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Kalisch R, Russo SJ, Müller MB. Neurobiology and systems biology of stress resilience. Physiol Rev 2024; 104:1205-1263. [PMID: 38483288 DOI: 10.1152/physrev.00042.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/16/2024] Open
Abstract
Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.
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Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Scott J Russo
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Brain and Body Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Marianne B Müller
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
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Zhao Y, Liu F, Lin P, Tu Z, Wu B. Sleep quality and mental health among Chinese nurses after the COVID-19 pandemic: A moderated model. PLoS One 2024; 19:e0295105. [PMID: 38820459 PMCID: PMC11142611 DOI: 10.1371/journal.pone.0295105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/15/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION AND AIMS In the specialized nursing setting, nurses are susceptible to developing negative mental health issues. Such conditions among nurses can potentially result in unfavorable medical outcomes. Consequently, this study aims to explore the role of social support in regulating between sleep and mental health in nurses. METHODS A cross-sectional study was carried out in September 2022 on 1219 nurses in Quanzhou. The study comprised general demographic information and utilized various questionnaires, namely the Social Support Rate Scale (SSRS), Pittsburgh Sleep Quality Index Questionnaire (PSQI), Generalized Anxiety Disorder Questionnaire (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). The data analysis was performed using t-tests, ANOVAs, Pearsons correlations and hierarchical regression analyses in SPSS software. RESULTS Results show that significant associations of sleep quality and social support with anxiety and depression. Simple slope analysis shows that under low levels of social support, sleep quality has a positive impact on anxiety(β = 0.598) and depression(β = 0.851), and the impact is significant. Under high levels of social support, sleep quality also has a positive impact on anxiety(β = 0.462) and depression(β = 0.578), but the impact is smaller. This indicates that as the level of social support increases, the positive predictive effect of sleep quality on anxiety and depression gradually diminishes. CONCLUSIONS Social support has the potential to alter the impact of sleep quality on anxiety and depression. Therefore, healthcare policymakers need to focus on enhancing the level of social support and mitigating the impact of poor sleep on anxiety and depression.
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Affiliation(s)
- Yanyan Zhao
- Department of Nursing, Quanzhou First Hospital, Quanzhou, China
| | - Fuzhi Liu
- Department of Preventive Medicine, School of Health, Quanzhou Medical College, Quanzhou, China
| | - Pingzhen Lin
- Department of Nursing, Quanzhou First Hospital, Quanzhou, China
| | - Zhuote Tu
- Department of Preventive Medicine, School of Health, Quanzhou Medical College, Quanzhou, China
| | - Biyu Wu
- Department of Nursing, Quanzhou First Hospital, Quanzhou, China
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Wadi M, Shorbagi A, Shorbagi S, Taha MH, Bahri Yusoff MS. The impact of the Systematic Assessment for Resilience (SAR) framework on students' resilience, anxiety, depression, burnout, and academic-related stress: a quasi-experimental study. BMC MEDICAL EDUCATION 2024; 24:506. [PMID: 38715022 PMCID: PMC11077819 DOI: 10.1186/s12909-024-05444-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Medical students face significant psychological stress, impacting their academic performance and well-being. The Systematic Assessment for Resilience (SAR) framework is designed to enhance resilience and mitigate stress among medical students, addressing the need for interventions within the assessment system in medical education. The aim of this study was to evaluate the implementation of SAR framework on medical students' resilience, anxiety, depression, burnout, and academic stress. METHODS This study employed a quasi-experimental design with pre- and post-testing. It involved the training of course coordinators in implementing the SAR framework and its integration into the daily learning activities. Fourth-year medical students were assessed before and after the intervention using standardized measures of resilience, anxiety, depression, burnout, and academic stress. Data were analyzed using quantitative methods and thematic analysis for qualitative feedback. RESULTS Post-intervention, students demonstrated a significant increase in resilience scores (p < 0.001) and a notable decrease in measures of anxiety, depression, and academic stress (p < 0.001). The burnout types were also statistically different (p < 0.001) except client-related burnout (p > 0.05). Qualitative feedback of the course coordinators highlighted an improved learning environment, increased coping strategies, and a more supportive academic culture. CONCLUSION The SAR framework significantly contributes to enhancing medical students' resilience and reducing psychological distress. Its implementation suggests a promising approach to fostering a supportive educational environment that not only addresses the psychological challenges faced by medical students but also enhances their academic performance and overall well-being. Further research is warranted to explore the long-term impacts of SAR across different medical education contexts.
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Affiliation(s)
- Majed Wadi
- Medical Education Department, College of Medicine, Qassim University, Buraydah, Saudi Arabia.
| | - Ali Shorbagi
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Sarra Shorbagi
- Department of Family and Community Medicine and Behavioral Science, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed Hassan Taha
- College of Medicine and Medical Education Center, University of Sharjah, Sharjah, United Arab Emirates
| | - Muhamad Saiful Bahri Yusoff
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Baas MAM, Stramrood CAI, Molenaar JE, van Baar PM, Vanhommerig JW, van Pampus MG. Continuing the conversation: a cross-sectional study about the effects of work-related adverse events on the mental health of Dutch (resident) obstetrician-gynaecologists (ObGyns). BMC Psychiatry 2024; 24:286. [PMID: 38627649 PMCID: PMC11022402 DOI: 10.1186/s12888-024-05678-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/12/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Obstetrician-Gynaecologists (ObGyns) frequently face work-related adverse events such as severe obstetric complications and maternal or neonatal deaths. In 2014, the WATER-1 study showed that ObGyns are at risk of developing work-related posttraumatic stress disorder (PTSD), while many hospitals lacked a professional support system. The aim of the present study is to evaluate the current prevalence of work-related traumatic events and mental health problems among Dutch ObGyns, as well as to examine the current and desired support. METHODS In 2022, an online questionnaire was sent to all members of the Dutch Society of Obstetrics and Gynaecology (NVOG), including resident and attending ObGyns. The survey included questions about experienced work-related events, current and desired coping strategies, and three validated screening questionnaires for anxiety, depression, and PTSD (HADS, TSQ, and PCL-5). RESULTS The response rate was 18.8% and 343 questionnaires were included in the analysis. Of the respondents, 93.9% had experienced at least one work-related adverse event, 20.1% had faced a complaint from the national disciplinary board, and 49.4% had considered leaving the profession at any moment in their career. The prevalence rates of clinically relevant anxiety, depression, and psychological distress were 14.3, 4.4, and 15.7%, respectively. The prevalence of work-related PTSD was 0.9% according to DSM-IV and 1.2% according to DSM-5. More than half of the respondents (61.3%) reported the presence of a structured support protocol or approach in their department or hospital, and almost all respondents (92.6%) rated it as sufficient. CONCLUSIONS The percentages of anxiety, depression, psychological distress and PTSD are comparable to the similar study performed in 2014. Most Dutch ObGyns experience adverse events at work, which can be perceived as traumatic and, in certain cases, may lead to the development of PTSD. Structured support after adverse work-related events is now available in almost two-thirds of workplaces, and was mostly experienced as good. Despite substantial improvements in the availability and satisfaction of professional support after work-related adverse events, the prevalence rates of mental problems remain considerable, and it is imperative to sustain conversation about the mental well-being of ObGyns.
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Affiliation(s)
- Melanie A M Baas
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, 9700 RB, Groningen, PO box 30.001, The Netherlands
| | - Claire A I Stramrood
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Beval Beter, 1000 AH, Amsterdam, PO box 345, The Netherlands
| | - Jolijn E Molenaar
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
| | - Petra M van Baar
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, 1105 AZ, Amsterdam, the Netherlands
| | - Joost W Vanhommerig
- Department of Research and Epidemiology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
| | - Maria G van Pampus
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands.
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Calo M, Judd B, Peiris C. Grit, resilience and growth-mindset interventions in health professional students: A systematic review and meta-analysis. MEDICAL EDUCATION 2024. [PMID: 38600797 DOI: 10.1111/medu.15391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Grit, resilience and a growth-mindset influence students' ability to positively adapt to the challenges of health professional training. However, it is unclear if interventions can improve these traits. This systematic review aimed to explore if interventions can improve these traits in health professional students (primary) and their impact on academic and/or wellbeing outcomes (secondary). METHODS A comprehensive search of CINAHL, MEDLINE, Eric and Embase was conducted from inception until 15 March 2023. Randomised or non-randomised controlled trials and single-group intervention studies that aimed to improve health professional students' resilience, grit and/or growth-mindset were eligible for inclusion. Two reviewers independently screened studies for inclusion and evaluated quality using the Mixed Methods Appraisal Tool. Post-intervention data from randomised and non-randomised control trials were pooled using a random-effects model to calculate standardised mean differences (SMD) and 95% confidence intervals (CIs). RESULTS Resilience interventions improved resilience by a moderate amount in 13 studies with 990 participants (pooled SMD 0.74, 95%CI 0.03 to 1.46) and a large amount when interventions were greater than one session duration in 10 trials with 740 participants (pooled SMD 0.97, 95%CI 0.08 to 1.85). Grit and growth-mindset interventions improved grit (pooled SMD 0.48, 95%CI -0.05 to 1.00, n = 2) and growth-mindset (pooled SMD 0.25, 95%CI -0.18 to 0.68, n = 2) by a small amount. Resilience interventions decreased perceived stress by a small amount (pooled SMD -0.38, 95%CI -0.62 to -0.14, n = 5). CONCLUSIONS Resilience interventions improve resilience and decrease perceived stress in health professional students. Preliminary evidence suggests grit and growth-mindset interventions may also benefit health professional students. Interventions may be most effective when they are longer than one session and targeted to students with low baseline levels of resilience and grit.
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Affiliation(s)
- Marlena Calo
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Belinda Judd
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Casey Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
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Mira JJ, Matarredona V, Tella S, Sousa P, Ribeiro Neves V, Strametz R, López-Pineda A. Unveiling the hidden struggle of healthcare students as second victims through a systematic review. BMC MEDICAL EDUCATION 2024; 24:378. [PMID: 38589877 PMCID: PMC11000311 DOI: 10.1186/s12909-024-05336-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND When healthcare students witness, engage in, or are involved in an adverse event, it often leads to a second victim experience, impacting their mental well-being and influencing their future professional practice. This study aimed to describe the efforts, methods, and outcomes of interventions to help students in healthcare disciplines cope with the emotional experience of being involved in or witnessing a mistake causing harm to a patient during their clerkships or training. METHODS This systematic review followed the PRISMA guidelines and includes the synthesis of eighteen studies, published in diverse languages from 2011 to 2023, identified from the databases MEDLINE, EMBASE, SCOPUS and APS PsycInfo. PICO method was used for constructing a research question and formulating eligibility criteria. The selection process was conducted through Rayyan. Titles and abstracts of were independently screened by two authors. The critical appraisal tools of the Joanna Briggs Institute was used to assess the risk of bias of the included studies. RESULTS A total of 1354 studies were retrieved, 18 met the eligibility criteria. Most studies were conducted in the USA. Various educational interventions along with learning how to prevent mistakes, and resilience training were described. In some cases, this experience contributed to the student personal growth. Psychological support in the aftermath of adverse events was scattered. CONCLUSION Ensuring healthcare students' resilience should be a fundamental part of their training. Interventions to train them to address the second victim phenomenon during their clerkships are scarce, scattered, and do not yield conclusive results on identifying what is most effective and what is not.
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Affiliation(s)
- José Joaquín Mira
- Atenea Research. FISABIO, Alicante, Spain.
