1
|
Hansen G, Burton-MacLeod S, Schellenberg KL. ALS Health care provider wellness. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:299-307. [PMID: 38069599 DOI: 10.1080/21678421.2023.2291710] [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: 06/30/2023] [Accepted: 11/27/2023] [Indexed: 04/18/2024]
Abstract
BACKGROUND Interest in health care provider (HCP) wellness and burnout is increasing; however, minimal literature explores HCP wellness in the context of Amyotrophic Lateral Sclerosis (ALS) care. OBJECTIVES We sought to determine rates of burnout and resiliency, as well as challenges and rewards in the provision of ALS care. METHODS A survey link was sent to physicians at all Canadian ALS centers for distribution to ALS HCPs in their network. The survey included demographics questions, and validated measures for resiliency and burnout; the Brief Resilient Coping Scale (BRCS) and the Single Item Burnout Score (SIBS). Participants were asked to describe challenges and rewards of ALS care, impact of COVID-19 pandemic, and how their workplace could better support them. RESULTS There were 85 respondents across multiple disciplines. The rate of burnout was 47%. Burnout for female respondents was significantly higher (p = 0.007), but not for age, role, or years in ALS clinic. Most participants were medium resilient copers n = 48 (56.5%), but resiliency was not related to burnout. Challenges included feeling helpless while patients relentlessly progressed to death, and emotionally charged interactions. Participants found fulfillment in providing care, and through relationships with patients and colleagues. There was a strongly expressed desire for increased resources, team building/debriefing, and formal training in emotional exhaustion and burnout. CONCLUSIONS The high rate of burnout and challenges of ALS care highlight the need for additional resources, team-building, and formal education around wellness.
Collapse
Affiliation(s)
- Gregory Hansen
- Divison of Pediatric Critical Care, Jim Pattison Children's Hospital, Saskatoon Canada
| | - Sarah Burton-MacLeod
- Divison of Palliative Care Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Kerri Lynn Schellenberg
- Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, Canada
| |
Collapse
|
2
|
Kwa EK, Cheong SK, Ong LK, Lee PF. Development of audio-guided deep breathing and auditory Go/No-Go task on evaluating its impact on the wellness of young adults: a pilot study. BIOMED ENG-BIOMED TE 2024; 69:141-150. [PMID: 37856824 DOI: 10.1515/bmt-2023-0410] [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: 04/19/2023] [Accepted: 10/08/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES Numerous studies indicate that deep breathing (DB) enhances wellbeing. Multiple deep breathing methods exist, but few employ audio to reach similar results. This study developed audio-guided DB and evaluated its immediate impacts on healthy population via self-created auditory Go/No-Go task, tidal volume changes, and psychological measures. METHODS Audio-guided DB with natural sounds to guide the DB was developed. Meanwhile, audio-based Go/No-Go paradigm with Arduino was built to measure the attention level. Thirty-two healthy young adults (n=32) were recruited. Psychological questionnaires (Rosenberg's Self-Esteem Scale (RSES), Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), Perceived Stress Scale (PSS)), objective measurements with tidal volume and attention level with auditory Go/No-Go task were conducted before and after 5 min of DB. RESULTS Results showed a significant increment in tidal volume and task reaction time from baseline (p=0.003 and p=0.033, respectively). Significant correlations were acquired between (1) task accuracy with commission error (r=-0.905), (2) CAMS-R with task accuracy (r=-0.425), commission error (r=0.53), omission error (r=0.395) and PSS (r=-0.477), and (3) RSES with task reaction time (r=-0.47), task accuracy (r=-0.362), PSS (r=-0.552) and CAMS-R (r=0.591). CONCLUSIONS This pilot study suggests a link between it and young adults' wellbeing and proposes auditory Go/No-Go task for assessing attention across various groups while maintaining physical and mental wellness.
Collapse
Affiliation(s)
- Eng Keat Kwa
- Lee Kong Chian Faculty of Engineering & Science, University Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Soon Keng Cheong
- M. Kandiah Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Lin Kooi Ong
- School of Health and Medical Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - Poh Foong Lee
- Lee Kong Chian Faculty of Engineering & Science, University Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| |
Collapse
|
3
|
Acharibasam JB, Hurlbert M, Datta R, Wâsakâyâsiw Lewis K. Meanings of indigenous land-based healing and the implications for water governance. Explore (NY) 2024:S1550-8307(24)00060-0. [PMID: 38609742 DOI: 10.1016/j.explore.2024.04.002] [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: 12/06/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
The continuous process of settler colonialism in Canada has profoundly impacted Indigenous Peoples' relationship with the Land and water, which holds immense significance in their healing journey. Reconnecting with the land and water through culturally rooted practices has far-reaching implications for the health and well-being of Indigenous communities. Maintaining a strong bond with the land and water is integral to Indigenous healing traditions. To gain insights into this connection we used a relational theoretical framework and engaged with Ministikwan Lake Cree Nation, a remote Indigenous community. Our approach centred around community-based participatory research, utilizing methods like deep listening, cultural camps and story-sharing to collect wisdom from community members, knowledge keepers, and Elders. The research findings show understanding the connection between Land-based healing practices and Indigenous-led water governance is critical to solving the water crises within remote Indigenous communities. This knowledge is indispensable for reshaping current water governance systems and ensuring the well-being of Indigenous communities across Canada.
