Develop Your CORE2 for Career Flourishing: A Career Development Workshop for Hospitalists

Introduction

Appreciative inquiry harnesses an individual's strengths to realize positive change, and a flourishing-focused mindset emphasizes engagement, social connectivity, and seeking meaningful work. Though the impact of these models on physician well-being and career planning has been evaluated in graduate medical education, their integration into career development initiatives for faculty has been limited. We designed a workshop to nurture hospitalist career development, based on our CORE2 conceptual framework (character strengths, overall vision, role assessment, explicit goals, and evaluation).

Methods

We presented the workshop at the 2022 and 2023 Society of Hospital Medicine (SHM) annual conferences. This 1.5-hour workshop comprised four modules and three small-group activities designed to help participants identify their signature character strengths, draft a professional vision statement, prioritize professional roles, and develop SMART goals aligned with these roles.

Results

At the 2023 SHM annual conference, 36 participants attended the workshop, and 32 (89%) completed pre- and postworkshop surveys. After workshop completion, participants' self-assessed familiarity with their signature character strengths, knowledge of evidence-based principles to develop SMART goals, and confidence in their ability to write a vision statement and SMART goals all increased significantly (p < .05).

Discussion

This workshop provides a valuable framework for self-directed longitudinal career development and reflection. We build on prior curricula on educator identity formation by guiding participants from identity definition to professional vision development to professional role evaluation to aligned goal creation and iterative evaluation. Our workshop's principles are readily generalizable to clinician-educators across medical disciplines.

Thriving In and Out of the Reading Room: A Faculty Development Workshop

RATIONALE AND OBJECTIVES

Given the immense time and energy radiologists dedicate to their profession, the experience at work should be a major contributor to a meaningful and fulfilling life. In pursuit of this vision, our department launched a novel faculty development workshop entitled "Thriving In and Out of the Reading Room: What They Didn't Teach Us in Training." We report on the design, implementation and initial outcomes of this faculty development workshop.

MATERIALS AND METHODS

The workshop drew upon positive psychology research and the PERMA model of well-being, which encompasses five key elements: Positive emotion, Engagement, Relationships, Meaning, and Achievement. These elements have been shown to enhance work satisfaction and foster resilience. Using interactive, small group exercises, the workshop provided strategies for incorporating PERMA elements into daily life. At the conclusion of each workshop, an anonymous voluntary electronic survey was distributed to participants.

RESULTS

The final version of the workshop was offered to 58 faculty over eight sessions between September 2022 and May 2023. Survey results indicate that participants found the workshop to be highly valuable and practical. They also found the workshop to promote camaraderie and peer learning. Developing the workshop internally allowed us to customize it to our faculty's unique experiences and engage a large number of participants.

CONCLUSION

The workshop shows promise in improving job satisfaction and addressing burnout among academic radiologists.

Psychosocial interventions on the posttraumatic growth of adults with cancer: A systematic review and meta-analysis of clinical trials

BACKGROUND

It has been increasingly recognized that some people experience post-traumatic growth (PTG) as a result of struggling with cancer.

OBJECTIVE

This systematic review aims to identify psychosocial interventions that might facilitate PTG in adults with cancer.

METHODS

A search was conducted in PsycINFO, PubMed, Scopus, the Cochrane Library, and ProQuest up to 16 September 2022. The PRISMA guidelines were followed; all included interventional studies had to comprise 30 or more adults with cancer, using the Posttraumatic Growth Inventory, from 1994 forward.

RESULTS

A total of 2731 articles were retrieved, 1028 of those were screened and 37 unique trials were included (46 articles). A large number of studies were published since 2018 (52.4%), were randomized controlled trials (43.2%), and had group interventions (34.8%), including mainly female participants (83.8%) with a single cancer type (54.1%). Most interventions (75.7%) were moderately to highly effective in increasing PTG (d = 0.65, 95% CI 0.39-0.91) with the most effective interventions using Cognitive Behavioral Therapy (d = 1.24, 95% CI: 0.05-2.44), Mindfulness-based (d = 0.54, 95% CI = 0.14-0.94) and Education, Peer Support and Health Coaching interventions (d = 0.28, 95% CI: 0.1-0.46). Expression-based and Positive Psychology-based approaches also showed promising results. Notably, the majority of studies had a high risk of bias.