- Universidad Miguel Hernández, Elche, Spain.
| | | | - Susanna Tella
- Faculty of Health and Social Care, LAB University of Applied Sciences, Lappeenranta, Finland
| | - Paulo Sousa
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | | | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), RheinMain UAS, Wiesbaden, Germany
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Sayer NA, Kaplan A, Nelson DB, Wiltsey Stirman S, Rosen CS. Clinician Burnout and Effectiveness of Guideline-Recommended Psychotherapies. JAMA Netw Open 2024; 7:e246858. [PMID: 38630477 PMCID: PMC11024738 DOI: 10.1001/jamanetworkopen.2024.6858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/19/2024] [Indexed: 04/19/2024] Open
Abstract
Importance Clinician burnout has been associated with clinician outcomes, but the association with patient outcomes remains unclear. Objective To evaluate the association between clinician burnout and the outcomes of patients receiving of guideline-recommended trauma-focused psychotherapies for posttraumatic stress disorder (PTSD). Design, Setting, and Participants This cohort study was set at the US Veterans Affairs Health Care System and included licensed therapists who provided trauma-focused psychotherapies and responded to an online survey between May 2 and October 8, 2019, and their patients who initiated a trauma-focused therapy during the following year. Patient data were collected through December 31, 2020. Data were analyzed from May to September 2023. Exposures Therapists completing the survey reported burnout with a 5-point validated measure taken from the Physician Worklife Study. Burnout was defined as scores of 3 or more. Main Outcomes and Measures The primary outcome was patients' clinically meaningful improvement in PTSD symptoms according to the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Patient dropout, therapist adherence, and session spacing was assessed through electronic health records. Multivariable random-effects logistic regression examined the association of therapist burnout and clinically meaningful improvement, adjusted for case-mix. Results In this study, 165 of 180 (91.7%) therapists (89 [53.9%] female) completed the burnout measure and provided trauma-focused psychotherapies to 1268 patients (961 [75.8%] male) with outcome data. Fifty-eight (35.2%) therapists endorsed burnout. One third of patients (431 [34.0%]) met criterion for clinically meaningful improvement. Clinically meaningful improvement in PTSD symptoms was experienced by 120 (28.3%) of the 424 patients seen by therapists who reported burnout and 311 (36.8%) of the 844 patients seen by therapists without burnout. Burnout was associated with lower odds of clinically meaningful improvement (adjusted odds ratio [OR],0.63; 95% CI, 0.48-0.85). The odds of clinically meaningful improvement were reduced for patients who dropped out (OR, 0.15; 95% CI, 0.11-0.20) and had greater session spacing (OR, 0.80; 95% CI, 0.70-0.92). Therapist adherence was not associated with therapy effectiveness. Adjusting for dropout or session spacing did not meaningfully alter the magnitude of the association between burnout and clinically meaningful improvement. Conclusions and Relevance In this prospective cohort study, therapist burnout was associated with reduced effectiveness of trauma-focused psychotherapies. Studying when and how burnout affects patient outcomes may inform workplace interventions.
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Affiliation(s)
- Nina A. Sayer
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Adam Kaplan
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis
| | - David B. Nelson
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis
| | - Shannon Wiltsey Stirman
- National Center for Posttraumatic Stress Disorder, Dissemination and Training Division at the Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Craig S. Rosen
- National Center for Posttraumatic Stress Disorder, Dissemination and Training Division at the Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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Bifano SM, Szeglin CJ, Garbers S, Gold MA. Emotional Freedom Techniques (EFT) Tapping for Pediatric Emergency Department Staff During the COVID-19 Pandemic: Evaluation of a Pilot Intervention. Med Acupunct 2024; 36:70-78. [PMID: 38665925 PMCID: PMC11040184 DOI: 10.1089/acu.2023.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Objective Emergency-department (ED) staff may experience psychologic distress due to the stressful nature of their work. The COVID-19 pandemic exacerbated this distress. Emotional Freedom Techniques (EFT) tapping, a somatic psychophysiologic intervention combining vibratory acupressure with elements of cognitive-behavioral and exposure therapies, can reduce psychologic distress. This study tested the short-term effect of 10-minute EFT tapping on the psychologic distress of pediatric ED staff responding to COVID-19. Materials and Methods During the COVID-19 pandemic, diverse staff in the pediatric ED of a New York City teaching hospital participated in this single-group study. A licensed creative arts therapist led participants in 10-minute EFT tapping sessions. A self-report questionnaire with 7 items based on the Trauma Exposure Response framework was administered immediately pre- and postintervention. Standardized mean differences between both timepoints were calculated. Results There were statistically significant reductions for 6 of the 7 items studied, including stress (3.32-2.14), obsessive and intrusive thoughts (2.50-1.85), feelings of pressure (3.20-2.17), loneliness (1.84-1.44), and emotional and physical pain (2.28-1.70); all P < 0.001. No significant changes in professional satisfaction were reported following the intervention. Conclusions Despite the limitations of a single-arm study design, a 10-minute brief EFT tapping session was a promising way to reduce short-term psychologic distress in pediatric ED health care workers. Future studies, including rigorous randomized controlled trials, are needed to evaluate the effectiveness of brief EFT tapping interventions in other settings.
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Affiliation(s)
- Susanne M. Bifano
- Creative Arts Therapy, New York–Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | | | - Samantha Garbers
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melanie A. Gold
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Pediatric, Columbia University Irving Medical Center, New York, NY, USA
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Sandars J, Jenkins L, Huntley E. Understanding the performance-related psychological characteristics and skills of doctors: A sport psychology perspective. MEDICAL TEACHER 2024:1-7. [PMID: 38555731 DOI: 10.1080/0142159x.2024.2331049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/12/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Doctors need to consistently maintain their clinical performance across a range of different situations by managing the stress response provoked by these situations. Six performance-related adaptive and maladaptive psychological characteristics and psychological skills can distinguish between how athletes manage their stress response and consistently maintain an optimal level of performance across a variety of situations. The aim of the study was to understand how the performance-related psychological characteristics and skills identified in athletes are applied by doctors. METHODS An exploratory qualitative study was conducted with semi-structured interviews. A purposive sample of 10 doctors were interviewed and the data were analysed by template analysis. RESULTS Doctors have similar performance-related psychological characteristics and skills as identified in athletes for managing their stress response to consistently maintain optimal clinical performance. The importance of maladaptive characteristics was also identified, especially in junior doctors. CONCLUSIONS The findings of this pilot study can be used for informing the design of performance-related educational interventions for doctors to manage their stress response for consistently maintaining optimal clinical performance. An important consideration will need to be a focus on specific groups in their career journey and the development of a multi-dimensional, reflective, and problem-solving approach.
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Affiliation(s)
- John Sandars
- Edge Hill University Medical School, Edge Hill University, Ormskirk, Lancashire, United Kingdom
| | - Liam Jenkins
- Edge Hill University Medical School, Edge Hill University, Ormskirk, Lancashire, United Kingdom
| | - Emma Huntley
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, Lancashire, United Kingdom
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Boris P, Kovács KE, Nagy BE. The comparative study of chronically ill and healthy children and adolescents in the light of their general mental health. Sci Rep 2024; 14:6754. [PMID: 38514800 PMCID: PMC10957949 DOI: 10.1038/s41598-024-57442-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
Children's hospitalisation is difficult for the family and the immediate environment. In these cases, the provision of psychological support is particularly important. Chronically ill children who are regularly hospitalised are in a particularly difficult situation, often feeling vulnerable. Our research aims to explore and analyse in detail the psychological state, attitudes and mental health of chronically ill children and to compare patient groups (children receiving care in pulmonology, gastroenterology, onco-haematology and rehabilitation) to understand the interacting factors, which may be of great importance for quality patient care and for measures to improve patient care in the future. We studied chronically ill children (N = 107) aged 10 to 18 years (M = 14.3; SD = 2.0), cared for by the Department of Paediatric Rehabilitation, Paediatric Psychiatry and Psychosomatics of the University of Debrecen Clinical Centre, the second largest paediatric institution in Hungary. In our survey, sociodemographic questions, the Connor-Davidson Resilience Scale, the Satisfaction With Life Scale, the Cantril Ladder, the Non-Productive Thoughts Questionnaire, the Problematic Internet Use Questionnaire, the Drawing version of Pictorial Representation of Illness Self-Measure (PRISM-D), the Beck Depression Inventory-Shortened Scale, the Illness Intrusiveness Ratings Scale, the Spielberger State-Trait Anxiety Questionnaire-Child Version and the Strength and Difficulty Questionnaire were applied. One-way analysis of variance (ANOVA) was used to examine differences between groups, and Pearson rank correlation analysis was used to measure the relationships between individual variables. The results show significant differences between patient groups in terms of resilience, depression, nonproductive thoughts, problematic internet use, anxiety and coping, but no consistent pattern in the development of scores. In addition, for some psychological correlates, the role of sociodemographic background also showed significant results. The practical utility of our study is that using questionnaire methods to map patient satisfaction, compliance, and patient attitudes will provide regarding the factors that influence the mental health status of children living with chronic illnesses. In the light of this, additional methods and tools can be included to improve the quality of healthcare and to develop a set of procedures that will serve the intended purpose.
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Affiliation(s)
- Péter Boris
- Laki Kálmán Doctoral School, University of Debrecen, Debrecen, 4032, Hungary
| | - Karolina Eszter Kovács
- Faculty of Arts, Institute of Psychology, University of Debrecen, Debrecen, 4032, Hungary.
| | - Beáta Erika Nagy
- Pediatric Rehabilitation, Pediatric Psychology and Psychosomatic Unit, Faculty of Medicine, Institute of Pediatrics, University of Debrecen, Debrecen, 4032, Hungary
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Cheng J, Zhao J, Song B, Han H, Liu N, Chen Y, Liu X, Dong Y, Bian W, Liu Z, Han S. Positive effects of parent-child group emotional regulation and resilience training on nonsuicidal self-injury behavior in adolescents: a quasi-experimental study. Front Psychiatry 2024; 15:1343792. [PMID: 38571996 PMCID: PMC10987729 DOI: 10.3389/fpsyt.2024.1343792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
Background Nonsuicidal self-injury (NSSI) among adolescents is a growing global concern. However, effective interventions for treating NSSI are limited. Method A 36-week quasi-experimental study design of parent-child group resilience training (intervention group) for adolescents aged 12-17 years was used and compared with treatment-as-usual (control group). The primary endpoint was the frequency of NSSI assessed with the Ottawa Self-Injury Inventory (OSI), and the secondary endpoints were the levels of depression, hope, resilience, and family adaptability and cohesion as assessed by the 24-item Hamilton depression rating scale (HAMD-24), Herth Hope Scale (HHS), Connor-Davidson Resilience Scale (CD-RISC), and Family Adaptability and Cohesion Evaluation Scale, second edition (FACES-II-CV), respectively. Result A total of 118 participants completed the trial. Both groups showed a significant reduction in NSSI frequency after 12, 24, and 36 weeks of intervention (p< 0.05), although the intervention group did not differ significantly from the control group. After 12, 24, and 36 weeks of intervention, the CD-RISC, HHS, HAMD-24, and FACES-II-CV scores in the intervention and control groups improved over baseline (p< 0.05). Furthermore, the intervention group had higher scores on the CD-RISC, HHS, and FACES-II-CV and lower scores on the HAMD-24 than the control group after 12, 24, and 36 weeks of intervention (p < 0.05). Conclusion Parent-child group emotional regulation and resilience training showed promise as treatment options for NSSI among adolescents, leading to increased hope, resilience, and improved family dynamics among NSSI teens. Moreover, NSSI frequency significantly decreased in the intervention group compared to baseline.
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Affiliation(s)
- Junxiang Cheng
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Juan Zhao
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Baoli Song
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hong Han
- Department of Magnetic Resonance Imaging, Shanxi Bethune Hospital, Taiyuan, China
| | - Na Liu
- Department of Orthopedics, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yangjie Chen
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaomei Liu
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yue Dong
- Department of Intensive Care Unit (ICU), the Affiliated Lianyungang Hospital of Xuzhou Medical University, Xuzhou, China
| | - Weina Bian
- Department of Nursing, Hanzhong Central Hospital, Hanzhong, China
| | - Zhifen Liu
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Shifan Han
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
- School of Nursing, Shanxi Medical University, Taiyuan, China
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Vogt KS, Johnson J, Coleman R, Simms-Ellis R, Harrison R, Shearman N, Marran J, Budworth L, Horsfield C, Lawton R, Grange A. Can the Reboot coaching programme support critical care nurses in coping with stressful clinical events? A mixed-methods evaluation assessing resilience, burnout, depression and turnover intentions. BMC Health Serv Res 2024; 24:343. [PMID: 38491374 PMCID: PMC10941361 DOI: 10.1186/s12913-023-10468-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/12/2023] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Critical care nurses (CCNs) are routinely exposed to highly stressful situations, and at high-risk of suffering from work-related stress and developing burnout. Thus, supporting CCN wellbeing is crucial. One approach for delivering this support is by preparing CCNs for situations they may encounter, drawing on evidence-based techniques to strengthen psychological coping strategies. The current study tailored a Resilience-boosting psychological coaching programme [Reboot] to CCNs. Other healthcare staff receiving Reboot have reported improvements in confidence in coping with stressful clinical events and increased psychological resilience. The current study tailored Reboot for online, remote delivery to CCNs (as it had not previously been delivered to nurses, or in remote format), to (1) assess the feasibility of delivering Reboot remotely, and to (2) provide a preliminary assessment of whether Reboot could increase resilience, confidence in coping with adverse events and burnout. METHODS A single-arm mixed-methods (questionnaires, interviews) before-after feasibility study design was used. Feasibility was measured via demand, recruitment, and retention (recruitment goal: 80 CCNs, retention goal: 70% of recruited CCNs). Potential efficacy was measured via questionnaires at five timepoints; measures included confidence in coping with adverse events (Confidence scale), Resilience (Brief Resilience Scale), depression (PHQ-9) and burnout (Oldenburg-Burnout-Inventory). Intention to leave (current role, nursing more generally) was measured post-intervention. Interviews were analysed using Reflexive Thematic Analysis. RESULTS Results suggest that delivering Reboot remotely is feasible and acceptable. Seventy-seven nurses were recruited, 81% of whom completed the 8-week intervention. Thus, the retention rate was over 10% higher than the target. Regarding preliminary efficacy, follow-up measures showed significant increases in resilience, confidence in coping with adverse events and reductions in depression, burnout, and intention to leave. Qualitative analysis suggested that CCNs found the psychological techniques helpful and particularly valued practical exercises that could be translated into everyday practice. CONCLUSION This study demonstrates the feasibility of remote delivery of Reboot and potential efficacy for CCNs. Results are limited due to the single-arm feasibility design; thus, a larger trial with a control group is needed.
