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Bajaj N, Phelan J, McConnell EE, Reed SM. A narrative medicine intervention in pediatric residents led to sustained improvements in resident well-being. Ann Med 2023; 55:849-859. [PMID: 36869726 PMCID: PMC9987757 DOI: 10.1080/07853890.2023.2185674] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Burnout in pediatric residents is widespread. Certain factors are associated with decreased burnout, such as empathy, self-compassion, mindfulness, and resilience, while perceived stress is associated with increased burnout. Narrative medicine may reduce burnout by its impact on protective and exacerbating factors and can be an active tool to promote wellness. The objective of this pilot study was to evaluate immediate and delayed benefits of a longitudinal narrative medicine intervention for pediatric residents using qualitative and quantitative measures. MATERIALS AND METHODS We designed a voluntary longitudinal narrative medicine intervention implemented via Zoom teleconferencing software over five months for pediatric residents at Nationwide Children's Hospital. It consisted of six one-hour long sessions where residents engaged with literature, responded to a writing prompt, and shared their reflections. It was evaluated using open-ended survey questions and established quantitative assessment tools of well-being with validity evidence. Results were compared before the intervention, immediately after, and six months later using one-way ANOVA and multiple linear regression. Qualitative data was analyzed using thematic analysis. RESULTS Twenty-two (14% of eligible) residents participated in at least one session. After the intervention, the following themes emerged for benefits to resident well-being: the ability to Build Community, have an Outlet for Self-Expression, reap Emotional and Mental Health Benefits, and work on Personal Growth. Benefits were sustained even six months later, which has not been shown previously. While there were significant qualitative findings, between all three time points, there was no change in any quantitative well-being measures. CONCLUSION Our longitudinal narrative medicine pilot study showed meaningful sustained qualitative benefits, though no quantitative changes, in measured well-being outcomes that have been previously associated with lower resident burnout. While not a panacea, narrative medicine can be a useful strategy for residency programs to improve pediatric resident well-being even after completion of planned interventions.Key MessageWe used a mixed-methods approach to assess the effects of a longitudinal narrative medicine intervention on well-being in pediatric residents.Open-ended responses indicated that residents found utility in and appreciated the intervention and experienced sustained improvements in their mental and emotional health, though the sample size was likely too small to show quantitative changes in well-being measures.Narrative medicine is not a panacea, but it can be a useful tool to provide to pediatric residents to promote sustained improvements in their well-being through the framework of relationship-centered care.
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Affiliation(s)
- Nimisha Bajaj
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - James Phelan
- Department of English, The Ohio State University, Columbus, OH, USA
| | - Erin E McConnell
- Internal Medicine/Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Suzanne M Reed
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
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Liu A, Ben-Zion S, Schwartz A, Mahan JD, Reed S. Well-being factors associated with confidence in providing calm, compassionate care in pediatric residents. PATIENT EDUCATION AND COUNSELING 2023; 115:107906. [PMID: 37478547 DOI: 10.1016/j.pec.2023.107906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/06/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE Engagement in calm, compassionate care (CCC) is important in fostering patient-centered care. We aimed to study factors which predict confidence in providing CCC in pediatric residents. METHODS We performed a retrospective, multi-center, cohort study utilizing data from the Pediatric Resident Burnout and Resilience Study (PRB-RSC) from 2016 to 2018. The Calm Compassionate Care Scale (CCCS) was used to assess confidence in delivering CCC. We examined cross-sectional associations between CCC, demographic measures, programmatic features, and psychological scales. RESULTS The following showed significant positive associations with confidence in providing CCC: Cognitive and Affective Mindfulness Scale, Neff's Self Compassion, Patient Reported Outcomes Measures-mental health, and Interpersonal Reactivity Index-empathetic concern. For the Maslach Burnout Index subscales, decreased personal accomplishment, increased emotional exhaustion, and increased depersonalization showed significant negative associations. CONCLUSIONS We found that several well-being measures and an increased sense of personal accomplishment are associated with increased confidence in providing CCC. These findings underscore the interrelatedness of these measures and highlight the importance of personal accomplishment as a positive factor in trainee development. PRACTICE IMPLICATIONS Program level interventions that decrease trainee burnout and enhance resiliency as well as support trainees' development of empathy and compassion may help trainees develop skills that promote patient-centered, compassionate care.