Collapse
Affiliation(s)
| | - Margot Hurlbert
- Johnson-Shoyama Graduate School of Public Policy, University of Regina, Canada
| | - Ranjan Datta
- Community Disaster Research at the Indigenous Studies, Department of Humanities, Mount Royal University, Canada
| | - Kevin Wâsakâyâsiw Lewis
- Translator and Transcriber at kâniyâsihk Culture Camps via kRDI, University of Saskatchewan, Canada
| |
Collapse
|
4
|
Duxbury MM, Sobczynski H, Flynn K, Rendahl A. A behavior screening questionnaire improves problem identification in veterinary primary care with implications for patient health. J Am Vet Med Assoc 2024; 262:1-9. [PMID: 38134451 DOI: 10.2460/javma.23.07.0405] [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: 07/26/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE To compare how often owners identified concerns about their pets' behavior during routine examinations in 2 test conditions (voluntarily or when completing a questionnaire), and to test the efficacy of a simple behavior screening questionnaire to be used by practicing veterinarians. ANIMALS Privately owned dogs and cats presenting for routine examinations to 1 of 2 primary care clinics. METHODS The study was conducted in 2 sequential phases. In Phase 1, veterinary staff recorded whether pet owners or veterinarians inquired about behavior during routine examinations. In Phase 2, a different set of pet owners completed a short behavioral screening questionnaire as they waited for the veterinarian. We compared the 2 phases for how often behavior concerns were identified, the types of concerns, the pets' ages, and the owners' levels of satisfaction and desire for help. RESULTS Dog and cat owners were more likely to identify behavior concerns when prompted than they were to volunteer this information, especially for older patients in which behavior changes may be the first sign of disease. Most owners were satisfied with their pets' behavior, though owners were more likely to be unsatisfied with certain identified concerns. Owners who were dissatisfied were much more likely to want help. CLINICAL RELEVANCE A behavior screening questionnaire enhances detection of behavior problems that may have medical implications and impact the security of the pet in its home. A behavior screening questionnaire can elevate standard of care by enabling veterinarians to quickly assess behavior during every examination.
Collapse
Affiliation(s)
| | | | - Kristi Flynn
- 2Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN
| | - Aaron Rendahl
- 3Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN
| |
Collapse
|
5
|
Babal JC, Lelkes E, Kloster H, Zwemer E, Lien ER, Sklansky D, Coller RJ, Moreno MA, Schultz R, Webber S. Pediatric Resident Well-being: A Group Concept Mapping Study. Acad Pediatr 2024; 24:535-543. [PMID: 38215904 DOI: 10.1016/j.acap.2024.01.004] [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: 06/09/2023] [Revised: 12/11/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVE Pediatric residency programs invest substantial resources in supporting resident well-being. However, no pediatric resident well-being conceptual model exists to guide interventions. This study aimed to understand how a diverse stakeholder sample conceptualized well-being. METHODS We used group concept mapping methodology. We sent a brainstorming survey to pediatric residents and program leaders at 24 US residencies with the prompt, "The experience of well-being for resident physicians includes…" Participants at 4 residencies sorted well-being ideas conceptually and rated idea importance. We performed multidimensional scaling and hierarchical cluster analysis to develop cluster maps. Using participant feedback and a consensus-driven process, we determined best cluster representation. We used pattern matching to compare domain ratings between subgroups. RESULTS In brainstorming, 136 residents and 22 program leaders from 22 residency programs generated 97 unique ideas. Ideas were sorted and rated by 33 residents, 14 program leaders. Eight domains aligning with 4 resident roles were identified. Domains were: 1) positive, safe, and diverse culture; 2) unity and connection; 3) professional fulfillment and mindset; 4) personal health and life satisfaction; 5) professional development and recognition; 6) schedule protections and downtime; 7) work systems and benefits; 8) proactive and compassionate leadership. Domains aligned with the following roles: 1) individual, 2) colleague, 3) employee, 4) emerging pediatrician. Residents placed higher value on schedule protections and downtime than program leaders, P < .05. CONCLUSIONS Pediatric resident well-being may be conceptualized as inter-related domains corresponding with various resident roles. Participants aligned on many well-being priorities but differed regarding work schedules.
Collapse
Affiliation(s)
- Jessica C Babal
- Department of Pediatrics (JC Babal, H Kloster, D Sklansky, RJ Coller, MA Moreno, and S Webber), University of Wisconsin School of Medicine and Public Health, Madison.
| | - Efrat Lelkes
- Department of Pediatrics (E Lelkes), University of California San Francisco.
| | - Heidi Kloster
- Department of Pediatrics (JC Babal, H Kloster, D Sklansky, RJ Coller, MA Moreno, and S Webber), University of Wisconsin School of Medicine and Public Health, Madison.
| | - Eric Zwemer
- Department of Pediatrics (E Zwemer), University of North Carolina, Chapel Hill.
| | | | - Daniel Sklansky
- Department of Pediatrics (JC Babal, H Kloster, D Sklansky, RJ Coller, MA Moreno, and S Webber), University of Wisconsin School of Medicine and Public Health, Madison.
| | - Ryan J Coller
- Department of Pediatrics (JC Babal, H Kloster, D Sklansky, RJ Coller, MA Moreno, and S Webber), University of Wisconsin School of Medicine and Public Health, Madison.
| | - Megan A Moreno
- Department of Pediatrics (JC Babal, H Kloster, D Sklansky, RJ Coller, MA Moreno, and S Webber), University of Wisconsin School of Medicine and Public Health, Madison.
| | - Roger Schultz
- Department of Neurobiology (R Schultz), University of Wisconsin, Madison.
