Does hydration have effects on competence in doctors?
| ISRCTN | ISRCTN79051745 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN79051745 |
| Secondary identifying numbers | P2S1 |
- Submission date
- 05/02/2021
- Registration date
- 10/02/2021
- Last edited
- 11/10/2022
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English Summary
Background and study aims
Research has found that doctors in the United Kingdom were clinically dehydrated at the start (36%) and end (45%) of shifts. As little as 2% dehydration as a percentage of total body weight can cause impaired physical, psychomotor, cognitive, psychiatric and visuomotor performance, in addition to greater fatigue, and reduced alertness. The addition of PPE as standard workplace practice (beyond what was previously expected) is likely to have magnified the speed at which doctors dehydrate (due to elevated temperature), and due to the functional infection-control barriers of fluid intake. Given the fundamental importance of hydration for psychophysiological functioning, exploring doctor’s hydration levels and impact on measures of competence is a valuable area of research. Therefore, the aim of this research is to explore the association between hydration and competence in doctors.
Who can participate?
This study invites adults currently in employment as a doctor by the National Health Service in the United Kingdom. Due to their specific health needs, we can’t include people who are pregnant or breastfeeding. Nor can we include doctors with current renal, cardiac, pulmonary, hepatic, digestive, thyroid, neurological or haematological disease, in addition to anyone taking medications (either prescribed or over-the-counter) that influence weight, fluid, or electrolyte balance.
What does the study involve?
Those who are eligible and decide to participate will be emailed a participant ID code, and a link to an online survey platform including the consent form. Participants will receive a testing pack in the post including sample pots, urinalysis reagent strips and comprehensive self-testing and online reporting instructions. They will be asked to complete online surveys on three occasions that they may access in private via a home laptop or PC. The first can be completed at any time convenient for the participant, the second and third must be completed when they return home following a working shift. In addition to the surveys, participants will be asked to undertake self-assessed urinalysis using reagent Labstick’s. The self-administered urinalysis method is quick, non-invasive and participants will be able to dispose of the sample immediately following input of their results. They will be required to provide a fluid record based over the duration of their working shift. On completion of the study you they will be provided with a written debriefing and offered a telephone debriefing (on request).
What are the possible benefits and risks of participating?
The aim of this study is to capture professional experiences. Results from this study may be published to inform future research and support professional and public awareness of any identified needs. Publication of the results from this study may allow dissemination of valuable information that may prompt support and understanding for the needs of medical staff. This study invites participants to think reflectively about their personal and professional experiences, this may have positive and negative emotional responses. Participants urinalysis results are non-diagnostic but may indicate health needs (e.g. dehydration), they will be given details of the healthy-range scores and advised to seek medical guidance if they need further support to meet their health needs.
Where is the study run from?
University of Reading (UK)
When is the study starting and how long is it expected to run for?
November 2020 to March 2023
Who is funding the study?
Investigator initiated and funded
Who is the main contact?
Kirsty Hodgson, k.l.hodgson@pgr.reading.ac.uk
Dr Allán Laville, a.laville@reading.ac.uk
Associate Professor Daniel Lamport, daniel.lamport@reading.ac.uk
Contact information
Scientific
The University of Reading School of Psychology
Harry Pitt Building
Whiteknights
University of Reading
Reading
RG6 6AH
United Kingdom
 ORCID ID |
0000-0001-9678-9269 |
|---|---|
| Phone | +44 (0)118 3788523 |
| a.laville@reading.ac.uk |
Scientific
The University of Reading School of Psychology
Harry Pitt Building
Whiteknights
University of Reading
Reading
RG6 6AH
United Kingdom
| ORCID ID |
0000-0002-4592-0439 |
|---|---|
| Phone | +44 (0)118 3788523 |
| daniel.lamport@reading.ac.uk |
Public
The University of Reading School of Psychology
Harry Pitt Building
Whiteknights
University of Reading
Reading
RG6 6AH
United Kingdom
| ORCID ID |
0000-0002-9680-0445 |