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Affiliation(s)
- K S Vogt
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK.
- Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK.
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Eleanor Rathbone Building, Liverpool, L69 7ZA, UK.
| | - J Johnson
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK
- School of Population Health, University of New South Wales, Sydney, 2052, Australia
| | - R Coleman
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- School of Health and Wellbeing: College of Medical, Veterinary and Life Sciences, University of Glasgow, Clarice Pears Building, Glasgow, G12 8TB, UK
| | - R Simms-Ellis
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - R Harrison
- School of Population Health, University of New South Wales, Sydney, 2052, Australia
- Centre for Health Systems and Safety Research: Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - N Shearman
- Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, LS1 3EX, UK
- Mid Yorkshire Teaching NHS Trust, Wakefield, UK
| | - J Marran
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - L Budworth
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Yorkshire & Humber Patient Safety Research Collaboration, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - C Horsfield
- West Yorkshire Adult Critical Care Network, Leeds Teaching Hospitals, Leeds, UK
| | - R Lawton
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - A Grange
- Bradford Institute for Health Research, Bradford Royal Infirmary, Temple Bank House, Duckworth Lane, Bradford, BD9 6RJ, UK
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Fazekas C, Zieser M, Hanfstingl B, Saretzki J, Kunschitz E, Zieser-Stelzhammer L, Linder D, Matzer F. Physician resilience and perceived quality of care among medical doctors with training in psychosomatic medicine during the COVID-19 pandemic: a quantitative and qualitative analysis. BMC Health Serv Res 2024; 24:249. [PMID: 38413956 PMCID: PMC10900785 DOI: 10.1186/s12913-024-10681-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/03/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND At an individual level, physician resilience protects against burnout and against its known negative effects on individual physicians, patient safety, and quality of care. However, it remains uncertain whether physician resilience also correlates with maintaining a high level of healthcare quality during crises such as a pandemic. This study aimed to investigate whether higher resilience among physicians, who had received training in resilience-related competences in the past, would be associated with higher quality of care delivered during the COVID-19 pandemic. METHODS This study enrolled physicians working in family medicine, psychiatry, internal medicine, and other medical specialties, who had obtained at least one of three consecutive diplomas in psychosomatic medicine in the past. Participants completed a quantitative and qualitative anonymous online survey. Resilience was measured using the Connor-Davidson Resilience Scale, and healthcare quality was assessed through single-item quality indicators, including perceived quality of care, professional autonomy, adequate time for patient care, and job satisfaction. RESULTS The study included 229 physicians (70 males/159 females) with additional training in psychosomatic medicine, working in family medicine (42.5%), psychiatry (28.1%), internal medicine (7.0%), or other medical specialties (22.4%). Participants represented four intensity levels of training background (level 1 to level 4: 9.2%, 32.3%, 46.3%, and 12.2% of participants). Training background in psychosomatic medicine was positively associated with resilience (B = 0.08, SE = 0.04, p <.05). Resilience and training background independently predicted perceived quality of care, even after controlling for variables such as own health concerns, involvement in the treatment of COVID-19 patients, financial strain, percentage of working hours spent on patient care, age, and gender (resilience: B = 0.33, SE = 0.12, p <.01; training background: B = 0.17, SE = 0.07, p <.05). Both resilience and training background predicted job satisfaction (resilience: B = 0.42, SE = 0.12, p <.001; training background: B = 0.18, SE = 0.07, p <.05), while resilience alone predicted professional autonomy (B = 0.27, SE = 0.12, p <.05). In response to an open question about their resources, resilient physicians more frequently reported applying conscious resilient skills/emotion regulation (p <.05) and personal coping strategies (p <.01) compared to less resilient medical doctors. CONCLUSION Physician resilience appears to play a significant role in the perceived quality of patient care, professional autonomy, and job satisfaction during healthcare crises.
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Affiliation(s)
- Christian Fazekas
- Department of Psychiatry, Psychosomatics and Psychotherapy, Division of Medical Psychology, Psychosomatics and Psychotherapy, Medical University of Graz, Auenbruggerplatz 3, 8036, Graz, Austria.
| | | | | | | | - Evelyn Kunschitz
- II. Medical Department for Cardiology, Hanusch Hospital, Vienna, Austria
- Karl Landsteiner Institute for Scientific Research in Clinical Cardiology, Hanusch Hospital, Vienna, Austria
| | - Luise Zieser-Stelzhammer
- Department of Psychosocial, Psychosomatic and Psychotherapeutic Medicine, Austrian Medical Association, Vienna, Austria
| | - Dennis Linder
- Department of Psychiatry, Psychosomatics and Psychotherapy, Division of Medical Psychology, Psychosomatics and Psychotherapy, Medical University of Graz, Auenbruggerplatz 3, 8036, Graz, Austria
- Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Franziska Matzer
- Department of Psychiatry, Psychosomatics and Psychotherapy, Division of Medical Psychology, Psychosomatics and Psychotherapy, Medical University of Graz, Auenbruggerplatz 3, 8036, Graz, Austria
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Taha S, King S, Atif S, Bate E. Changes in harm reduction service providers professional quality of life during dual public health emergencies in Canada. Harm Reduct J 2024; 21:48. [PMID: 38388932 PMCID: PMC10882723 DOI: 10.1186/s12954-024-00966-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 02/20/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Harm reduction (HR) is a critical response to the pronounced toxicity deaths being experienced in Canada. HR providers report many benefits of their jobs, but also encounter chronic stress from structural inequities and exposure to trauma and death. This research study sought to quantify the emotional toll the toxicity emergency placed on HR providers (Cycle One; 2019). Study objectives were later expanded to determine the impact of the ongoing toxicity as well as the pandemic's impact on well-being (Cycle Two; 2021). METHODS Standardized measures of job satisfaction, burnout, secondary traumatic stress, and vulnerability to grief were used in an online national survey. Open-ended questions addressed resources and supports. HR partners across Canada validated the findings and contributed to alternative interpretations and implications. RESULTS 651 respondents in Cycle One and 1,360 in Cycle Two reported moderately high levels of job satisfaction; they reported finding great meaning in their work. Yet, mean levels of burnout and secondary traumatic stress were moderate, with the latter significantly increasing in Cycle Two. Reported vulnerability to grief was moderate but increased significantly during COVID. When available, supports lacked the quality necessary to respond to the complexities of HR workers' experiences, or an insufficient number of sessions were covered through benefits. Respondents shared that their professional quality of life was affected more by policy failures and gaps in the healthcare system than it was by the demands of their jobs. CONCLUSION Both the benefits and the strain of providing harm reduction services cannot be underestimated. For HR providers, these impacts are compounded by the drug toxicity emergency, making the service gaps experienced by them all the more critical to address. Implications highlight the need for integration of HR into the healthcare system, sustainable and reliable funding, sufficient counselling supports, and equitable staffing models. Support for this essential workforce is critical to ensuring the well-being of themselves, the individuals they serve, and the health of the broader healthcare system.
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Affiliation(s)
- Sheena Taha
- Canadian Centre on Substance Use and Addiction, 75 Albert St, Ottawa, ON, K1P 5E7, Canada.
| | - Samantha King
- Canadian Centre on Substance Use and Addiction, 75 Albert St, Ottawa, ON, K1P 5E7, Canada
| | - Sara Atif
- Canadian Centre on Substance Use and Addiction, 75 Albert St, Ottawa, ON, K1P 5E7, Canada
| | - Eliza Bate
- Canadian Centre on Substance Use and Addiction, 75 Albert St, Ottawa, ON, K1P 5E7, Canada
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15
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Urtubia-Herrera V, Navarta-Sánchez MV, Palmar-Santos AM, Pedraz-Marcos A, García-Gomez A, Luis EO, Bermejo-Martins E. The relationship between sense of coherence and emotional intelligence as individual health assets for mental health promotion in students and healthcare professionals: a scoping review. Front Public Health 2024; 12:1304310. [PMID: 38450140 PMCID: PMC10916004 DOI: 10.3389/fpubh.2024.1304310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/07/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Workplace Mental health promotion in healthcare sector, is a global priority due to the stress associated with caregiving environments and the increase of mental health problems among health professionals and students. The role of emotional intelligence (EI) and sense of coherence (SOC) have been identified as critical health protectors. However, the relationship between them as well as the underlying mechanisms of these relationships on health benefits in this population is still unclear. Aim To synthetize the existing literature on the relationship between emotional intelligence and sense of coherence, as well as their mutual impact on healthcare workers' and student's well-being. Method A scoping review was conducted following the Joanna Briggs Institute guidelines. A systematic search was conducted in PsyCINFO, CINHAL, SCOPUS and PUBMED databases, using key-terms such as students, health professionals, emotional intelligence, and sense of coherence. Results A total of 11 articles were included, with a range of years from 2014 to 2022. Evidence was found to support the positive relationship between sense of coherence and emotional intelligence. The use of EI as a training pathway to improve SOC and health promoting behaviors is suggested. The benefits of intervening on these factors contribute to improved health professionals' and students' general well-being and motivation for a better performance, either in their studies or clinical work. Conclusion The positive relationship between emotional intelligence and a sense of coherence has direct and indirect benefits on students' and healthcare professionals' well-being. Future studies should address longitudinal and experimental analysis to confirm these findings.
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Affiliation(s)
| | - María Victoria Navarta-Sánchez
- Nursing Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Nursing and Health Care Research Group, Puerta de Hierro-Segovia Arana Health Research Institute, Madrid, Spain
| | - Ana María Palmar-Santos
- Nursing Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- Nursing and Health Care Research Group, Puerta de Hierro-Segovia Arana Health Research Institute, Madrid, Spain
| | - Azucena Pedraz-Marcos
- Health Care and Health Services Research Unit (Investén-ISCIII), Carlos III Health Institute (ISCIII), Madrid, Spain
| | | | - Elkin O. Luis
- Psychological Processes in Education and Health Group, School of Education and Psychology, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Elena Bermejo-Martins
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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16
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Schäfer SK, von Boros L, Schaubruch LM, Kunzler AM, Lindner S, Koehler F, Werner T, Zappalà F, Helmreich I, Wessa M, Lieb K, Tüscher O. Digital interventions to promote psychological resilience: a systematic review and meta-analysis. NPJ Digit Med 2024; 7:30. [PMID: 38332030 PMCID: PMC10853230 DOI: 10.1038/s41746-024-01017-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/18/2024] [Indexed: 02/10/2024] Open
Abstract
Societies are exposed to major challenges at an increasing pace. This underscores the need for preventive measures such as resilience promotion that should be available in time and without access barriers. Our systematic review summarizes evidence on digital resilience interventions, which have the potential to meet these demands. We searched five databases for randomized-controlled trials in non-clinical adult populations. Primary outcomes were mental distress, positive mental health, and resilience factors. Multilevel meta-analyses were performed to compare intervention and control groups at post-intervention and follow-up assessments. We identified 101 studies comprising 20,010 participants. Meta-analyses showed small favorable effects on mental distress, SMD = -0.24, 95% CI [-0.31, -0.18], positive mental health, SMD = 0.27, 95% CI [0.13, 0.40], and resilience factors, SMD = 0.31, 95% CI [0.21, 0.41]. Among middle-aged samples, older age was associated with more beneficial effects at follow-up, and effects were smaller for active control groups. Effects were comparable to those of face-to-face interventions and underline the potential of digital resilience interventions to prepare for future challenges.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany.