| | - Sarah Webber
- Department of Pediatrics (JC Babal, H Kloster, D Sklansky, RJ Coller, MA Moreno, and S Webber), University of Wisconsin School of Medicine and Public Health, Madison.
| |
Collapse
|
6
|
Scott D, Bruinvels G, Norris D, Lovell R. The Dose-Response in Elite Soccer: Preliminary Insights From Menstrual-Cycle Tracking During the FIFA Women's World Cup 2019. Int J Sports Physiol Perform 2024; 19:331-339. [PMID: 38198788 DOI: 10.1123/ijspp.2022-0282] [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: 07/07/2022] [Revised: 10/27/2023] [Accepted: 11/26/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE This preliminary study examined the influence of estimated menstrual-cycle (MC) phase on responses to soccer matches and training sessions in preparation for and during the FIFA (Fédération internationale de football association) Women's World Cup 2019. METHODS Twenty outfield players representing a national team were tracked over a 45-day period. External (10-Hz global positioning system; total and distance covered at high-metabolic power [≥20 W·kg-1]) and internal load measures (minutes ≥80% heart-rate maximum, sessional ratings of perceived exertion) were collected during all training and matches, with single-item wellness measures (fatigue, soreness, sleep quality, and sleep duration) collected each morning prior to activity. MC phase was estimated individually via an algorithm, informed from pretournament survey responses and ongoing symptom reporting (FitrWoman). Model comparison statistics were used to determine the impact of estimated MC phase in nonhormonal contraceptive users (n = 16). RESULTS Sessional rating of perceived exertion responses to total distances ≥5 km were higher during the luteal phase (+0.6-1.0 au; P ≤ .0178) versus menstruation (phase 1), but no other observable dose-response trends were observed. Sleep, fatigue, and soreness ratings were not typically associated with MC phase, with the exception of exacerbated fatigue ratings in luteal versus follicular phase 48 hours postmatch (-0.73 au, P = .0275). CONCLUSIONS Preliminary findings suggest that estimated MC phase may contribute to the understanding of the dose-response to soccer training and matches.
Collapse
Affiliation(s)
- Dawn Scott
- Performance, Medical & Innovation Department, Washington Spirit Soccer Club, Washington, DC, USA
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | - Georgie Bruinvels
- Orreco Ltd, Galway, Ireland
- University College London, London, United Kingdom
- St Mary's University, London, United Kingdom
| | - Dean Norris
- School of Health Sciences, Western Sydney University, Penrith, Australia
| | - Ric Lovell
- School of Health Sciences, Western Sydney University, Penrith, Australia
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| |
Collapse
|
7
|
Savage NM, Santen SA, Rawls M, Marzano DA, Wong JH, Burrows HL, Hicks RA, Aboff BM, Hemphill RR. Understanding resident wellness: A path analysis of the clinical learning environment at three institutions. Med Teach 2024:1-7. [PMID: 38557254 DOI: 10.1080/0142159x.2024.2331038] [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: 09/02/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE The clinical learning environment (CLE) affects resident physician well-being. This study assessed how aspects of the learning environment affected the level of resident job stress and burnout. MATERIALS AND METHODS Three institutions surveyed residents assessing aspects of the CLE and well-being via anonymous survey in fall of 2020 during COVID. Psychological safety (PS) and perceived organizational support (POS) were used to capture the CLE, and the Mini-Z Scale was used to assess resident job stress and burnout. A total of 2,196 residents received a survey link; 889 responded (40% response rate). Path analysis explored both direct and indirect relationships between PS, POS, resident stress, and resident burnout. RESULTS Both POS and PS had significant negative relationships with experiencing a great deal of job stress; the relationship between PS and stress was noticeably stronger than POS and stress (POS: B= -0.12, p=.025; PS: B= -0.37, p<.001). The relationship between stress and residents' level of burnout was also significant (B = 0.38, p<.001). The overall model explained 25% of the variance in resident burnout. CONCLUSIONS Organizational support and psychological safety of the learning environment is associated with resident burnout. It is important for educational leaders to recognize and mitigate these factors.
Collapse
Affiliation(s)
- Nastassia M Savage
- FMP Consulting, Arlington, VA, USA
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Sally A Santen
- Dean's Office, Virginia Commonwealth University, Richmond, VA, USA
- Emergency Medicine and Medical Education, University of Cincinnati, Cincinnati, OH, USA
| | - Meagan Rawls
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Bon Secours Mercy Health, Richmond, VA, USA
| | - David A Marzano
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Jean H Wong
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Heather L Burrows
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Ralph A Hicks
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - Brian M Aboff
- Graduate Medical Education, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Robin R Hemphill
- Cincinnati Veterans Association Medical Center, Cincinnati, OH, USA
| |
Collapse
|
8
|
Dodelzon K, Milch HS, Mullen LA, Dialani V, Jacobs S, Parikh JR, Grimm LJ. Factors Contributing to Disproportionate Burnout in Women Breast Imaging Radiologists: A Review. J Breast Imaging 2024; 6:124-132. [PMID: 38330442 DOI: 10.1093/jbi/wbad104] [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: 07/20/2023] [Indexed: 02/10/2024]
Abstract
Physician burnout continues to increase in prevalence and disproportionately affects women physicians. Breast imaging is a woman-dominated subspeciality, and therefore, worsening burnout among women physicians may have significant repercussions on the future of the breast imaging profession. Systemic and organizational factors have been shown to be the greatest contributors to burnout beyond individual factors. Based on the Mayo Model, we review the evidence regarding the 7 major organizational contributors to physician burnout and their potential disproportionate impacts on women breast radiologists. The major organizational factors discussed are work-life integration, control and flexibility, workload and job demands, efficiency and resources, finding meaning in work, social support and community at work, and organizational culture and values. We also propose potential strategies for institutions and practices to mitigate burnout in women breast imaging radiologists. Many of these strategies could also benefit men breast imaging radiologists, who are at risk for burnout as well.
