The impact and effect of emotional resilience on performance: an overview for surgeons and other healthcare professionals

Medicine and surgery can be demanding professions with high levels of burnout, but few healthcare professionals are given training or education in the management of stress, and the ability of individuals to cope with work and other pressures is often taken for granted. Emotional resilience - the ability to recover from a stressful event, whether at work or at home - is influenced by factors that are both within and outside our control. In this review, we provide an overview of emotional resilience for surgeons and other healthcare professionals, and focus on the factors that can be modulated to help us cope with difficult or complex situations. We also discuss the importance of teamwork and camaraderie, which can easily be forgotten in busy working practice. A greater awareness and understanding of emotional resilience and ways to cope with stress and pressure at work are essential if we are to look after ourselves better, improve the work of our teams, and provide the best care for our patients.

Optimizing brain performance: Identifying mechanisms of adaptive neurobiological plasticity

Although neuroscience research has debunked the late 19^th century claims suggesting that large portions of the brain are typically unused, recent evidence indicates that an enhanced understanding of neural plasticity may lead to greater insights related to the functional capacity of brains. Continuous and real-time neural modifications in concert with dynamic environmental contexts provide opportunities for targeted interventions for maintaining healthy brain functions throughout the lifespan. Neural design, however, is far from simplistic, requiring close consideration of context-specific and other relevant variables from both species and individual perspectives to determine the functional gains from increased and decreased markers of neuroplasticity. Caution must be taken in the interpretation of any measurable change in neurobiological responses or behavioral outcomes, as definitions of optimal functions are extremely complex. Even so, current behavioral neuroscience approaches offer unique opportunities to evaluate adaptive functions of various neural responses in an attempt to enhance the functional capacity of neural systems.

"Teaching, my passion; publishing, my pain": unpacking academics' professional identity tensions through the lens of emotional resilience

In the global competition of higher education, an increasing emphasis has been placed on university research excellence. Accordingly, academics have to engage in both research and teaching activities. The multiple and fragmented identities of academics can sometimes be contested, leading to identity tensions, and impeding their professional development. This raises the issue of how, and whether at all, academics integrate their professional identities in a culture of performativity. Against this backdrop, this qualitative study explored how a specific group of Chinese academics negotiate identity tensions as teachers and researchers through an emotional resilience lens. The narrative frames and interviews with 10 college English teachers yielded four types of identity negotiation in the continuum from identity conflicts to identity integration mediated by emotional resilience, including the disheartened performer, the miserable follower, the strenuous accommodator, and the fulfilled integrator. Emotional resilience as a mediator in professional identity tensions is discussed. Our findings offer a nuanced understanding of the complexity of academics developing an integrated professional identity. Policymakers should recognize the potential of emotional resilience in integrating academic professional identities and jointly support academics to cope with their identity tensions. However, if identity tensions are too complex for academics to solve, the policymakers should consider tensions as signals that the existing institutional policies may be counterproductive and need to be revised, rather than merely calling on academics' resilience.

Coping with post-hurricane mental distress: The role of neighborhood green space

BACKGROUND

Although increases in the prevalence of mental distress have been reported after natural disasters, less is known about the role the environment may play in mitigating posttraumatic stress disorder (PTSD) in hurricane-impacted communities.

AIM

This study aims to investigate the extent to which concentration and perceived quality of neighborhood greenness are associated with lower levels of PTSD, along with potential mechanisms through which these effects occur.

METHODS

We conducted a cross-sectional survey of individuals (N=272) from 30 Houston neighborhoods that were affected during Hurricane Harvey. Perceived quality of neighborhood green space was measured using a scale adapted from the Neighborhood Open Space (NOS) scale, and concentration of greenness was measured objectively using the normalized difference vegetation index (NDVI). Probable PTSD was measured using the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and hurricane-related distress using the Impact of Event Scale (IES-R). Generalized linear mixed models were used to fit individual models. Based on the results, structural equation models were employed to test direct and indirect pathways simultaneously. Models were adjusted for neighborhood- and individual-level confounders.

RESULTS

Greater perceived quality of neighborhood green space was significantly associated with lower likelihoods of probable PTSD and hurricane-related distress. The effects of perceived green space quality on hurricane-related distress were mediated by higher levels of emotional resilience. Social cohesion, although significantly correlated with PTSD and distress, did not mediate the effect of perceived green space quality on either. Neighborhood NDVI was significantly associated with hurricane-related distress, but not with PTSD.

CONCLUSION

We conclude that living in neighborhoods with greater perceived quality of green space was associated with lower levels of post-hurricane distress, with mediation especially through the emotional resilience pathway. These findings suggest that in disaster recovery policy frameworks, more attention should be paid to the benefits of high-quality neighborhood green infrastructure.

"We are taking every precaution to do our part…": a comparative analysis of nursing, palliative and hospice care facilities' websites during the COVID-19 pandemic

Background

The COVID-19 pandemic has a significant impact on health care processes. Precautions such as restrictions imposed on visitors and social distancing have led to multiple challenges, particularly in terms of communication. Using the case of nursing, palliative and hospice care facilities in Germany and drawing on agenda-setting theory, the present study aims to shed light on how health care facilities use their websites to inform (potential) health care users about changes in regulations, new protective measures implemented and about recommendations in the context of the COVID-19 pandemic.