CONCLUSIONS

PTG facilitation is a promising field that should be pursued as it not only allows people with cancer to overcome their trauma but also results in them going over and above their pre-cancer state, enhancing resilience, health, and well-being.

Counseling With Male Clients: The Case for Relational Resilience Approach

Although there is no lack of research on masculinity and help-seeking behavior, men continue to seek counseling less often than women. It is crucial we find effective therapeutic approaches to connect and meet men where they are, acknowledging the positive aspects of their masculinity while addressing their needs in the counseling setting. In this conceptual research article, we propose a new approach for counselors to utilize with men seeking counseling, the Relational Resilience Approach, which applies tenets of Relational-Cultural Theory, Positive Psychology, and Shame Resilience Theory.

A Robotic Companion for Psychological Well-being: A Long-term Investigation of Companionship and Therapeutic Alliance

Social support plays a crucial role in managing and enhancing one's mental health and well-being. In order to explore the role of a robot's companion-like behavior on its therapeutic interventions, we conducted an eight-week-long deployment study with seventy participants to compare the impact of (1) a control robot with only assistant-like skills, (2) a coach-like robot with additional instructive positive psychology interventions, and (3) a companion-like robot that delivered the same interventions in a peer-like and supportive manner. The companion-like robot was shown to be the most effective in building a positive therapeutic alliance with people, enhancing participants' well-being and readiness for change. Our work offers valuable insights into how companion AI agents could further enhance the efficacy of the mental health interventions by strengthening their therapeutic alliance with people for long-term mental health support.

Psychological Well-being across the Perinatal Period: Life Satisfaction and Flourishing in a Longitudinal Study of Black and White American Women

Psychological well-being (life satisfaction and flourishing) during the perinatal period has implications for both maternal and child health. However, few studies have investigated the extent to which psychological well-being changes from preconception to postpartum periods, particularly among diverse samples of women. Using prospectively collected data from an ongoing longitudinal study, we investigated changes in two dimensions of psychological well-being from preconception to postpartum among 173 Black and White American women. Results showed that changes in life satisfaction (i.e., global quality of life) and flourishing (e.g., self-acceptance, sense of purpose) over the perinatal period were moderated by race. For life satisfaction, White women reported an increase from preconception to pregnancy with increased life satisfaction levels remaining stable from pregnancy to postpartum. However, Black women reported no changes in life satisfaction across these timepoints. In contrast, both Black and White women reported an increase in flourishing levels across the perinatal period, although the timing of these changes differed. Findings highlight a need for greater clinical and empirical attention to the way in which psychological well-being changes during the perinatal period to optimize health and inform strengths-based intervention targets.

Implementation of a Student Success Seminar and its Correlation with Resilience in Nursing Students: A Mixed-Methods Study

AIM

To identify sustainable curricular practices that promote student resilience.

METHOD

Sophomore students in a four-year baccalaureate nursing program attended a positive psychology seminar and a formal mentoring program led by senior- and junior-level nursing students. Sophomore students 'resilience was measured pre- and post-intervention using the Predictive 6-Factor Resilience Scale (PR6). Additional rich descriptions from the experience of the mentoring program were obtained in surveys from the study participants and mentors at the completion of the program.

FINDINGS

Quantitative and qualitative results supported a strong increase in resilience.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Nursing schools can provide students with sustainable support that promotes resilience.