Collapse
Affiliation(s)
- Katerina Dodelzon
- Department of Radiology, Weill Cornell Medicine at NewYork-Presbyterian, New York, NY, USA
| | - Hannah S Milch
- Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Lisa A Mullen
- Division of Breast Imaging, The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Vandana Dialani
- Division of Breast Imaging, Department of Radiology, Beth Israel Lahey Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah Jacobs
- New Ulm Medical Center Radiology, Allina Health, New Ulm, MN, USA
| | - Jay R Parikh
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lars J Grimm
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
9
|
Hobgood CD, Jarman AF. Resilience Building Practices for Women Physicians. J Womens Health (Larchmt) 2024; 33:532-541. [PMID: 37843899 DOI: 10.1089/jwh.2022.0502] [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] [Indexed: 10/17/2023] Open
Abstract
Women now make up more than half of the physician workforce, but they are disproportionately plagued by burnout. Medicine is a fast-paced stressful field, the practice of which is associated with significant chronic stress due to systems issues, crowding, electronic medical records, and patient case mix. Hospitals and health care systems are responsible for mitigating system-based burnout-prone conditions, but often their best efforts fail. Physicians, particularly women, must confront their stressors and the daily burden of significant system strain when this occurs. Those who routinely exceed their cumulative stress threshold may experience burnout, career dissatisfaction, and second victim syndrome and, ultimately, may prematurely leave medicine. These conditions affect women in medicine more often than men and may also produce a higher incidence of health issues, including depression, substance use disorder, and suicide. The individual self-care required to maintain health and raise stress thresholds is not widely ingrained in provider practice patterns or behavior. However, the successful long-term practice of high-stress occupations, such as medicine, requires that physicians, especially women physicians, attend to their wellness. In this article, we address one aspect of health, resilience, and review six practices that can create additional stores of personal resilience when proactively integrated into a daily routine.
Collapse
Affiliation(s)
- Cherri D Hobgood
- Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Angela F Jarman
- Department of Emergency Medicine, University of California, Davis School of Medicine, California, USA
| |
Collapse
|
10
|
Chan CCK, Fok EHW, Lo YTR, Ng WY, Botelho MG. Well-being of undergraduate dental students: Questionnaire design, findings and future directions. Eur J Dent Educ 2024. [PMID: 38526000 DOI: 10.1111/eje.13003] [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: 07/21/2023] [Revised: 11/13/2023] [Accepted: 02/04/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION The recent pandemic has highlighted the importance of addressing well-being in the overall health of students. There is a need for support systems within dental schools to help students demonstrate resilience, adapt to learning environments and thrive in their professional careers. OBJECTIVES The main aim of the study was to evaluate Bachelor of Dental Surgery (BDS) students' understanding and experience of well-being. The objectives were to create a suitable survey to assess students' well-being, investigate the factors affecting dental students' well-being and develop a student well-being action plan based on the analysis of the survey. METHODS A literature review was conducted to identify and critically assess existing measures of well-being in dental students. Four domains of well-being (emotional, physical, social, intellectual) relevant to dental students were identified. Through a comprehensive iterative process, a two-part survey was developed and tested, which measured individual experiences of well-being across the four domains and collected feedback on proposed initiatives to support student well-being. The survey was disseminated to all 452 dental students from Years 1 through 6, of which 71% (321) responded. RESULTS The survey revealed low levels of overall well-being among the dental student population, which worsened with increasing years of clinical study. Fear of failing exams presented the biggest challenge with regard to emotional well-being, while sleep deprivation and occupational health hazards most affected the physical well-being domain. Intellectual well-being was compromised by insufficient free time to pursue extracurricular interests and concerns about achieving the required skills. Despite a majority experiencing positive relationships with their peers and tutors, less than a fifth agreed that the Faculty of Dentistry 'supported my well-being as a dental student'. CONCLUSION As the first investigation of the well-being of dental students in Hong Kong, the key stressors identified were examinations, long schedules and the physical burden of dental work, which are consistent with international literature. The findings reveal students' needs and preferences for well-being initiatives which will be optimized in the implementation of student-centred curricular activities.
Collapse
Affiliation(s)
- Charlotte Cheuk Kwan Chan
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Elise Hoi Wan Fok
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Yan Ting Rosealeen Lo
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Wing Yan Ng
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Michael George Botelho
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| |
Collapse
|
11
|
McMullen C, Kejner A, Nicolli E, Abouyared M, Coblens O, Fedder K, Thakkar P, Patel R. Parental leave and family building experiences among head and neck surgeons in the United States: Career impact and opportunities for improvement. Head Neck 2024. [PMID: 38511311 DOI: 10.1002/hed.27752] [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: 01/24/2024] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The availability of paid parental leave is an important factor for retention and wellness. The experiences of head and neck surgeons with parental leave have never been reported. METHODS A survey was electronically distributed to head and neck subspecialty surgeons in the United States. Responses were collected and analyzed. RESULTS Male surgeons had more children and took significantly less parental leave than women. Thirty percent of respondents reported that parental leave negatively impacted compensation, and 14% reported a delay in promotion due to leave, which impacted women more than men. The vast majority reported they are happy or neutral about covering those on leave. Most respondents utilized paid childcare, and approximately one quarter of respondents spending 11%-20% of their income on childcare. CONCLUSIONS This study illuminates the current disparities regarding parental leave-taking within the subspecialty of head and neck surgery in the United States. Women surgeons are more likely to be impacted professionally and financially.
