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Bennett-Weston A, Keshtkar L, Jones M, Sanders C, Lewis C, Nockels K, Solomon J, Howick J. Interventions to promote medical student well-being: an overview of systematic reviews. BMJ Open 2024; 14:e082910. [PMID: 38724055 PMCID: PMC11086405 DOI: 10.1136/bmjopen-2023-082910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE To conduct an overview of systematic reviews that explore the effectiveness of interventions to enhance medical student well-being. DESIGN Overview of systematic reviews. DATA SOURCES The Cochrane Library of Systematic Reviews, MEDLINE, APA PsychInfo, CINAHL and Scopus were searched from database inception until 31 May 2023 to identify systematic reviews of interventions to enhance medical student well-being. Ancestry searching and citation chasing were also conducted. DATA EXTRACTION AND SYNTHESIS The Assessing the Methodological Quality of Systematic Reviews V.2 tool was used to appraise the quality of the included reviews. A narrative synthesis was conducted, and the evidence of effectiveness for each intervention was rated. RESULTS 13 reviews (with 94 independent studies and 17 616 students) were included. The reviews covered individual-level and curriculum-level interventions. Individual interventions included mindfulness (n=12), hypnosis (n=6), mental health programmes (n=7), yoga (n=4), cognitive and behavioural interventions (n=1), mind-sound technology (n=1), music-based interventions (n=1), omega-3 supplementation (n=1), electroacupuncture (n=1) and osteopathic manipulative treatment (n=1). The curriculum-level interventions included pass/fail grading (n=4), problem-based curriculum (n=2) and multicomponent curriculum reform (n=2). Most interventions were not supported by sufficient evidence to establish effectiveness. Eleven reviews were rated as having 'critically low' quality, and two reviews were rated as having 'low' quality. CONCLUSIONS Individual-level interventions (mindfulness and mental health programmes) and curriculum-level interventions (pass/fail grading) can improve medical student well-being. These conclusions should be tempered by the low quality of the evidence. Further high-quality research is required to explore additional effective interventions to enhance medical student well-being and the most efficient ways to implement and combine these for maximum benefit.
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Affiliation(s)
- Amber Bennett-Weston
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Leila Keshtkar
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Max Jones
- Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Christopher Sanders
- Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Cara Lewis
- Dartmouth College, Hanover, New Hampshire, USA
| | - Keith Nockels
- University Library, University of Leicester, Leicester, UK
| | - Josie Solomon
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
- University of Lincoln, Lincoln, UK
| | - Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
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van de Voort I, Grossmann I, Leistikow I, Weenink JW. What's up doc? Physicians' reflections on their sustainable employability throughout careers: a narrative inquiry. BMC Health Serv Res 2024; 24:539. [PMID: 38671449 PMCID: PMC11055295 DOI: 10.1186/s12913-024-10924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Physicians have complex and demanding jobs that may negatively affect their sustainable employability (SE) and quality of care. Despite its societal and occupational relevance, empirical research on physicians' SE is scarce. To further advance our understanding of physicians' SE, this study explores how physicians perceive their employment context to affect their SE, how physicians self-regulate with the intent to sustain their employability, and how self-regulations affect physicians' SE and their employment context. METHODS Twenty Dutch physicians from different specialisms were narratively interviewed between March and September 2021 by a researcher with a similar background (surgeon) to allow participants to speak in their own jargon. The interviews were analyzed collaboratively by the research team in accordance with theory-led thematic analysis. RESULTS According to the interviewees, group dynamics, whether positive or negative, and (mis)matches between personal professional standards and group norms on professionalism, affect their SE in the long run. Interviewees self-regulate with the intent to sustain their employability by (I) influencing work; (II) influencing themselves; and (III) influencing others. Interviewees also reflect on long-term, unintended, and dysfunctional consequences of their self-regulations. CONCLUSIONS We conclude that physicians' SE develops from the interplay between the employment context in which they function and their self-regulations intended to sustain employability. As self-regulations may unintentionally contribute to dysfunctional work practices in the employment context, there is a potential for a vicious cycle. Insights from this study can be used to understand and appraise how physicians self-regulate to face complex challenges at work and to prevent both dysfunctional work practices that incite self-regulation and dysfunctional consequences resulting from self-regulations.
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Affiliation(s)
- Iris van de Voort
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Oudlaan 50, Rotterdam, 3062 PA, The Netherlands.
| | - Irene Grossmann
- Center for Safety in Healthcare, Institute for Health Systems Science at TPM Faculty, Delft University of Technology, Delft, The Netherlands
| | - Ian Leistikow
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Oudlaan 50, Rotterdam, 3062 PA, The Netherlands
- Dutch Health & Youth Care Inspectorate, Ministry of Health, Welfare & Sport, Utrecht, the Netherlands
| | - Jan-Willem Weenink
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Oudlaan 50, Rotterdam, 3062 PA, The Netherlands
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Pranić S, Pulumati A, Vuković D. Protocol for a systematic review and meta-analysis on Janus kinase inhibitors in the management of vitiligo. Syst Rev 2024; 13:110. [PMID: 38641831 PMCID: PMC11027385 DOI: 10.1186/s13643-024-02522-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/02/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Vitiligo is a disease that affects people of all skin shades and can impact their quality of life. Reliable evidence on the effectiveness and adverse events associated with the recent use of Janus kinase (JAK) inhibitors to treat vitiligo is needed. This protocol for a systematic review and meta-analysis seeks to collect evidence from both randomized controlled trials (RCTs) and observational studies to determine the effectiveness and patient-centered outcomes concerning treatment with JAK inhibitors. METHODS We will conduct a systematic review of the literature for RCTs and observational studies that used upadacitinib, ritlecitinib, brepocitinib, ifidancitinib, cerdulatinib, deglocitinib, baricitinib, tofacitinib, and ruxolitinib JAK inhibitors as treatments for vitiligo compared to placebo, no treatment, or combination therapies. We will systematically search from inception in Epistemonikos, MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials.gov, PsycINFO, Allied and Complementary Medicine Database, Latin American and Caribbean Health Sciences Literature, Web of Science Core Collection, relevant preprint servers, and the gray literature. Ethics approval was not sought as the protocol and systematic review will not involve human participants, but rather summarized and anonymous data from studies. Primary outcomes include quality of life, percentage repigmentation, decreased vitiligo within 1 year or more, lasting repigmentation after a 2-year follow-up, cosmetic acceptability of repigmentation and tolerability or burden of treatment, and adverse events. Secondary outcomes are patient and study characteristics. We will include full-text articles, preprints, and clinical trial data in any language and all geographic regions. For data sources unavailable in English, we will obtain translations from global collaborators via the Cochrane Engage network. We will exclude articles for which sufficient information cannot be obtained from the authors of articles and systematic reviews. At least two investigators will independently assess articles for inclusion and extract data; reliability will be assessed before subsequent selection and data extraction of remaining studies. The risk of bias and certainty of evidence with Grading of Recommendations Assessment, Development, and Evaluation guidelines will be assessed independently by at least two investigators. We will estimate treatment effects by random-effects meta-analyses and assess heterogeneity using I2. Data that cannot be included in the meta-analysis will be reported narratively using themes. DISCUSSION The proposed systematic review and meta-analysis describe the methods for summarizing and synthesizing the evidence on the effectiveness and patient-centered outcomes concerning the treatment of vitiligo with JAK inhibitors that were recently approved for this indication. To disseminate further the results of our systematic review, we plan to present them at international conferences and meetings. Our findings will provide robust evidence to facilitate decision-making at the policy or practitioner level. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023383920.
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Affiliation(s)
- Shelly Pranić
- School of Medicine, University of Split, Šoltanska 2, 21000, Split, Croatia
- Cochrane Croatia, Šoltanska 2, 21000, Split, Croatia
| | - Anika Pulumati
- University of Missouri-Kansas City School of Medicine, 2411 Holmes, Kansas City, MO, 64108, USA
| | - Dubravka Vuković
- University Hospital of Split, Spinčićeva 1, 21000, Split, Croatia.
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Baas MAM, Stramrood CAI, Molenaar JE, van Baar PM, Vanhommerig JW, van Pampus MG. Continuing the conversation: a cross-sectional study about the effects of work-related adverse events on the mental health of Dutch (resident) obstetrician-gynaecologists (ObGyns). BMC Psychiatry 2024; 24:286. [PMID: 38627649 PMCID: PMC11022402 DOI: 10.1186/s12888-024-05678-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/12/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Obstetrician-Gynaecologists (ObGyns) frequently face work-related adverse events such as severe obstetric complications and maternal or neonatal deaths. In 2014, the WATER-1 study showed that ObGyns are at risk of developing work-related posttraumatic stress disorder (PTSD), while many hospitals lacked a professional support system. The aim of the present study is to evaluate the current prevalence of work-related traumatic events and mental health problems among Dutch ObGyns, as well as to examine the current and desired support. METHODS In 2022, an online questionnaire was sent to all members of the Dutch Society of Obstetrics and Gynaecology (NVOG), including resident and attending ObGyns. The survey included questions about experienced work-related events, current and desired coping strategies, and three validated screening questionnaires for anxiety, depression, and PTSD (HADS, TSQ, and PCL-5). RESULTS The response rate was 18.8% and 343 questionnaires were included in the analysis. Of the respondents, 93.9% had experienced at least one work-related adverse event, 20.1% had faced a complaint from the national disciplinary board, and 49.4% had considered leaving the profession at any moment in their career. The prevalence rates of clinically relevant anxiety, depression, and psychological distress were 14.3, 4.4, and 15.7%, respectively. The prevalence of work-related PTSD was 0.9% according to DSM-IV and 1.2% according to DSM-5. More than half of the respondents (61.3%) reported the presence of a structured support protocol or approach in their department or hospital, and almost all respondents (92.6%) rated it as sufficient. CONCLUSIONS The percentages of anxiety, depression, psychological distress and PTSD are comparable to the similar study performed in 2014. Most Dutch ObGyns experience adverse events at work, which can be perceived as traumatic and, in certain cases, may lead to the development of PTSD. Structured support after adverse work-related events is now available in almost two-thirds of workplaces, and was mostly experienced as good. Despite substantial improvements in the availability and satisfaction of professional support after work-related adverse events, the prevalence rates of mental problems remain considerable, and it is imperative to sustain conversation about the mental well-being of ObGyns.
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Affiliation(s)
- Melanie A M Baas
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, 9700 RB, Groningen, PO box 30.001, The Netherlands
| | - Claire A I Stramrood
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Beval Beter, 1000 AH, Amsterdam, PO box 345, The Netherlands
| | - Jolijn E Molenaar
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
| | - Petra M van Baar
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, 1105 AZ, Amsterdam, the Netherlands
| | - Joost W Vanhommerig
- Department of Research and Epidemiology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands
| | - Maria G van Pampus
- Department of Obstetrics and Gynaecology, OLVG, 1090 HM, Amsterdam, PO box 95500, The Netherlands.
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Folk DD, Brown C, Bissell CC, Fowler LA. Depression and associated risk factors among emergency medicine interns: Results from a national longitudinal cohort study. AEM Educ Train 2024; 8:e10970. [PMID: 38532738 PMCID: PMC10962121 DOI: 10.1002/aet2.10970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024]
Abstract
Objective Despite depression being common in residents, there are no published studies on the prevalence and risk factors for depression in emergency medicine (EM) interns. Our objectives were to explore the prevalence of depression among EM interns and to identify risk factors for depression including sleep, work hours, rotation type, race, ethnicity, sex, and age. Methods The Intern Health Study is a national longitudinal cohort study on intern mental health in all specialties. Secondary analysis was performed for EM interns only in this study. Data were collected from 2007 to 2021 and study participants completed a pre-intern year baseline survey and quarterly surveys throughout intern year, which included demographics and information on depressive symptoms, work hours, sleep, and rotation specifics. Depression severity was objectified using the Patient Health Questionnaire (PHQ9) with scores of 10 and higher meeting criteria for moderate to severe depression. Results A total of 1123 EM interns completed all surveys. The prevalence of moderate to severe depression among EM interns before starting internship was 4.8%. At Months 3, 6, 9, and 12 of intern year, the prevalence of moderate to severe depression was 17.8%, 20.5%, 20.8%, and 18.8%, respectively. PHQ9 scores were significantly higher at Month 3 of intern year compared to pre-intern year, but there were no differences at subsequent time points during intern year (p < 0.001). Females were more likely to have PHQ9 scores of 10 or above at all time points (p < 0.001). Clinical rotation type had a significant effect on PHQ9 scores, with intensive care unit rotations having a significantly higher PHQ9 score than other rotations (p < 0.001). Pearson's correlation revealed significant weak positive correlations between work hours and PHQ9 at each time point (r = 0.195, 0.200, 0.202, 0.243) and significant weak negative correlations between sleep hours and time off with PHQ9 (-0.162, -0.223, -0.180, -0.178; all p < 0.001). Conclusions Many EM interns experience moderate to severe depression. Female EM interns are more likely to be depressed than male interns. Numerous factors influence depression scores for interns, many of which are modifiable.
