Do More of What Makes You Happy? The Applicability of Signature Character Strengths and Future Physicians' Well-Being and Health Over Time

Building on Strengths: An Affirmational and Systems-Level Approach to Revisiting Character in Medicine

ABSTRACT

Although U.S. medical education has continued to place increased emphasis on defining competency standards and ensuring accountability to the public, health care inequities have persisted, several basic health outcomes have worsened, public trust in the health care system has eroded, and moral distress, burnout, and attrition among practicing physicians have escalated. These opposing trends beg the question of how the "good doctor" concept may be strengthened. In this perspective, the authors argue that revisiting the construct of physician character from an affirmational perspective could meaningfully improve medical education's impact on overall health by more holistically conceptualizing what-and who-a good doctor is. The authors introduce positive psychology's framework of character strengths, probe the distinction between character strengths and medical professionalism, and summarize the role of character strengths in promoting physician engagement and well-being in health care work. They contend that a systems-level approach to cultivating character strengths will foster physician moral agency and well-being and, by extension, transformational change in health care. Consistent with best practice in modern character education, the authors propose that institutions mindfully cultivate moral community among all stakeholders (students, faculty, staff, postgraduate trainees, and patients) and that moral community interaction centers on each member's personal aspirations with respect to living a good life, guided by the character strengths framework and informed by patient perspectives.

The associations among gratitude, job crafting, teacher-student relationships, and teacher psychological well-being

Introduction

This study explores the complex dynamics among gratitude, job crafting, teacher psychological well-being, and teacher-student relationships within the context of Chinese English as a Foreign Language (EFL) teachers.

Methods

A sample of 456 Chinese EFL teachers participated in this study. Valid scales were administered to collect data on gratitude, job crafting, teacher psychological well-being, and teacher-student relationships. Structural Equation Modeling (SEM) was employed to investigate these relationships.

Results

The findings reveal significant connections between gratitude, job crafting, teacher psychological well-being, and teacher-student relationships. SEM analysis demonstrates that gratitude and job crafting have direct effects on teacher psychological well-being. Furthermore, teacher-student relationships were identified as a mediator in these relationships.

Discussion

This study underscores the importance of gratitude and job crafting in enhancing the psychological well-being of EFL teachers. It highlights the mediating role of positive teacher-student relationships in the associations between gratitude, job crafting, and teacher psychological well-being. These results have implications for the development of interventions and practices aimed at promoting gratitude, job crafting, and positive teacher-student relationships in the EFL teaching context.

Well-Being, Mental Health, and Study Characteristics of Medical Students before and during the Pandemic

Medical students report high demands, stressors, pressure to perform, and a lack of resources, and are therefore at a higher risk for mental strain and burnout. Due to the COVID-19 pandemic, study conditions have changed, and new challenges have emerged. Thus, this study aimed to examine medical students' well-being, mental health, and study characteristics before and during the pandemic. Data from 988 Austrian medical students were included into the cross-sectional comparisons, and 63 students were included into the longitudinal analyses (variance analyses/t-tests or appropriate non-parametric tests). Well-being before and during the pandemic did not differ significantly but the peri-pandemic cohort reported higher study satisfaction, more social support from lecturers, and less emotional exhaustion, cognitive demands, and stressors (information problems, organizational stressors, work overload). Longitudinally, work overload was also perceived to be higher before the pandemic; however, study satisfaction was lower. During the pandemic, approximately every seventh student exceeded the cut-off value for generalized anxiety disorder, and approximately every tenth student exceeded the cut-off value for major depression. These unexpected peri-pandemic results concerning constant high well-being, study satisfaction, and the perception of conditions may be based on response shift effects that require further exploration. The scores exceeding the reasonable cut-point for identifying probable cases of generalized anxiety disorder and depression may reflect medical students' needs, calling for an in-depth analysis if further health promotion is necessary.