- Department of Clinical Psychology, Psychotherapy and Diagnostics - Child and Adolescent Psychology and Psychotherapy, Technische Universität Braunschweig, Braunschweig, Germany.
| | - Lisa von Boros
- Leibniz Institute for Resilience Research, Mainz, Germany
| | | | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Saskia Lindner
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Friederike Koehler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
- Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä, Jyväskylä, Finland
| | - Tabea Werner
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | - Michèle Wessa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
- Institute for Molecular Biology, Johannes Gutenberg University Mainz, Mainz, Germany
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Kreienkamp M, Wheatley D, Ndobo A. Assessing the efficacy of a resilience training intervention for long-term improvements in well-being and resilience. Appl Psychol Health Well Being 2024. [PMID: 38226711 DOI: 10.1111/aphw.12525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 12/24/2023] [Indexed: 01/17/2024]
Abstract
This article has two aims: (1) to assess the impacts of a novel training intervention for individual well-being and (2) to measure the trajectory of resilience over the training period dependent on reported significant life events. Using a randomised controlled trial with a diverse German sample with the majority drawn from a student population, we measure the effects of the intervention to provide insight into its impacts and act as a proof of concept for the training. We find that the training intervention boosts resilience and other related well-being measures with a high effect size in comparison with a control group and compared with existing resilience training studies.
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Affiliation(s)
- Martin Kreienkamp
- Fachbereich Psychologie, HMKW Hochschule für Medien, Kommunikation und Wirtschaft, Cologne, Germany
| | - Daniel Wheatley
- Birmingham Business School, University of Birmingham, Birmingham, UK
| | - André Ndobo
- Laboratoire de Psychologie des Pays de la Loire, Nantes Université, Univ Angers, Nantes, France
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Bourdeau C, Lippé S, Robaey P, Rondeau É, Krajinovic M, Sinnett D, Laverdière C, Sultan S. Contributing factors to well-being in a sample of long-term survivors of childhood acute lymphoblastic leukemia: the role of social support in emotional regulation. Health Psychol Behav Med 2024; 12:2301550. [PMID: 38239926 PMCID: PMC10795780 DOI: 10.1080/21642850.2023.2301550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024] Open
Abstract
Objectives: To understand why some long-term childhood cancer survivors experience positive adjustment in the long run,[Q1] this study aimed to (1) explore associations between well-being, health status, social support, and emotion regulation (ER) strategies in a cohort of long-term childhood lymphoblastic leukemia (cALL) survivors, (2) identify the individual contribution of each ER strategy to well-being (3) and their interaction with social support. Methods: We used data from 92 participants from the PETALE cohort (51% female, aged 24 ± 7 years). Measures included well-being (WHO-5), health status (15D), social support (SSQ-6), cognitive reappraisal and expressive suppression (ERQ), and emotional processing and expression (EAC). We modeled the odds of high well-being adjusting for health status in logistic regressions and explored the moderating role of social support with bootstrap techniques. Independent of clinical history, high well-being was associated with better health status, higher social support, more frequent use of cognitive reappraisal and emotional processing. Results: We found a main contribution of emotional processing to well-being (OR = 2.12, 95% CI = 1.09-5.37). The interaction between low suppression and high social support was significant (OR = .40, 95% CI = .13-.79). Probabilities for high well-being were 96% when expressive suppression was low and social support was high. Results suggest approaching one's own emotions may contribute to well-being in long-term childhood cancer survivors. Clinical implications: Combining curbing emotional suppression with promoting supportive social environment could be a promising target for future supportive care interventions in survivors.
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Affiliation(s)
- Camille Bourdeau
- Department of Psychology, Université de Montréal, Montreal, Canada
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
| | - Sarah Lippé
- Department of Psychology, Université de Montréal, Montreal, Canada
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
| | - Philippe Robaey
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
| | - Émélie Rondeau
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
| | - Maja Krajinovic
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Daniel Sinnett
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Caroline Laverdière
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montreal, Canada
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
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Ohta R, Yakabe T, Sano C. Decision-Making in the Admission of Older Patients: A Thematic Analysis From Multiple-Stakeholder Perspectives. Cureus 2024; 16:e51966. [PMID: 38333500 PMCID: PMC10851036 DOI: 10.7759/cureus.51966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction As rural healthcare systems grapple with an aging population, understanding the factors influencing hospital admission decisions for elderly patients is crucial. This study explores the complex interplay of medical, social, and psychological factors that shape these decisions, as perceived by multiple stakeholders, including physicians, patients, and their families. Method This study was conducted in Unnan City Hospital, a rural community hospital in Unnan, Japan, using a qualitative thematic analysis approach. Participants included general physicians, patients admitted more than once, and their families. One-on-one semi-structured interviews were conducted in Japanese, recorded, transcribed, and analyzed. The analysis focused on identifying themes that influence decision-making processes regarding the admission of elderly patients. The research team, comprising family medicine, public health, and community health care experts, ensured a multi-perspective approach through collaborative coding and discussion. Results Three primary themes emerged from the analysis: "dilemma between medical indications and social admissions," "risks and benefits of hospitalization in response to unpredictable changes in the elderly," and "social factors intertwined with the multilayered nature of hospital admission decisions." Physicians reported a conflict between their medical training and the social needs of patients, often leading to stress and negative emotions. The unpredictable health trajectories of elderly patients necessitated a nuanced risk-benefit analysis for hospitalization. In addition, social factors, such as bed availability, patient's living environment, and psychosocial contexts, significantly influenced admission decisions. Conclusion The study highlights the need for a more holistic approach to medical education and practice, especially in rural healthcare settings. Recognizing the complexity of factors influencing hospitalization decisions, including medical, social, and individual patient circumstances, is vital. The findings underscore the importance of integrating biopsychosocial aspects into the decision-making process for the hospitalization of elderly patients, advocating for patient-centered care that respects the unique challenges in rural healthcare environments.
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Affiliation(s)
| | | | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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Hirsh DA, Crampton PES, Osman NY. Applying self-determination theory to stem medical schools' clinical teacher sustainability crisis. MEDICAL EDUCATION 2024; 58:118-128. [PMID: 37593835 DOI: 10.1111/medu.15181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/19/2023]
Abstract
THE PROBLEM Medical schools require highly skilled and committed clinical faculty to teach, assess, supervise and mentor students' clinical care. Medical education is facing a crisis in recruiting and sustaining these clinical teachers. Faced with multiple demands and responsibilities in fast-paced clinical environments, teachers may not have the time, resources or stamina to sustain these critical roles. Medical school leaders must commit to and provide structures and processes to attract, sustain and retain clinical teachers. CONCEPTUAL FRAMEWORK The authors use the lens of self-determination theory to frame approaches to support teacher sustainability. Self-determination theory describes sources of human motivation. The theory and its evidence base characterise three human psychological needs: autonomy, competence, and relatedness. This theory can bridge individual psychological and institutional leadership perspectives to help medical school leaders anticipate and respond to their clinical teachers' needs. The authors propose three practical steps: practices to advance employee-centredness, processes to align individual and institutional values, and restructuring education to support clinical teachers' needs alongside student and patient needs. The authors describe limitations to this relational approach that focuses on leadership actions and consider individual agency as another key factor for sustainability. DISCUSSION Medical school leaders can develop and apply theory-driven approaches to advance sustainability. Sustainability now and in the future requires careful attention to the needs of clinical teachers and to their relationships with and within medical schools.
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Affiliation(s)
- David A Hirsh
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts, USA
| | - Paul E S Crampton
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK
| | - Nora Y Osman
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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21
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Korošec D, Vrbnjak D, Štiglic G. Prevalence of mental disorders and high rates of absenteeism from work among healthcare professionals in Slovenia: a retrospective study. BMJ Open 2023; 13:e075718. [PMID: 38070887 PMCID: PMC10729225 DOI: 10.1136/bmjopen-2023-075718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES To investigate the prevalence of mental disorders and the higher rates of absenteeism from work among healthcare workers employed in Slovenia by analysing the prevalence of sick leave and medication prescriptions for treatment of mental health and behavioural disorders from 2015 to 2020. DESIGN Retrospective analysis of nationwide data on absenteeism and prescription of medications for treatment of mental health and behavioural disorders (anxiolytics, antipsychotics, antidepressants). SETTING National databases of the National Institute of Public Health in Slovenia. PARTICIPANTS All employed healthcare workers (35 008 in December 2020): dentists, midwives, nurses, nursing assistants, pharmacists and physicians in Slovenia from 2015 to 2020. RESULTS The most time spent on sick leave by male healthcare workers aged >50 was for 'neoplasms' (71.50 days on average), followed by 'mental health and behavioural disorders' (62.08 days on average). Female healthcare workers under 40 years old spent the most time on sick leave for 'pregnancy, childbirth, and the postpartum period (puerperium)', causing an average of 58.38 days of sick leave. From 2015 to 2020, the highest increase in prescribed medications for treatment of mental health and behavioural disorders was among nursing assistants (an increase of 38.42%), pharmacists (an increase of 29.36%) and nurses (an increase of 26.61%); since the COVID-19 pandemic, an increase of 12.36% was found among dentists, an increase of 11.51% among pharmacists and an increase of 11.36% among nurses. CONCLUSION The prescription of medications for treatment of mental health and behavioural disorders was on the rise from 2015 to 2020. The importance of employee health to individuals and society necessitates the systematisation of effective prevention programmes as well as programmes to assist those in need, especially health workers, whose work contributes significantly to maintaining public health.
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Affiliation(s)
- Darja Korošec
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Dominika Vrbnjak
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Gregor Štiglic
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
- University of Edinburgh, Usher Institute, Edinburgh, UK
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Zhang J, Wang Y, Zheng K, Fang C, Cao S, Liu D. Factors Influencing Professional Identity of Psychiatric Nurses as Second Victims: A Cross-Sectional Study. J Psychosoc Nurs Ment Health Serv 2023; 61:47-54. [PMID: 37379122 DOI: 10.3928/02793695-20230622-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
The current study aimed to explore the status and influencing factors of professional identity among psychiatric nurses as second victims in China by using a cross-sectional design. We investigated 291 psychiatric nurses from two psychiatric hospitals. Participants were asked to complete a demographic questionnaire, Second Victim Experience and Support Scale, Multidimensional Health Locus of Control Scale, and Professional Identity Scale for Nurses. Scores of professional identity of psychiatric nurses as second victims were moderate. Regression analysis showed that the second victim experience and support and internal control were significant predictors, explaining 34.2% of the variance in professional identity. Identifying risk factors related to the professional identity of psychiatric nurses as second victims will help managers take timely preventive measures to improve the awareness of the self-health responsibility of psychiatric nurses and reduce the adverse effects of patient safety incidents to enhance their professional identity. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 47-54.].
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Lan L, Zhou M, Wang L, Chen X, Dai M, Zhang J. Enhancing Emergency Nurses' Disaster Nursing Ability and Psychological Resilience: A Randomized Controlled Trial. Emerg Med Int 2023; 2023:6108057. [PMID: 38054165 PMCID: PMC10695688 DOI: 10.1155/2023/6108057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/07/2023] Open
Abstract
Objective This study aimed to investigate emergency nurses' disaster nursing ability and psychological resilience, validate the effectiveness of a training system for disaster nursing ability based on psychological resilience, and verify the relationship between psychological resilience and disaster nursing ability among emergency nurses. Methods A training system was developed to enhance psychological resilience and disaster nursing ability. A multicenter, randomized controlled experiment was conducted in five Grade III hospitals in Sichuan Province. A total of 93 emergency nurses were randomly assigned to the following three groups: the blank group, intervention group, and control group. The corresponding interventions were as follows: no intervention, psychological resilience, and nurses' disaster nursing ability training. Personal information forms, the Connor-Davidson Resiliency Scale, and the Nurses' Disaster Nursing Ability Assessment Scale were used in the survey. Results There was no significant difference in the scores of psychological resilience and disaster nursing ability in the blank group in the pretest and posttest (P > 0.05). The disaster nursing ability of both the intervention and control groups significantly improved in the posttest (P < 0.05). Compared with the control group, the intervention group demonstrated significant improvement in psychological resilience in the posttest (P < 0.05). However, there was no statistical difference in psychological resilience scores in the control group in the pretest and posttest (P > 0.05). Conclusion The study concluded that the psychological resilience and disaster nursing ability of emergency nurses could be enhanced through the implemented training system.