Collapse
Affiliation(s)
- Caitlin McMullen
- Department of Head & Neck - Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Alexandra Kejner
- Department of Otorhinolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Elizabeth Nicolli
- Department of Otolaryngology - Head and Neck Surgery, University of Miami, Miami, Florida, USA
| | - Marianne Abouyared
- Department of Otolaryngology - Head and Neck Surgery, UC Davis, Sacramento, California, USA
| | - Orly Coblens
- Department of Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Katie Fedder
- Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Punam Thakkar
- Department of Otolaryngology - Head and Neck Surgery, George Washington University, Washington, DC, USA
| | - Rusha Patel
- Division of Otolaryngology - Head and Neck Surgery, University of Oklahoma, Oklahoma City, Oklahoma, USA
| |
Collapse
|
12
|
Cole D, Eneim AS, White CJ, Eddings CR, Beckett MQ, Clark V, Jeffery J, Wimalasena VK, Figueroa A, Rosado-Franco JJ, Alhariri R, Powell BH, Washington PW, Christensen LN, Wilson KL, Kavran JM. Deepening biomedical research training: Community-Building Wellness Workshops for Post-Baccalaureate Research Education Program (PREP) Trainees. bioRxiv 2024:2024.03.10.584300. [PMID: 38559081 PMCID: PMC10979910 DOI: 10.1101/2024.03.10.584300] [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] [Indexed: 04/04/2024]
Abstract
Problem All trainees, especially those from historically minoritized backgrounds, experience stresses that may reduce their continuation in science, technology, engineering, math, and medicine (STEMM) careers. The Johns Hopkins University School of Medicine is one of ~45 institutions with a National Institutes of Health funded Postbaccalaureate Research Education Program (PREP) that provides mentoring and a year of fulltime research to prepare students from historically excluded groups for graduate school. Having experienced the conflation of stresses during the COVID-19 pandemic and related shutdown, we realized our program lacked a component that explicitly helped PREP Scholars recognize and cope with non-academic stresses (financial, familial, social, mental) that might threaten their confidence and success as scientists and future in STEMM. Intervention We developed an early-intervention program to help Scholars develop life-long skills to become successful and resilient scientists. We developed a year-long series comprised of 9 workshops focused on community, introspection, financial fitness, emotional intelligence, mental health, and soft-skills. We recruited and compensated a cohort of PhD students and postdoctoral fellows to serve as Peer Mentors, to provide a community and the safest 'space' for Scholars to discuss personal concerns. Peer Mentors were responsible for developing and facilitating these Community-Building Wellness Workshops (CBWW). Context CBWW were created and exectued as part of the larger PREP program. Workshops included a PowerPoint presentation by Peer Mentors that featured several case studies that prompted discussion and provided time for small-group discussions between Scholars and Peer Mentors. We also included pre- and post-work for each workshop. These touch-points helped Scholars cultivate the habit of introspection. Impact The CBWW exceeded our goals. Both Peer Mentors and Scholars experienced strong mutual support, and Scholars developed life-long skills. Notably, several Scholars who had been experiencing financial, mental or mentor-related stress immediately brought this to the attention of program leadership, allowing early and successful intervention. At the completion of CBWW, PREP Scholars reported implementing many workshop skills into practice, were reshaping their criteria for choosing future mentors, and evaluating career decisions. Strikingly, Peer Mentors found they also benefitted from the program as well, suggesting a potential larger scope for the role of CBWW in academia. Lessons Learned Peer Mentors were essential in creating a safe supportive environment that facilitated discussions, self-reflection, and self-care. Providing fair compensation to Peer Mentors for their professional mentoring and teaching contributions was essential and contributed meaningfully to the positive energy and impact of this program.
Collapse
Affiliation(s)
- Dezmond Cole
- Department of Biological Chemistry, School of Medicine
| | - Andrew S. Eneim
- Department of Biophysics & Biophysical Chemistry, School of Medicine
| | - Cory J. White
- Department of Molecular and Comparative Pathobiology, School of Medicine
| | | | | | - Vincent Clark
- Chemistry-Biology Interface Program, Zanvyl Krieger School of Arts & Sciences
| | | | | | - Alexis Figueroa
- Division of Infectious Diseases, Department of Medicine, School of Medicine
| | | | | | - Bonita H. Powell
- Department of Biological Chemistry, School of Medicine
- Department of Molecular and Comparative Pathobiology, School of Medicine
| | | | | | | | - Jennifer M. Kavran
- Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health
| |
Collapse
|
13
|
Wilkie T, Jones RM, Ramshaw L, Glancy G, Groat L, Chatterjee S. Contributors to Physician Burnout and Well-Being in Forensic Psychiatrists in Canada. J Am Acad Psychiatry Law 2024; 52:41-50. [PMID: 38467442 DOI: 10.29158/jaapl.230078-23] [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] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The experience of burnout in forensic psychiatrists has not been well studied, with most studies focusing on the experiences of forensic nurses, the impact of vicarious trauma and compassion fatigue in forensic mental health professionals, and the risk of posttraumatic stress disorder related to workplace exposures. This study reports on a national survey (34% response rate) conducted with forensic psychiatrists across Canada to understand the rate of, and contributors to, burnout and professional fulfillment. Just over half of the physician respondents reported experiencing burnout, which is in line with other recent surveys in Canada that have indicated elevated levels of burnout since the onset of the pandemic. The highest rates were found among early-career psychiatrists and those whose values did not align with their workplace. Intellectual stimulation, the interface with the legal system, and flexibility in one's job were all strongly linked with professional fulfillment. The goal of this survey was not only to identify rates and variables affecting burnout and wellness in this population but also to expand the dialogue on potential interventions at institutional and systems levels that can reduce burnout, promote professional fulfillment, and enhance recruitment and retention in the field of forensic psychiatry.