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Affiliation(s)
- Destiny D. Folk
- Department of Emergency MedicineAtrium Health Carolinas Medical CenterCharlotteNorth CarolinaUSA
| | - Cortlyn Brown
- Department of Emergency MedicineAtrium Health Carolinas Medical CenterCharlotteNorth CarolinaUSA
| | - Carrie C. Bissell
- Department of Emergency MedicineAtrium Health Carolinas Medical CenterCharlotteNorth CarolinaUSA
| | - Lauren A. Fowler
- Department of Physiology and PharmacologyWake Forest School of MedicineCharlotteNorth CarolinaUSA
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Wang Y, Ram SS, Scahill S. Understanding Risk Factors for Complaints Against Pharmacists: A Content Analysis. J Patient Saf 2024:01209203-990000000-00209. [PMID: 38506483 DOI: 10.1097/pts.0000000000001217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVES Pharmacists constitute a crucial component of the healthcare system, significantly influencing the provision of medication services and ensuring patient safety. This study aims to understand the characteristics and risk factors for complaints against pharmacists through Health and Disability Commissioner (HDC) published decisions. METHODS This study adopts a retrospective, qualitative approach. An inductive content analysis technique was used to analyze 37 complaints against pharmacists published decisions from the New Zealand Health and Disability Commissioner website to investigate a range of underlying risk factors contributing to the occurrence of complaints against pharmacists. RESULTS A set of 20 categories of risk factors emerged through the content analysis and were subsequently grouped into five overarching themes: pharmacist individual factors, organizational factors, system factors, medication-specific factors, and external environmental factors. CONCLUSIONS The findings of this study provide valuable insights that expand the understanding of risk management in pharmacist practice, serving as a valuable resource for regulatory bodies, policymakers, educators, and practitioners. It is recommended not only to focus solely on individual pharmacists but also to consider integrating their environment and individual behaviors to proactively address situations prone to errors and subsequent complaints.
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Affiliation(s)
- Yufeng Wang
- From the School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Collins RA, Herman T, Snyder RA, Haines KL, Stey A, Arora TK, Geevarghese SK, Phillips JD, Vicente D, Griggs CL, McElroy IE, Wall AE, Hughes TM, Sen S, Valinejad J, Alban A, Swan JS, Mercaldo N, Jalali MS, Chhatwal J, Gazelle GS, Rangel E, Yang CFJ, Donelan K, Gold JA, West CP, Cunningham C. Unspoken Truths: Mental Health Among Academic Surgeons. Ann Surg 2024; 279:429-436. [PMID: 37991182 DOI: 10.1097/sla.0000000000006159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To characterize the current state of mental health within the surgical workforce in the United States. BACKGROUND Mental illness and suicide is a growing concern in the medical community; however, the current state is largely unknown. METHODS Cross-sectional survey of the academic surgery community assessing mental health, medical error, and suicidal ideation. The odds of suicidal ideation adjusting for sex, prior mental health diagnosis, and validated scales screening for depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol use disorder were assessed. RESULTS Of 622 participating medical students, trainees, and surgeons (estimated response rate=11.4%-14.0%), 26.1% (141/539) reported a previous mental health diagnosis. In all, 15.9% (83/523) of respondents screened positive for current depression, 18.4% (98/533) for anxiety, 11.0% (56/510) for alcohol use disorder, and 17.3% (36/208) for PTSD. Medical error was associated with depression (30.7% vs. 13.3%, P <0.001), anxiety (31.6% vs. 16.2%, P =0.001), PTSD (12.8% vs. 5.6%, P =0.018), and hazardous alcohol consumption (18.7% vs. 9.7%, P =0.022). Overall, 13.2% (73/551) of respondents reported suicidal ideation in the past year and 9.6% (51/533) in the past 2 weeks. On adjusted analysis, a previous history of a mental health disorder (aOR: 1.97, 95% CI: 1.04-3.65, P =0.033) and screening positive for depression (aOR: 4.30, 95% CI: 2.21-8.29, P <0.001) or PTSD (aOR: 3.93, 95% CI: 1.61-9.44, P =0.002) were associated with increased odds of suicidal ideation over the past 12 months. CONCLUSIONS Nearly 1 in 7 respondents reported suicidal ideation in the past year. Mental illness and suicidal ideation are significant problems among the surgical workforce in the United States.
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Affiliation(s)
- Reagan A Collins
- Department of Surgery, Massachusetts General Hospital, Boston, MA
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX
| | - Tianna Herman
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Rebecca A Snyder
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Anne Stey
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Tania K Arora
- Department of Surgery, Augusta University at the Medical College of Georgia, Augusta, GA
| | | | | | - Diego Vicente
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Cornelia L Griggs
- Department of Pediatric Surgery, Massachusetts General Hospital, Boston, MA
| | - Imani E McElroy
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Anji E Wall
- Department of Surgery, Baylor University Medical Center, Dallas, TX
| | - Tasha M Hughes
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Srijan Sen
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Jaber Valinejad
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Andres Alban
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - J Shannon Swan
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Nathaniel Mercaldo
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Mohammad S Jalali
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Jagpreet Chhatwal
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - G Scott Gazelle
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Erika Rangel
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | | | - Karen Donelan
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
| | - Jessica A Gold
- Department of Psychiatry, Washington University in St Louis, St Louis, MO
| | - Colin P West
- Department of Medicine, Mayo Clinic, Rochester, MN
| | - Carrie Cunningham
- Department of Surgery, Massachusetts General Hospital, Boston, MA
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA
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Petrie K, Gayed A, Spittal MJ, Glozier N, Shand F, Harvey SB. Work-related factors and the risk of common mental disorder 1 year later: A prospective cohort study among junior doctors. Aust N Z J Psychiatry 2024; 58:227-237. [PMID: 37933864 DOI: 10.1177/00048674231209843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
OBJECTIVE This study investigated the relationship between work-related factors at baseline and the risk of common mental disorder at 12 month follow-up among a cohort of junior doctors. METHOD The data comprised the junior doctor respondents from two annual waves of the 'Medicine in Australia: Balancing Employment and Life' (MABEL) survey, a national longitudinal cohort of Australian doctors. Individual and work-related risk factors were assessed at baseline and the mental health outcome of caseness of common mental disorder (CMD) was assessed using the 6-item Kessler Psychological Distress Scale at 12-month follow-up. Unadjusted and adjusted logistic regressions were conducted to estimate the association between each baseline variable and the likelihood of CMD caseness at follow-up 1 year later. RESULTS Among 383 junior doctors, 24 (6%) had CMD 1 year later. Five work-related baseline variables were significantly associated with a higher likelihood of CMD 1 year later in adjusted models; lack of social support in work location (odds ratios (OR) = 6.11; 95% confidence intervals (CI) = [2.52, 14.81]), work-life imbalance (OR = 4.50; 95% CI = [1.31, 15.46]), poor peer support network in the workplace (OR = 2.61; 95% CI = [1.08, 6.27]), perceptions of patient expectations (OR = 2.46; 95% CI = [1.06, 5.71]) and total weekly work hours (OR 1.04; 95% CI = [1.01, 1.07]; p = 0.002)in models adjusting for gender. CONCLUSION These results identify key modifiable work-related factors that are associated with junior doctors' future mental health. Our findings suggest the need for a greater focus upon interpersonal factors and work-life balance in multi-level interventions while continuing to address workplace and system-level factors to prevent future mental disorder in junior doctors.
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Affiliation(s)
- Katherine Petrie
- Discipline of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Aimee Gayed
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Nicholas Glozier
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Australian Research Council (ARC) Centre of Excellence for Children and Families over the Life Course, Sydney, NSW, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
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Wang Y, Ram SS, Scahill S. Characteristics and risk factors of pharmacist misconduct in New Zealand: a retrospective nationwide analysis. BMC Health Serv Res 2024; 24:223. [PMID: 38378632 PMCID: PMC10880377 DOI: 10.1186/s12913-024-10591-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Professional misconduct has evolved into a worldwide concern, involving various forms and types of behaviours that contribute to unsafe practices. This study aimed to provide insights into the patterns characterising pharmacist misconduct and uncover underlying factors contributing to such instances in New Zealand. METHODS This research examined all cases of pharmacist misconduct sourced from the Health Practitioners Disciplinary Tribunal (HPDT) database in New Zealand since 2004. Characteristics of the sampled pharmacists and cases were extracted, followed by a systematic coding of the observed misconduct issues. Identification of risk factors was accomplished through content analysis techniques, enabling an assessment of their prevalence across various forms of misconduct. RESULTS The dataset of pharmacist misconduct cases comprised 58 disciplinary records involving 55 pharmacists. Seven types of misconduct were identified, with the most commonly observed being quality and safety issues related to drug, medication and care, as well as criminal conviction. A total of 13 risk factors were identified and systematically classified into three categories: (1) social, regulatory, and external environmental factors, (2) systematic, organisational, and practical considerations in the pharmacy, and (3) pharmacist individual factors. The most frequently mentioned and far-reaching factors include busyness, heavy workload or distraction; health impairment issues; and life stress or challenges. CONCLUSIONS The patterns of pharmacist misconduct are complicated, multifaceted, and involve complex interactions among risk factors. Collaborative efforts involving individual pharmacists, professional bodies, responsible authorities, policy-makers, health funders and planners in key areas such as pharmacist workload and well-being are expected to mitigate the occurrence of misconduct. Future research should seek to uncover the origins, manifestations, and underlying relationships of various contributing factors through empirical research with appropriate individuals.
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Affiliation(s)
- Yufeng Wang
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland, 1023, New Zealand.
| | - Sanyogita Sanya Ram
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Shane Scahill
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland, 1023, New Zealand
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Wang Y, Ram S(S, Scahill S. Risk identification and prediction of complaints and misconduct against health practitioners: a scoping review. Int J Qual Health Care 2024; 36:mzad114. [PMID: 38155372 PMCID: PMC10791111 DOI: 10.1093/intqhc/mzad114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/17/2023] [Accepted: 12/26/2023] [Indexed: 12/30/2023] Open
Abstract
Identifying the risk and predicting complaints and misconduct against health practitioners are essential for healthcare regulators to implement early interventions and develop long-term prevention strategies to improve professional practice and enhance patient safety. This scoping review aims to map out existing literature on the risk identification and prediction of complaints and misconduct against health practitioners. This scoping review followed Arksey and O'Malley's five-stage methodological framework. A comprehensive literature search was conducted on MEDLINE, EMBASE, and CINAHL databases and finished on the same day (6 September 2021). Articles meeting the eligibility criteria were charted and descriptively analysed through a narrative analysis method. The initial search generated 5473 articles. After the identification, screening, and inclusion process, 81 eligible studies were included for data charting. Three key themes were reported: methods used for identifying risk factors and predictors of the complaints and misconduct, synthesis of identified risk factors and predictors in eligible studies, and predictive tools developed for complaints and misconduct against health practitioners. The findings reveal that risk identification and prediction of complaints and misconduct are complex issues influenced by multiple factors, exhibiting non-linear patterns and being context specific. Further efforts are needed to understand the characteristics and interactions of risk factors, develop systematic risk prediction tools, and facilitate the application in the regulatory environment.
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Affiliation(s)
- Yufeng Wang
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Sanyogita (Sanya) Ram
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Shane Scahill
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Level 3, Building 503, 85 Park Road, Grafton, Auckland 1023, New Zealand
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11
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Robison R, Brendle M, Moore C, Cross H, Helm L, Darling S, Thayer S, Thielking P, Shannon S. Ketamine-Assisted Group Psychotherapy for Frontline Healthcare Workers with COVID-19-Related Burnout and PTSD: A Case Series of Effectiveness/Safety for 10 Participants. J Psychoactive Drugs 2024; 56:23-32. [PMID: 36862829 DOI: 10.1080/02791072.2023.2186285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 12/01/2022] [Accepted: 12/14/2022] [Indexed: 03/04/2023]
Abstract
This study reports on 10 frontline healthcare workers, employed during the COVID-19 pandemic and experiencing symptoms of burnout and PTSD, treated with group ketamine-assisted psychotherapy (KAP) in a private outpatient clinic setting. Participants attended 6 sessions once weekly. These included 1 preparation session, 3 ketamine sessions (2 sublingual, 1 intramuscular), 2 integration sessions. Measures of PTSD (PCL-5), depression (PHQ-9), and anxiety (GAD-7) were administered at baseline and post-treatment. During ketamine sessions, the Emotional Breakthrough Inventory (EBI) and the 30-item Mystical Experience Questionnaire (MEQ-30) were recorded. Participant feedback was gathered 1-month post-treatment. We observed improvements in participants' average PCL-5 (59% reduction), PHQ-9 (58% reduction), and GAD-7 (36% reduction) scores from pre- to post-treatment. At post-treatment, 100% of participants screened negative for PTSD, 90% had minimal/mild depression or clinically significant improvement, and 60% had minimal/mild anxiety or clinically significant improvement. MEQ and EBI scores had large variations among participants at each ketamine session. Ketamine was well tolerated, and no significant adverse events were reported. Participant feedback corroborated findings of improvements observed in mental health symptoms. We found immediate improvements treating 10 frontline healthcare workers experiencing burnout, PTSD, depression, and anxiety using weekly group KAP and integration.