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Affiliation(s)
- Lin Lan
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Meichi Zhou
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nephrology and Urology Ward West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Ling Wang
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Xiaoli Chen
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Min Dai
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Jianna Zhang
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
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Aljuwaiser S, Brazzelli M, Arain I, Poobalan A. Common mental health problems in medical students and junior doctors - an overview of systematic reviews. J Ment Health 2023:1-37. [PMID: 37933550 DOI: 10.1080/09638237.2023.2278095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 09/24/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Common mental health problems (CMHP) are prevalent among junior doctors and medical students, and the COVID-19 pandemic has brought challenging situations with education disruptions, early graduations, and front-line work. CMHPs can have detrimental consequences on clinical safety and healthcare colleagues; thus, it is vital to assess the overall prevalence and available interventions to provide institutional-level support. AIMS This overview summarises the prevalence of CMHPs from existing published systematic reviews and informs public health prevention and early intervention practice. METHODS Four electronic databases were searched from 2012 to identify systematic reviews on the prevalence of CMHPs and/or interventions to tackle them. RESULTS Thirty-six reviews were included: 25 assessing prevalence and 11 assessing interventions. Across systematic reviews, the prevalence of anxiety ranged from 7.04 to 88.30%, burnout from 7.0 to 86.0%, depression from 11.0 to 66.5%, stress from 29.6 to 49.9%, suicidal ideation from 3.0 to 53.9% and one obsessive-compulsive disorder review reported a prevalence of 3.8%. Mindfulness-based interventions were included in all reviews, with mixed findings for each CMHP. CONCLUSIONS The prevalence of CMHPs is high among junior doctors and medical students, with anxiety remaining relatively stable and depression slightly increasing during the COVID-19 pandemic. Future research on mindfulness-based interventions is required for a resilient and healthy future workforce. PRISMA/PROSPERO the researchers have followed PRISMA guidance. This overview was not registered with PROSPERO as it was conducted as part of an MSc research project.
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Affiliation(s)
- Sameera Aljuwaiser
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Imran Arain
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Amudha Poobalan
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Lam MI, Chen P, Zhang Q, Sha S, An FR, Su Z, Cheung T, Ungvari GS, Ng CH, Xiang YT, Feng Y. Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey. Front Public Health 2023; 11:1280688. [PMID: 37965522 PMCID: PMC10642929 DOI: 10.3389/fpubh.2023.1280688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Background China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective. Methods A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function." Results A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048). Conclusion This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.
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Affiliation(s)
- Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Kiang Wu Nursing College of Macau, Macao, Macao SAR, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Gabor S. Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
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Schäfer SK, Fritz J, Sopp MR, Kunzler AM, von Boros L, Tüscher O, Göritz AS, Lieb K, Michael T. Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints. Transl Psychiatry 2023; 13:328. [PMID: 37872216 PMCID: PMC10593776 DOI: 10.1038/s41398-023-02603-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023] Open
Abstract
Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
- Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - M Roxanne Sopp
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lisa von Boros
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
- Institute for Molecular Biology, Mainz, Germany
| | - Anja S Göritz
- Behavioral Health Technology, Augsburg University, Augsburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Tanja Michael
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany.
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Vogt KS, Simms-Ellis R, Grange A, Griffiths ME, Coleman R, Harrison R, Shearman N, Horsfield C, Budworth L, Marran J, Johnson J. Critical care nursing workforce in crisis: A discussion paper examining contributing factors, the impact of the COVID-19 pandemic and potential solutions. J Clin Nurs 2023; 32:7125-7134. [PMID: 36823696 DOI: 10.1111/jocn.16642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 02/25/2023]
Abstract
AIMS AND OBJECTIVES The critical care nursing workforce is in crisis, with one-third of critical care nurses worldwide intending to leave their roles. This paper aimed to examine the problem from a wellbeing perspective, offering implications for research, and potential solutions for organisations. DESIGN Discursive/Position paper. METHOD The discussion is based on the nursing and wellbeing literature. It is guided by the authors' collaborative expertise as both clinicians and researchers. Data were drawn from nursing and wellbeing peer-reviewed literature, such as reviews and empirical studies, national surveys and government and thinktank publications/reports. RESULTS Critical care nurses have been disproportionately affected by the COVID-19 pandemic with studies consistently showing critical care nurses to have the worst psychological outcomes on wellbeing measures, including depression, burnout and post-traumatic stress disorder (PTSD). These findings are not only concerning for the mental wellbeing of critical care nurses, they also raise significant issues for healthcare systems/organisations: poor wellbeing, increased burnout and PTSD are directly linked with critical care nurses intending to leave the profession. Thus, the wellbeing of critical care nurses must urgently be supported. Resilience has been identified as a protective mechanism against the development of PTSD and burnout, thus offering evidence-based interventions that address resilience and turnover have much to offer in tackling the workforce crisis. However, turnover data must be collected by studies evaluating resilience interventions, to further support their evidence base. Organisations cannot solely rely on the efficacy of these interventions to address their workforce crisis but must concomitantly engage in organisational change. CONCLUSIONS We conclude that critical care nurses are in urgent need of preventative, evidence-based wellbeing interventions, and make suggestions for research and practice.
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Affiliation(s)
- Katharina Sophie Vogt
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
| | - Ruth Simms-Ellis
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
| | - Angela Grange
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | | | - Rebecca Coleman
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
| | - Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | | | | | - Luke Budworth
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Medicine, University of Leeds, Leeds, UK
| | - Jayne Marran
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Judith Johnson
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Psychology, University of Leeds, Leeds, UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Wang Q, Luan Y, Liu D, Dai J, Wang H, Zhang Y, Wang S, Dong X, Bi H. Guided self-help mindfulness-based intervention for increasing psychological resilience and reducing job burnout in psychiatric nurses: A randomized controlled trial. Int J Nurs Pract 2023:e13204. [PMID: 37727093 DOI: 10.1111/ijn.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
AIMS The present study aimed to explore the effects of a guided self-help mindfulness intervention on psychological resilience and job burnout among psychiatric nurses. BACKGROUND Psychiatric nurses work in challenging and potentially high stress settings. Mindfulness interventions can improve psychological resilience and reduce job burnout of nurses. However, face-to-face delivery of mindfulness interventions may be inconvenient for individuals. Guided self-help interventions may be more accessible. METHODS This randomized controlled trial was conducted from January to August 2022. One hundred and eighteen psychiatric nurses were randomized into the intervention and control groups. The individuals in the intervention group received an 8-week guided self-help mindfulness intervention, while the individuals in the control group received a psycho-educational brochure. The Five Facet Mindfulness Questionnaire, the Connor-Davidson Resilience Scale and the Maslach Burnout Inventory-Human Services Survey were used to evaluate the levels of mindfulness, psychological resilience and job burnout, respectively. RESULTS After an 8-week intervention, compared with the control group, the levels of mindfulness and psychological resilience were higher, while the level of job burnout was lower in the intervention group. CONCLUSIONS The guided self-help mindfulness intervention can improve psychological resilience and reduce job burnout among psychiatric nurses.
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Affiliation(s)
- Qi Wang
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Yue Luan
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Dandan Liu
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Jiali Dai
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Haina Wang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Yang Zhang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Shuang Wang
- Third Hospital of Daqing, Daqing, Heilongjiang, China
| | - Xiaomei Dong
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Hongsheng Bi
- Third Hospital of Daqing, Daqing, Heilongjiang, China
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Gerson JS, Marco KC, Staab JH, Dixon CA. Paws to Care: Implementation of a Novel Medical Dog Office Hours Program to Foster Pediatric Health Care Staff Resilience and Joy. Clin Pediatr (Phila) 2023; 62:849-855. [PMID: 36856075 DOI: 10.1177/00099228231152860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Burnout and resiliency are significant challenges among health care workers. Animal-assisted therapy (AAT) has shown to improve patient-level outcomes; however, AAT research involving hospital staff is limited. Our novel Medical Dog ("MD") Office Hours Program aimed to provide support to pediatric hospital staff and explore the program's impact on burnout. Participant surveys described work role and years of experience, well-being, and emotional/physical descriptions and symptoms. Of 149 participants, 85% endorsed baseline distress/burnout; nearly half had at-risk Well-Being Index scores. Compared with baseline, postintervention participants endorsed significantly fewer negative (more positive) emotions; greater feelings of comfort and energy; and decreased tiredness and pain (P < .0001). Readiness to return to work scores were high (M = 78.1, SD = 18.4). Our Medical Dog ("MD") Office Hours Program resulted in improvements in emotional descriptions and physical symptoms among pediatric health care staff. Leveraging AAT among health care staff may help mitigate burnout and increase resiliency.
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Affiliation(s)
| | | | | | - Cinnamon A Dixon
- Children's Hospital Colorado, Aurora, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
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Behrendt D, Boß L, Hannibal S, Kunzler AM, Wessa M, Lehr D. Feasibility and efficacy of a digital resilience training: A pilot study of the strengths-based training RESIST. Internet Interv 2023; 33:100649. [PMID: 37545556 PMCID: PMC10400467 DOI: 10.1016/j.invent.2023.100649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 08/08/2023] Open
Abstract
Background Work-related stress is a risk factor for a number of adverse health and work outcomes. Resilience trainings are a promising approach for adequately dealing with work stress and keeping employees mentally healthy. However, results of previous resilience trainings have been heterogeneous, ranging from null findings to large effects. Existing digital resilience interventions show a lack of consistency in terms of an underlying theoretical framework and methods used to foster resilience. Positive Appraisal Style Theory of Resilience offers an innovative conceptualization of resilience. Strengths-based cognitive behavioral therapy is a corresponding therapeutically method reflecting resilience as a resource-oriented process of dealing with stress. Based on this background, a new hybrid web-and app-based digital resilience intervention for employees named RESIST was developed. Objective The first aim of the study was to investigate the feasibility of the newly developed training RESIST regarding its usability, user behavior, user experience and motivation to use. Second, the study sought to explore preliminary effects of the intervention on reducing stress and enhancing resilience by conducting a pilot randomized controlled trial. Methods The feasibility study was conducted in three phases. First, the usability of the app was investigated in a pre-test with five participants using a thinking-aloud method. Second, the preliminary efficacy of the training was examined in a pilot randomized controlled trial. A sample of 30 employees were randomized either to receive the resilience training (n = 15) or to be member of a control group (n = 15). The primary outcome was measuring perceived stress. Secondary outcomes included measures of resilience and depressive symptoms. Third, semi-structured interviews were undertaken with six participants of the resilience training group on training content, motivation for use, and user experience. Results Overall, results indicate that RESIST can be a feasible training for resilience promotion and stress reduction with high user satisfaction. Analysis of covariance showed that, relative to controls, participants who received RESIST reported significantly lower stress scores at post-intervention (F1,27 = 16.91, p < 0.001; Cohen's d = 1.57; 95 % CI 0.71-2.43) than controls. Significant differences, with moderate-to-large effect sizes, were also detected for general resilience and various resilience factors. Conclusions Results are promising and provide hope that a hybrid web- and app-based resilience intervention based on strengths-based cognitive behavioral therapy can have a positive impact on dealing adequately with stress and improve resilience of employees.
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Affiliation(s)
- Dörte Behrendt
- Department of Health Psychology and Applied Biological Psychology, Institute for Sustainability Education and Psychology, Lueneburg, Germany
| | - Leif Boß
- Department of Health Psychology and Applied Biological Psychology, Institute for Sustainability Education and Psychology, Lueneburg, Germany
| | - Sandy Hannibal
- Department of Health Psychology and Applied Biological Psychology, Institute for Sustainability Education and Psychology, Lueneburg, Germany
| | - Angela M. Kunzler
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Institute for Evidence in Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University, Mainz, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute for Sustainability Education and Psychology, Lueneburg, Germany
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Wallace MM. Strategies for Improving Mental Health in Physician Assistant Students. J Physician Assist Educ 2023; 34:157-159. [PMID: 37133898 DOI: 10.1097/jpa.0000000000000507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Michelle M Wallace
- Michelle M. Wallace, DMSc, PA-C, is a clinical professor and Director of Didactic Education in the Physician Associate Program, Wichita State University, Wichita, Kansas
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Brami C, Sultan S, Robieux L, Piot MA, Gartili H, Zenasni F. Understanding students' motivations for participating in a mindfulness course: a qualitative analysis of medical students' views. BMC Complement Med Ther 2023; 23:163. [PMID: 37210498 DOI: 10.1186/s12906-023-03949-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/06/2023] [Indexed: 05/22/2023] Open
Abstract
OBJECTIVES Improving medical students' wellbeing and empowerment through curricular activities is a topic of interest worldwide. Mindfulness-based interventions (MBIs) are increasingly implemented in medical education often as part of elective courses. To better understand training outcomes and adjust curriculum to students' needs, we will explore why will medical students participate in meditation-based education? METHODS We analyzed 29 transcripts from the first session of an 8-week MBSR program offered to medical students in French. Transcripts were coded and analyzed using a qualitative content thematic analysis and the constant comparison method. RESULTS Analyses resulted in three themes describing students' motivation: (1) Medical education and the physician's role, i.e. improving interpersonal skills, acquiring skills oriented toward a more integrative medicine, being more productive in a highly competitive context. (2) Caring for my health i.e. aiming at stress reduction, emotion regulation, and improving self-compassion. (3) A quest for meaning, i.e. optimizing meaning of care, and meaning of life. CONCLUSION The results highlight the congruence between the perceived motivations and the evidence on the effect of mindfulness on self-care, the development of humanistic medical skills, and the meaning of care. Some findings raise the issue of the limits of using mindfulness to enhance one's productivity. Notably, participants articulated the need for self-care as in mindfulness training, with the ability to care for others.