Collapse
Affiliation(s)
- Treena Wilkie
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada.
| | - Roland M Jones
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Ramshaw
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| | - Graham Glancy
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Groat
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| | - Sumeeta Chatterjee
- Dr. Wilkie is Chief, Division of Forensic Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Jones is Medical Lead, Research and Fellowships (Forensic Division), Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Ramshaw is Forensic Psychiatry Staff Psychiatrist, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Associate Professor, University of Toronto, Toronto, Ontario, Canada. Dr. Glancy is Professor and Director, Division of Forensic Psychiatry, University of Toronto, Toronto, Ontario, Canada. Dr. Groat is Research Coordinator, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Director, Forensic Psychiatry Subspecialty Program, Assistant Professor, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
14
|
Castelletti C, Dolz Del Castellar B, Miret M, Mercier H, Lara E. Loneliness and Subjective Wellbeing During the Covid-19 Pandemic: A Systematic Review. J Psychol 2024:1-25. [PMID: 38466316 DOI: 10.1080/00223980.2024.2319172] [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: 02/11/2023] [Accepted: 02/11/2024] [Indexed: 03/12/2024] Open
Abstract
To prevent the transmission of COVID-19, unprecedented measures were implemented, such as community lockdowns. With limited social interactions, the problem of loneliness might have worsened. As loneliness is thought to have a detrimental effect on subjective wellbeing (SWB), the present systematic review aims to better investigate and summarize the existing evidence about the association of loneliness and SWB during the COVID-19 pandemic. A total of 18 articles were included. In all studies, independently of the component of wellbeing assessed or of the instrument used, a negative association between loneliness and SWB was found. The results show an increase in loneliness during times of restrictions on social contacts, with a subsequent association with lower SWB, and underscore the need for developing specific interventions to tackle loneliness and for promoting alternative forms of social interaction if further physical distancing measures are needed. However, the literature had several limitations, since most of the studies followed cross-sectional and descriptive methodologies.
Collapse
Affiliation(s)
- Chiara Castelletti
- Universidad Autónoma de Madrid
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa)
| | | | - Marta Miret
- Universidad Autónoma de Madrid
- Centro de Investigación Biomédica en Red de Salud Mental
| | | | - Elvira Lara
- Centro de Investigación Biomédica en Red de Salud Mental
- Universidad Complutense de Madrid
| |
Collapse
|
15
|
Bonnet JP. Content and Face Validation of the Lifestyle Medicine Assessment. Am J Lifestyle Med 2024; 18:252-259. [PMID: 38559789 PMCID: PMC10979726 DOI: 10.1177/15598276231214712] [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: 04/04/2024] Open
Abstract
Introduction: There are no validated global lifestyle medicine brief screening tools that measure health behaviors in all six lifestyle domains. The Lifestyle Medicine Assessment (LMA) tool was initially developed and revised based on feedback elicited from colleagues, experts, and patients. During the developmental process, every item underwent language changes. Three of the original 24 items were removed. However, there have not been any formal validation efforts. This study aims to formally evaluate the face and content validity of the LMA. Methods: A survey was emailed to 12 board-certified lifestyle medicine experts asking them to rank items in the LMA on a 1-4 scale for content relevance and clarity. Content and face validity were quantitatively determined using the item-level content validity index (I-CVI), scale-level content validity index (S-CVI), and item-level face validity index (I-FVI), scale-level face validity index (S-FVI), respectively. Literature accepted thresholds of I-CVI/I-FVI ≥.79 and S-CVI/S-FVI average ≥ .80 were used. Results: Eleven experts returned evaluations of the 21-item LMA. All 21 items had I-CVI for relevance ≥.91 and I-FVI ≥.81 with excellent kappa values. The S-CVI/I-FVI average for relevance and clarity were .99 and .95, respectively. Conclusion: The 21-item LMA is a brief global lifestyle medicine tool that has demonstrated excellent content and face validity.