|---|---|
| Phone | +44 (0)118 3788523 |
| k.l.hodgson@pgr.reading.ac.uk |
Study information
| Study design | Observational cohort study |
|---|---|
| Primary study design | Observational |
| Secondary study design | Cohort study |
| Study setting(s) | Internet/virtual |
| Study type | Other |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet |
| Scientific title | Exploration of the association between hydration status and competence in doctors |
| Study hypothesis | Through psychophysiological effects, this research hypothesises that there will be a positive association between hydration status and competency. |
| Ethics approval(s) | Approved 14/01/2021, The University of Reading School of Psychology Research Ethics Committee (Whiteknights, University of Reading, Reading, Berkshire, RG6 6AH, UK; +44 (0)118 3788523; pclsethics@reading.ac.uk), ref: 2020-193-AL |
| Condition | Measures of competence, hydration and psychophysiological status in doctors in the United Kingdom |
| Intervention | Those who are eligible and decide to participate will be emailed a participant ID code, and a link to an online survey platform including the consent form. Participants will receive a testing pack in the post including sample pots, urinalysis reagent strips and comprehensive self-testing and online reporting instructions. They will be asked to complete online surveys on three occasions that they may access in private via a home laptop or PC. The first can be completed at any time convenient for the participant, the second and third must be completed when they return home following a working shift. In addition to the surveys, participants will be asked to undertake self-assessed urinalysis using reagent Labstick’s. The self-administered urinalysis method is quick, non-invasive and participants will be able to dispose of the sample immediately following input of their results. They will be required to provide a fluid record based over the duration of their working shift. On completion of the study they will be provided with a written debriefing and offered a telephone debriefing (on request). Within 3-days following the baseline testing session, participants will also be asked to complete Day 1 of the working day assessment. B0 - T2 is designed to be completed within a 7-day period according to each doctor’s shift pattern. |
| Intervention type | Other |
| Primary outcome measure | 1. Competence is measured using a Self-Assessment Questionnaire (M-SQ) following two working shifts (T1 - T2) 2. Hydration status is measured using self-assessed urinalysis reagent Labstick’s reporting urine specific gravity (Uspecific gravity) at T1 and T2 |
| Secondary outcome measures | Current secondary outcome measures as of 01/03/2021: Measured at B0: 1. The Professional Quality of Life – Version 5 (ProQOL-5) to assess coping competence, burnout, secondary traumatic stress and compassion satisfaction (Stamm, 2009) 2. The Profile of Emotional Competence (PEC) as a self-reported measure of intra- and inter-personal emotional competence and global emotional intelligence (Brasseur, Grégoire, Bourdu, & Mikolajczak, 2013) 3. The Almost Perfect Scale-Revised Short Form (APS-R SF) to assess attitudes towards others, themselves and their performance, orthogonally measuring the maladaptive and adaptive aspects of perfectionism (Slaney et al., 2001) 4. The Diagnostic Thinking Inventory (DTI) which is a widely applied self-assessment tool used to determine clinical diagnostic reasoning in doctors at all stages of their career. The DTI assesses two clinical reasoning domains: knowledge structure in memory and flexibility in thinking (Bordage, Grant & Marsden, 1990)5. The Lifestyle Appraisal Questionnaire (LAQ) as a comprehensive assessment of lifestyle (Craig, Hancock & Craig, 1996) Measured at T1 and T2: 5. The Daily Stress Inventory (DSI) items measure a 24-hour period and three daily scores are derived on the number of events, the sum of the impact of the events, and the average impact rating of the events (Brantley, Waggoner, Jones & Rappaport, 1987) 6. N-back Letters Tasks (level 2 and 3), tasks will be used as a cognitive assessment to measure performance of a part of working memory and working memory capacity 7. Reagent Labstick’s: urinary pH (UpH) as a measure of physiologic and psychological stress 8. Urine colour (Ucolour) will be analysed using an NHS 8-level colour chart 9. Fluid record based on the volume and type of fluid consumed over the duration of their working shift 10. Professional context questions (questions relating to their occupational role, working conditions, shift duration, amount of patient contact and the impact of COVID-19 on their ability to maintain healthy fluid intake at work) ____ Previous secondary outcome measures: Measured at T1 and T2: 