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Affiliation(s)
- Cloé Brami
- LaPEA - Université Paris Cité and Univ Gustave Eiffel, LaPEA, Boulogne- Billancourt, F-92100, France.
- GIS Théorie et Pratiques du Care, Université Paul Valéry, Montpellier, France.
| | - Serge Sultan
- Centre Hospitalier Universitaire Sainte-Justine, Québec, Montréal, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Léonore Robieux
- Laboratory of Psychopathology and processes of change, Université Paris 8, LPPC, Saint Denis, F- 93000, France
| | - Marie-Aude Piot
- Necker Enfants malades hospital, Child and adolescent psychiatry unit, Université de Paris-Cité, AP-HP, CESP, USQV Paris-Saclay, Paris, Inserm, 1018, France
| | - Honorine Gartili
- LaPEA - Université Paris Cité and Univ Gustave Eiffel, LaPEA, Boulogne- Billancourt, F-92100, France
| | - Franck Zenasni
- LaPEA - Université Paris Cité and Univ Gustave Eiffel, LaPEA, Boulogne- Billancourt, F-92100, France
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Tamminga SJ, Emal LM, Boschman JS, Levasseur A, Thota A, Ruotsalainen JH, Schelvis RM, Nieuwenhuijsen K, van der Molen HF. Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database Syst Rev 2023; 5:CD002892. [PMID: 37169364 PMCID: PMC10175042 DOI: 10.1002/14651858.cd002892.pub6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions. OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms. SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022. SELECTION CRITERIA We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms. DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour); 2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise); 3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above. The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended). MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised. The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants. Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention. A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar. AUTHORS' CONCLUSIONS Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.
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Affiliation(s)
- Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lima M Emal
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Julitta S Boschman
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Alice Levasseur
- Faculté des sciences de l'éducation, Université Laval, Québec, Canada
| | | | - Jani H Ruotsalainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Roosmarijn Mc Schelvis
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Henk F van der Molen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Mallon A, Mitchell G, Carter G, McLaughlin D, Wilson CB. A rapid review of evaluated interventions to inform the development of a resource to support the resilience of care home nurses. BMC Geriatr 2023; 23:275. [PMID: 37147594 PMCID: PMC10162002 DOI: 10.1186/s12877-023-03860-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/28/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGOUND Nurses working in care homes face significant challenges that are unique to that context. The importance of effective resilience building interventions as a strategy to enable recovery and growth in these times of uncertainty have been advocated. The aim of this rapid review was to inform the development of a resource to support the resilience of care home nurses. We explored existing empirical evidence as to the efficacy of resilience building interventions. undertaken with nurses. METHODS We undertook a rapid review using quantitative studies published in peer reviewed journals that reported resilience scores using a valid and reliable scale before and after an intervention aimed at supporting nurse resilience. The databases; Cumulative Index to Nursing and Allied Health Literature, Medline and PsychInfo. and the Cochrane Library were searched. The searches were restricted to studies published between January 2011 and October 2021 in the English language. Only studies that reported using a validated tool to measure resilience before and after the interventions were included. RESULTS Fifteen studies were included in this rapid review with over half of the studies taking place in the USA. No studies reported on an intervention to support resilience with care home nurses. The interventions focused primarily on hospital-based nurses in general and specialist contexts. The interventions varied in duration content and mode of delivery, with interventions incorporating mindfulness techniques, cognitive reframing and holistic approaches to building and sustaining resilience. Thirteen of the fifteen studies selected demonstrated an increase in resilience scores as measured by validated and reliable scales. Those studies incorporating 'on the job,' easily accessible practices that promote self-awareness and increase sense of control reported significant differences in pre and post intervention resilience scores. CONCLUSION Nurses continue to face significant challenges, their capacity to face these challenges can be nurtured through interventions focused on strengthening individual resources. The content, duration, and mode of delivery of interventions to support resilience should be tailored through co-design processes to ensure they are both meaningful and responsive to differing contexts and populations.
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Affiliation(s)
- Anita Mallon
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland
| | - Gary Mitchell
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland
| | - Gillian Carter
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland
| | - Derek McLaughlin
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland
| | - Christine Brown Wilson
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland.
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Miguel C, Amarnath A, Akhtar A, Malik A, Baranyi G, Barbui C, Karyotaki E, Cuijpers P. Universal, selective and indicated interventions for supporting mental health at the workplace: an umbrella review of meta-analyses. Occup Environ Med 2023; 80:225-236. [PMID: 36828633 PMCID: PMC10086469 DOI: 10.1136/oemed-2022-108698] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/19/2023] [Indexed: 02/26/2023]
Abstract
The current umbrella review aimed to assess and summarise evidence on universal, selective and indicated interventions for mental health at the workplace. This umbrella review forms one of the evidence reviews which were commissioned by the WHO to develop global guidelines on mental health at work. We conducted systematic searches in five bibliographic databases (PubMed, Embase, PsycINFO, Cochrane and Global Medicus Index) and included meta-analyses of randomised trials examining psychosocial, physical activity and lifestyle interventions delivered to all general workers (universal interventions), at-risk workers (selective interventions) and workers already experiencing symptoms of mental disorders (indicated interventions). We included outcomes from seven domains: symptoms of mental health conditions, positive mental health, quality of life, work-related outcomes, substance use, suicide-related outcomes and potential adverse effects. We identified 16 meta-analyses producing 66 pooled effect sizes of the examined interventions, mostly on symptoms of mental health conditions (n=43 pooled effect sizes) (eg, burnout, insomnia, stress) and positive mental health (n=15) (eg, well-being). Most of the evidence on universal, selective and indicated interventions was focused on psychosocial interventions, showing small to moderate effects across the various outcomes. Certainty levels according to GRADE (Grading of Recommendations Assessment, Development and Evaluation) were low to very low in almost all of the examined outcomes. The results of existing meta-analyses are promising for the use of preventative and early treatment interventions in the workplace. However, the quality and certainty of the evidence were very modest, and further research on the effectiveness of these interventions is warranted.
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Affiliation(s)
- Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Arpana Amarnath
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aemal Akhtar
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aiysha Malik
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Gergő Baranyi
- Society and Health, The University of Edinburgh, Edinburgh, UK
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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The effect of positive thinking on resilience and life satisfaction of older adults: a randomized controlled trial. Sci Rep 2023; 13:3478. [PMID: 36859479 PMCID: PMC9977771 DOI: 10.1038/s41598-023-30684-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/28/2023] [Indexed: 03/03/2023] Open
Abstract
The cumulative effects of adversity and unhappiness affect life satisfaction and quality of life in the growing older adult population. Most of the interventions aimed at improving the health and quality of life of older adults have adopted a problem-oriented or weakness-focused approach. However, a positive or strengths-focused approach can also have a virtuous but more effective capacity to contribute to the well-being and life satisfaction of older adults. Therefore, the present study was conducted to investigate the effect of positive thinking training on improving resilience and life satisfaction among older adults. A randomized controlled trial was conducted on 100 older adults with simple random sampling. The intervention group received 90-min weekly sessions for eight weeks on positive thinking training through written homework for reflection, group discussion, and media. The data were collected using Ingram and Wisnicki Positive Thinking Questionnaire, Connor-Davidson Resilience Scale, and Tobin Life Satisfaction Questionnaire at baseline and one week and two months after the training. The collected data were analyzed using descriptive and inferential statistics in SPSS software 26. P values below 0.05 were considered statistically significant. Positive thinking training led to better thinking (p < 0.001), higher resilience (p < 0.001), and greater life satisfaction (p < 0.001). The study's findings showed the effectiveness of the positive thinking training approach in improving resilience and life satisfaction in older adults. It is recommended to evaluate the long-term outcome in populations with different social, economic, and cultural statuses in future studies.
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Naegle MA, Kelly LA, Embree JL, Valentine N, Sharp D, Grinspun D, Hines-Martin VP, Crawford CL, Rosa WE. American Academy of Nursing consensus recommendations to advance system level change for nurse well-being. Nurs Outlook 2023; 71:101917. [PMID: 36736029 PMCID: PMC9889942 DOI: 10.1016/j.outlook.2023.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/08/2022] [Accepted: 12/31/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has required close examination of workforce-related stressors that over decades have contributed to widespread burnout, negative health outcomes, including mental health outcomes, and the loss of the well-educated professionals who are the future of the nursing profession. In the United States and globally, evidence points to factors known to diminish well-being, including inequities, issues of minority status, persistent discrimination, and demanding work environments. The American Academy of Nursing (AAN), dedicated to organizational excellence, nursing leadership and evidence-based policy, develops statements reflecting its mission and those of its nursing affiliates and corporate member, The American Nurses Association. Within nursing, despite the efforts of its members toward advancement, professional fulfillment is often constrained by the systems in which nurses practice and workplace factors over which they have little control. Action by key organizations to initiate changes at systems levels in workplace safety, to increase professional mobility, and propel policies that increase access to health care resources could improve nurse well-being. This paper proposes recommendations from the AAN Expert Panels on Building Health Care System Excellence, Psychiatric Mental Health and Substance Use, and Global Health Expert Panels for the American Academy of Nursing to leverage related policy in the arenas of government and professional/healthcare organizations. Transforming health care work environments and advancing nurse well-being and equity can be accomplished through key, innovative policy changes. These will be achieved through collaboration among associations, organizations, nonprofit groups, and with the public and the media.
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Affiliation(s)
- Madeline A Naegle
- Psychiatric Mental Health and Substance Use Expert Panel, New York, NY.
| | - Lesly A Kelly
- Building Health Care Systems Excellence Expert Panel
| | | | | | - Daryl Sharp
- Psychiatric Mental Health and Substance Use Expert Panel, New York, NY
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Hoseini Azizi T, Dehghan Nayeri N, Jackson AC, Bahramnezhad F. Mixed-methods study protocol for exploring the perception of nurses' resilience in the COVID-19 pandemic: Designing, implementing and evaluation of intervention. Nurs Open 2023; 10:4111-4119. [PMID: 36790876 PMCID: PMC10170888 DOI: 10.1002/nop2.1627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND While the necessity for interventions to build resilient nurses in the COVID-19 pandemic is recognized, there is disagreement about the effective methods for achieving this. AIM We present our research protocol that describes plans to design and test an interventional program for promoting nurses' resilience. DESIGN This sequential exploratory interventional mixed-methods study is conducted in three phases (qualitative, intervention design, and quantitative). METHODS It was funded from May 2021 for 24 months. In phase 1, we explored strategies for promoting resilience in the COVID-19 pandemic from nurses' perspectives (through semi-structured interviews). In phase 2, we will design an interventional program for promoting nurses' resilience (using the qualitative phase and literature review results). We will assess the program's effectiveness on nurses' resilience in a randomized controlled trial in phase 3. DISCUSSION Given the different experiences of nurses of resilience in COVID-19, our innovative program can guide future research to enhance nurses' resilience based on specific situations.
