Making DEEP Sense of Lifestyle Risk and Resilience

What motivates critical care nurses to stay in their job? - Structural aspects for empowering intrinsic motivation in permissive professional contexts: A scoping review

OBJECTIVE

In the wake of the COVID-19 pandemic, a significant number of critical care nurses have left their positions, citing overload, burnout, and moral distress. This scoping review is not just a theoretical exploration but a timely and crucial investigation into the aspects and structures of critical care nursing that can make the job fulfilling and appealing, thereby promoting intrinsic motivation and staff retention.

METHODOLOGY

A scoping review of studies reporting on factors that allow critical care nurses to fall back on their intrinsic job motivation. Qualitative, quantitative, and mixed methods studies from 2019 until 2023 that examined critical care nurses are included. This scoping review, which was conducted in 12 databases, follows the framework proposed by Arksey and O'Malley and the PRISMA framework.

RESULTS

22 studies met the inclusion criteria. The thematic synthesis identified 'meaning' as the overarching theme. Meaning can help critical nurses identify their intrinsic motivation and hold tight to it during professional challenges or low morale. Previous studies found meaning-making as an essential element of spirituality. In the present study, it is strongly related to the other subthemes: sense of pride and joy, personal relationships, thriving, and moral responsibility.

CONCLUSION

It makes sense for care management to create specific structures and work conditions, such as flexible scheduling, opportunities for professional development, and supportive team environments that encourage critical care nurses in their professional autonomy. Measures tailored to the individual needs and resources are also crucial. In this way, existing intrinsic motivation can be nurtured, and critical care nurses are enabled to autonomously discern values set by the employer into their own value system.

IMPLICATION FOR CLINICAL PRACTICE

Institutions need to offer critical care nurses decision-making discretion whenever possible, broad information sharing, and a climate of trust and respect, in which the individual may feel autonomous and can develop personally and professionally.

Discrimination of semantically similar verbal memory traces is affected in healthy aging

Mnemonic discrimination of highly similar memory traces is affected in healthy aging via changes in hippocampal pattern separation-i.e., the ability of the hippocampus to orthogonalize highly similar neural inputs. The decline of this process leads to a loss of episodic specificity. Because previous studies have almost exclusively tested mnemonic discrimination of visuospatial stimuli (e.g., objects or scenes), less is known about age-related effects on the episodic specificity of semantically similar traces. To address this gap, we designed a task to assess mnemonic discrimination of verbal stimuli as a function of semantic similarity based on word embeddings. Forty young (Mage = 21.7 years) and 40 old adults (Mage = 69.8 years) first incidentally encoded adjective-noun phrases, then performed a surprise recognition test involving exactly repeated and highly similar lure phrases. We found that increasing semantic similarity negatively affected mnemonic discrimination in both age groups, and that compared to young adults, older adults showed worse discrimination at medium levels of semantic similarity. These results indicate that episodic specificity of semantically similar memory traces is affected in aging via less efficient mnemonic operations and strengthen the notion that mnemonic discrimination is a modality-independent process supporting memory specificity across representational domains.

Musical Activity During Life Is Associated With Multi-Domain Cognitive and Brain Benefits in Older Adults

Regular musical activity as a complex multimodal lifestyle activity is proposed to be protective against age-related cognitive decline and Alzheimer’s disease. This cross-sectional study investigated the association and interplay between musical instrument playing during life, multi-domain cognitive abilities and brain morphology in older adults (OA) from the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE) study. Participants reporting having played a musical instrument across three life periods (n = 70) were compared to controls without a history of musical instrument playing (n = 70), well-matched for reserve proxies of education, intelligence, socioeconomic status and physical activity. Participants with musical activity outperformed controls in global cognition, working memory, executive functions, language, and visuospatial abilities, with no effects seen for learning and memory. The musically active group had greater gray matter volume in the somatosensory area, but did not differ from controls in higher-order frontal, temporal, or hippocampal volumes. However, the association between gray matter volume in distributed frontal-to-temporal regions and cognitive abilities was enhanced in participants with musical activity compared to controls. We show that playing a musical instrument during life relates to better late-life cognitive abilities and greater brain capacities in OA. Musical activity may serve as a multimodal enrichment strategy that could help preserve cognitive and brain health in late life. Longitudinal and interventional studies are needed to support this notion.

Embodied Prevention

Evidence-based recommendations for lifestyles to promote healthy cognitive aging (exercise, education, non-smoking, balanced diet, etc.) root in reductionistic studies of mostly physical measurable factors with large effect sizes. In contrast, most people consider factors like autonomy, purpose, social participation and engagement, etc. as central to a high quality of life in old age. Evidence for a direct causal impact of these factors on healthy cognitive aging is still limited, albeit not absent. Ultimately, however, individual lifestyle is a complex composite of variables relating to both body and mind as well as to receiving input and generating output. The physical interventions are tied to the more subjective and mind-related aspects of lifestyle and wellbeing in the idea of the “embodied mind,” which states that the mind is shaped by and requires the body. The causality is reciprocal and the process is dynamic, critically requiring movement: the “embodied mind” is a “embodied mind in motion.” Hiking, playing musical instruments, dancing and yoga are examples of body–mind activities that assign depth, purpose, meaning, social embedding, etc. to long-term beneficial physical “activities” and increase quality of life not only as delayed gratification. The present motivational power of embodied activities allows benefiting from the side-effects of late-life resilience. The concept offers an access point for unraveling the mechanistic complexity of lifestyle-based prevention, including their neurobiological foundations.

The Global Brain Health Survey: Development of a Multi-Language Survey of Public Views on Brain Health

Background: Brain health is a multi-faceted concept used to describe brain physiology, cognitive function, mental health and well-being. Diseases of the brain account for one third of the global burden of disease and are becoming more prevalent as populations age. Diet, social interaction as well as physical and cognitive activity are lifestyle factors that can potentially influence facets of brain health. Yet, there is limited knowledge about the population's awareness of brain health and willingness to change lifestyle to maintain a healthy brain. This paper introduces the Global Brain Health Survey protocol, designed to assess people's perceptions of brain health and factors influencing brain health.

Methods: The Global Brain Health Survey is an anonymous online questionnaire available in 14 languages to anyone above the age of 18 years. Questions focus on (1) willingness and motivation to maintain or improve brain health, (2) interest in learning more about individual brain health using standardized tests, and (3) interest in receiving individualized support to take care of own brain health. The survey questions were developed based on results from a qualitative interview study investigating brain health perceptions among participants in brain research studies. The survey includes 28 questions and takes 15–20 min to complete. Participants provide electronically informed consent prior to participation. The current survey wave was launched on June 4, 2019 and will close on August 31, 2020. We will provide descriptive statistics of samples distributions including analyses of differences as a function of age, gender, education, country of residence, and we will examine associations between items. The European Union funded Lifebrain project leads the survey in collaboration with national brain councils in Norway, Germany, and Belgium, Brain Foundations in the Netherlands and Sweden, the National University of Ostroh Academy and the Women's Brain Project.

Discussion: Results from this survey will provide new insights in peoples' views on brain health, in particular, the extent to which the adoption of positive behaviors can be encouraged. The results will contribute to the development of policy recommendations for supporting population brain health, including measures tailored to individual needs, knowledge, motivations and life situations.