1. The Professional Quality of Life – Version 5 (ProQOL-5) to assess coping competence, burnout, secondary traumatic stress and compassion satisfaction (Stamm, 2009) 2. The Profile of Emotional Competence (PEC) as a self-reported measure of intra- and inter-personal emotional competence and global emotional intelligence (Brasseur, Grégoire, Bourdu, & Mikolajczak, 2013) 3. The Almost Perfect Scale-Revised Short Form (APS-R SF) to assess attitudes towards others, themselves and their performance, orthogonally measuring the maladaptive and adaptive aspects of perfectionism (Slaney et al., 2001) 4. The Diagnostic Thinking Inventory (DTI) which is a widely applied self-assessment tool used to determine clinical diagnostic reasoning in doctors at all stages of their career. The DTI assesses two clinical reasoning domains: knowledge structure in memory and flexibility in thinking (Bordage, Grant & Marsden, 1990) 5. The Lifestyle Appraisal Questionnaire (LAQ) as a comprehensive assessment of lifestyle (Craig, Hancock & Craig, 1996) 6. The Daily Stress Inventory (DSI) items measure a 24-hour period and three daily scores are derived on the number of events, the sum of the impact of the events, and the average impact rating of the events (Brantley, Waggoner, Jones & Rappaport, 1987) 7. N-back Letters Tasks (level 2 and 3), tasks will be used as a cognitive assessment to measure performance of a part of working memory and working memory capacity 9. Reagent Labstick’s: urinary pH (UpH) as a measure of physiologic and psychological stress 10. Urine colour (Ucolour) will be analysed using an NHS 8-level colour chart 11. Fluid record based on the volume and type of fluid consumed over the duration of their working shift 12. Professional context questions (questions relating to their occupational role, working conditions, shift duration, amount of patient contact and the impact of COVID-19 on their ability to maintain healthy fluid intake at work) |
| Overall study start date | 15/11/2020 |
| Overall study end date | 15/03/2023 |
Eligibility
| Participant type(s) | Health professional |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | A minimum of 30 participants are required for this study |
| Total final enrolment | 61 |
| Participant inclusion criteria | Healthy adult volunteers currently in employment as a doctor by the National Health Service in the United Kingdom, and have access to a private home laptop or PC to complete the online testing. |
| Participant exclusion criteria | 1. Pregnant, or breastfeeding 2. Current renal, cardiac, pulmonary, hepatic, digestive, thyroid, neurological or haematological disease, in addition to anyone taking medications (either prescribed or over-the-counter) that influence weight, fluid, or electrolyte balance |
| Recruitment start date | 15/02/2021 |
| Recruitment end date | 01/09/2022 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
Whiteknights
University of Reading
Reading
RG6 6AH
United Kingdom
Sponsor information
University/education
Whiteknights
Reading
RG6 6AH
England
United Kingdom
| Phone | +44 (0)118 378 8523 |
|---|---|
| pcls@reading.ac.uk | |
| Website | https://www.reading.ac.uk/pcls/ |
"ROR" |
https://ror.org/05v62cm79 |
Funders
Funder type
Other
No information available
Results and Publications
| Intention to publish date | 15/12/2023 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | Planned publication in a high-impact peer-reviewed journal. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol file | 01/03/2021 | No | No |
Additional files
- ISRCTN79051745_PROTOCOL_no_date.docx
- uploaded 01/03/2021
Editorial Notes
11/10/2022: The following changes were made to the trial record:
1. The overall end date was changed from 01/10/2022 to 15/03/2023.
2. The intention to publish date was changed from 01/12/2022 to 15/12/2023.
3. The plain English summary was updated to reflect these changes.
4. The total final enrolment was added.
11/07/2022: The recruitment end date has been changed from 01/07/2022 to 01/09/2022.
08/11/2021: The following changes were made to the trial record:
1. The recruitment end date was changed from 01/11/2021 to 01/07/2022.
2. The overall end date was changed from 01/01/2022 to 01/10/2022.
3. The intention to publish date was changed from 15/05/2022 to 01/12/2022.
4. The plain English summary was updated to reflect these changes.
14/04/2021: Internal review.
01/03/2021: The following changes were made to the trial record:
1. The protocol (not peer reviewed) Version n/a, no date, was uploaded to the study record. The protocol document was provided to the ISRCTN editorial team on 10/02/2021.
2. The secondary outcome measures were updated to correct an error made previously by the ISRCTN editorial team.
10/02/2021: Trial’s existence confirmed by University of Reading