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Affiliation(s)
- Reid Robison
- Numinus Wellness, Draper, UT, USA
- University of Utah School of Medicine, SL, UT, USA
| | - Madeline Brendle
- Numinus Wellness, Draper, UT, USA
- Department of Pharmacotherapy, University of Utah College of Pharmacy, SLC, UT, USA
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12
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Chan KKY, Yeung NCY, Mo PKH, Yang X. Common stressors, coping processes, and professional help-seeking of medical professionals in Hong Kong: A qualitative study. J Health Psychol 2023:13591053231218658. [PMID: 38160404 DOI: 10.1177/13591053231218658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Despite the high prevalence of perceived stress and mental health problems among medical professionals (MPs), their professional help-seeking is extremely low. This qualitative study explored MPs' stressors, stress-coping, barriers and facilitators of professional help-seeking. 10 MPs (30% male, Mage = 34.8 years) were recruited by purposive-sampling for views from different roles/settings. Thematic analyses revealed five central stressors: emerging novel diseases, challenges from technology-advancement, patient-communication difficulties, lack of workplace mental health care culture, excessive workload/manpower shortage. Participants predominantly used peer support/supervision and de-stress activities for stress-coping. Five factors affecting professional help-seeking were time constraint versus flexibility, mental health stigma versus de-stigmatization, concern over confidentiality/anonymity versus sense of privacy, worry about damage on professional role versus least work disruption, doubts of service providers versus perceived efficacy. All participants indicated a preference for online mental health service delivery. Results reflected unmet needs and service gaps from MPs' perspectives for the development of future interventions.
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Affiliation(s)
| | | | | | - Xue Yang
- The Chinese University of Hong Kong, Hong Kong
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13
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Yang S, Fu Y, Dong S, Yang B, Li Z, Feng C, Reinhardt JD, Shi W, Jia P, Zeng H, Yu B. Association between perceived noise at work and mental health among employed adults in Southwest China. J Affect Disord 2023; 343:22-30. [PMID: 37739020 DOI: 10.1016/j.jad.2023.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Perceived noise at work may contribute more to worsening mental health than objectively measured noise. However, evidence regarding this association is scarce. We investigated the associations of perceived noise at work with anxiety and depression and identified vulnerable subpopulations. METHODS Data from 28,661 participants of the Chinese Cohort of Working Adults (CCWA) were analyzed. Logistic or multinomial logistic regression models were used to determine associations between perceived noise at work and the severity of probable anxiety, depression, and their comorbidity. The generalized additive model with restricted cubic splines was applied to estimate the non-linear trend of associations. RESULTS The mean age of participants was 36.55 ± 10.42 years. We observed that a higher level of perceived noise at work was associated with a higher risk of severe anxiety (OR = 1.55. 95%CI: 1.51-1.59) and severe depression (OR = 1.77. 95%CI: 1.72-1.84). More perceived noise at work was further associated with increased odds of comorbid anxiety and depression (OR = 1.28, 95%CI: 1.26-1.30). We observed an approximately J-shaped curve for the association between perceived noise at work with anxiety, depression, and their comorbidity. Participants, who were male, aged <45 years, had high education levels, and worked on trains were characterized by a greater impact of perceived noise at work on mental health problems. CONCLUSION Increased perceived noise at work was associated with an elevated risk of anxiety, depression, and their comorbidity. These associations were moderated by sex, age, education level and occupation. Interventions targeting perceived noise at work may promote employed adults' mental health.
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Affiliation(s)
- Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China; International Institute of Spatial Health Epidemiology (ISLE), Wuhan University, Wuhan, China.
| | - Yao Fu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shu Dong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Yang
- Department of Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Zhitao Li
- Social Insurance Administration Department, China Railway Chengdu Group Co., Ltd., Chengdu, China
| | - Chuanteng Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; Jiangsu Province Hospital/Nanjing University First Affiliated Hospital, Nanjing, China; Swiss Paraplegic Research, Nottwil, Switzerland; University of Lucerne, Switzerland
| | - Wei Shi
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China
| | - Peng Jia
- International Institute of Spatial Health Epidemiology (ISLE), Wuhan University, Wuhan, China; School of Resource and Environmental Sciences, Wuhan University, China
| | - Honglian Zeng
- Department of Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
| | - Bin Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China.
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Gostoli S, D’Oronzo A, Malaguti C, Guolo F, Balducci C, Subach R, Lodi V, Petio C, Rafanelli C. Psychopathological Burden among Healthcare Workers during the COVID-19 Pandemic Compared to the Pre-Pandemic Period. Int J Environ Res Public Health 2023; 20:7153. [PMID: 38131705 PMCID: PMC10742499 DOI: 10.3390/ijerph20247153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
This retrospective observational study on hospital staff requesting an "application visit" (from 2017 to 2022) at the Occupational Medicine department aimed at comparing a "pre-COVID group" (2017-2019) with a "COVID group" (2020-2022) regarding (a) sociodemographic data (i.e., age, sex, occupation, years of employment at the hospital), (b) rate and type of psychiatric diagnoses in both groups and rate of psychiatric diagnoses per subject, and (c) rate of drug/psychotherapeutic prescriptions. Two hundred and five healthcare workers (F = 73.7%; mean age = 50.7 ± 10.33) were visited. Compared with the pre-COVID group, healthcare workers evaluated during COVID-19 were significantly younger and reported fewer years of employment at the hospital. Although rates of primary psychiatric diagnoses were similar in both samples, an increased number of psychopathologies per subject and associated treatment prescriptions in the COVID group was observed. In the COVID group, 61% had one psychiatric diagnosis, and 28% had 2+ psychiatric diagnoses, compared with 83.8% and 6.7% of pre-COVID. Furthermore, 56.2%/1.9% in pre-COVID and 73%/6% in the COVID group were prescribed drugs/psychotherapy, respectively. The findings of the present study highlighted an increase in both younger workers' requests and psychiatric comorbidities during the pandemic, representing a burden on the Italian healthcare system. It is thus relevant to address the mental health challenges of healthcare workers accordingly.
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Affiliation(s)
- Sara Gostoli
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Angelica D’Oronzo
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Carlotta Malaguti
- Occupational Health Unit, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy; (C.M.); (V.L.)
| | - Francesco Guolo
- Division of Cardiology, Bellaria Hospital, AUSL Bologna, 40139 Bologna, Italy;
| | - Cristian Balducci
- Department of Quality of Life Sciences, University of Bologna, 47921 Rimini, Italy;
| | - Regina Subach
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
| | - Vittorio Lodi
- Occupational Health Unit, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy; (C.M.); (V.L.)
| | - Carmine Petio
- Department of Psychiatry, Bologna University Hospital Authority St. Orsola Malpighi Polyclinic IRCCS, 40138 Bologna, Italy
| | - Chiara Rafanelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (S.G.); (A.D.); (R.S.); (C.R.)
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15
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Saeri M, Vaezi A, Tavakolifard N, Haghjooy Javanmard S. Mental Health of Healthcare Workers During the Third Wave of the COVID-19 Pandemic: Did We Forget them after the First Wave? Adv Biomed Res 2023; 12:266. [PMID: 38192898 PMCID: PMC10772797 DOI: 10.4103/abr.abr_439_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 05/12/2023] [Accepted: 10/04/2023] [Indexed: 01/10/2024] Open
Abstract
Background Since December 2019, countries experienced different numbers of COVID-19 pandemic waves. The COVID-19 pandemic led to adverse psychologic problems in the communities and among healthcare workers (HCWs), but the dynamic of these problems through different waves needs to be established more. Materials and Methods This cross-sectional study was conducted in October 2020, through the third wave of the COVID-19 pandemic, in Isfahan, Iran. We studied HCWs' depression, anxiety, and stress using Depression, Anxiety, Stress Scale-21 (DASS-21) and insomnia using Insomnia Severity Index (ISI) questionnaires. Multiple linear regression was used to evaluate the association of some characteristic factors with different psychologic symptoms. Results Our results showed that about 80% of HCWs had one or more psychological problems. The prevalence of depression, anxiety, stress, and insomnia was 46.0%, 50.2%, 44.6%, and 66.5%, respectively. Female sex, working in ICU, and having a history of chronic disease were predictors of psychological symptoms in our participants. Conclusion HCWs' mental health state could be underestimated or neglected. The third pandemic wave negatively affected the mental health of the HCWs. Since mental health problems of HCWs may reduce the quality of care, the potential impact of not addressing this issue should be highlighted.
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Affiliation(s)
- Mahdieh Saeri
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atefeh Vaezi
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negah Tavakolifard
- Department of Community and Preventive Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh Haghjooy Javanmard
- Department of Physiology, Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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16
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Chen WY, Lin FL. On the Asymmetric Relationship Between Physician Mental Health Disorders on Quality of Healthcare Under the COVID-19 Pandemic in Taiwan: Quantile on Quantile Regression Analyses. Risk Manag Healthc Policy 2023; 16:2291-2307. [PMID: 37953809 PMCID: PMC10638657 DOI: 10.2147/rmhp.s429516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose When examining the nexus of physician mental health disorders and healthcare quality from the empirical perspective, mental health disorders are frequently associated with cyclical patterns corresponding to cyclic seasonality, mood swings, emission of air pollution and business cycles, the potential asymmetric effects of physician mental health disorders on healthcare quality have not received adequate attention from researchers. Therefore, the purpose of this study is to explore the asymmetric relationship between physician mental health disorders and healthcare quality during the pandemic outbreak in Taiwan. Methods Daily data for care quality indicators and physician mental health disorders were collected from the National Insurance Research Database in Taiwan, and the quantile-on-quantile regression model was applied to proceed with our analyses. Results Our results indicated that the overall aggregate effects of each quantile of physician mental health disorders on the cumulative quantiles of healthcare quality are negative (positive) for the 14-day readmission rate (preventable hospitalization rate and non-urgent ED-visit rate). Positively (negatively) cumulative effects of each quantile of physician mental health disorders were detected in the middle (low and high) quantiles of the preventable hospitalization rate. The cumulative effects of each quantile of physician mental health disorders on the high (low and middle) quantiles of the 14-day readmission rate are negative (positive), but the cumulative effects on various quantiles of the non-urgent ED-visit rate exhibit the opposite pattern. Conclusion The observed variation in the relationship between physician mental health disorders and different quantiles of healthcare quality suggests the need for tailored strategic interventions based on distinct levels of healthcare quality when addressing the higher risk of physician mental health disorders during the pandemic outbreak conditions.
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Affiliation(s)
- Wen-Yi Chen
- Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung City, Taiwan
| | - Feng-Li Lin
- Department of Accounting, Chaoyang University of Technology, Taichung City, Taiwan
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17
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Tian H, Qiao T, Teng J, Kang C, Ke J, Shan L, Li M, Shen C, Han Y. Factors associated with depression among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Psychol Med 2023:1-10. [PMID: 37712399 DOI: 10.1017/s0033291723002271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The COVID-19 pandemic has had a profound impact on the mental health of healthcare workers (HCWs). We aimed to identify the factors associated with depression among HCWs during the pandemic. We conducted literature search using eight electronic databases up to July 27 2022. Observational studies with more than 200 participants investigating correlates of depression in HCWs after COVID-19 outbreak were included. We used fixed- and random-effects models to pool odds ratios (ORs) across studies, and Cochran's chi-squared test and I 2 statistics to assess study heterogeneity. Publication bias was evaluated by funnel plots. Thirty-five studies involving 44,362 HCWs met the inclusion criteria. Female (OR=1.50, 95% CI [1.23,1.84]), single (OR=1.36, 95% CI [1.21,1.54]), nurse (OR=1.69, 95% CI [1.28,2.25]), history of mental diseases (OR=2.53, 95% CI [1.78,3.58]), frontline (OR=1.79, 95% CI [1.38,2.32]), health anxiety due to COVID-19 (OR=1.88, 95% CI [1.29,2.76]), working in isolation wards (OR=1.98, 95% CI [1.38,2.84]), and insufficient personal protective equipment (OR=1.49, 95% CI [1.33,1.67]) were associated with increased risk of depression. Instead, HCWs with a positive professional prospect (OR=0.34, 95% CI [0.24,0.49]) were less likely to be depressed. This meta-analysis provides up-to-date evidence on the factors linked to depression among HCWs during the COVID-19 pandemic. Given the persistent threats posed by COVID-19, early screening is crucial for the intervention and prevention of depression in HCWs.