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Affiliation(s)
- Tooba Hoseini Azizi
- Department of Critical Care Nursing and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Nahid Dehghan Nayeri
- School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Victoria, Melbourne, Australia.,Centre on Behavioural Health, Hong Kong University, Hong Kong, PRC
| | - Fatemeh Bahramnezhad
- School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Mavragani A, Davey Z, Srikesavan C, Hart L, Butcher D, Cipriani A. Implementation of a Web-Based Resilience Enhancement Training for Nurses: Pilot Randomized Controlled Trial. J Med Internet Res 2023; 25:e43771. [PMID: 36787181 PMCID: PMC9975925 DOI: 10.2196/43771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/22/2022] [Accepted: 01/12/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Global workforce challenges faced by health care providers are linked to low levels of job satisfaction, recruitment, retention, and well-being, with detrimental impacts on patient care outcomes. Resilience-building programs can provide support for staff who endure highly stressful environments, enhance resilience, and support recruitment and retention, with web-based formats being key to increasing accessibility. OBJECTIVE We aimed to examine participants' engagement with a newly developed Resilience Enhancement Online Training for Nurses (REsOluTioN), explore its acceptability, and compare levels of resilience and psychological well-being in nurses who completed REsOluTioN with those who did not. METHODS We carried out a pilot randomized trial (1:1), conducted at a single site (mental health and community trust in South England) between August 2021 and May 2022. Local research ethics approvals were obtained. Nurses were invited to participate and were randomly assigned to a waitlist group or REsOluTioN group. Training lasted for 4 weeks, consisting of prereading, web-based facilitated sessions, and mentorship support. We evaluated trial engagement, acceptability of training, and pre-post changes in resilience, measured by the Brief Resilience Scale, and psychological well-being, measured by the Warwick Edinburgh Mental Wellbeing Scale. Qualitative participant feedback was collected. Consolidated Standards of Reporting Trials 2010 extension guidelines for reporting pilot and feasibility trials were used. RESULTS Of 108 participants recruited, 93 completed the study. Participants' mean age was 44 (SD 10.85) years. Most participants were female (n=95, 88.8%), White (n=95, 88.8%), and worked in community settings (n=91, 85.0%). Sixteen facilitated and 150 mentoring sessions took place. Most REsOluTioN program participants reported the sessions helped improve their resilience (n=24, 72.8%), self-confidence (n=24, 72.7%), ability to provide good patient care (n=25, 75.8%), relationships with colleagues (n=24, 72.7%), and communication skills (n=25, 75.8%). No statistically significant differences between training and control groups and time on well-being (F1,91=1.44, P=.23, partial η2=0.02) and resilience scores (F1,91=0.33, P=.57, partial η2=0.004) were revealed; however, there were positive trends toward improvement in both. Nurse participants engaged with the REsOluTioN program and found it acceptable. Most found web-based training and mentoring useful and enjoyed learning, reflection, networking, and participatory sessions. CONCLUSIONS The REsOluTioN program was acceptable, engaging, perceived as useful, and nurses were keen for it to be implemented to optimize resilience, psychological health, communication, and workplace environments. The study has evidenced that it is acceptable to implement web-based resilience programs with similar design features within busy health care settings, indicating a need for similar programs to be carefully evaluated. Mentorship support may also be a key in optimizing resilience. Trial limitations include small sample size and reduced statistical power; a multicenter randomized controlled trial could test effectiveness of the training on a larger scale. TRIAL REGISTRATION ClinicalTrials.gov NCT05074563; https://clinicaltrials.gov/ct2/show/NCT05074563. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/37015.
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Affiliation(s)
| | - Zoe Davey
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Cynthia Srikesavan
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Liam Hart
- Research and Development, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Dan Butcher
- Oxford Institute for Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Shi X, Xiong D, Zhang X, Han M, Liu L, Wang J. Analysis of factors influencing the job satisfaction of medical staff in tertiary public hospitals, China: A cross-sectional study. Front Psychol 2023; 14:1048146. [PMID: 36818068 PMCID: PMC9932040 DOI: 10.3389/fpsyg.2023.1048146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Since the outbreak of the novel coronavirus pneumonia (COVID-19), China has entered normalization phase of its epidemic prevention and control measures that emphasizes 'precise prevention and control,' 'dynamic zeroing', and 'universal vaccination'. However, medical staff continue to face physical and mental stress. The present study aimed to investigate the job satisfaction of medical staff in China, as well as any associated factors. Methods 2,258 medical staff completed a questionnaire specially designed for this study. Independent samples t-tests, one-way analysis of variance, and binary logistic regression were used to analyze associated factors. Results Overall, 48.4% of the participants expressed satisfaction with their job; the highest-scoring dimension was interpersonal relationships (3.83 ± 0.73), while the lowest scoring dimension was salary and benefits (3.13 ± 0.94). The logistic regression model indicated that job satisfaction among medical staff is associated with being aged 40-49 years [odds ratio (OR) = 2.416] or > 50 years (OR = 2.440), having an above-undergraduate education level (OR = 1.857), holding a position other than doctor [i.e., nurse (OR = 3.696) or 'other' (OR = 2.423)], having a higher income (OR = 1.369), and having fewer monthly overtime shifts (OR = 0.735-0.543). Less than half of the medical staff expressed satisfaction with their job, indicating that the overall level is not high. Discussion This research enriches the study of medical workers' job satisfaction during periods when epidemic prevention and control has become familiar and routine. To improve medical workers' job satisfaction, administrators should seek to enhance medical staff's remuneration, reduce their work pressure, and meet their needs (where reasonable).
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Affiliation(s)
- Xiang Shi
- School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Dekai Xiong
- School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Xingmin Zhang
- School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Miaomiao Han
- School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Liu Liu
- Department of Scientific Research, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China,*Correspondence: Liu Liu, ✉
| | - Jinian Wang
- Department of Education, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China,Jinian Wang, ✉
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McLean CP, Betsworth D, Bihday C, Daman MC, Davis CA, Kaysen D, Rosen CS, Saxby D, Smith AE, Spinelli S, Watson P. Helping the Helpers: Adaptation and Evaluation of Stress First Aid for Healthcare Workers in the Veterans Health Administration During the COVID-19 Pandemic. Workplace Health Saf 2023; 71:162-171. [PMID: 36726298 PMCID: PMC9899680 DOI: 10.1177/21650799221148650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Early interventions are needed to support the behavioral health of healthcare staff in the context of the COVID-19 pandemic. Stress First Aid (SFA) is a self-care and peer support model for reducing burnout and stress that is designed for use in high-stress occupations. METHODS We conducted a mixed-methods evaluation of an SFA program in the Veterans Health Administration (VHA). This brief, multi-session, didactic program was adapted for hospital workgroups. Program attendees completed a survey assessing implementation outcomes, burnout, stress, mood, and SFA skills at the beginning (N = 246) and end (n = 94) of the SFA program and a subgroup (n = 11) completed qualitative feedback interviews. FINDINGS Program acceptability, appropriateness, and feasibility were rated highly. From pre- to post-SFA, the impact of the pandemic on stress and anxiety, as well as proficiency in supporting peers increased. Qualitative findings suggest the program provided a shared language to discuss stress, normalized stress reactions, met a need for stress management tools, and helped staff feel valued, empowered, connected with each other. Staff reported being more aware of their stress, but SFA was insufficient to address many of the systemic sources of burnout and stress. CONCLUSIONS AND APPLICATIONS TO PRACTICE While the SFA program was well received, the impact of brief programs is likely to be modest when implemented in the middle of an ongoing pandemic and when burnout arises from chiefly from systemic sources. Lessons learned during the program implementation that may guide future efforts are discussed.
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Affiliation(s)
- Carmen P. McLean
- Dissemination and Training Division, VA
Palo Alto Healthcare System, National Center for PTSD,Department of Psychiatry and Behavioral
Sciences, Stanford University,Carmen P. McLean, PhD, National Center for
PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 795
Willow Rd, Menlo Park, CA 94025, USA;
| | | | | | | | - C. Adrian Davis
- Dissemination and Training Division, VA
Palo Alto Healthcare System, National Center for PTSD
| | - Debra Kaysen
- Dissemination and Training Division, VA
Palo Alto Healthcare System, National Center for PTSD,Department of Psychiatry and Behavioral
Sciences, Stanford University
| | - Craig S. Rosen
- Dissemination and Training Division, VA
Palo Alto Healthcare System, National Center for PTSD,Department of Psychiatry and Behavioral
Sciences, Stanford University
| | | | | | | | - Patricia Watson
- Executive Division, VA Medical Center
(116D), National Center for PTSD,Department of Psychiatry, Geisel School
of Medicine, Dartmouth University
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Okamura M, Fujimori M, Goto S, Ohisa K, Boku N, Nakahara R, Uchitomi Y, Suzuki T, Matsuda T. Psychological distress among healthcare providers in oncology during the COVID-19 pandemic in Japan: The mediating role of moral distress and resilience. Front Psychol 2023; 14:1105800. [PMID: 36818071 PMCID: PMC9929353 DOI: 10.3389/fpsyg.2023.1105800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/04/2023] [Indexed: 02/04/2023] Open
Abstract
Objective Even though vaccines have become widespread, there is an explosion of infection due to the emergence of new mutant strains, and support for healthcare providers' mental health is necessary. The aims of this study were to explore factors associated with the psychological distress, and to determine the degree of association between moral distress, resilience and psychological distress in order to consider intervention models for psychological distress of healthcare providers involved with cancer patients during the COVID-19 pandemic. Method We conducted a cross-sectional survey among healthcare providers at the National Cancer Center, Japan. Psychological distress was assessed by the Hospital Anxiety and Depression Scale. We also assessed moral distress using the Moral Distress Thermometer and resilience using the Connor-Davidson Resilience Scale 10 in April and May 2020 which was the first surge of the epidemic period. Results Five hundred sixty-six of 3,900 healthcare providers (14.5%) responded. Sixty-eight percent (385/566) responders were above the Hospital Anxiety and Depression Scale cutoff. Hierarchical regression analyses indicated that nurses, allied health professionals and office workers/engineers (odds ratio = 4.63; 95% confidence interval 1.90-11.29; p < 0.001, odds ratio = 3.88; 95% confidence interval 1.88-8.00; p < 0.001, odds ratio = 2.10; 95% confidence interval 1.06-4.18; p < 0.05) as well as healthcare providers with low resilience (odds ratio = 0.88; 95% confidence interval 0.85-0.91; p < 0.001) were at risk of psychological distress. Moral distress was not significantly associated with prevalence of psychological distress. Conclusion During the first surge of the pandemic, a high prevalence of psychological distress was demonstrated among cancer center healthcare providers. The study suggests that mental health care should be available to cancer care providers. Since the COVID-19 pandemic is still going on, in addition to the efforts by our facilities, we should consider interventions that promote resilience and a feasibility study of these interventions.
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Affiliation(s)
- Masako Okamura
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Maiko Fujimori
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan,*Correspondence: Maiko Fujimori,
| | - Shinichi Goto
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Keiko Ohisa
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Narikazu Boku
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Rika Nakahara
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan,Strategic Planning Bureau, National Cancer Center, Tokyo, Japan
| | - Tomohiro Matsuda
- Division of International Health Policy Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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Casà C, Dinapoli L, Marconi E, Chiesa S, Cornacchione P, Beghella Bartoli F, Bracci S, Salvati A, Scalise S, Colloca GF, Chieffo DPR, Gambacorta MA, Valentini V, Tagliaferri L. Integration of art and technology in personalized radiation oncology care: Experiences, evidence, and perspectives. Front Public Health 2023; 11:1056307. [PMID: 36755901 PMCID: PMC9901799 DOI: 10.3389/fpubh.2023.1056307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Cancer diagnoses expose patients to traumatic stress, sudden changes in daily life, changes in the body and autonomy, with even long-term consequences, and in some cases, to come to terms with the end-of-life. Furthermore, rising survival rates underline that the need for interventions for emotional wellbeing is in growing demand by patients and survivors. Cancer patients frequently have compliance problems, difficulties during treatment, stress, or challenges in implementing healthy behaviors. This scenario was highlighted during the COVID-19 emergency. These issues often do not reach the clinical attention of dedicated professionals and could also become a source of stress or burnout for professionals. So, these consequences are evident on individual, interpersonal, and health system levels. Oncology services have increasingly sought to provide value-based health care, considering resources invested, with implications for service delivery and related financing mechanisms. Value-based health care can improve patient outcomes, often revealed by patient outcome measures while seeking balance with economical budgets. The paper aims to show the Gemelli Advanced Radiation Therapy (ART) experience of personalizing the patients' care pathway through interventions based on technologies and art, the personalized approach to cancer patients and their role as "co-stars" in treatment care. The paper describes the vision, experiences, and evidence that have guided clinical choices involving patients and professionals in a co-constructed therapeutic pathway. We will explore this approach by describing: the various initiatives already implemented and prospects, with particular attention to the economic sustainability of the paths proposed to patients; the several pathways of personalized care, both from the patient's and healthcare professional perspective, that put the person's experience at the Gemelli ART Center. The patient's satisfaction with the treatment and economic outcomes have been considered. The experiences and future perspectives described in the manuscript will focus on the value of people's experiences and patient satisfaction indicators, patients, staff, and the healthcare organization.