Adaptation and validation of the Adult Dispositional Hope Scale in the Ecuadorian context

This study aimed to evidence the validity and reliability of the Ecuadorian version of the Adult Dispositional Hope Scale, one of the most studied concepts of positive psychology. The adaptation process included translation and semantic and idiomatic validation. For content validation, an expert review and focus group were conducted. The questionnaire was applied to 2423 workers in Ecuador with a mean age of 37 years (SD = 9.04), and 65.6% were women. A confirmatory factor analysis was conducted to assess the validity of the scale's dimensionality. The reliability and convergent and discriminant validity were also evaluated. In order to investigate the best solution for an Ecuadorian version of the Adult Dispositional Hope Scale, four structural models were assessed. The unidimensional solution was the most adequate structure for the scale. The internal consistency of the scale was adequate. The Adult Dispositional Hope Scale (ADHS) was developed to assess this positive psychological state and has been the most used tool in many contexts. To our knowledge, this study is the first to adapt the Adult Dispositional Hope Scale into the Ecuadorian context and evaluate its validity. The findings support its reliability, factorial, and construct validity in the Ecuadorian context. Furthermore, the results show that dispositional hope acts as a protective factor, promoting work engagement and preventing burnout.

Positive attributes in elderly people with different degrees of depression: a study based on network analysis

INTRODUCTION

Depression in aging may lead to loss of autonomy and worsening of comorbidities. Understanding how positive attributes contribute to healthier and happier aging has been one of the purposes of Positive Psychology. However, the literature still lacks studies that evaluate how depression in the elderly is related to constructs considered positive.

OBJECTIVE

The present study aimed comparing scores of constructs of spiritual well-being, social support, self-esteem, life satisfaction, affection, optimism, and hope in the elderly with minimal, mild, moderate, and severe depression and healthy controls in order to investigate possible indirect and mediated relationships between positive constructs and depression.

METHODS

A cross-sectional study was conducted with elderly, 62 of whom were diagnosed with different severity of Major Depression (DSM-V) (minimum, mild, moderate, and severe according to the Beck Depression Inventory - BDI) and 66 healthy controls matched by age, sex and schooling. The instruments used were adapted and validated versions of the Spirituality Self-Rating Scale, the Rosenberg Self-Esteem Scale, the Medical Outcomes Social Scale of Support, the Life Satisfaction Scale, the Positive and Negative Affect Schedule, the Revised Life Orientation Test, and the Adult Dispositional Hope Scale. After comparing the means of scores between groups, an analysis of normalized partial association networks was performed to investigate the direct and mediated relationships between depression and other evaluated constructs.

RESULTS

Scores of spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affects, and hope differed significantly between the control group and the degrees of depression (p < 0.001). The analysis of normalized partial association networks has shown that the relations of depression with the constructs of life satisfaction, self-esteem, and social support are mediated, while the constructs of dispositional hope, positive affect, spiritual well-being, and optimism are indirectly related to depression. The social class was also positively related to depression.

CONCLUSION

Depression in different degrees is associated with a reduction in the scores of instruments that evaluate positive attributes. The constructs directly associated with depression are spiritual well-being, optimism, positive affect, and dispositional hope. The others had mediated relationship. These results may contribute to the planning of future interventions for the prevention of depression among the elderly.

Resilience-based Integrated IBD Care Is Associated With Reductions in Health Care Use and Opioids

BACKGROUND & AIMS

Integrated inflammatory bowel disease (IBD) care is effective but not routinely implemented. Validated methods that simultaneously address mind and body targets such as resilience may improve access and outcomes. We describe the development and implementation of the GRITT method and its impact on resilience, health care utilization (HCU), and opioid use in IBD.

METHODS

Consecutive patients from an academic IBD center were evaluated for low resilience on the basis of provider referral. Low resilience patients were invited to participate in the GRITT program. Primary outcome was % reduction in HCU. Secondary outcomes were change in resilience and corticosteroid and opioid use. Patients were allocated into 2 groups for analysis: GRITT participants (GP) and non-participants (NP). Clinical data and HCU in the year before enrollment were collected at baseline and 12 months. One-way repeated measures multivariate analysis of covariance evaluated group × time interactions for the primary outcome. Effect size was calculated for changes in resilience over time.

RESULTS

Of 456 screened IBD patients 394 were eligible, 184 GP and 210 NP. GP had greater reduction in HCU than NP: 71% reduction in emergency department visits, 94% reduction in unplanned hospitalizations. There was 49% reduction in opioid use and 73% reduction in corticosteroid use in GP. Resilience increased by 27.3 points (59%), yielding a large effect size (d = 2.4).