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Affiliation(s)
- Haoyu Tian
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tianci Qiao
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Teng
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chen Kang
- Second Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jia Ke
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lili Shan
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengting Li
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chun Shen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Yan Han
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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18
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Wang Y, Kong X, Li F, Zhao H. Understanding professional development challenges of Chinese public health professionals: association and prediction analyses with data validity screening. Front Public Health 2023; 11:1250606. [PMID: 37719725 PMCID: PMC10501391 DOI: 10.3389/fpubh.2023.1250606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Background Little is known about the public health professionals engaged in educating and training new or future researchers in public health. Research in this direction identifies their issues, concerns, challenges, and needs. This study focused on the professional development challenges of Chinese public health professionals. Methods Snowball sampling was utilized. A total of 265 public health professionals participated. An instrument of 6 dimensions (burnout, sleep issue, mood issue, friends' support, exercise, and challenges) was developed, revised, and administered online. Two different approaches, the conventional and data screening approaches, were applied. The former started with item quality analyses, whereas the latter began with data quality checks. The chi-square tests of associations and logistic regressions were performed on both approaches. Results and discussion 19.25% of the participants were detected and deleted as careless respondents. Using both approaches, six professional development challenges except one ("Multidisciplinary learning") were significantly associated with various demographic features. The two approaches produced different models though they converged sometimes. The latent variables of exercise predicted professional development challenges more frequently than other latent variables. Regarding correct classification rates, results from the data screening approach were comparable to those from the conventional approach. Conclusion The latent variables of exercise, such as "Exercise effects," "Expectations of exercise," and "Belief in exercise," might be understudied. More research is necessary for professional development challenges using exercise as a multidimensional construct. Based on the current study, screening and deleting careless responses in survey research is necessary.
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Affiliation(s)
- Yingchen Wang
- Shandong Youth University of Political Science, Jinan, China
| | - Xiangran Kong
- Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fang Li
- Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hongyan Zhao
- Central Hospital Affiliated to Shandong First Medical University, Jinan, China
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19
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Del Bene VA, Geldmacher DS, Howard G, Brown C, Turnipseed E, Fry TC, Jones KA, Lazar RM. A rationale and framework for addressing physician cognitive impairment. Front Public Health 2023; 11:1245770. [PMID: 37693707 PMCID: PMC10485616 DOI: 10.3389/fpubh.2023.1245770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Medical error is costly, in terms of the health and wellbeing of the patient, their family, and the financial burden placed on the medical system. Reducing medical error is paramount to minimizing harm and improving outcomes. One potential source of medical error is physician cognitive impairment. Determining how to effectively assess and mange physician cognitive impairment is an important, albeit difficult problem to address. There have been calls and attempts to implement age-based cognitive screening, but this approach is not optimal. Instead, we propose that neuropsychological assessment is the gold standard for fitness-for-duty evaluations and that there is a need for the development of physician-based, normative data to improve these evaluations. Here, we outline the framework of our research protocol in a large, academic medical center, in partnership with hospital leadership and legal counsel, which can be modeled by other medical centers. With high rates of physician burnout and an aging physician population, the United States is facing a looming public health crisis that requires proactive management.
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Affiliation(s)
- Victor A. Del Bene
- Department of Neurology, Division of Neuropsychology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - David S. Geldmacher
- Department of Neurology, Division of Neuropsychology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - George Howard
- School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Catherine Brown
- Nursing Academic Affairs, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Elizabeth Turnipseed
- Department of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - T. Charles Fry
- University of Alabama Health Services Foundation, P.C., Birmingham, AL, United States
| | - Keith A. Jones
- University of Alabama Health Services Foundation, P.C., Birmingham, AL, United States
- Department of Anesthesiology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
- Department of Neurobiology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ronald M. Lazar
- Department of Neurology, Division of Neuropsychology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
- Department of Neurobiology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
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Rátiva Hernández NK, Carrero-Barragán TY, Ardila AF, Rodríguez-Salazar JD, Lozada-Martinez ID, Velez-Jaramillo E, Ortega Delgado DA, Fiorillo Moreno O, Navarro Quiroz E. Factors associated with suicide in physicians: a silent stigma and public health problem that has not been studied in depth. Front Psychiatry 2023; 14:1222972. [PMID: 37645639 PMCID: PMC10461439 DOI: 10.3389/fpsyt.2023.1222972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Suicide is a complex and multifaceted public health issue that affects individuals from all walks of life, including healthcare professionals such as physicians. According to research, physicians have a higher risk of suicide compared to the general population, with an estimated suicide rate that is two to three times greater than that of the general population. Suicide in physicians can have devastating consequences, not only for the individual but also for their patients and colleagues. The factors contributing to suicide in physicians are numerous and often interrelated. Physicians are exposed to numerous stressors in their daily lives, including long work hours, high workload, burnout, and exposure to traumatic events. These stressors can lead to mental health problems such as depression, anxiety, and substance use disorders, which in turn can increase the risk of suicide. In addition to work-related stressors, personal factors such as relationship problems, financial stress, and a history of mental health problems can also contribute to suicide risk in physicians. Stigma and shame around seeking help for mental health issues may also prevent physicians from seeking treatment, exacerbating the problem. Understanding the complex factors that contribute to suicide in physicians is crucial for developing effective prevention strategies. For this reason, it is necessary to know the behavior of this phenomenon and the factors associated with a higher risk of suicide in this population. However, taking into account that different regions of the world vary in socioeconomic, cultural, professional, occupational, and health attributes, it is to be expected that the behavior of these risk factors will also be heterogeneous. At present, it is presumed that there is a significant gap in the evidence, due to a predominance of evidence on this topic from high-income countries. Considering the importance of having a comprehensive understanding of the risk factors for suicide in the medical population and possible strategies to mitigate this condition, the aim of this review is to analyze the most recent evidence on these factors, and to assess the quality of the evidence and gaps that need to be studied further.
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Affiliation(s)
| | | | | | | | - Ivan David Lozada-Martinez
- Epidemiology Program, Department of Graduate Studies in Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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de Sá E Camargo ML, Torres RV, Cotta KCG, Ezequiel ODS, Lucchetti G, Lucchetti ALG. Mental health throughout the medical career: A comparison of depression, anxiety, and stress levels among medical students, residents, and physicians. Int J Soc Psychiatry 2023; 69:1260-1267. [PMID: 36825658 DOI: 10.1177/00207640231157258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Different stages of a physician's career may be associated with different types of mental health impairment. AIMS This study aimed to compare symptoms of anxiety, depression, and stress and their associated factors among medical students, medical residents, and physicians. METHODS A cross-sectional study was conducted. Data collection included sociodemographic data, religiosity (Duke University Religion Index), and mental health (21-item Depression, Anxiety and Stress Scale - DASS-21) data. The comparison between the groups was performed using ANOVA, and the associated factors were evaluated via linear regression models. RESULTS The sample consisted of 1,417 participants: 778 medical students, 190 medical residents, and 468 established physicians. Medical students had significantly higher depression, anxiety, and stress scores as compared to medical residents and established physicians. However, regarding DASS 21 scores, no significant differences were found between established physicians and medical residents. The factors associated with mental health in the different groups showed that being married and male were associated with better mental health among physicians and medical residents, while the factors of male gender, being in later years of the course, and lower religious attendance were associated with better mental health in students. CONCLUSION Medical students had worse mental health outcomes when compared to residents and established physicians. Interventions are needed to minimize suffering during medical education and career.
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Affiliation(s)
| | - Raquel Vieira Torres
- Department of Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
| | | | | | - Giancarlo Lucchetti
- Department of Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
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Terry DL, Safian G, Terry C, Vachharajani K. Bystander Responses to Bullying and Harassment in Medical Education. PRiMER 2023; 7:23. [PMID: 37791054 PMCID: PMC10544639 DOI: 10.22454/primer.2023.805720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background and Objectives Bullying and harassment in medical education are common. The aims of this study were (a) to describe how medical trainees respond to harassment or bullying in medical settings, and (b) to determine whether trainees respond differently based on the type of harassment. Methods Participants were medical students, residents, and fellows (N=80) recruited from a rural teaching hospital in Pennsylvania. We invited them to complete an electronic survey and react to four standardized situations that included common harassment types in graduate medical education. Results On average, 31.6% reported that they would consult with peer colleagues, 50.6% would provide direct support to the victim, 16.3% would approach the perpetrator or intervene directly, and 19.3% would file a formal report with a supervisor or human resources. Findings indicated that respondents as bystanders would intervene significantly more often when harassment was related to inappropriate racial or ethnic comments. Conclusions Given that a sizable portion of trainees would speak directly with a victim, training bystanders in strategies to address or mentor others on how to address harassment more effectively could be useful in graduate medical education. Future research might explore trainees' differential reactions to harassment types toward developing more comprehensive intervention programs in graduate and undergraduate medical education.
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Kleinhendler-Lustig D, Hamdan S, Mendlovic J, Gvion Y. Burnout, depression, and suicidal ideation among physicians before and during COVID-19 and the contribution of perfectionism to physicians' suicidal risk. Front Psychiatry 2023; 14:1211180. [PMID: 37520224 PMCID: PMC10374214 DOI: 10.3389/fpsyt.2023.1211180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives There is limited data regarding the prevalence of suicidal risk among physicians during COVID-19, and the risk factors relating to it. Dominant risk factors for suicide among physicians are depression and burnout. Maladaptive perfectionism may also serve as a profound risk factor for suicidality among physicians and may aggravate symptoms of distress under the challenges of COVID-19. This study aims to evaluate current suicidal risk, suicidal ideation, depression, and burnout before and during COVID-19 among physicians in Israel, and to identify the best sets of correlates between perfectionism and burnout, depression and suicidal ideation, during these time periods. Methods A sample of 246 Israeli physicians (160 before COVID-19 and 86 during COVID-19) completed online surveys assessing lifetime suicidal risk, suicidal ideation during the last year and current suicidal ideation, depression, burnout symptoms and maladaptive perfectionism. Results More than one-fifth of the sample (21.9%) reported high suicidal risk (Lifetime suicidal behaviors). More than one-fourth (27.2%) reported suicidal ideation during the last 12 months; and 13.4% reported suicidal ideation during the last 3 months. In addition, more than one-third (34.6%) exhibited moderate-severe levels of depressive symptoms and more than a half of the sample reported burnout symptoms. Maladaptive perfectionism was positively correlated with current suicidal ideation, burnout, and depression. Moderated serial mediation analysis demonstrated indirect effect of perfectionism on suicidal ideation by its impact on burnout and depression only during COVID-19. Before COVID-19, physicians were more likely to experience depressive symptoms. Conclusion Physicians in Israel are at increased risk for depression and suicidal ideation, regardless of the COVID-19 pandemic. Maladaptive perfectionism was found to be a risk factor for burnout, depression, and suicidal ideation. During the first waves of the pandemic, physicians were less likely to experience depressive symptoms. However, among physicians who were characterized with high maladaptive perfectionism, depression served as a significant risk factor for suicidal ideation during the pandemic, which places these individuals at increased risk for suicidality. These results highlight the importance of implementing intervention programs among physicians to reduce suicidal risk and to better identify rigid perfectionism and depressive symptoms.
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Affiliation(s)
| | - Sami Hamdan
- School of Behavioral Sciences, The Academic College of Tel-Jaffa (MTA), Tel-Jaffa, Israel
| | - Joseph Mendlovic
- Shaare Zedek Medical Center, Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
- Ministry of Health, Jerusalem, Israel
| | - Yari Gvion
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
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Rossi A, Heyman NB, Rossi MO, Wolf S, White T. Exploring the Association Between the Healthcare Design Elements and Physician Well-Being: A Scoping Review. HERD 2023; 16:362-378. [PMID: 36722306 DOI: 10.1177/19375867231151687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the association between elements of the built environment and physician well-being using a scoping review. BACKGROUND Physicians currently report low work satisfaction, high burnout and depression. The built environment has been shown to affect well-being in the general population, but its relationship to physician well-being is not well understood. Gaining a better understanding of this relationship will allow for better evidence-based design for physician well-being. METHODS A scoping review of the literature was conducted of Scopus and PubMed databases using key words for (1) environmental variables such as "environmental design"; (2) physician terms, such as "doctor"; and (3) outcome measures of well-being, such as "burnout." Studies were included if they had at least one measure of the built environment and one measure of physician well-being. Of 1,723 abstracts screened, 146 full-text articles were reviewed, leaving 16 articles to be included for data extraction. RESULTS Included studies were from all around the world, except for, notably, the United States. Robust interpretation of the data was challenging because of the lack of standardization in the assessment of environmental factors and physician well-being. Excessive noise was the variable most linked to well-being. Suitable surroundings, including lighting, furniture, and art, were also linked with satisfaction, but it was unclear whether there was an association with well-being. CONCLUSION Understanding how environmental factors affect physician well-being is paramount but considerably understudied. Standardization of research approach should be developed in order to produce more robust research to create evidence-based designs for physician well-being.