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Affiliation(s)
- Calogero Casà
- UOC di Radioterapia Oncologica, Fatebenefratelli Isola Tiberina, Gemelli Isola, Rome, Italy
| | - Loredana Dinapoli
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Elisa Marconi
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,*Correspondence: Elisa Marconi ✉
| | - Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Patrizia Cornacchione
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Beghella Bartoli
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Serena Bracci
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alessandra Salvati
- Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sara Scalise
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giuseppe Ferdinando Colloca
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Scienze della Salute della Donna, del Bambino e di Sanità Pubblica Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Antonietta Gambacorta
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Tagliaferri
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy,Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore, Rome, Italy
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He Q, Xu P, Wang H, Wang S, Yang L, Ba Z, Huang H. The mediating role of resilience between perceived social support and sense of security in medical staff following the COVID-19 pandemic: A cross-sectional study. Front Psychiatry 2023; 14:1096082. [PMID: 36960462 PMCID: PMC10027772 DOI: 10.3389/fpsyt.2023.1096082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/09/2023] [Indexed: 03/09/2023] Open
Abstract
Background The COVID-19 pandemic not only posed a serious threat to public life and health but also had a serious impact on people's mental health, especially that of medical staff. Perceived social support is an important factor in one's sense of security. Objective Following the COVID-19 pandemic, the goal is to explore the potential mediating role of resilience in the relationship between perceived social support and the sense of security of Chinese medical personnel. Methods The multi-stage proportionally stratified convenience sampling method was adopted to select 4,076 medical professionals from 29 hospitals in Guangdong Province between September 2020 and October 2020. The Sense of Security Scale for Medical Staff, the Chinese version of the Connor-Davidson Resilience Scale, and the Perceived Social Support Scale were employed in this study. For statistical analysis and structural equation modeling (SEM), the SPSS 23.0 and Amos 24.0 software packages were used. Regression analysis was used to select the control variables to be included in the SEM. SEM analysis was conducted to verify the mediating effect of resilience on the relationship between perceived social support and a sense of security. Results Pearson's correlation analysis showed that perceived social support and resilience were positively associated with a sense of security (correlation coefficients range from 0.350 to 0.607, P < 0.01), and perceived social support (correlation coefficients range from 0.398 to 0.589, P < 0.01) was positively associated with resilience. Structural equation modeling revealed that resilience played a partial mediating role in the association between perceived social support and a sense of security (60.3% of the effect of perceived social support on security was direct, and 39.7% of the effect was mediated by resilience). Conclusions Hospital managers should make efforts to develop resilience. Interventions based on resilience should be developed to enhance the perception of social support and strengthen one's sense of security.
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Affiliation(s)
- Qingxia He
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Peng Xu
- Nursing Department, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Huajun Wang
- Nursing Department, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Shibin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Lulu Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zhiqiong Ba
- Nursing Department, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Huigen Huang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- *Correspondence: Huigen Huang
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Merrigan JJ, Quatman-Yates C, Caputo J, Daniel K, Briones N, Sen I, Bretz S, Duchemin AM, Steinberg B, Hagen JA, Klatt M. Assessment of Virtual Mindfulness-Based Training for Health Care Professionals: Improved Self-Reported Respiration Rates, Perceived Stress, and Resilience. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130231187636. [PMID: 37434793 PMCID: PMC10331219 DOI: 10.1177/27536130231187636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Background Mindfulness in Motion (MIM) is a workplace resilience-building intervention that has shown reductions in perceived stress and burnout, as well as increased resilience and work engagement in health care workers. Objective To evaluate effects of MIM delivered in a synchronous virtual format on self-reported respiratory rates (RR), as well as perceived stress and resiliency of health care workers. Methods Breath counts were self-reported by 275 participants before and after 8 weekly MIM sessions. MIM was delivered virtually in a group format as a structured, evidence-based workplace intervention including a variety of mindfulness, relaxation, and resilience-building techniques. Participants counted their breaths for 30 seconds, which was then multiplied by 2 to report RR. Additionally, participants completed Perceived Stress Scale and Connor-Davidson Resiliency Scale. Results According to mixed effect analyses there were main effects of MIM Session (P < .001) and Weeks (P < .001), but no Session by Week interaction (P = .489) on RR. On average, RR prior to MIM sessions were reduced from 13.24 bpm (95% CI = 12.94, 13.55 bpm) to 9.69 bpm (95% CI = 9.39, 9.99 bpm). When comparing average Pre-MIM and Post-MIM RR throughout the MIM intervention, Week-2 (mean = 12.34; 95% CI = 11.89, 12.79 bpm) was not significantly different than Week-1 (mean = 12.78; 95% CI = 12.34, 13.23 bpm), but Week-3 through Week-8 demonstrated significantly lower average Pre-MIM and Post-MIM RR compared to Week-1 (average weekly difference range: 1.36 to 2.48 bpm, P < .05). Perceived stress was reduced from Week-1 (17.52 ± 6.25) to after Week-8 (13.52 ± 6.04; P < .001), while perceived resiliency was increased from Week-1 (11.30 ± 5.14) to after Week-8 (19.29 ± 2.58); P < .001). Conclusion Thus far, completion of MIM sessions has shown acute and long-term effects on self-reported RR, but more research is required to determine the extent of improved parasympathetic (relaxed) states. Collectively, this work has shown value for mind-body stress mitigation and resiliency-building in high stress acute health care environments.
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Affiliation(s)
- Justin J. Merrigan
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA
| | - Catherine Quatman-Yates
- School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, OH, USA
| | - Jacqueline Caputo
- School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, OH, USA
| | - Kayla Daniel
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Nadia Briones
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Ilayda Sen
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Slate Bretz
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Anne-Marie Duchemin
- Stress, Trauma and Resilience Program, Department of Psychiatry, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Beth Steinberg
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Gabbe Health and Wellbeing, The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Joshua A. Hagen
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA
- Department of Integrated Systems Engineering, The Ohio State University, Columbus, OH, USA
| | - Maryanna Klatt
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Gabbe Health and Wellbeing, The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, OH, USA
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Shahid M. Physician Well-Being and the Promise of Positive Psychology. Ochsner J 2023; 23:2-4. [PMID: 36936482 PMCID: PMC10016205 DOI: 10.31486/toj.22.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Affiliation(s)
- Mahum Shahid
- Director of Program Diversity and Early Career Development for Women in Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD
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Cockroft JD, Rabin J, Yockey RA, Toledo I, Fain S, Jacquez F, Vaughn LM, Stryker SD. Psychometric Properties of Scales Measuring Resilience in U.S. Latinx Populations: A Systematic Review. Health Equity 2023; 7:148-160. [PMID: 36895705 PMCID: PMC9989511 DOI: 10.1089/heq.2022.0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/06/2023] Open
Abstract
Objectives Instruments used to measure resilience have typically been developed in European or Anglosphere countries and emphasize personal factors of resilience. In addition to being a quickly growing ethnic minority group in the United States, Latinx individuals face unique stressors and protective factors that may contribute to resilience. This review sought to determine the extent to which instruments measuring resilience have been validated in U.S. Latinx populations and what domains of resilience those scales capture. Methods A systematic literature review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and included studies describing psychometric properties of resilience scales for Latinx individuals living in the United States. Articles were assessed for quality of psychometric validation; scales used in the final studies were assessed for representation of domains of the social ecological resilience model. Results Nine studies were included in the final review examining eight separate resilience measures. The populations of these studies were heterogeneous geographically and demographically; more than half the studies only included Latinx populations as a subgroup. The breadth and quality of psychometric validation were variable across studies. The domains represented by the scales in the review most heavily assessed individual domains of resilience. Conclusion The literature to date on psychometric validation of resilience measures in Latinx populations in the United States is limited and does not robustly capture aspects of resilience that may be particularly meaningful for Latinx populations, such as community or cultural factors. Instruments that are developed with and for Latinx populations are necessary to better understand and measure resilience in this population.
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Affiliation(s)
- Joshua D Cockroft
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Julia Rabin
- Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio, USA
| | - R Andrew Yockey
- Department of Biostatistics and Epidemiology, The University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas, USA
| | - Isabella Toledo
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Susan Fain
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Farrah Jacquez
- Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio, USA
| | - Lisa M Vaughn
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,School of Education, University of Cincinnati College of Criminal Justice, Education, and Human Services, Cincinnati, Ohio, USA
| | - Shanna D Stryker
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Trajectories of resilience and mental distress to global major disruptions. Trends Cogn Sci 2022; 26:1171-1189. [PMID: 36302711 PMCID: PMC9595401 DOI: 10.1016/j.tics.2022.09.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022]
Abstract
The COVID-19 pandemic has resulted in a major societal disruption, raising the question of how people can maintain or quickly regain their mental health (i.e., be resilient) during such times. Researchers have used the pandemic as a use case for studying resilience in response to a global, synchronously starting, and chronic set of stressors on the individual and societal level. Our review of this recent literature reveals that mental distress trajectories during the pandemic largely resemble mental distress responses to individual-level macro-stressors, except for a lower prevalence of recovery trajectories. Results suggest more resilient responses in older adults, but trajectories are less consistent for younger and older ages compared with middle-aged adults. We call for more research integrating state-of-the-art operationalizations of resilience and using these to study resilience over the lifespan.
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Hubenschmid L, Helmreich I, Köber G, Gilan D, Frenzel SB, van Dick R, Lieb K. Effects of general and corona-specific stressors on mental burden during the SARS-CoV-2 pandemic in Germany. Front Public Health 2022; 10:991292. [PMID: 36483250 PMCID: PMC9724653 DOI: 10.3389/fpubh.2022.991292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/18/2022] [Indexed: 11/23/2022] Open
Abstract
The SARS-CoV-2 pandemic turned out to be a serious threat to mental and physical health. However, the relative contribution of corona-specific (DHs) and general stressors (DHg) on mental burden, and specific protective and risk factors for mental health are still not well understood. In a representative sample (N = 3,055) of the German adult population, mental health, potential risk, and protective factors as well as DHs and DHg exposure were assessed online during the SARS-CoV-2 pandemic (June and July 2020). The impact of these factors on mental health was analyzed using descriptive statistics, data visualizations, multiple regressions, and moderation analyses. The most burdensome DHg were financial and sleeping problems, respectively, and DHs corona-media reports and exclusion from recreational activities/important social events. 31 and 24% of total mental health was explained by DHg and DHs, respectively. Both predictors combined explained 36%, resulting in an increase in variance due to DHs of only 5% (R2 adjusted). Being female, older and a lower educational level were identified as general risk factors, somatic diseases as a corona-specific risk factor, and self-efficacy and locus of control (LOC) proved to be corona-specific protective factors. Further analyses showed that older age and being diagnosed with a somatic illness attenuated the positive influence of LOC, self-efficacy, and social support on resilience. Although the data showed that after the first easing restrictions, the stressor load was comparable to pre-pandemic data (with DHs not making a significant contribution), different risk and protective factors could be identified for general and corona-specific stressors. In line with observations from network analysis from other groups, the positive impact of resilience factors was especially diminished in the most vulnerable groups (elderly and somatically ill). This highlights the need to especially target these vulnerable groups to foster their resilience in upcoming waves of the corona pandemic.
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Affiliation(s)
- Lara Hubenschmid
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany,*Correspondence: Lara Hubenschmid
| | | | - Göran Köber
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center – University of Freiburg, Freiburg im Breisgau, Germany,Freiburg Center for Data Analysis and Modeling, University of Freiburg, Freiburg im Breisgau, Germany
| | - Donya Gilan
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany,Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Svenja B. Frenzel
- Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Rolf van Dick
- Department of Psychology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany,Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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50
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Monfries N, Sandhu N, Millar K. A Smartphone App to Reduce Burnout in the Emergency Department: A Pilot Randomized Controlled Trial. Workplace Health Saf 2022; 71:181-187. [PMID: 36373628 PMCID: PMC10080362 DOI: 10.1177/21650799221123261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Burnout is a significant concern among health care professionals, particularly those working in the emergency department (ED). Given the negative personal and professional consequences that burnout can have on all health care professionals, multidisciplinary solutions are needed to address burnout. Our objective was to evaluate the feasibility and potential impact of resilience training delivered through a smartphone application on burnout among health care professionals working at a tertiary-care pediatric ED. Methods: We conducted a single-center pilot randomized controlled study enrolling multidisciplinary health care professionals working in our ED. Participants assigned to the intervention group received self-driven access to a smartphone application that provided a structured resilience curriculum for a period of 3 months. The participants completed psychometric assessments both prior to and following the invention period. Changes in psychometric measures of the intervention group were then compared with a waitlist-control group. Results: Following the intervention period, a total of 20 participants were included in the final analysis. The change in participant scores on psychometric measures prior to and following the intervention period was calculated. A statistically significant mean decrease in burnout measure (emotional exhaustion subscale of Maslach-Burnout Inventory mean score −5.88, p < .001) and increase in mindfulness measure (Mindful Attention Awareness Scale mean score 0.51, p < .001) was observed among the intervention group participants. Conclusions/Application to Practice: Our study suggests that a resilience training program delivered using a smartphone application can be an effective intervention in reducing burnout and increasing mindfulness skills. Our study also demonstrated the potential feasibility of a randomized controlled study of burnout within a multidisciplinary group of health care professionals.
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