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Affiliation(s)
- Alex Liu
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sabrina Ben-Zion
- Department of Pediatrics, Akron Children's Hospital, Akron, OH, USA
| | - Alan Schwartz
- Department of Pediatrics, University of Illinois College of Medicine - Chicago, Chicago, IL, USA
| | - John D Mahan
- Department of Pediatrics Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, OH, USA
| | - Suzanne Reed
- Department of Pediatrics Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, OH, USA.
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Purdie DR, Federman M, Chin A, Winston D, Bursch B, Olmstead R, Bulut Y, Irwin MR. Hybrid Delivery of Mindfulness Meditation and Perceived Stress in Pediatric Resident Physicians: A Randomized Clinical Trial of In-Person and Digital Mindfulness Meditation. J Clin Psychol Med Settings 2023; 30:425-434. [PMID: 35778655 PMCID: PMC10078965 DOI: 10.1007/s10880-022-09896-3] [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] [Accepted: 06/11/2022] [Indexed: 11/30/2022]
Abstract
Physicians are experiencing epidemic levels of work-related stress and burnout. Determine efficacy of mindfulness meditation delivered as a hybrid (in-person and digital) format to reduce perceived stress in pediatric residents. Pediatric residents (n = 66) were block randomized to a hybrid Mindful Awareness Practices (MAPs) intervention, comprised of one in-person 60-min session and 6-week access to a digitally delivered MAPs curriculum (n = 27) or wait-list control (n = 39). Perceived Stress Scale (PSS) was administered at baseline and post-intervention as the primary outcome measure. A priori secondary outcomes were measured using the Abbreviated Maslach Burnout Inventory-9, Beck Depression Inventory, Beck Anxiety Inventory, UCLA Loneliness Scale, and Pittsburgh Sleep Quality Index. After the first session, 58% participated at least one digital session (M = 2.0; SD = 1.3). MAPs participants showed significant decrease in PSS compared to controls, with between-group mean difference of 2.20 (95% CI 0.47-3.93) at post-intervention (effect size 0.91; 0.19-1.62). No secondary outcome group differences were detected. Exposure to a hybrid mindfulness intervention was associated with improvement in perceived stress among pediatric residents.Trial Registration: NCT03613441.
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Affiliation(s)
- Denise R Purdie
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Department of Pediatrics, Irvine School of Medicine, University of California, Irvine, CA, USA
| | - Myke Federman
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Alan Chin
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Diana Winston
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Semel 48-241, Los Angeles, CA, 90024-1759, USA
| | - Brenda Bursch
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Semel 48-241, Los Angeles, CA, 90024-1759, USA.
| | - Richard Olmstead
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Semel 48-241, Los Angeles, CA, 90024-1759, USA
| | - Yonca Bulut
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Michael R Irwin
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Semel 48-241, Los Angeles, CA, 90024-1759, USA
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Delgado N, Delgado J, Betancort M, Bonache H, Harris LT. What is the Link Between Different Components of Empathy and Burnout in Healthcare Professionals? A Systematic Review and Meta-Analysis. Psychol Res Behav Manag 2023; 16:447-463. [PMID: 36814637 PMCID: PMC9939791 DOI: 10.2147/prbm.s384247] [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: 08/17/2022] [Accepted: 12/05/2022] [Indexed: 02/17/2023] Open
Abstract
Research on healthcare shows that the relationship between empathy and burnout is complex. The aim of this systematic review and meta-analysis is to clarify the link between different empathic components and burnout components in healthcare professionals. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. The search strategy was applied in PubMed, PsycINFO, CINAHL, Scopus, and Medline, from January 1990 to January 2021. Population included nurses and doctors. Key inclusion criteria were articles addressing the relationship between different components of empathy and professional performance and wellbeing or burn out, or studies using burnout and empathy measures with validity support from commonly accepted sources of evidence. Risk of bias was assessed using the Mixed Methods Appraisal Tool. From 1159 references identified, 22 studies were included in the systematic review, and 5 studies in the meta-analysis. Empathic Concern was significantly correlated with Depersonalization and Personal Accomplishment. Moreover, the links between Perspective Taking, Depersonalization and Personal Accomplishment were statistically significant. In conclusion, exploring and understanding the complex links between empathy and burnout could help healthcare professionals as well as institutions to reduce the risk of suffering burnout.