CONCLUSIONS

Mind-body care that focuses on building resilience in the context of IBD care may be a novel approach to reduce unplanned HCU and opioid use, but large, multicenter, randomized controlled trials are needed.

Altruistic Social Activity, Depressive Symptoms, and Brain Regional Gray Matter Volume: Voxel-Based Morphometry Analysis from 8695 Old Adults

Altruistic social activity, such as giving support to others, has shown protective benefits on dementia risk and cognitive decline. However, the pathological mechanism is unclear. In the present study, we investigated the association between altruistic social activity and brain regional gray matter. Furthermore, to explore the psychological interplay in altruistic social activity, we tested mediating effect of depressive symptoms on brain regional gray matter. We performed a cross-sectional Voxel-Based Morphology (VBM) analysis including 8695 old adults (72.9±6.1 years) from Japan Prospective Studies Collaboration for Aging and Dementia (JPSC-AD) Cohort. We measured altruistic social activities by self-report questionnaire, depressive symptoms by Geriatric Depression Scale (GDS)-short version. We employed the whole-brain VBM method to detect relevant structural properties related to altruistic social activity. We then performed multiple regression models to detect the mediating effect of depressive symptoms on particular brain regional gray matter volume while adjusting possible physical and social lifestyle covariables. We found that altruistic social activity is associated with larger gray matter volume in posterior insula, middle cingulate gyrus, hippocampus, thalamus, superior temporal gyrus, anterior orbital gyrus, and middle occipital gyrus. Depressive symptoms mediated over 10% on altruistic social activity and hippocampus volume, over 20% on altruistic social activity and cingulate gyrus volume. Our results indicated that altruistic social activity might preserve brain regional gray matter where are sensitive to aging and cognitive decline. Meanwhile, this association may be explained by indirect effect on depressive symptoms, suggesting that altruistic social activity may mitigate the neuropathology of dementia.

Evaluation of the Happiness through Goal-Setting Training

This paper describes the evaluation of the Happiness through Goal-Setting Training, a multiple intervention approach which helps participants to reflect on, and modify their reasons for goal pursuit. The training is theoretically grounded in the goal-striving reasons framework. This framework captures four important reasons for goal pursuit and has received a substantial amount of empirical support for its predictive power in relation to positive psychological functioning. The four goal-striving reasons are the pursuit of goals out of pleasure, altruism, fear of self-esteem loss or necessity. The evaluation of the training, employing a before-and-after study design, is based on two data sets comprising data from a face-to-face delivery of the training (N = 41) and an online delivery of the training (N = 40). Overall, the findings from both studies, using paired sample t-tests, show that the Happiness through Goal-Setting Training significantly improves the quality of people's reasons for goal pursuit as well as their positive psychological functioning measured through life satisfaction, positive affect, negative affect and work-engagement. Thus, the Happiness through Goal-Setting Training complements the existing suite of well-being interventions by providing a happiness training that focusses specifically on improving people's reasons for goal-pursuit.

Maternal Psychological Resilience During Pregnancy and Newborn Telomere Length: A Prospective Study

OBJECTIVE

In the context of the importance of elucidating the determinants of the initial, newborn setting of telomere length (TL), it is increasingly evident that maternal stress and stress-related processes during pregnancy play a major role. Although psychological resilience may function as a buffer, research in this area has not yet examined its potential role vis-à-vis that of stress. The authors examined the relationship between maternal psychological resilience during pregnancy and newborn TL.

METHODS

In a sample of 656 mother-child dyads from the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction cohort, multiple serial assessments were conducted over the course of pregnancy to quantify maternal stress, negative and positive emotional responses to pregnancy events, positive affect, and perceived social support. Principal component analysis identified two latent factors: stress and positivity. A measure of resilience was computed by regressing the positivity factor on the stress factor, in order to quantify positivity after accounting for stress. TL was measured using quantitative polymerase chain reaction in leukocytes extracted from cord blood shortly after birth. Linear regression was used to predict newborn TL from maternal resilience during pregnancy, adjusting for other potential determinants.