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Affiliation(s)
- Amerigo Rossi
- New York Institute of Technology, Old Westbury, NY, USA
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Petrie K, Sanatkar S, Shand F, Harvey SB. Common mental disorder and suicidality among doctors: differences by specialty. Occup Med (Lond) 2023; 73:249-256. [PMID: 37261470 DOI: 10.1093/occmed/kqad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Common mental disorders (CMDs) and suicidal ideation (SI) are prevalent among doctors, yet limited evidence exists investigating the relationship of specialty area to these outcomes. AIMS This study aimed to determine the prevalence of likely CMD and SI among doctors and to investigate whether likelihood of these outcomes varied by area of medical specialty. METHODS A secondary analysis of a representative national survey of 12,252 Australian doctors was conducted. Demographic and work-related variables, SI and CMD (GHQ-28), were assessed among doctors (n = 7037; 57%) working in a range of specialty areas. Logistic regression was used to examine the association between specialty and mental health outcomes in unadjusted and adjusted models. RESULTS Almost one-quarter of doctors (n = 1560; 23%) reported symptom levels indicating likely CMD whilst 9% (n = 667) reported SI in the last year. Doctors in surgery (adjusted odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.54-0.97, P = 0.03) were at significantly lower risk of CMD than General Practitioners (GPs), whilst doctors in anaesthetics (adjusted OR = 1.45; 95% CI 1.09-1.93, P = 0.01) and paediatrics (adjusted OR = 1.88; 95% CI 1.02-3.47, P = 0.04) were at significantly higher risk of experiencing SI compared to GPs after accounting for confounders. CONCLUSIONS Results demonstrated that doctors in Australia working in certain specialties, specifically anaesthetics and paediatrics, were at significantly greater risk of suicidal ideation compared to GPs after accounting for confounders. Interventions to address CMD and SI among doctors in all specialties remain urgently needed.
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Affiliation(s)
- K Petrie
- School of Psychiatry, University of New South Wales, Sydney, New South Wales 2033, Australia
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - S Sanatkar
- School of Psychiatry, University of New South Wales, Sydney, New South Wales 2033, Australia
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - F Shand
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
| | - S B Harvey
- Black Dog Institute, University of New South Wales, Randwick, New South Wales 2031, Australia
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Silva NM, da Nobrega Lucena Pinho R, Costa TF, Areal AFB, De Mattos Salles A, Ribeiro Alves Oliveira AP, Esselin Rassi CHR, Valero CEB, Gomes CM, da Silva DLM, de Oliveira FAR, Jochims I, Vaz Filho IHR, De Brito Seixas Neves J, de Brito Oliveira LA, Dantas MLN, Rosal MA, Soares MVA, Kurizky PS, Peterle VCU, Faro YF, Gomides APM, da Mota LMH, de Albuquerque CP, Simaan CK, Amado VM. High prevalence of mental disorder symptoms among medical and other health specialties residents during the COVID-19 pandemic. BMC Med Educ 2023; 23:361. [PMID: 37217908 DOI: 10.1186/s12909-023-04202-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/28/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND The COVID-19 pandemic put healthcare professionals, including residents (postgraduate trainees of health professions), under intense physical and psychological stress, hence at risk for mental disorders. We evaluated the prevalence of mental disorders among healthcare residents during the pandemic. METHODS From July to September 2020, residents in medicine and other healthcare specialties in Brazil were recruited. The participants completed electronic forms with validated questionnaires (DASS-21, PHQ-9, BRCS) to screen for depression, anxiety, and stress, and to evaluate resilience. Data on potential predisposing factors for mental disorders were also collected. Descriptive statistics, chi-squared, students t, correlation and logistic regression models were applied. The study received ethical approval, and all participants provided informed consent. RESULTS We included 1313 participants (51.3% medical; 48.7% nonmedical) from 135 Brazilian hospitals; mean (SD) age: 27.8 (4.4) years; 78.2% females; 59.3% white race. Of all participants, 51.3%, 53.4% and 52.6% presented symptoms consistent with depression, anxiety, and stress, respectively; 61.9% showed low resilience. Nonmedical residents exhibited higher anxiety compared to medical residents (DASS-21 anxiety score, mean difference: 2.26; 95% CI: 1.15-3.37; p < 0.001). In multivariate analyses, having any pre-existent, nonpsychiatric chronic disease was associated with higher prevalence of symptoms indicative of depression (odds ratio, OR: 2.05; 95% CI: 1.47-2.85, on DASS-21 | OR: 2.26; 95% CI: 1.59-3.20, on PHQ-9), anxiety (OR: 2.07; 95% CI: 1.51-2.83, on DASS-21), and stress (OR: 1.53; 95% CI: 1.12-2.09, on DASS-21); other predisposing factors were identified; by contrast, high resilience (BRCS score) was protective against symptoms of depression (OR 0.82; 95% CI: 0.79-0.85, on DASS-21 | OR 0.85; 95% CI: 0.82-0.88, on PHQ-9), anxiety (OR 0.90; 95% CI: 0.87-0.93, on DASS-21), and stress (OR 0.88; 95% CI: 0.85-0.91, on DASS-21); p < 0.05 for all outcomes. CONCLUSIONS We found a high prevalence of mental disorder symptoms among healthcare residents during COVID-19 pandemic in Brazil. Nonmedical residents exhibited higher levels of anxiety than medical ones. Some predisposing factors for depression, anxiety and stress among residents were identified.
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Affiliation(s)
- Nayane Miranda Silva
- Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil.
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil.
| | - Rebeca da Nobrega Lucena Pinho
- Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
| | - Thais Ferreira Costa
- State Health Department of the Federal District (SES DF), Central Administration: North Radio and TV Sector (SRTVN), 701 North, Postal Code 70.719-040, Brasília, Brazil
| | - Adriana Ferreira Barros Areal
- Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
- State Health Department of the Federal District (SES DF), Central Administration: North Radio and TV Sector (SRTVN), 701 North, Postal Code 70.719-040, Brasília, Brazil
| | - André De Mattos Salles
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
| | - Andrea Pedrosa Ribeiro Alves Oliveira
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
- University of Brasília (UnB) - Darcy Ribeiro University Campus - Asa Norte, 70.910-900, Brasília, DF, Brazil
| | - Carlos Henrique Reis Esselin Rassi
- University of Brasília (UnB) - Darcy Ribeiro University Campus - Asa Norte, 70.910-900, Brasília, DF, Brazil
- Sírio-Libanês Hospital, SGAS 614/615, Postal Code, Asa Sul, Brasília, 70200-730, Brazil
| | - Caroline Elizabeth Brero Valero
- Empresa Brasileira de Serviços Hospitalares (EBSERH), SCS Quadra 6 Block A, Postal Code, Asa Sul, Brasília, 70308-200, Brazil
| | - Ciro Martins Gomes
- Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
- Center for Tropical Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
| | | | | | - Isadora Jochims
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
| | - Ivan Henrique Ranulfo Vaz Filho
- Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
- University of Brasília (UnB) - Darcy Ribeiro University Campus - Asa Norte, 70.910-900, Brasília, DF, Brazil
| | - Juliana De Brito Seixas Neves
- Empresa Brasileira de Serviços Hospitalares (EBSERH), SCS Quadra 6 Block A, Postal Code, Asa Sul, Brasília, 70308-200, Brazil
| | - Lucas Alves de Brito Oliveira
- Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
| | - Maria Luisa Nogueira Dantas
- Empresa Brasileira de Serviços Hospitalares (EBSERH), SCS Quadra 6 Block A, Postal Code, Asa Sul, Brasília, 70308-200, Brazil
| | - Marta Alves Rosal
- Federal University of Piauí (UFPI), Minister Petrônio Portella University Campus, Postal Code, Ininga, 64049-550, Teresina, Brazil
| | - Mayra Veloso Ayrimoraes Soares
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
| | - Patrícia Shu Kurizky
- Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
| | - Viviane Cristina Uliana Peterle
- School of Health Sciences (ESCS), SMHN Conjunto A Block 01 Fepecs Building, Postal Code, Asa Norte, Brasília, 70710-907, Brazil
| | - Yasmin Furtado Faro
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
| | - Ana Paula Monteiro Gomides
- Brasília University Centre (Uniceub), 707/907 North, University Campus, Postal Code, Asa Norte, Brasília, 70790- 075, Brazil
| | - Licia Maria Henrique da Mota
- Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
| | - Cleandro Pires de Albuquerque
- Graduate Program in Medical Sciences, Faculty of Medicine, University of Brasília-UnB - Darcy Ribeiro University Campus - Asa Norte, Brasília, 910-900, DF, Brazil
- University Hospital of Brasília (HUB)-UnB, North Large Area Sector 605 - Asa Norte, Postal, Code, Brasília, 70840-901, DF, Brazil
| | - Cezar Kozak Simaan
- University of Brasília (UnB) - Darcy Ribeiro University Campus - Asa Norte, 70.910-900, Brasília, DF, Brazil
| | - Veronica Moreira Amado
- University of Brasília (UnB) - Darcy Ribeiro University Campus - Asa Norte, 70.910-900, Brasília, DF, Brazil
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Schimmels J, Groh C, Neft M, Wocial L, Young C, Davidson JE. American Academy of Nursing Expert Panel Consensus Statement on leveraging equity in policy to improve recognition and treatment of mental health, substance use disorders, and nurse suicide. Nurs Outlook 2023; 71:101970. [PMID: 37104889 PMCID: PMC10129051 DOI: 10.1016/j.outlook.2023.101970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 04/29/2023]
Abstract
Rates of nurse mental health and substance use disorders are high. Heightened by the COVID-19 pandemic, nurses are challenged to care for patients in ways that often jeopardize their own health and increase risks for their families. These trends exacerbate the epidemic of suicide in nursing underscored by several professional organization clarion calls to nurses' risk. Principles of health equity and trauma-informed care dictate urgent action. The purpose of this paper is to establish consensus among clinical and policy leaders from Expert Panels of the American Academy of Nursing about actions to address risks to mental health and factors contributing to nurse suicide. Recommendations for mitigating barriers drew from the CDC's 2022 Suicide Prevention Resource for Action strategies to guide the nursing community to inform policy, education, research, and clinical practice with the goals of greater health promotion, risk reduction, and sustainment of nurses' health and well-being are provided.
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Affiliation(s)
- JoEllen Schimmels
- Psychiatric Mental Health and Substance Use Expert Panel, Detroit, MI; Military and Veterans Health Expert Panel.
| | - Carla Groh
- Psychiatric Mental Health and Substance Use Expert Panel, Detroit, MI
| | - Michael Neft
- Psychiatric Mental Health and Substance Use Expert Panel, Detroit, MI
| | | | - Cara Young
- Psychiatric Mental Health and Substance Use Expert Panel, Detroit, MI
| | - Judy E Davidson
- Psychiatric Mental Health and Substance Use Expert Panel, Detroit, MI
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Medisauskaite A, Silkens MEWM, Rich A. A national longitudinal cohort study of factors contributing to UK medical students' mental ill-health symptoms. Gen Psychiatr 2023; 36:e101004. [PMID: 37304054 PMCID: PMC10254595 DOI: 10.1136/gpsych-2022-101004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/26/2023] [Indexed: 06/13/2023] Open
Abstract
Background The mental health of current medical students is predictive of their mental health as future doctors. The prevalence of anxiety, depression and burnout is high among medical students, but less is known about the occurrence of other mental ill-health symptoms, such as eating or personality disorders, and factors contributing to mental ill-health. Aims (1) To explore the prevalence of various mental ill-health symptoms in medical students and (2) to investigate what medical school factors and students' attitudes contribute to these mental ill-health symptoms. Methods Between November 2020 and May 2021, medical students from nine geographically spread medical schools in the UK participated by completing online questionnaires at two points in time, approximately 3 months apart. Results Of the 792 participants who filled in the questionnaire at baseline, over half experienced medium to high somatic symptoms (50.8%; 402) and drank alcohol at hazardous levels (62.4%; 494). Adjusted longitudinal data analysis of 407 students who completed the follow-up questionnaire demonstrated that less supportive educational climates that were more competitive and less centralised around the students, lower feelings of belongingness, greater stigma towards mental ill-health and lower intentions to seek help for mental ill-health, all contributed to students' mental ill-health symptoms. Conclusions Medical students experience a high prevalence of various mental ill-health symptoms. This study suggests that medical school factors and students' attitudes towards mental ill-health are significantly associated with students' mental health.