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Affiliation(s)
- Naira Delgado
- Departamento de Psicología Cognitiva, Social y Organizacional, Universidad de La Laguna, San Cristóbal de La Laguna, Spain,Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San Cristóbal de La Laguna, Spain,Correspondence: Naira Delgado, C/ Professor José Luis Moreno Becerra s/n, Campus de Guajara, Apartado 456, San Cristóbal de La Laguna, S/C de Tenerife, 38200, Spain, Tel +34 922317527, Email
| | - Janet Delgado
- Departamento de Filosofía I, Universidad de Granada, Granada, Spain
| | - Moisés Betancort
- Departamento de Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Helena Bonache
- Departamento de Psicología Cognitiva, Social y Organizacional, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Lasana T Harris
- Experimental Psychology, University College London, London, UK
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AlSaif HI, Alenezi MN, Asiri M, Alshaibani KO, Alrasheed AA, Alsaad SM, Batais MA. Empathy among Saudi Residents at a Tertiary Academic Center during the COVID-19 Pandemic and Its Association with Perceived Stress. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091258. [PMID: 36143935 PMCID: PMC9506239 DOI: 10.3390/medicina58091258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
Background and Objectives: Empathy is an important attribute of a healthy doctor−patient relationship. Although multiple studies have assessed empathy in different countries, little is known about its levels among Saudi residents and its association with perceived stress. Objectives: To assess the levels of empathy and to identify if there is an association with stress in general and across the demographic and training characteristics of residents. Materials and Methods: A cross-sectional questionnaire-based study was carried out from December 2020 to March 2021 among residents training at a tertiary academic center in Riyadh, Saudi Arabia. Empathy and perceived stress were measured using the Jefferson Scale of Empathy (JSE) and the Perceived Stress Scale (PSS). Results: A total of 229 residents participated. The mean JSE score was 105.25 ± 15.35. The mean JSE scores were significantly higher among residents training in pediatrics (mean difference (MD) = 17.35, p < 0.001), family medicine (MD = 12.24, p = 0.007), and medical specialties (MD = 11.11, p = 0.012) when compared with surgical specialties and anesthesia. In addition, residents who worked 1−4 on-calls per month had a higher mean JSE score (MD = 11.23, p = 0.028) compared with those who worked 7 or more on-calls. Lastly, no correlation between empathy and perceived stress was detected in the whole sample (r = −0.007, p = 0.913); however, there was a correlation among residents training in medical specialties (r = −0.245, p = 0.025). Conclusion: Residents in our study had empathy levels comparable with Asian but lower than Western residents. We recommend qualitative studies that explore potential factors that might affect empathy among residents and studying the association between empathy and perceived stress among medical residents. Postgraduate curricula should incorporate interventions that foster a more empathetic doctor−patient relationship.
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Affiliation(s)
- Haytham I AlSaif
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mamdouh N Alenezi
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mohammed Asiri
- Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925 (38), Riyadh 11461, Saudi Arabia
| | | | - Abdullah A Alrasheed
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Saad M Alsaad
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mohammed A Batais
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
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Predictors of Physician Compassion, Empathy, and Related Constructs: a Systematic Review. J Gen Intern Med 2022; 37:900-911. [PMID: 34545471 PMCID: PMC8452146 DOI: 10.1007/s11606-021-07055-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/20/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Compassion in healthcare provides measurable benefits to patients, physicians, and healthcare systems. However, data regarding the factors that predict care (and a lack of care) are scattered. This study systematically reviews biomedical literature within the Transactional Model of Physician Compassion and synthesizes evidence regarding the predictors of physician empathy, compassion, and related constructs (ECRC). METHODS A systematic literature search was conducted in CENTRAL, MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, OvidJournals, ProQuest, Web of Science, and Scopus using search terms relating to ECRC and its predictors. Eligible studies included physicians as participants. Methodological quality was assessed based on the Cochrane Handbook, using ROBINS-I risk of bias tool for quantitative and CASP for qualitative studies. Confidence in findings was evaluated according to GRADE-CERQual approach. RESULTS One hundred fifty-two included studies (74,866 physicians) highlighted the diversity of influences on compassion in healthcare (54 unique predictors). Physician-related predictors (88%) were gender, experience, values, emotions and coping strategies, quality of life, and burnout. Environmental predictors (38%) were organizational structure, resources, culture, and clinical environment and processes. Patient-related predictors (24%) were communication ease, and physicians' perceptions of patients' motives; compassion was also less forthcoming with lower SES and minority patients. Evidence related to clinical predictors (15%) was scarce; high acuity presentations predicted greater ECRC. DISCUSSION The growth of evidence in the recent years reflects ECRC's ongoing importance. However, evidence remains scattered, concentrates on physicians' factors that may not be amenable to interventions, lacks designs permitting causal commentary, and is limited by self-reported outcomes. Inconsistent findings in the direction of the predictors' effects indicate the need to study the relationships among predictors to better understand the mechanisms of ECRCs. The current review can guide future research and interventions.
