could impact babies’ responses to the smell of bitter and non-bitter vegetables. The research involved the children of white British mothers, and the researchers say that future studies should be widened to explore how different cultural dietary practices might influence foetal receptivity to a broader array of flavours. Research co-author Professor Jackie Blissett, at Aston University’s School of Psychology, said: “These findings add to the weight of evidence that suggests that flavours of foods eaten by mothers during late pregnancy are learnt by the foetus, preparing them for the flavours they are likely to experience in postnatal life.” Research co-author Professor Benoist Schaal, National Centre for Scientific Research (CNRS)-University of Burgundy, France said: “Foetuses not only detect minute amounts of all types of flavours the mothers ingest, but they overtly react to them and remember them while in the womb and then after birth for quite long times. In this way, mothers have an earlier than early teaching role, as the providers of the infant’s first odour or flavour memories.” Visit https://doi.org/10.1016/j.appet.2025.107891 to read the full research paper in Appetite.

3 min

Putting least calorific meals first on menu makes teenagers more likely to order them according to a study co-led at Aston University

The research was carried out by the University of Birmingham’s Katie Edwards and Aston University’s Jackie Blissett and James Reynolds Both the availability of high-calorie options and their position on the menu affects teenagers’ choices Restaurants provide an important location for implementing low-cost and high-reach interventions to tackle obesity. New research from the University of Birmingham and Aston University has found that putting lower-calorie meal choices at the top of a restaurant menu, and reducing the availability of high-calorie options, makes teenagers more likely to order the healthier options. Childhood obesity rates have been increasing year on year, with government pledges and targets to reduce obesity unfulfilled or missed. Restaurants are a common food environment for adolescents, with one fifth of children consuming meals out at least once a week. The study has been published in the journal Appetite. Dr Katie Edwards, research fellow in psychology at the University of Birmingham and a visiting researcher at Aston University, who led the study, said: “Childhood obesity is a significant public health challenge. A key period for targeting dietary intervention is adolescence, when young people become more independent, making their own decisions about diet and socialising with friends more. Interventions have targeted healthy eating at home and at school, but we wanted to see how altering restaurant menus can impact the choices teenagers make.” The researchers asked 432 13 to 17-year-olds to take part in an online experiment. They presented the teenagers with three different menus, with five starters, ten main courses and five desserts in separate sections, as one would find on a standard restaurant menu. Each menu was slightly different; one which reduced the number of high-calorie options on offer, one with menu positioning of low- to high-calorie meals, one which combined the availability and position interventions, and then one ‘typical’ menu. The participants were asked to select a starter, main and dessert from each menu. The experiment showed that the availability and the position interventions resulted in significantly lower calorie meal choices, compared to the choices made from the menu with no intervention (the ‘typical’ menu). The average number of calories for a selected meal reduced from 2099.78 to 1992.13 when the items were ordered from least to highest calorie content. The availability intervention reduced it from 2134.26 kcal to 1956.18 kcal. The group who had the combined availability and positioning intervention menu saw their meals’ calorie value plummet from 2173.60 kcal to 1884.44 kcal. The study also found that the positioning intervention had the biggest impact on main course choices. The availability intervention and the combined interventions, on the other hand, did not have a big impact on the calorie value of main course choices. The availability intervention had the most impact on starter choices. None of the interventions had a significant impact on dessert choices. Dr Edwards said: “Main menu choices saw the biggest reduction in calories following the position intervention, going from 1104.17 kcal to 1045.16 kcal, while the availability intervention saw the biggest reduction in the starter option. While not all interventions saw statistically significant reductions for all courses, each intervention saw a significant reduction in the calorie content of the overall meals.” Dr James Reynolds, senior lecturer in psychology at Aston University, said: “People tend to consume higher calorie meals when they eat out, so restaurants provide an important location for implementing low-cost and high-reach interventions which can encourage healthier eating in teenagers. Many restaurants are already required to display calorie information on their menus, but our research has shown that tactics like altering the position or availability of high-calorie options on menus could also be a useful tool in trying to reduce obesity and help young people make healthier choices. The next step for this research would be to replicate the study in restaurant settings.” Read the full paper in the journal Appetite at https://www.sciencedirect.com/science/article/pii/S0195666324005749

View all posts