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Affiliation(s)
| | - Milou E W M Silkens
- Department of Health Services Research and Management, City University of London, London, UK
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Ye WQW, Rietze BA, McQueen S, Zhang K, Quilty LC, Wickens CM. Barriers to Accessing Mental Health Support Services in Undergraduate Medical Training: A Multicenter, Qualitative Study. Acad Med 2023; 98:491-496. [PMID: 36731096 DOI: 10.1097/acm.0000000000004966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Medical students report higher levels of burnout, anxiety, and depression compared with age-matched peers. These mental health challenges have been linked to reduced workplace productivity, empathy, and professionalism. Yet, students experiencing mental health issues often decide not to access mental health resources, citing limited time and concerns about confidentiality, stigma, and the cost of private therapy. This study aimed to provide a framework for understanding barriers medical students face regarding access to mental health resources. METHOD A constructivist grounded theory approach was employed, with 24 students from 6 medical schools in Ontario, Canada, participating in semistructured telephone interviews between May 2019 and February 2020. Participants were purposively sampled to capture a broad range of experiences, institutional contexts, and training levels. The authors then developed a framework to conceptualize the barriers that medical students face while accessing mental health resources. RESULTS The information obtained from the interviews revealed that the barriers were both overt and covert. Overt barriers were primarily administrative challenges, including restrictive leave of absence policies and sick days, mandatory reporting of extended sick leave time during the residency selection process, time-restricted academic and clinical schedules, and difficulty in accessing mental health supports during distance education. Covert barriers to accessing mental health supports included a medical culture not conducive to mental health, felt stigma (i.e., fear of stigma and being labeled as weak), and the hidden curriculum (i.e., the unofficial or unintended rules and mannerisms propagated within medical education systems). CONCLUSIONS Better understanding the overt and covert barriers that medical students to face while accessing mental health supports may help guide and inspire new advocacy efforts to enhance medical student well-being.
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Affiliation(s)
- Wen Qing Wendy Ye
- W.Q.W. Ye was resident physician, Michael G. DeGroote School of Medicine in McMaster University, Hamilton, Ontario, at the time of writing and is now resident physician, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bradley A Rietze
- B.A. Rietze is resident physician, Northern Ontario School of Medicine, Laurentian University, Faculty of Medicine, Sudbury, Ontario, Canada
| | - Sydney McQueen
- S. McQueen is an MD-PhD candidate, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kevin Zhang
- K. Zhang is a medical student, Michael G. DeGroote School of Medicine in McMaster University, Hamilton, Ontario, Canada
| | - Lena C Quilty
- L.C. Quilty is senior scientist, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and also has an affiliation with the Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Christine M Wickens
- C.M. Wickens is independent scientist, Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and also has affiliations with the Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
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Wu AW, Pham JC. How does it feel? The system-person paradox of medical error. Emerg Med J 2023; 40:318-319. [PMID: 37001977 DOI: 10.1136/emermed-2022-212999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Albert W Wu
- Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Julius Cuong Pham
- Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Emergency Medicine, Queen's Medical Center, Honolulu, Hawaii, USA
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Ku M, Ng I, Barson E, Fisher C, Segal R, Williams DL, Krieser RB, Mezzavia PM, Lee K, Chen Y, Sindoni T, Withiel T. The psychological impact on perioperative healthcare workers during Victoria's second COVID-19 wave: A prospective longitudinal thematic analysis. J Health Psychol 2023; 28:293-306. [PMID: 35837671 PMCID: PMC9982396 DOI: 10.1177/13591053221111021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has had a profound psychological impact on our frontline healthcare workers. Throughout the entire second COVID-19 wave at one major tertiary hospital in Melbourne Australia, longitudinal qualitative data between perioperative staff members, and analyses of intrapersonal changes were reported. Inductive analysis of three open-ended questions generated four major themes: Organisational Response to the Pandemic, Psychological Impact, Changes in Feelings of Support Over Time and Suggestions for Changes. Understanding the challenges, perception and suggestions from this longitudinal study allows us to provide a range of support services and interventions to minimise the long-term negative psychological impact and be better prepared should another similar situation arises again.
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Affiliation(s)
| | - Irene Ng
- The University of Melbourne,
Australia
- Royal Melbourne Hospital,
Australia
| | | | | | - Reny Segal
- The University of Melbourne,
Australia
- Royal Melbourne Hospital,
Australia
| | | | | | | | - Keat Lee
- The University of Melbourne,
Australia
- Royal Melbourne Hospital,
Australia
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Banstola A, Pokhrel S, Hayhoe B, Nicholls D, Harris M, Anokye N. Economic evaluations of interventional opportunities for the management of mental-physical multimorbidity: a systematic review. BMJ Open 2023; 13:e069270. [PMID: 36854591 PMCID: PMC9980364 DOI: 10.1136/bmjopen-2022-069270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES Economic evaluations of interventions for people with mental-physical multimorbidity, including a depressive disorder, are sparse. This study examines whether such interventions in adults are cost-effective. DESIGN A systematic review. DATA SOURCES MEDLINE, CINAHL Plus, PsycINFO, Cochrane CENTRAL, Scopus, Web of Science and NHS EED databases were searched until 5 March 2022. ELIGIBILITY CRITERIA We included studies involving people aged ≥18 with two or more chronic conditions (one being a depressive disorder). Economic evaluation studies that compared costs and outcomes of interventions were included, and those that assessed only costs or effects were excluded. DATA EXTRACTION AND SYNTHESIS Two authors independently assessed risk of bias in included studies using recommended checklists. A narrative analysis of the characteristics and results by type of intervention and levels of healthcare provision was conducted. RESULTS A total of 19 studies, all undertaken in high-income countries, met inclusion criteria. Four intervention types were reported: collaborative care, self-management, telephone-based and antidepressant treatment. Most (14 of 19) interventions were implemented at the organisational level and were potentially cost-effective, particularly, the collaborative care for people with depressive disorder and diabetes, comorbid major depression and cancer and depression and multiple long-term conditions. Cost-effectiveness ranged from £206 per quality-adjusted life year (QALY) for collaborative care programmes for older adults with diabetes and depression at primary care clinics (USA) to £79 723 per QALY for combining collaborative care with improved opportunistic screening for adults with depressive disorder and diabetes (England). Conclusions on cost-effectiveness were constrained by methodological aspects of the included studies: choice of perspectives, time horizon and costing methods. CONCLUSIONS Economic evaluations of interventions to manage multimorbidity with a depressive disorder are non-existent in low-income and middle-income countries. The design and reporting of future economic evaluations must improve to provide robust conclusions. PROSPERO REGISTRATION NUMBER CRD42022302036.
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Affiliation(s)
- Amrit Banstola
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Subhash Pokhrel
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Benedict Hayhoe
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
| | - Dasha Nicholls
- Department of Brain Sciences, Imperial College London Faculty of Medicine, London, UK
| | - Matthew Harris
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
| | - Nana Anokye
- Department of Health Sciences, Brunel University London, Uxbridge, UK
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33
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Pergol-Metko P, Staniszewska A, Metko S, Sienkiewicz Z, Czyzewski L. Compassion Fatigue and Perceived Social Support among Polish Nurses. Healthcare (Basel) 2023; 11:healthcare11050706. [PMID: 36900712 PMCID: PMC10001227 DOI: 10.3390/healthcare11050706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Social support has a vital role in preventing traumatic stress in nurses. Nurses are regularly exposed to contact with violence, suffering, and death. The situation worsened during the pandemic because they were also faced with the possibility of infection SARS-CoV-2 and death from COVID-19. Many nurses are faced with increased pressure, stress, and other adverse effects on their mental health. The study aimed to measure the relationship between compassion fatigue and perceived social support in polish nurses. METHODS The study was conducted on 862 professionally active nurses in Poland using the CAWI method (Computer-Assisted Web Interview). The professional Quality of Life scale (ProQOL) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. StatSoft, Inc. (2014) was used for data analysis. For comparisons between the groups: Mann-Whitney U test, ANOVA Kruskal-Wallis test, and multiple comparisons (post-hoc). The relationships between variables were tested using Spearman's rho, Tau Kendall, and the chi-square test. RESULTS The research showed the presence of compassion satisfaction, compassion fatigue, and burnout in the group of Polish hospital nurses. A higher level of perceived social support was associated with lower compassion fatigue (r = -0.35; p < 0.001). A higher level of social support was associated with higher job satisfaction (r = 0.40; p < 0.001). The study also found that a higher level of social support was associated with a lower risk of burnout (r = -0.41; p < 0.001). CONCLUSIONS Preventing compassion fatigue and burnout should be a priority for healthcare managers. Notably, an essential predictor of compassion fatigue is that Polish nurses often work overtime. It is necessary to pay more attention to the crucial role of social support in preventing compassion fatigue and burnout.
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Affiliation(s)
- Paulina Pergol-Metko
- Department of Development of Nursing and Social & Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
- Correspondence:
| | - Anna Staniszewska
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | - Zofia Sienkiewicz
- Department of Development of Nursing and Social & Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Lukasz Czyzewski
- Department of Geriatric Nursing, Medical University of Warsaw, 02-091 Warsaw, Poland
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Dresbach T, Müller A, Trepels-Kottek S, Soff J, Hoffmann J, Scholten N. Die Neonatologie/Pädiatrische Intensivmedizin – ein attraktiver Arbeitsplatz? Monatsschr Kinderheilkd 2023. [DOI: 10.1007/s00112-023-01717-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Zusammenfassung
Hintergrund
Die Arbeitszufriedenheit wie auch das Wohlbefinden der ärztlichen und pflegerischen Mitarbeiter*innen sind zum einen relevant zur Mitarbeiter*innenbindung, aber auch zur Aufrechterhaltung einer qualitativ hochwertigen Patient*innenversorgung. Aufgrund des Personalmangels in der Neonatologie ist es wichtig, mehr über den aktuellen Stand der Arbeitsplatzzufriedenheit, der Work-Life Balance wie auch der Wechselabsichten zu erfahren.
Methode
Hierzu sind insgesamt 389 Ärzt*innen und Pflegekräfte befragt worden.
Ergebnisse
Insgesamt arbeiten 74 % der Ärzt*innen in Vollzeit (≥ 38 h/Woche) (Ärzte: 80 %, Ärztinnen: 69 %), wobei dies jedoch nur von 49 % der befragten Ärzt*innen (Ärzte: 57 %, Ärztinnen: 41 %) gewünscht ist. Mit 56 % an Ärzt*innen mit einem klinisch auffälligen WHO-5-Wohlbefindens Index zeigt sich auch hier Handlungsbedarf. Circa 44 % der befragten Ärzt*innen unter 60 Jahren planen, in den nächsten 5 Jahren ihren Arbeitgeber zu wechseln. Dies steht im signifikanten Zusammenhang zu Burn-out und Work-Life-Balance-Konflikten.
Diskussion
Insgesamt zeigen sich große Herausforderungen in der Vereinbarkeit von Arbeit und Familie und hierdurch der vermehrte Wunsch nach Teilzeit.
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35
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Affiliation(s)
- Ahmad Z Al Meslamani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates.,College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
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Bouaddi O, Abdallahi NM, Fadel Abdi CM, Hassouni K, Jallal M, Benjelloun R, Belrhiti Z, Nejjari C, Khalis M. Anxiety, Stress, and Depression Among Healthcare Professionals During the COVID-19 Pandemic: A Cross-Sectional Study in Morocco. Inquiry 2023; 60:469580221147377. [PMID: 36708313 PMCID: PMC9892525 DOI: 10.1177/00469580221147377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The COVID-19 pandemic has caused an enormous psychological impact worldwide. This study aimed to assess anxiety, depression, stress, and compensatory behaviors among Moroccan healthcare workers (HCWs) during COVID-19. This descriptive cross-sectional study was conducted using a snowball sampling strategy. This descriptive cross-sectional study was conducted using a snowball sampling strategy. Online surveys were sent to groups of HCWs working in Casablanca and Fez cities. Post-traumatic stress disorder (PTSD) was measured using the Impact of Event Scale revised (IES-R) scale, and the DASS-21 was used to measure anxiety, depression, and stress among participants. Compensatory behaviors used by HCWs to manage these symptoms were also investigated. The majority of participants (72.5%) experienced moderate to severe distress during the COVID-19 pandemic. The majority of participants (53.1%) reported symptoms of mild to extremely severe depression. Overall, nurses, female, and frontline HCWs experienced more stress, anxiety, and depression (P < .001). Leisure activities (29%), sport (19%), and drinking tea/coffee (19%) were the most common compensatory behaviors. Our findings suggest that psychological support and interventions targeting high-risk HCWs with heavy psychological distress are needed. It is of paramount importance to improve the psychological endurance and safeguard the mental and physical well-being of HCWs, who find themselves on the frontline of health and humanitarian crises, when they are needed the most.