Collapse
Affiliation(s)
- Jonathan P. Bonnet
- Palo Alto Veterans Affairs Health System, Palo Alto, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
16
|
Ruiz J, Kaminnik P, Kibble J, Kauffman C. Relationships between medical student wellness, self-efficacy, and academic performance during the "post-COVID" period. Adv Physiol Educ 2024; 48:137-146. [PMID: 38153844 DOI: 10.1152/advan.00190.2023] [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: 09/13/2023] [Revised: 12/05/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
This study was a part of a longitudinal study investigating the relationships between medical student wellness, self-efficacy, and performance. Eighty-two eligible students were asked to complete online surveys during their second (M2) and third (M3) years. Performance outcomes included scores on various summative assessments during the M.D. program. Wellness survey results indicated that the sample of 38 M2 and 28 M3 students were overall well and self-efficacious, and they broadly maintained similar wellness characteristics across their medical education despite COVID-19 disruptions. Twenty-three students completed both surveys, and a paired analysis for this subgroup showed modest increases in stress and burnout in the M3 year. Notable correlations were observed between self-efficacy for academic work and a whole range of wellness variables for M2 students. M2 academic performance was modestly correlated to self-efficacy (rs = 0.38, P = 0.02, n = 38) and student burnout (rs = -0.34, P = 0.04, n = 38). In contrast, for the M3 students there was little correlation between wellness, clinical self-efficacy, and clinical performance, with the only significant relationships observed to be between overall clinical self-efficacy and the strength of social networks (rs = 0.41, P = 0.03, n = 28) and between scores for postencounter notes during Objective Structure Clinical Examinations (OSCEs) and self-efficacy in evidence-based medicine (rs = 0.44, P = 0.02, n = 28). In conclusion, 1) students remained generally well throughout the post-COVID period, and 2) self-efficacy for academic work is a good predictor of student wellness and performance during the preclerkship period but not during clinical training.NEW & NOTEWORTHY This study followed a group of medical students through the "post-COVID" period to assess their wellness as they transitioned from basic sciences to clinical training. We found that their wellness and belief in their ability to succeed (self-efficacy) remained strong, showing their resiliency. We observed correlations between self-efficacy and their level of wellness and academic performance during basic science classes but not during clinical training.
Collapse
Affiliation(s)
- Jonathan Ruiz
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, United States
| | - Phillip Kaminnik
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, United States
| | - Jonathan Kibble
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, United States
| | - Christine Kauffman
- Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, United States
| |
Collapse
|
17
|
Shahin MN, Horak VJ, Kemeny H, Youngblood MW, Lam SK, Raskin JS. Neurosurgery trainee well-being in a pediatric neurosurgery hospital: baseline data to motivate toward implementing change. J Neurosurg Pediatr 2024; 33:295-299. [PMID: 38064703 DOI: 10.3171/2023.11.peds23482] [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: 10/18/2023] [Accepted: 11/16/2023] [Indexed: 03/03/2024]
Abstract
OBJECTIVE The aim of this study was to obtain aggregated baseline pediatric neurosurgery well-being data at a tertiary care institution. METHODS An institutional grant funded the completion of the Maslach Burnout Inventory (MBI) by 100% (n = 13) of the trainees during a 1-year period, including 1 pediatric neurosurgery fellow and 12 residents from 4 regional neurosurgery training programs. Aggregated and anonymized group results included frequency scores ranging from 0 (never) to 6 (every day). The mean ± SD group scores were compared to the general population of > 11,000 people in the human services professions. Burnout profiles were calculated on the basis of MBI scale scores by using established comparisons to standardized normal values. Burnout profile types include engaged, ineffective, overextended, disengaged, and burnout. RESULTS The mean ± SD score for emotional exhaustion was 2.6 ± 1.1 for trainees compared with 2.3 ± 1.2 in the comparison population. The mean ± SD score for depersonalization was 1.6 ± 1 compared with 1.7 ± 1.2 in the comparison population. The mean ± SD score for personal accomplishment was 4.9 ± 0.7 compared with 4.3 ± 0.9 in the comparison population. Profiles were classified as engaged (n = 6), ineffective (n = 3), overextended (n = 3), and burnout (n = 1). CONCLUSIONS Problematic profiles were present for more than half (7 [53.8%]) of pediatric neurosurgery trainees who cited higher emotional exhaustion than the general population of healthcare providers. Trainees scored lower in depersonalization and higher in personal accomplishment compared with the general population, which are both protective against burnout. Targeting factors that contribute to emotional exhaustion may have an impact on improving the overall well-being of pediatric neurosurgery trainees.
Collapse
Affiliation(s)
- Maryam N Shahin
- 1Department of Neurological Surgery, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon
| | - V Jane Horak
- 2Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Hanna Kemeny
- 3Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
| | - Mark W Youngblood
- 3Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
| | - Sandi K Lam
- 3Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
- 4Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois
| | - Jeffrey S Raskin
- 3Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
- 4Division of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois
| |
Collapse
|
18
|
Sibold J. An Evidence Based Rationale for Health and Wellness Coaching as a Complementary Certification in Undergraduate Health Education. Am J Lifestyle Med 2024; 18:181-185. [PMID: 38559783 PMCID: PMC10979724 DOI: 10.1177/15598276231189206] [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: 04/04/2024] Open
Abstract
Health and wellness coaching (HWC) is an effective intervention for many chronic lifestyle diseases. Chronic diseases represent a majority of our severe national healthcare burden. Yet, HWC certification programs vary in delivery method and degree awarded. The purpose of this paper is to provide an evidence based rationale for HWC as a complementary area of study to non-licensure granting, undergraduate health degrees in higher education. A comprehensive review of the literature related to the efficacy of HWC was completed. In addition, the national program directory was mined for descriptive data for approved HWC programs. Given the growing body of support for HWC as an effective intervention, we recommend that institutions deliver HWC curricula as an academic minor for undergraduate students in non-licensure granting health-related degrees to position graduates for entry level careers in HWC. Evidence from the successful deployment of an undergraduate program in HWC supports our contention that HWC be delivered as an academic minor in support of lifestyle health and wellness education. In doing so, the field can offer HWC in a way that is widely accessible to the undergraduate population, while providing a mechanism for direct employment as a professional health and wellness coach.
