Hard shell, soft core? Multi-disciplinary and multi-national insights into mental toughness among surgeons

Background

With the prevalence of burnout among surgeons posing a significant threat to healthcare outcomes, the mental toughness of medical professionals has come to the fore. Mental toughness is pivotal for surgical performance and patient safety, yet research into its dynamics within a global and multi-specialty context remains scarce. This study aims to elucidate the factors contributing to mental toughness among surgeons and to understand how it correlates with surgical outcomes and personal well-being.

Methods

Utilizing a cross-sectional design, this study surveyed 104 surgeons from English and German-speaking countries using the Mental Toughness Questionnaire (MTQ-18) along with additional queries about their surgical practice and general life satisfaction. Descriptive and inferential statistical analyses were applied to investigate the variations in mental toughness across different surgical domains and its correlation with professional and personal factors.

Results

The study found a statistically significant higher level of mental toughness in micro-surgeons compared to macro-surgeons and a positive correlation between mental toughness and surgeons' intent to continue their careers. A strong association was also observed between general life satisfaction and mental toughness. No significant correlations were found between the application of psychological skills and mental toughness.

Conclusion

Mental toughness varies significantly among surgeons from different specialties and is influenced by professional dedication and personal life satisfaction. These findings suggest the need for targeted interventions to foster mental toughness in the surgical community, potentially enhancing surgical performance and reducing burnout. Future research should continue to explore these correlations, with an emphasis on longitudinal data and the development of resilience-building programs.

Impact of sarcopenia on outcomes in surgical patients: a systematic review and meta-analysis

BACKGROUND

Surgeons have historically used age as a preoperative predictor of postoperative outcomes. Sarcopenia, the loss of skeletal muscle mass due to disease or biological age, has been proposed as a more accurate risk predictor. The prognostic value of sarcopenia assessment in surgical patients remains poorly understood. Therefore, the authors aimed to synthesize the available literature and investigate the impact of sarcopenia on perioperative and postoperative outcomes across all surgical specialties.

METHODS

The authors systematically assessed the prognostic value of sarcopenia on postoperative outcomes by conducting a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching the PubMed/MEDLINE and EMBASE databases from inception to 1st October 2022. Their primary outcomes were complication occurrence, mortality, length of operation and hospital stay, discharge to home, and postdischarge survival rate at 1, 3, and 5 years. Subgroup analysis was performed by stratifying complications according to the Clavien-Dindo classification system. Sensitivity analysis was performed by focusing on studies with an oncological, cardiovascular, emergency, or transplant surgery population and on those of higher quality or prospective study design.

RESULTS

A total of 294 studies comprising 97 643 patients, of which 33 070 had sarcopenia, were included in our analysis. Sarcopenia was associated with significantly poorer postoperative outcomes, including greater mortality, complication occurrence, length of hospital stay, and lower rates of discharge to home (all P <0.00001). A significantly lower survival rate in patients with sarcopenia was noted at 1, 3, and 5 years (all P <0.00001) after surgery. Subgroup analysis confirmed higher rates of complications and mortality in oncological (both P <0.00001), cardiovascular (both P <0.00001), and emergency ( P =0.03 and P =0.04, respectively) patients with sarcopenia. In the transplant surgery cohort, mortality was significantly higher in patients with sarcopenia ( P <0.00001). Among all patients undergoing surgery for inflammatory bowel disease, the frequency of complications was significantly increased among sarcopenic patients ( P =0.007). Sensitivity analysis based on higher quality studies and prospective studies showed that sarcopenia remained a significant predictor of mortality and complication occurrence (all P <0.00001).

CONCLUSION

Sarcopenia is a significant predictor of poorer outcomes in surgical patients. Preoperative assessment of sarcopenia can help surgeons identify patients at risk, critically balance eligibility, and refine perioperative management. Large-scale studies are required to further validate the importance of sarcopenia as a prognostic indicator of perioperative risk, especially in surgical subspecialties.

Physical Education with Eduball Stimulates Non-Native Language Learning in Primary School Students

Although the neuronal mechanisms of action and cognition are related, the division of intellectual and physical lessons is standard in schools. This is surprising, because numerous studies show that integrating physical education (PE) with teaching content stimulates critical skills. For example, several experiments indicate that Eduball-based PE (i.e., lessons in a sports hall during which students play team mini-games with educational balls with printed letters, numbers, and other signs) develops mathematical and language competencies. At the same time, the Eduball method does not slow down learners’ physical development. However, we have little knowledge about the effects of such techniques on non-native language learning. Consequently, the absence of incorporating core academic subjects into PE in dual-language schools or during foreign language education is exceptionally high. Here, we replicated the Eduball experiment, but with the goal of testing this method for non-native language learning. Thus, the intervention occurred in a dual-language primary school and we evaluated second language (L2) learning. As before, we used the technique of parallel groups (experimental and control); in both groups, there were three 45-min PE classes per week. In the experimental class, two of them were held using Eduball. After a half-year experiment, children from the experimental group (one second-grade, N = 14) improved their non-native language skills significantly more than their peers from the control group (one second-grade, N = 12). These findings demonstrate that Eduball-type intervention stimulates non-native language learning in children. Hence, our report suggests that specific body training forms can support L2 learning.