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Affiliation(s)
- Oumnia Bouaddi
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco,Knowledge for Health Policies Center, Casablanca, Morocco,Mohammed VI Center for Research and Innovation,Oumnia Bouaddi, Mohammed VI University of Health Sciences, Avenue Mohamed Taieb Naciri, Casablanca 82 403, Morocco.
| | | | | | - Kenza Hassouni
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Manar Jallal
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Roukaya Benjelloun
- Psychiatry Department, Cheikh Khalifa International University Hospital, Mohammed VӀ University of Health Sciences, Casablanca, Morocco
| | - Zakaria Belrhiti
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco,Knowledge for Health Policies Center, Casablanca, Morocco
| | - Chakib Nejjari
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Mohamed Khalis
- International School of Public Health, Mohammed VӀ University of Health Sciences (UM6SS), Casablanca, Morocco,Knowledge for Health Policies Center, Casablanca, Morocco,Mohammed VI Center for Research and Innovation,Higher Institute of Nursing Professions and Health Technology, Rabat, Morocco
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37
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Song C, Du XT, Hong YX, Mao JH, Zhang W. Association between social supports and negative emotions among pediatric residents in China: The chain-mediating role of psychological resilience and burnout. Front Public Health 2023; 10:962259. [PMID: 36755738 PMCID: PMC9899841 DOI: 10.3389/fpubh.2022.962259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/27/2022] [Indexed: 01/24/2023] Open
Abstract
Background Chinese pediatricians are facing challenges, and there is a need to examine the issue of negative emotions, namely, stress, anxiety and depression, among front-line pediatric residents in clinical settings. Understanding the current situation and influencing factors of negative emotions among pediatric residents in China and exploring the formation mechanism can lay a foundation for psychological interventions. Methods A total of 138 pediatric residents in the Children's Hospital, Zhejiang University School of Medicine, China, were surveyed using the Depression Anxiety Stress Scale-21 (DASS-21), Social Support Rating Scale (SSRS), Connor-Davidson Resilience Scale (CD-RISC), and Maslach Burnout Inventory-General Survey (MBI-GS). Results (1) The incidence of abnormal stress, anxiety, and depression among pediatric residents was 18.8%, 47.8%, and 47.8% respectively. (2) Negative emotions were significantly negatively correlated with social supports and psychological resilience, and positively correlated with burnout. (3) The chain-mediating effect of resilience and burnout between social supports and negative emotions was significant. Conclusion Psychological resilience and burnout played a chain-mediating role between social supports and negative emotions. Measures should be taken to improve the mental health of Chinese pediatric residents.
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Affiliation(s)
- Chao Song
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
| | - Xiao-Tian Du
- School of Public Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yun-Xia Hong
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China,*Correspondence: Yun-Xia Hong ✉
| | - Jian-Hua Mao
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China,Jian-Hua Mao ✉
| | - Wen Zhang
- Department of Philosophy, Beijing Normal University, Beijing, China
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Wang J, Mu K, Gong Y, Wu J, Chen Z, Jiang N, Zhang G, Lv C, Yin X. Occurrence of self-perceived medical errors and its related influencing factors among emergency department nurses. J Clin Nurs 2023; 32:106-114. [PMID: 35037324 DOI: 10.1111/jocn.16200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/12/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To determine the prevalence and the associated factors of self-perceived medical errors among Chinese emergency department nurses. BACKGROUND The emergency department is a place with a high incidence of medical errors. Studies about the occurrence and related influencing factors of medical errors among emergency nurses in China are very insufficient. DESIGN A nationwide cross-sectional study. METHODS A nationwide cross-sectional study was conducted from July 2018-August 2018. A total of 17,582 emergency department nurses from 31 provinces across China were eventually included in the analysis. Logistic regression is applied to examine the association of the independent variables with the perceived medical errors. The reporting of this study was compliant with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. RESULTS Of 17,582 participating nurses, 4445 (25.28%) reported self-perceived medical errors in the past 3 months. Nurses who were serving as nurses-in-charge; who reported fair or bad physical health; who reported staff shortage; who were exposed to more verbal abuse at work; who experienced effort-reward imbalance; who reported more over-commitment; or who had depressive symptoms were more likely to report medical errors. Older age and female gender were protective factors. CONCLUSIONS In this study, a quarter of the emergency nurses reported that they had made medical errors in the past 3 months. Self-perceived medical errors are associated with multiple domains of work-related factors and personal distress. Feasible measures should be taken to reduce nurses' workload, improve their working environment, monitor and minimise the occurrence of medical errors among emergency department nurses. RELEVANCE TO CLINICAL PRACTICE Emergency nurses, who are the most frequently in contact with patients, play an important role in identifying risk factors and preventing medical errors. Identifying risk factors that may lead to medical errors in the medical environment from both internal and external aspects will help nursing practitioners, hospital administrators and policy makers to take timely preventive measures to reduce the occurrence of medical errors and reduce harm to patients.
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Affiliation(s)
- Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Teβchnology, Wuhan, China
| | - Ketao Mu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Teβchnology, Wuhan, China
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Teβchnology, Wuhan, China
| | - Zhenyuan Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Teβchnology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Teβchnology, Wuhan, China
| | - Guopeng Zhang
- Department of Nuclear medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanzhu Lv
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China.,Department of Emergency Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.,Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Teβchnology, Wuhan, China
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ZHANG L, BAO Y, LI G, TAO S, LIU M. Prevalence and risk factors of cardiovascular diseases and psychological distress among female scientists and technicians. J Zhejiang Univ Sci B 2022; 23:1057-1064. [PMID: 36518057 PMCID: PMC9758715 DOI: 10.1631/jzus.b2200162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to explore the prevalence and risk factors of cardiovascular disease (CVD) and psychological distress among female scientists and technicians in China. Accordingly, we included scientists and technicians from representative research institutions, medical institutions, colleges, universities, and businesses in China, and the data were collected from July 1, 2019 to March 31, 2021 via online questionnaires. The parameters evaluated in this study included age, sex, marital status, educational background, monthly income, sleep hours, sleep problems, smoking, alcohol consumption, work-related stress, work burnout, cardiovascular symptoms, CVD, family history, and depressive and anxiety symptoms. A total of 14 530 scientists and technicians were included, comprising 7144 men and 7386 women. We found 34.9% men and 16.6% women with CVD, 35.1% men and 21.4% women with depressive symptoms, 28.7% men and 13.8% women with anxiety symptoms, and 22.0% men and 9.5% women with CVD combined with depressive or anxiety symptoms. This study focused on the details of women. Younger women (age≤35 years) had the highest prevalence of depressive symptoms (24.9%), anxiety symptoms (16.2%), and comorbidity (11.2%). It was established that, despite traditional risk factors, unmanageable work burnout, depressive symptoms, and anxiety symptoms were associated with a higher risk of CVD in women; insomnia, overwhelming work stress, unmanageable work burnout, and CVD were linked to a higher risk of depressive symptoms and anxiety; insomnia, overwhelming work stress, and unmanageable work burnout were related to CVD combined with depressive or anxiety symptoms. A bidirectional relationship was noted between CVD and depression or anxiety in female scientists and technicians, and insomnia and overwhelming work stress were positively associated with comorbidity. It is suggested that effective measures should be taken to protect female scientists and technicians from CVD and psychological distress.
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Affiliation(s)
- Lijun ZHANG
- Department of Psycho-Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China
| | - Yanping BAO
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing100191, China,School of Public Health, Peking University, Beijing100191, China
| | - Guo LI
- Department of Psycho-Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China
| | - Shuhui TAO
- Department of Psycho-Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China,Henan Medical School, Henan University, Kaifeng475001, China
| | - Meiyan LIU
- Department of Psycho-Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China,Meiyan LIU,
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40
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Qiu L, Feng Y, Luo J, Zhang Y, Yang Q. Predictors of personal depression stigma in medical students in China: differences in male and female groups. Med Educ Online 2022; 27:2093427. [PMID: 35747998 PMCID: PMC9245981 DOI: 10.1080/10872981.2022.2093427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Depression is common worldwide, and stigmatizing attitudes toward depression have proved to be one of the major barriers to seeking professional help. The purpose of this study was to evaluate the level of personal depression stigma and identify its predictive factors among medical students in Hainan, China, as well as explore the gender difference. A total of 2,186 medical students were recruited using stratified random cluster sampling and interviewed by structured anonymous questionnaires. Personal stigma was measured by the standardized Depression Stigma Scale (DSS). Multivariate linear regression models were used to identify predictors of stigma, and the interactions between gender and each predictor were included to test its gender difference. The mean score on DSS Scale was 13.71 ± 5.35, with males significantly higher than females (14.85 vs 12.99, P < 0.0001). Compared to females, males were more likely to agree with 'I would not vote for a class cadre if I knew they had been depressed' and 'I would not make friends with him if I knew he had been depressed'. Multivariate linear regression analysis revealed that males' personal stigma was predicted by being only child (ß = 1.01, P = 0.0083), moderate-to-severe depression (ß = 1.12, P = 0.0302), and lower self-rated academic core competitiveness (Competitive: ß = 1.29, P = 0.0088, Not at all/Somewhat competitive: ß = 1.04, P = 0.0381), while females' personal stigma was only associated with moderate-to-severe depression (ß = 1.75, P < 0.0001). Significant interactions were found between gender and self-rated academic core competitiveness. Stigmatizing attitudes toward depression were prevalent among Chinese medical students, especially male students. Gender differences were found in the predictors of stigma. Effective measures must be taken to reduce the stigma of mental health among Chinese medical students.
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Affiliation(s)
- Lei Qiu
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Yawen Feng
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Jiaxin Luo
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Yinuo Zhang
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Qin Yang
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, P. R. China
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Guessoum SB, Marvaldi M, Thomas I, Lachal J, Carretier E, Moro MR, Benoit L. The experience of anaesthesiology care providers in temporary intensive care units during the COVID-19 pandemic in France: a qualitative study. Anaesth Crit Care Pain Med 2022; 41:101061. [PMID: 35472584 DOI: 10.1016/j.accpm.2022.101061] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/06/2022] [Accepted: 02/21/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, care providers (CPs) worldwide grappled with the extraordinary number of severely ill patients with high fatality rates. The objective of this study is to explore the experience of anaesthesiology CPs in temporary intensive care units during the COVID-19 pandemic's first wave. METHODS CPs were interviewed at a university hospital in Paris, France. We conducted a qualitative study using interpretative phenomenological analysis. RESULTS Fifteen participants were included (five nurses, three nurse managers, and seven physicians). The analysis uncovered four themes: 1. Overworked care providers in an intensive care unit under pressure; 2. The disrupted relationship among patients, their families, and end-of-life care; 3. Short-term coping strategies; 4. A long-term transformative experience for care providers. DISCUSSION The COVID-19 pandemic has drained CPs physically and emotionally. Infection control protocols, lack of knowledge about this new disease, the establishment of open-space care settings, and the disruption of relationships have posed ethical dilemmas, leading CPs to question the meaning of their profession, and their future professional involvement. CPs at both an individual and institutional level employed numerous coping strategies, relying on a strong team spirit and a reinforced sense of duty. Nevertheless, after the end of the first wave, participants described the long-lasting psychological impact of this experience and frustration at the lack of recognition from their institutions and from policymakers. This study can inform institutional interventions and public health policy to support CPs during and after such a crisis to ensure their well-being and high standards of care.
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Chen L, Zhao Z, Wang Z, Zhou Y, Zhou X, Pan H, Shen F, Zeng S, Shao X, Frank E, Sen S, Li W, Burmeister M. Prevalence and risk factors for depression among training physicians in China and the United States. Sci Rep 2022; 12:8170. [PMID: 35581251 DOI: 10.1038/s41598-022-12066-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/18/2022] [Indexed: 11/08/2022] Open
Abstract
During their first year of medical residency (internship), 35% of training physicians in the United States suffer at least one depression episode. We assessed whether there is a similar increase of depression among first year residents in China, and identified predictors of depression in the two systems. 1006 residents across three cohorts (2016-2017, 2017-2018 and 2018-2019) at Shanghai Jiao Tong University and Peking Union Medical College were assessed in parallel with three cohorts of 7028 residents at 100 + US institutions. The Patient Health Questionnaire-9 (PHQ-9) depressive symptoms were measured at baseline and quarterly. Demographic, personal and residency factors were assessed as potential predictors of PHQ-9 depression scores. Similar to training interns in the US, the proportion of participants in China who met depression criteria at least once during the first year of residency increased substantially, from 9.1 to 35.1%. History of depression and symptoms at baseline were common factors significantly associated with depression during residency. By contrast, neuroticism, early family environment, female gender and not being coupled were associated with depression risk only in the US, while young age was a predictor of depression only in China. Fear of workplace violence also was a predictor in China. Long duty hours and reduced sleep duration emerged as training predictors of depression in both countries. The magnitude of depression increase and work-related drivers of depression were similar between China and the US, suggesting a need for effective system reforms in both systems.