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Peccoralo LA, Kaplan CA, Pietrzak RH, Charney DS, Ripp JA. The impact of time spent on the electronic health record after work and of clerical work on burnout among clinical faculty. J Am Med Inform Assoc 2021; 28:938-947. [PMID: 33550392 DOI: 10.1093/jamia/ocaa349] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/30/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To identify specific thresholds of daily electronic health record (EHR) time after work and daily clerical time burden associated with burnout in clinical faculty. MATERIALS AND METHODS We administered an institution-wide survey to faculty in all departments at Mount Sinai Health System from November 2018 to February 2019. The Maslach Burnout Inventory and Mayo Well-Being Index assessed burnout. Demographics, possible confounding variables, and time spent on EHR work/clerical burden were assessed. RESULTS Of 4156 eligible faculty members, 1781(42.9%) participated in the survey. After adjustment for background factors, EHR frustration (odds ratio [OR]=1.64-1.66), spending >90 minutes on EHR-outside the workday by self-report (OR = 1.41-1.90) and >1 hour of self-reported clerical work/day (OR = 1.39) were associated with burnout. Reporting that one's practice unloads clerical burden (OR = 0.50-0.66) and higher resilience scores (OR = 0.77-0.84) were negatively associated with burnout.Spending >90 minutes/day on EHR-outside work (OR = 0.66-0.67) and >60 minutes/day on clerical work (OR = 0.54-0.58) was associated with decreased likelihood of satisfactory work-life integration (WLI) and professional satisfaction (PS). Greater meaning in work was associated with an increased. LIKELIHOOD of achieving WLI (OR = 2.51) and PS (OR = 21.67). CONCLUSION Results suggest there are thresholds of excessive time on the EHR-outside the workday (>90 minutes) and overall clerical tasks (>60 minutes), above which clinical faculty may be at increased risk for burnout, as well as reduced WLI and PS, independent of demographic characteristics and clinical work hours. These thresholds of EHR and clerical burden may inform interventions aimed at mitigating this burden to reduce physician burnout.
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Affiliation(s)
- Lauren A Peccoralo
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Office of Well-being and Resilience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Carly A Kaplan
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Robert H Pietrzak
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Dennis S Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jonathan A Ripp
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Office of Well-being and Resilience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Baker J, Savage A, Pendleton S, Bate JM. Implementation of multidisciplinary reflective rounds within a children's hospital before and during the COVID-19 pandemic. J Paediatr Child Health 2021; 57:1044-1048. [PMID: 33586828 PMCID: PMC8014822 DOI: 10.1111/jpc.15386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 12/28/2022]
Abstract
AIM Regular reflective practice within a large group setting has been shown to reduce levels of burnout in healthcare professionals. We describe how regular reflective rounds were designed and implemented within an existing educational program at a UK children's hospital and report on the feedback received from participants. METHODS Eight face-to-face reflective rounds took place in Southampton Children's Hospital, UK, from September 2017 to February 2020 with a further virtual round in July 2020 during the COVID-19 pandemic. Each round was facilitated by a clinical psychologist and consultant. For each round, up to three volunteer panellists from different staff groups were invited to share their personal experiences on a pre-selected subject to the large group. The group would then contribute to the discussion by offering their own reflections. Feedback forms were distributed to attendees and collated. RESULTS Eight rounds were held with mean attendance of 32 (range 19-47). Across the eight rounds, the total attendance was 256 staff members. The virtual round had 20 participants. Feedback was received from 202 participants. The majority (98%) would recommend the rounds to colleagues with 64 participants (32%) rating the rounds as 'exceptional' and 91 (45%) as 'excellent'. The virtual round received similar positive feedback. CONCLUSION Large group reflective practice can be implemented within an existing regular educational program. Rounds have been well received by participants and are likely to be of relevance and value to other healthcare groups. The rounds can also be delivered effectively virtually, which may increase participation.