Health-related quality of life in working-age adults with visual impairments in Germany

Purpose The purpose of this study was to gather data about physical activity and quality of life (QoL) for people of working age with visual impairments to optimize upcoming physical activity-based interventions in vocational rehabilitation. Methods Two hundred and seventy-seven former participants of four vocational rehabilitation centres in Germany answered an online questionnaire. The health-related QOL has been assessed by means of the WHOQOL-BREF questionnaire. The data were analysed via multivariate analysis of covariances (MANCOVAs), univariate analysis of covariances (ANCOVAs) and discriminant function analysis. Results Compared to a normative group of adults aged 36-45, the study group showed lower values in all domains of QOL. The MANCOVA (visual acuity) produced no multivariate significant effect. Also, the ANCOVA showed no significant effect for the global dimension of the WHOQOL-BREF. The MANCOVA (leisure time activity) produced a multivariate significant effect. Post-hoc ANCOVAS revealed significant effects for all four domains of QoL. The ANCOVA analysing the global domain showed a similar significant effect as well. The active persons had higher values in all domains of QoL compared to the more passive participants. Conclusion Interventions in vocational rehabilitation should focus on leisure time activity to enhance QoL. At this stage, the role of physical activity is still unclear and further studies are needed. Implications for rehabilitation People with visual impairments often show a worse quality of life than normal-sighted people. The degree of severity of the visual impairment does not affect quality of life. Sport and physical activity are effective means of improving quality of life. An active leisure time activity supports the improvement of the quality of life of visual-impaired people that participated in a vocational rehabilitation.

The Sports Background, Personality, Att Itudes, and Social Competencies of Coaches and Assistant Coaches in the Just Soccer Program for Pupils with Intellectual Disabilities

Purpose. The purpose of this study was to empirically analyze the sports background, personality dimensions, attitudes, and social competencies of adult head coaches and young assistant coaches involved in the German Einfach Fußball (Just Soccer) program, which promotes the participation of pupils with intellectual disabilities in soccer/sports and society. Methods. The study recruited 28 head coaches and 29 assistant coaches who completed a questionnaire battery of standardized instruments (NEO Five-Factor Inventory, Interpersonal Reactivity Index, Social Self-Efficacy) as well as self-developed instruments. Analysis of the data involved descriptive and inferential statistical procedures. A descriptive comparison of the assistant coaches with a normative sample of males aged 16-20 years was performed. Results. The head coaches were found with little soccer/sports experience with persons with disabilities prior to participation in the Just Soccer program. However, the majority were familiar with these persons through personal/vocational contacts. Overall, the head coaches were differentiated by formal coaching levels and playing backgrounds, with very few holding any additional formal qualifications in special education. The assistant coaches presented below average scores in the analyzed five personality dimensions when compared with the normative sample. Their attitudes and social competencies did not change during their 8-month involvement in Just Soccer. Conclusions. The findings highlight the important role of the coaching staff in the success of the Just Soccer program. Coaches involved in such activities should be familiarized with needs of people with disabilities, be stress-resistant, and possess a balanced set of personality traits. In addition, the results suggest that such individuals should be coaches/players from conventional soccer clubs instead of special school physical education teachers.

Teammerkmale und Teamdiagnose – Arbeits- und Sportteams im Vergleich

Zusammenfassung. Auf der Basis überwiegender Gemeinsamkeiten in der Einschätzung von Gruppenmerkmalen zwischen realen Arbeits- und Sportteams geht der Beitrag zunächst der Frage nach, welche Modelle zur Beschreibung und Analyse von Gruppenaufgaben und -merkmalen in der Kleingruppenforschung favorisiert werden und in wie weit diese in Verbindung mit Instrumenten zur Teamdiagnose in der Arbeits- und Sportpsychologie stehen. Das Kasseler Teampyramide-Modell ( Kauffeld, 2001 ) und der daraus abgeleitete Fragebogen zur Arbeit im Team (F-A-T) von Kauffeld (2004) werden als schlüssig für die Anwendung im Sport bewertet. Der F-A-T wurde daher in einer Feldstudie bei Sportteams (G = 27, N = 255) eingesetzt. Der Versuch, die strukturelle Validität des F-A-T im Sport zu replizieren, gelingt zwar im Wesentlichen, allerdings werden in einigen psychometrischen Parametern (z. B. Cronbachs α) keine zufriedenstellenden Werte erzielt. Es wird empfohlen, ein sportspezifisches Teamdiagnoseinstrument zu entwickeln.