Character strengths and mental health as complex systems: a network analysis to identify bridge strengths

The network approach poses an alternative focus to understand psychological constructs as emerging from mutual interactions among indicators. Network psychometrics has been applied to psychopathology to unravel the connections between symptoms, but it can also be applied to the study of well-being. The role of character strengths in mental health is at the forefront of research attention. Previous findings suggest that heart character strengths are more predictive of mental health than mind character strengths. Nevertheless, researchers have rarely applied the network approach in this context. The present study examines, from the network approach, the connections between heart and mind character strengths and mental health. Building upon the dual-factor model of mental health, positive (i.e., happiness and life satisfaction) and negative indicators (i.e., depression) were included in the assessment of this construct. A sample of 597 Spanish undergraduates (M = 23.52; SD = 5.25; 75.6% females) completed cross-sectional self-report measures. Network analysis was used to estimate a network composed of two communities: character strengths and mental health. We used centrality analysis to calculate the importance of each node and bridge centrality to examine the interactions between the communities. The results indicated that the heart strengths of love, zest, hope, and gratitude reported the highest bridge strength centrality, suggesting that they played an intermediary role activating and deactivating components of mental health. Adopting the network approach to explore the connections between character strengths and mental health can help design focused intervention strategies in psychology.

Psychological Capital, Well-being, and Distress of International Students

International students continue to experience myriad of challenges, some of which further transpired disproportionately during the COVID-19 pandemic era. To this effect, this study investigated psychological capital (PsyCap), psychological distress, and well-being among 188 international students attending U.S universities. Results using Hayes PROCESS indicated that well-being mediated the relationship between PsyCap and psychological distress and in particular moderated the relationship between PsyCap and depression. When higher education institutions are considering steps to mitigate psychological distress experienced by international students during the COVID-19 pandemic and beyond, based on the findings of our study, we suggest investing efforts and resources into two aspects: (a) promotion of positive mental health and well-being and (b) identification and development of positive psychological capital. We further discuss these results and implications for mental health promotion of international students in light of its limitations and recommendations for future research.

Reality Meets Belief: A Mixed Methods Study on Character Strengths and Well-Being of Hospital Physicians

Positive psychology deals with factors that make life most worth living and focuses on enhancing individual potentials. Particularly, character strengths can positively contribute to well-being and work-related health, bearing a promising potential for professions, such as physicians, who are at risk for burnout or mental illnesses. This study aims to identify beneficial character strengths by examining the quantitative and qualitative data. In a cross-sectional multi-method study, 218 hospital physicians completed an online survey assessing their character strengths and their general and work-related well-being, comprising thriving, work engagement, and burnout dimensions (outcome variables). Quantitative data were analyzed for the total sample and by tertiary split. Additionally, interview-gathered opinions of four resident physicians and four medical specialist educators were collected to expand the perspective on which character strengths might be beneficial for the well-being of the resident physicians. The highest significant correlations between character strengths and outcome variables were found for hope and thriving (r = 0.67), zest, and work engagement (r = 0.67) as well as emotional exhaustion (r = -0.47), perseverance/leadership and depersonalization (r = -0.27), bravery, and reduced personal accomplishment (r = -0.39). Tertiary splits revealed that some correlations were not consistent across the entire scale continuum, for example, creativity was only significantly correlated with comparatively high levels of thriving (r = 0.28) or forgiveness with comparatively high levels of depersonalization (r = -0.34). Humility, social intelligence, and teamwork showed predominantly low correlations with all outcome variables (r = -0.17 - 0.34), although humility was stated by all interviewed medical specialist educators to be the most relevant for the well-being at work, and the latter two by three resident physicians, respectively. Different perspectives resulting from quantitative and qualitative data in terms of beneficial character strengths for work-related well-being may be driven by different work experiences, professional understandings, generational beliefs, or social expectations. Some significant correlations between character strengths and well-being outcomes varied depending on low, medium, or high outcomes. This raises questions about suitable work-related well-being interventions, as simple single intervention approaches (one intervention fits all) may not work for the respective outcome levels. These new findings warrant further research on how to foster the well-being of resident physicians at work.