RESULTS

Maternal stress significantly predicted shorter newborn TL (β=-0.079), and positivity significantly predicted longer TL (β=0.135). Maternal resilience (positivity accounting for stress) was significantly and positively associated with newborn TL (β=0.114, 95% CI=0.035, 0.189), with each standard deviation increase in resilience predicting 12% longer newborn TL.

CONCLUSIONS

The results indicate that maternal psychological resilience may exert a salubrious effect on offspring telomere biology and highlight the importance of enhancing maternal mental health and well-being during pregnancy.

The Hummingbird Project: A Positive Psychology Intervention for Secondary School Students

Mental health in schools has attracted a lot of attention in recent years. Positive Psychology Interventions (PPIs) in secondary schools have been shown to improve mental health outcomes for students. Previous PPIs have tended to be delivered by trained Psychology specialists or have tended to focus on a single aspect of Positive Psychology such as Mindfulness. The current study involved 2 phases. Phase 1 was a pilot PPI, delivered by current university students in Psychology, which educated secondary school students (N = 90) in a variety of Positive Psychology concepts. Phase 2 involved delivering the PPI to secondary school students (N = 1,054). This PPI, the Hummingbird Project, led to improvements in student well-being, as measured by the World Health Organization Well-Being Index (WHO-5). The intervention also led to improvements in student resilience, as measured by the Bolton Uni-Stride Scale (BUSS), and hope, as measured by the Children's Hope Scale (CHS). Results are discussed in the context of their implications for the future of psychological intervention in secondary school settings.

Positive Psychology: A Personal History

As president of the American Psychological Association in 1998, I organized researchers and practitioners to work on building well-being, not just on the traditional task of reducing ill-being. Substantial research then found that well-being causes many external benefits, including better physical and mental health. Among the applications of Positive Psychology are national psychological accounts of well-being, Positive Psychotherapy, the classification of strengths and virtues, Comprehensive Soldier Fitness, and Positive Education. Positive Psychology has spread beyond psychology into neuroscience, health, psychiatry, theology, and even to the humanities. Positive Psychology has many critics, and I comment on the strongest criticisms. I conclude with the hope that the building of well-being will become a cornerstone of morality, politics, and religion.

Positive medical education: Are we focusing on the right things while teaching?

This article was migrated. The article was marked as recommended. Neuropsychiatric disorders are a global problem and medical students are a population with high vulnerability to mental disorders. Medical education is currently in crisis considering the alarming rates of mental health problems reported in medical students. These problems not only compromise the health of students but also their learning processes and patient care. In this context, it is necessary to move towards a medical education that considers, in addition to the academic performance, the well-being of medical students as a central focus. Positive psychology with interventions at individual level and positive education with interventions at institutional level could provide a response based on the evidence to this problem through positive medical education. This article addressed a personal view of how positive medical education can benefit medical students.

Positive Psychological Factors are Linked to Successful Cognitive Aging Among Older Persons Living with HIV/AIDS

We aimed to characterize successful cognitive aging (SCA) among older HIV-infected (HIV+) and HIV-uninfected (HIV-) adults, and to determine associations with positive psychological factors and health-related quality of life (HRQoL). Ninety-nine HIV+ and 46 HIV- older adults (≥ 50 years) completed measures of neurocognition, positive psychological factors, and HRQoL. Using study-defined SCA criteria (i.e., no cognitive or everyday impairment or major depressive disorder), we compared positive psychological factors and HRQoL across four groups: HIV+/SCA+, HIV+/SCA-, HIV-/SCA+, HIV-/SCA-. SCA was identified in 29% of the HIV+ sample compared to 61% of the HIV- sample (p < 0.01). HIV+/SCA+ participants had higher scores on 8 of 10 measures of positive psychological factors as well as better HRQoL (ps < 0.05) as compared to the HIV+/SCA- group. Furthermore, the HIV+/SCA+ participants had comparable scores on these factors as HIV- adults. Fewer HIV+ than HIV- participants met SCA criteria; however, the level of positive psychological factors among the HIV+/SCA+ group was comparable to the HIV- sample. Our findings present opportunities for interventions to optimize positive psychological factors and potentially improve SCA among older HIV+ adults.