Methods

The websites of nursing, palliative and hospice care facilities in Germany were examined using qualitative document analysis and qualitative content analysis. A total of 138 websites was analysed in the study. The data gathered includes all information about COVID-19 on these websites published from the beginning of March until August 15, 2020.

Results

Facilities show similarities in adhering to the measures taken by the authorities to restrict the spread of SARS-CoV-2 and to protect vulnerable patients and employees. All facilities urged the public to avoid paying visits to patients in facilities unless there was an emergency; however, visiting procedures in practice varied by types of facilities. For optimal communication, telephone and especially video calls were the options preferred by health care providers and health care users. Facilities made great efforts to prevent emotional stress and to strengthen resilience among all stakeholders. Transparency was adopted by many facilities in order to build the public’s trust.

Conclusions

The agenda of health care facilities has been seriously affected by the COVID-19 pandemic. The study sheds light on the strategies developed by facilities, their efforts to increase emotional resilience among health care staff and health care users, the ethical guidelines they have adopted regarding privacy policies as well as how these themes are communicated via the facilities’ websites. The results can inform other health care facilities about how websites can be used as essential communication tools in times of public health crises.

Learning and teaching Emotional Logic in Zimbabwe: A lifelong learning emotional literacy training package that promotes healthy adjustment in resource-poor settings

This article describes an innovative, rapidly effective, low cost, health promoting educational input that can strengthen social systems to support the social and emotional development of orphan children. The training project took place in a resource-poor area of rural southern Zimbabwe. The teaching was found to be culturally relevant and transferable, to the extent that several of the learners progressed to become tutors, training others to use the method in local languages. The method promotes healthy adjustment, emotional resilience and intelligent decision-making for health. By reducing chronic stress in orphans and their carers, lifelong learning may improve immune function.

A Call for Active Resilience Training in Dance

Dancers represent a unique subset of athletes who face physical and psychological stressors throughout their careers. These challenges pose risks for injury, burnout, and diminished performance capacity. This article proposes a proactive intervention. The Active Resilience Training in Dance curriculum would provide dancers with useable instruction at key career inflection points (amateur to preprofessional, preprofessional to professional, and professional to retirement) to bolster the 4 pillars of their resilience (emotional, cognitive, spiritual, and physical).

The more mindfulness practice, the more post-trauma stress symptoms? Trait mindfulness and PTSS during the COVID-19 pandemic

Investigating the contributing factors of post-traumatic stress symptoms (PTSS) has always been an important topic in the field of traumatic psychology research. The current study explored the influences of pandemic/epidemic experiences, meditation experiences, and trait mindfulness on PTSS and the mediating role of emotional resilience during the COVID-19 pandemic. A total of 522 participants in Hubei province completed the Five Facet Mindfulness Questionnaire, the Adolescents' Emotional Resilience Questionnaire, and the PTSD Checklist for DSM-5. The results showed that (1) participants who had family or friends diagnosed with COVID-19 scored higher on avoidance. (2) Participants who had family or friends had been diagnosed with SARS or H1N1 scored higher on PTSS. (3) Participants with meditation experience scored significantly higher on all dimensions of PTSS, other than avoidance. (4) The mediating role of recovering from negative emotions in the relationship between trait mindfulness and PTSS was significant (95%CI= [-0.212, -0.094]), while the generating positive emotion was not significant (95%CI= [-0.050, 0.071]). Individuals with pandemic/epidemic experience are more likely to have a high level of PTSS. Individuals who have meditation experience also express a higher level of PTSS, which may be a result of the quality of meditation. Trait mindfulness and the ability to recover from negative emotions were protective factors against PTSS.

Effect of music therapy on emotional resilience, well-being, and employability: a quantitative investigation of mediation and moderation

This study explores the impact of music therapy on emotional resilience, well-being, and employability. Through an 8-week music therapy intervention involving 256 participants, the results demonstrated that music therapy significantly enhanced participants' emotional resilience, which in turn improved their well-being and employability. A significant positive correlation was found between emotional resilience, well-being, and employability, with well-being mediating the relationship between emotional resilience and employability. Additionally, the study identified moderating effects of age and education level, revealing that younger individuals and those with higher education levels benefit more from emotional resilience in terms of well-being and employability. These findings suggest that music therapy is an effective intervention for enhancing emotional resilience and career development, with well-being playing a crucial role in this process. Future research should continue to investigate the long-term benefits of music therapy, explore its effects across diverse populations, and incorporate objective measures and longitudinal designs to validate and expand upon these findings.