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Affiliation(s)
- Jonathan Baker
- Department of General PaediatricsSouthampton Children's HospitalSouthamptonUnited Kingdom
| | - Amy Savage
- Child Clinical Psychology ServiceSouthampton Children's HospitalSouthamptonUnited Kingdom
| | - Shannon Pendleton
- School of PsychologyUniversity of SouthamptonSouthamptonUnited Kingdom
| | - Jessica M Bate
- Department of Paediatric OncologySouthampton Children's HospitalSouthamptonUnited Kingdom
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Fowler JB, Fiani B, Kiessling JW, Khan YR, Li C, Quadri SA, Mahato D, Siddiqi J. The Correlation of Burnout and Optimism among Medical Residents. Cureus 2020; 12:e6860. [PMID: 32181095 PMCID: PMC7053691 DOI: 10.7759/cureus.6860] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Introduction Burnout is common among clinical specialties and has implications on the residents' well-being and mental health. Evidence suggests that optimism and burnout are correlated, but research has not focused on the applicability to medical residents. The objective of the study was to define burnout in residents and correlate it with optimism. Methods The authors conducted a correlational, prospective cross-sectional study using self-reported single item burnout (1-10) and Life Oriented Test-Revised (LOT-R) (0-24) survey instruments among residents of neurosurgery, neurology, internal medicine, family medicine and emergency medicine at a community-based hospital. Residents were asked to fill out the survey once in the 2018 academic year and once again in the 2019 academic year. Burnout and optimism scores were correlated and compared across subgroups for each year. Results There was no statistical significance found amongst any subgroups in burnout in 2018 but significance was found for both internal medicine (t = 3.74, p = 0.001) and neurosurgery (t = -3.07, p = 0.01) in 2019. Mean burnout increased from 2018 to 2019 from 4.39 to 5.1. Optimism remained constant from 2018 to 2019 (16.7 and 16.76, respectively) and there was no difference across subgroups. There was a statistically significant negative correlation between burnout and optimism in both 2018 (r = -0.364, p = 0.006) and 2019 (r = -0.39, p = .001). Conclusion Burnout and optimism are negatively correlated. Although burnout increased over time, optimism remained constant indicating the stability of this trait and implication for future interventions.
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Affiliation(s)
- James B Fowler
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Brian Fiani
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | | | - Yasir R Khan
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Chao Li
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Syed A Quadri
- Neurosurgery, Massachusetts General Hospital Harvard Medical School, Boston, USA
| | | | - Javed Siddiqi
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
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Kemper KJ, Schwartz A, Wilson PM, Mahan JD, Schubert CJ, Staples BB, McClafferty H, Serwint JR, Batra M. Burnout in Pediatric Residents: Three Years of National Survey Data. Pediatrics 2020; 145:peds.2019-1030. [PMID: 31843859 DOI: 10.1542/peds.2019-1030] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND We aimed to describe the national epidemiology of burnout in pediatric residents. METHODS We conducted surveys of residents at 34 programs in 2016, 43 programs in 2017, and 49 programs in 2018. Survey items included the Maslach Burnout Inventory, demographics, program characteristics, personal qualities, experiences, and satisfaction with support, work-life balance, and learning environment. Analyses included cross-sectional comparisons and cross-sectional and longitudinal regression. RESULTS More than 60% of eligible residents participated; burnout rates were >50% in all years and not consistently associated with any demographic or residency characteristics. Cross-sectional associations were significant between burnout and stress, sleepiness, quality of life, mindfulness, self-compassion, empathy, confidence in providing compassionate care (CCC), being on a high-acuity rotation, recent major medical error, recent time off, satisfaction with support and career choice, and attitudes about residency. In cross-sectional logistic regression analyses, 4 factors were associated with an increased risk of burnout: stress, sleepiness, dissatisfaction with work-life balance, and recent medical error; 4 factors were associated with lower risk: empathy, self-compassion, quality of life, and CCC. Longitudinally, after controlling for 2017 burnout and 2018 risk factors (eg, recent error, sleepiness, rotation, and time off), 2017 quality of life was associated with 2018 burnout; 2017 self-compassion was associated with lower 2018 stress; and 2017 mindfulness, empathy, and satisfaction with learning environment and career choice were associated with 2018 CCC. CONCLUSIONS A majority of residents met burnout criteria. Several identified factors (eg, stress, sleepiness, medical errors, empathy, CCC, and self-compassion) suggest targets for interventions to reduce burnout in future studies.
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Affiliation(s)
- Kathi J Kemper
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio;
| | - Alan Schwartz
- Departments of Medical Education and Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Paria M Wilson
- Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John D Mahan
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
| | | | - Betty B Staples
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Hilary McClafferty
- Department of Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Janet R Serwint
- Depatrtment of Pediatrics, Johns Hopkins University, Baltimore, Maryland; and
| | - Maneesh Batra
- Division of Neonatology, Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
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