Tobacco consumption and positive mental health: an epidemiological study from a positive psychology perspective

Background

Positive mental health (PMH) is much more than the absence of mental illnesses. For example, PMH explains that to be happy or resilient can drive us to live a full life, giving us a perception of well-being and robustness against everyday problems. Moreover, PMH can help people to avoid risky behaviours like tobacco consumption (TC). Our hypothesis was that PMH is negatively associated with TC, and this association differs across rural, urban and migrant populations.

Methods

A cross-sectional study was conducted using the PERU MIGRANT Study’s dataset, including rural population from the Peruvian highlands (n = 201), urban population from the capital city Lima (n = 199) and migrants who were born in highlands but had to migrated because of terrorism (n = 589). We used an adapted version of the 12-item Global Health Questionnaire to measure PMH. The outcome was TC, measured as lifetime and recent TC. Log-Poisson robust regression, performed with a Maximum Likelihood method, was used to estimate crude prevalence ratios (PR) and 95 % confidence intervals (95%CI), adjusted by sex, age, family income and education which were the confounders. The modelling procedure included the use of LR Test, Akaike information criteria (AIC) and Bayesian information criteria (BIC).

Results

Cumulative occurrence of tobacco use (lifetime TC) was 61.7 % in the rural group, 78 % in the urban group and 76.2 % in rural-to-urban migrants. Recent TC was 35.3 % in the rural group, 30.7 % in the urban group and 20.5 % in rural-to-urban migrants. After adjusting for confounders, there was evidence of a negative association between PMH and lifetime TC in the rural group (PR = 0.93; 95%CI: 0.87–0.99), and a positive association between PMH and recent TC in migrants (PR = 1.1; 95%CI: 1.0–1.3).

Conclusions

PMH was negatively associated with TC in rural participants only. Urbans exhibited just a similar trend, while migrants exhibited the opposite one. This evidence represents the first step in the route of knowing the potential of PMH for fighting against TC. For rural populations, this study supplies new information that could support decisions about prevention programmes and psychotherapy for smoking cessation. However, more research in the topic is needed.

Electronic supplementary material

The online version of this article (doi:10.1186/s40359-016-0130-7) contains supplementary material, which is available to authorized users.

Bioethical and Other Philosophical Considerations in Positive Psychiatry

The paper begins by asserting the need for bioethical and related philosophical considerations in the emerging subspecialty Positive Psychiatry. Further discussion proceeds after offering operational definitions of the concepts fundamental to the field – Bioethics, Positive Psychology, Positive Psychiatry and Positive Mental Health - with their conceptual analysis to show their areas of connect and disconnect. It then studies the implications of positive and negative findings in the field, and presents the Positive Psychosocial Factors (PPSFs) like Resilience, Optimism, Personal Mastery, Wisdom, Religion/Spirituality, Social relationships and support, Engagement in pleasant events etc. It then evaluates them on the basis of the 4-principled bioethical model of Beneficence, Non-malfeasance, Autonomy and Justice (Beauchamp and Childress, 2009[5], 2013[6]), first offering a brief clarification of these principles and then their bioethical analysis based on the concepts of ‘Common Morality’, ‘Specific Morality’, ‘Specification’, ‘Balancing’ and ‘Double Effects’. The paper then looks into the further development of the branch by studying the connectivity, synergy and possible antagonism of the various Positive Psychosocial Factors, and presents technical terms in place of common terms so that they carry least baggage. It also takes note of the salient points of caution and alarm that many incisive analysts have presented about further development in the related field of Positive Mental Health. Finally, the paper looks at where, and how, the field is headed, and why, if at all, it is proper it is headed there, based on Aristotle's concept of the four causes - Material, Efficient, Formal and Final. Suitable case vignettes are presented all through the write-up to clarify concepts.