Adolescents' Mental Health Concerns in Pre- and During COVID-19: Roles of Adverse Childhood Experiences and Emotional Resilience

Limited research has explored the trend of adolescent mental health concerns pre- and during the COVID-19 pandemic and how such mental health concerns are explained by emotional resilience and Adverse Childhood Experiences (ACEs). The purpose of this study is to investigate the prevalence and severity of mental health concerns among U.S. adolescents and examine the mediating role of emotional resilience in the relationship between ACEs and mental health concerns (i.e., anxiety and depression). Using the 2018-2021 National Survey of Children's Health, we analyzed a large sample of 12-17 aged adolescents. Descriptive statistics of the prevalence and severity of mental health concerns were conducted. Further, four separate mediation analyses were conducted to examine the association between ACEs, emotional resilience, and mental health concerns for each year. Two key findings are as follows. First, the prevalence and severity of mental health concerns have shown an upward trend across pre- and during COVID-19. Second, all paths in the mediation models were found to be statistically associated with one another over four years. We used parents' reports for variables of interest; further we used a single item to capture emotional resilience. This study not only demonstrates the trend of adolescent mental health concerns before and during COVID-19 but also highlights the crucial role of emotional resilience as a mediator of ACEs and mental health concerns. Findings emphasize the imperative for prevention and intervention efforts to strengthen adolescents' emotional capacity to cope with childhood adversities and additional life challenges.

Responding to patient deterioration from simulation to practice: A narrative study of undergraduate nursing students

OBJECTIVE

This study explores the impact of simulation-based training on nursing students' readiness to respond to patient deterioration in clinical practice.

BACKGROUND

With limited in-hospital training opportunities, nursing educators seek alternative strategies to teach clinical skills. Simulation-based training offers a controlled environment for skill development and refinement.

DESIGN

A narrative research design was used to examine the experiences of senior undergraduate nursing students (n = 12) at a private university in the Western United States.

METHODS

Data were collected through semi-structured interviews conducted via Zoom.

RESULTS

The study identified three key themes: the application of simulation experiences to real-world settings, the aspects of simulation training valued by students and the role of simulation in emotional regulation and coping. The findings highlight the importance of simulation training in preparing nursing students for clinical emergencies.

CONCLUSIONS

Simulation training enhances clinical judgment and emotional resilience in nursing students, equipping them to handle emergent patient care. Integrating simulation into nursing curricula prepares students for clinical roles and nurse educators can enhance this by creating realistic clinical challenges in simulations.

Narrative nursing as a holistic approach in modern healthcare: Integrating emotional and physical care

Narrative nursing (NN) is emerging as a critical approach in modern healthcare, addressing the complex interplay between psychological well-being and physical recovery. This manuscript discusses a study on NN and its role in alleviating psychological distress in patients with acute pancreatitis, published in the World Journal of Psychiatry. Their research demonstrates that NN, through structured storytelling, significantly reduces anxiety and depression, thereby enhancing patient satisfaction and fostering emotional resilience. This therapeutic approach extends beyond symptom management, offering a comprehensive strategy that supports the mental and emotional recovery of patients facing severe health challenges. NN provides a unique framework for engaging patients in their care journey, promoting a sense of agency, and strengthening the patient-provider relationship. In this manuscript, we explore the broader implications of NN by synthesizing findings from various studies, showing that NN is effective not only in acute settings but also in oncology, chronic illness management, and palliative care. The evidence indicates that integrating NN into standard clinical practice could enhance healthcare outcomes by addressing the holistic needs of patients, supporting psychological resilience, and fostering a compassionate healthcare environment.

Protocol of randomized-controlled trial to examine the effectiveness of three different interventions to reduce healthcare provider burnout

BACKGROUND

Burnout is among the greatest challenges facing healthcare today. Healthcare providers have been found to experience burnout at significant rates, with COVID-19 exacerbating the challenge. Burnout in the healthcare setting has been associated with decreases in job satisfaction, productivity, professionalism, quality of care, and patient satisfaction, as well as increases in career choice regret, intent to leave, and patient safety incidents. In this context, there is a growing need to reduce provider burnout through targeted interventions, yet little is known about what types of interventions may be most effective. The present study aims to contribute to and extend prior literature by using rigorous randomized controlled trial (RCT) methodology with a parallel group design to examine the effectiveness of different interventions in decreasing mental distress, increasing self-efficacy and attenuating inefficiencies and dissatisfiers in the work environment to achieve sustainable improvement.'

METHODS

The present study is an ongoing randomized controlled trial (RCT) that examines the effectiveness of three different types of interventions to reduce provider burnout: an intervention targeting emotional wellbeing and resilience, Electronic Health Record (EHR) skills training, and performance improvement training, relative to a no-treatment control group. This study aims to enroll a total of 400 healthcare providers in a large urban hospital system. Outcomes will be assessed at post-treatment and 6-month follow-up. Key outcomes include burnout, emotional health, intent to leave, EHR mastery, and confidence in performance improvement. Changes in outcome measurements from baseline to post-intervention across the intervention and control groups will be conducted using linear mixed-effects models (LMM).

DISCUSSION

This study is novel in that it compares several interventions addressing both personal as well as system-level drivers of provider burnout that have been theorized to operate among healthcare providers. In addition, post-treatment and longer-term follow-up assessments will provide insight into the maintenance of effects. Another innovation is the inclusion of different types of patient-facing providers in the study population (doctors, nurses, and therapists).

TRIAL REGISTRATION

This study was registered at ClinicalTrials.gov (NCT05780892) on March 10th, 2023.