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Lopes MCC, Oliva CCC, Bezerra NMS, Silva MT, Galvão TF. Relationship between depressive symptoms, burnout, job satisfaction and patient safety culture among workers at a university hospital in the Brazilian Amazon region: cross-sectional study with structural equation modeling. SAO PAULO MED J 2022; 140:412-421. [PMID: 35508009 PMCID: PMC9671242 DOI: 10.1590/1516-3180.2021.0614.15092021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/15/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Workplaces can be sources of mental distress. In healthcare services, this can also affect patients. OBJECTIVE To assess the prevalence of and factors associated with depressive symptoms, burnout, job satisfaction and patient safety culture and the relationships between these constructs, among healthcare workers. DESIGN AND SETTING Cross-sectional study in a university hospital in Manaus, Brazil. METHODS Randomly selected workers were interviewed based on Brazilian-validated tools. We calculated the prevalence ratio (PR) and 95% confidence interval (CI) of depressive symptoms and burnout using Poisson regression with robust variance; and the β-coefficient of safety culture and job satisfaction using linear regression. Outcome relationships were assessed using partial least-squares structural equation modeling. RESULTS 300 professionals were included; 67.3% were women. The prevalence of depressive symptom was 19.0% (95% CI: 14.5; 23.5%) and burnout, 8.7% (95% CI: 5.2; 12.3%). Lack of work stability increased depression (PR = 1.88; 95% CI: 1.17; 3.01) and burnout (PR = 2.17; 95% CI: 1.03; 4.57); and reduced job satisfaction (β = -11.93; 95% CI: -18.79; -5.07). Depressive symptoms and burnout were positively correlated, as also were job satisfaction and safety culture (P < 0.001); job satisfaction was negatively correlated with burnout (P < 0.001) and depression (P = 0.035). CONCLUSION Impermanent employment contracts increased depression and burnout and reduced job satisfaction. Job satisfaction reduced poor mental health outcomes and increased safety culture. Job satisfaction and safety culture were directly proportional (one construct increased the other and vice versa), as also were depression and burnout. Better working conditions can provide a virtuous cycle of patient safety and occupational health.
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Affiliation(s)
- Marcélia Célia Couteiro Lopes
- MSc. Pharmacist, Postgraduate Pharmaceutical Sciences Program, Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.
| | - Carmen Conceição Carrilho Oliva
- MSc. Pharmacist, Postgraduate Pharmaceutical Sciences Program, Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.
| | - Nádia Maria Soares Bezerra
- MBA. Health Inspector, Department of Health Surveillance, Municipal Health Department of Manaus, Manaus (AM), Brazil.
| | - Marcus Tolentino Silva
- MSc, PhD. Professor, Postgraduate Pharmaceutical Sciences Program, Universidade de Sorocaba (UNISO), Sorocaba (SP), Brazil.
| | - Tais Freire Galvão
- MSc, PhD. Professor, School of Pharmaceutical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
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Chang Q, Su H, Xia Y, Gao S, Zhang M, Ma X, Liu Y, Zhao Y. Association Between Clinical Competencies and Mental Health Symptoms Among Frontline Medical Staff During the COVID-19 Outbreak: A Cross-Sectional Study. Front Psychiatry 2022; 13:760521. [PMID: 35558425 PMCID: PMC9086962 DOI: 10.3389/fpsyt.2022.760521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background In China, mental health of frontline medical staff might be influenced by clinicians' ability to handle the outbreak of coronavirus disease 2019 (COVID-19). Few studies to-date have addressed the association between clinicians' competencies and mental health in this context. This cross-sectional study was to examine the prevalence of mental health symptoms among frontline medical staff that fought against the COVID-19 outbreak, and explore the associations between their competencies, and separate and concurrent depressive and anxiety symptoms. Methods A total of 623 frontline medical staff was included in this study. Competencies, depressive symptoms, and anxiety symptoms were assessed using a self-reported short form of the Chinese clinical physicians' competency model, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaire, respectively. Logistic regression models were used to evaluate the associations between one SD increase in competency scores and the prevalence of mental health problems. Results The prevalence of depressive, anxiety, and comorbid depressive and anxiety symptoms was 40.93, 31.78, and 26.00%, respectively. Among the medical staff with higher total competency scores, the prevalence of depressive [odds ratios (ORs) = 0.67, 95% confidence intervals (CIs): 0.55-0.81], anxiety (OR = 0.68, 95% CI: 0.56-0.83), and comorbid anxiety and depressive symptoms (OR = 0.69, 95% CI: 0.55-0.83) was lower than among their lower-scoring counterparts. Subgroup analyses stratified by core competency scores revealed similar associations as the main analyses. Conclusion The present findings highlight the association between high core competency scores and lower prevalence of depressive, anxiety, and comorbid anxiety and depressive symptoms.
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Affiliation(s)
- Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Graduate Medical Education, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Han Su
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shanyan Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming Zhang
- Office of Medical Administration and Management, Health Commission of Liaoning Province, Shenyang, China
| | - Xiaoyu Ma
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yashu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
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Pereira-Lima K, Loureiro SR, Silveira ILM, Crippa JA, Hallak JEC, Zuardi AW, Osório FDL. Workplace Protections and Burnout Among Brazilian Frontline Health Care Professionals During the COVID-19 Pandemic. Front Psychol 2022; 13:880049. [PMID: 35707652 PMCID: PMC9191624 DOI: 10.3389/fpsyg.2022.880049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
Health care workers from low- and middle-income countries have been playing a critical role in overcoming the challenges related to the COVID-19 pandemic; yet little is known about the relationship between workplace protections and wellbeing of Brazilian health care workers during the pandemic. This study aimed to evaluate whether Brazilian health care workers were satisfied with their workplace measures to protect their physical and mental health during the pandemic, and to assess the associations of such levels of satisfaction with indicators of burnout. Licensed Brazilian health care professionals were recruited via popular media between 5/19/2020 and 8/23/2020 to complete an online survey including questions about their demographic/professional characteristics, satisfaction with their workplace protective measures during the pandemic, and validated questionnaires assessing neuroticism, resilient coping, and symptoms of burnout. Most participants reported being dissatisfied with their workplace measures to protect their physical (516, 56.3%) and mental health (756, 82.5%). In multivariable analysis adjusted for personal and environmental factors, dissatisfaction with workplace physical health protections was significantly associated with higher levels of emotional exhaustion (B = 1.08, 95% CI = 0.47–1.69) and depersonalization (B = 0.61, 95% CI = 0.10–1.12), and dissatisfaction with workplace mental health protections significantly associated with higher levels emotional exhaustion (B = 1.17, 95% CI = 0.40–1.95). Efforts to improve both physical and mental health protective measures are critical to guarantee that health care workers continue to provide care at their maximum capacity.
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Affiliation(s)
- Karina Pereira-Lima
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sonia Regina Loureiro
- Departamento de Neurociências e Ciências do Comportamento, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - José Alexandre Crippa
- Departamento de Neurociências e Ciências do Comportamento, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Antonio Waldo Zuardi
- Departamento de Neurociências e Ciências do Comportamento, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Flávia de Lima Osório
- Departamento de Neurociências e Ciências do Comportamento, Universidade de São Paulo, Ribeirão Preto, Brazil
- *Correspondence: Flávia de Lima Osório,
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Helm MF, Kimball AB, Butt M, Stuckey H, Costigan H, Shinkai K, Nagler AR. Challenges for dermatologists during the COVID-19 pandemic: A qualitative study. Int J Womens Dermatol 2022; 8:e013. [PMID: 35620026 PMCID: PMC9112396 DOI: 10.1097/jw9.0000000000000013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/16/2022] [Indexed: 11/25/2022] Open
Abstract
Burnout is increasing in all fields of medicine, including dermatology. The coronavirus disease 2019 (COVID-19) pandemic presented new and additional challenges for dermatologists. Objective Dermatologists of different ages, areas of expertise, and practice settings were convened in 5 focus group to describe the impact of the COVID-19 pandemic on their clinical practice, working environment, and personal lives. Methods Qualitative analysis of the discussions w\s performed on the result of the 5 focus groups of dermatologists (n = 22). Groups were prompted with questions relating to their jobs, personal lives, teledermatology, and pandemic. Responses were recorded, transcribed, deidentified, and coded for recurring themes. The focus groups occurred via a secure videoconferencing platform between December 2020 and January 2021. All participants were currently practicing dermatology in a variety of setting including academic institutions, private practices, and multiple practice types. General dermatologists, residents in training, dermatologic surgeons, dermatopathologists, and dermatologists with significant administrative or educational duties were included. Results We identified 4 main themes from the focus group discussions regarding dermatologist and physician wellbeing during the COVID-19 pandemic: (1) adjusting to new administrative, staffing, and educational demands; (2) integration of work as a dermatologist with family life; (3) new technologies such as teledermatology; and (4) adjusting to change with redefining personal and professional priorities. Limitations The small number of participants in our convenience cohort disproportionately represented academic dermatologists. Impacts of regional COVID-19 vaccination rates and ideological differences in different geographical locations were not assessed. All of our participants were located in the United States. Physicians severely impacted by health or financial concerns may not have been able to participate in our study. We did not have a comparison group and did not measure or assess burnout in individual participants. Conclusion During the COVID-19 pandemic, there were common changes and stressors that dermatologists experienced, which affected physician wellbeing. Identifying and addressing these changes could offer the opportunity to improve the wellbeing of dermatologists.
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Affiliation(s)
- Matthew F. Helm
- Department of Dermatology, Penn State Hershey, Hershey, Pennsylvania
| | - Alexa B. Kimball
- Department of Dermatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Melissa Butt
- Department of Dermatology, Penn State Hershey, Hershey, Pennsylvania
| | - Heather Stuckey
- Department of Internal Medicine, The Penn State Hershey, Hershey, Pennsylvania
| | - Heather Costigan
- Department of Internal Medicine, The Penn State Hershey, Hershey, Pennsylvania
| | - Kanade Shinkai
- Department of Dermatology, The University of California San Francisco, San Francisco, California
| | - Arielle R. Nagler
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
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Wei Z, Wang Y, Yang S, Sun L. Association Between Perceived Medical Errors and Suicidal Ideation Among Chinese Medical Staff: The Mediating Effect of Depressive Symptoms. Front Med (Lausanne) 2022; 9:807006. [PMID: 35223904 PMCID: PMC8866240 DOI: 10.3389/fmed.2022.807006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/10/2022] [Indexed: 12/18/2022] Open
Abstract
Both medical errors and suicidal behaviors are important problems for medical staff. Although the association between them was implied in previous studies, their association has not been built until now. In this study, the first aim was to build the association between perceived medical errors and suicidal ideation, and we also want to explore the mediating role of depression in the association between perceived medical errors and suicidal ideation among Chinese medical staff. In this study, we interviewed 3,338 medical staff in Chinese general hospitals. Questions about suicidal ideation (SI) and perceived medical errors were interviewed for medical staff. Depressive symptoms were evaluated by the Chinese version of Center for Epidemiologic Studies Depression Scale (CES-D). Social-demographic and occupation-related variables were also assessed in the data collection. This study found that the prevalence of suicidal ideation among medical staff was 9%. After the adjustment for controlling variables, suicidal ideation was significantly associated with a higher level of depression (OR = 1.10, p < 0.001) and perceived medical errors (OR = 2.41, p < 0.001). The other associated factors were female (OR = 2.21, p < 0.001), religious belief (OR = 2.66, p < 0.001), and weekly work hours (OR = 1.02 p < 0.001). The mediating effect of depressive symptoms on the association between perceived medical errors and suicidal ideation was also supported in this study, and it can explain the 38.73% of the total effects of the perceived medical errors on suicidal ideation. The medical staff, with perceived medical errors, were in higher risk of suicidal ideation, and depressive symptoms can partially mediate the association between perceived medical errors and suicidal ideation. For the medical staff who are experiencing medical errors, some scanning on their suicidal ideation and depressive symptoms are necessary to promote their mental health.
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Affiliation(s)
- Zhen Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yifan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shijun Yang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- *Correspondence: Long Sun
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Brady KJ, Barlam TF, Trockel MT, Ni P, Sheldrick RC, Schneider JI, Rowe SG, Kazis LE. Clinician Distress and Inappropriate Antibiotic Prescribing for Acute Respiratory Tract Infections: A Retrospective Cohort Study. Jt Comm J Qual Patient Saf 2022; 48:287-297. [DOI: 10.1016/j.jcjq.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
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Meeks LM, Cleary J, Horwitz A, Pereira-Lima K, Zhao Z, Fang Y, Sen S. Analysis of Depressive Symptoms and Perceived Impairment Among Physicians Across Intern Year. JAMA Netw Open 2022; 5:e2144919. [PMID: 35076705 PMCID: PMC8790665 DOI: 10.1001/jamanetworkopen.2021.44919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cohort study compares perceived impairment associated with depressive symptoms among physicians before intern year vs during intern year.
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Affiliation(s)
- Lisa M. Meeks
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor
- Center for a Diverse Healthcare Workforce, School of Medicine, University of California, Davis, Sacramento
| | - Jennifer Cleary
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor
- Department of Psychology, University of Michigan, Ann Arbor
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
| | - Adam Horwitz
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | | | - Zhuo Zhao
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
| | - Yu Fang
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
| | - Srijan Sen
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
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