Collapse
Affiliation(s)
- Jeremy Sibold
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, USA
| |
Collapse
|
19
|
Eriksson M, Ekström-Bergström A, Arvidsson S, Jormfeldt H, Thorstensson S, Åström U, Lundgren I, Roxberg Å. Meaning of wellness in caring science based on Rodgers's evolutionary concept analysis. Scand J Caring Sci 2024; 38:185-199. [PMID: 37507842 DOI: 10.1111/scs.13196] [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: 03/17/2023] [Revised: 06/17/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Wellness is a holistic, multidimensional, and process-oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well-being without an in-depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. AIM To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. METHOD Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer-reviewed papers in English; papers published in scientific journals using the surrogate terms 'wellness', 'health', 'health care', and 'health care and wellness'; and papers discussing and/or defining the concept of wellness. Twenty-six studies met the inclusion criteria. RESULTS Based on the findings from this concept analysis, a definition of wellness was developed: 'a holistic and multidimensional concept represented on a continuum of being well that goes beyond health'. Implications for nursing practice were correspondingly presented. CONCLUSION Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well-being without an in-depth clarification of its theoretical foundation.
Collapse
Affiliation(s)
- Monica Eriksson
- Department of Health Sciences, University West, Trollhättan, Sweden
| | | | - Susann Arvidsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | | | - Ulrica Åström
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ingela Lundgren
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Åsa Roxberg
- Department of Health Sciences, University West, Trollhättan, Sweden
- VID University, Bergen, Norway
- UiT Harstad, Harstad, Norway
| |
Collapse
|
20
|
Underwood RA, Wood RJ, Tomchek AD, Celestin MD, Culbertson R, Phillippi S, Broyles ST. Exploring Successful Implementation of Organizational Supports at the Worksite Environment: A Mixed Methods Approach. Health Promot Pract 2024; 25:188-195. [PMID: 36321610 DOI: 10.1177/15248399221127045] [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] [Indexed: 02/17/2024]
Abstract
While there is evidence that organizational supports may lead to better employee health, research on implementing such organizational supports is lacking. This research sought to understand organizational supports and implementation of those supports using an Explanatory Sequential Mixed Methods design approach. Employee survey responses (n = 202) were used to classify organizations into "high" and "low" categories for employee-reported health behavior improvement, agreement, and readiness for implementing change. For the qualitative phase of research (organization-level), semi-structured interviews were conducted with organization leads, and data were analyzed through constant comparative analysis procedure. Analyses sought to identify differences between "high" versus "low" organizations. In addition, the researcher used the "high" and "low" classifications to further review themes that emerged, to determine where there may be differences in organizations classified as "high" versus "low." Study results found the following nine themes to explain how organizations can improve implementing organizational supports: provide a contracted wellness program, formalized programming, and wellness incentives; create a culture of wellness in the organization; provide consistency in the supports offered; provide clear communication to employees; utilize leadership role modeling to show support; focus on leadership support that ensures organizational supports are implemented and sustained; and work to combat employee hesitation of organizational supports. The results of this study show that organizations have the opportunity to improve implementation of their organizational supports by applying the nine themes found.
Collapse
Affiliation(s)
| | - Ralph J Wood
- Southeastern Louisiana University, Hammond, LA, USA
| | | | - Michael D Celestin
- CTTS Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | | | - Stephen Phillippi
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Stephanie T Broyles
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| |
Collapse
|
21
|
Khodr ZG, McAnany J, Haile YG, Perez VG, Rohrbeck P. A summary of the U.S. Marine Recruit Assessment Program (RAP) procedures and survey from 2003 to 2021. MSMR 2024; 31:2-8. [PMID: 38466968 PMCID: PMC10957181] [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] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The Recruit Assessment Program (RAP) is a cross-sectional, baseline survey of U.S. Marine recruits administered at Marine Corps Recruit Depot, San Diego. This report presents RAP study procedures and survey content that was administered to 229,015 participants between 2003 and 2021. Self-reported data were collected on recruit demographics, physical and mental health, adverse life experiences, lifestyle and risky behaviors, and substance use. In 2013, the survey was updated to remove questions with other linkable and reliable sources and those with low completion rates and low relevance to Marine health research; the removal of these items allowed for the addition of instrument measures for major depression, post-traumatic stress disorder, anger, and resilience with no significant change to overall survey length. Average completion rates are approximately 95%. Multiple studies have shown the utility of RAP data collected thus far as a robust data repository of pre-service health and behavioral measures.
Collapse
Affiliation(s)
| | | | | | | | - Patricia Rohrbeck
- Military Population Health Directorate, Naval Health Research Center, San Diego, CA
| |
Collapse
|
22
|
Locke S, Osborne J. Determining the Right Levels of Health Coaching and Heart Rate Variability Biofeedback in a Workplace Behavior Change Intervention: Multiphase Optimization Strategy Preparation Study. JMIR Form Res 2024; 8:e47181. [PMID: 38354036 PMCID: PMC10902773 DOI: 10.2196/47181] [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: 03/10/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Work-related stress is associated with poor job performance and negative health outcomes. Changing health behaviors through corporate wellness programs can improve physical and mental health and help employees manage stress. This project sought to pilot the potential addition of brief coaching and biofeedback to an 8-week web-based self-help program to improve employee stress using the multiphase optimization strategy. OBJECTIVE This study aims to determine which candidate components will be tested in a later optimization phase and at what dose they will be tested, examine the feasibility and acceptability of delivering the different components, investigate whether the outcomes can be feasibly measured, and review evidence to build a conceptual model before the optimization phase. METHODS The study was positioned within the preparation phase of the multiphase optimization strategy. It is a 2×2×2×2 design with 4 components: 2 types of health coaching and 2 types of biofeedback. All components were tested by turning them on or off. A total of 16 adult office workers (mean age 40, SD 14.3 years; n=15 women) completed an 8-week self-paced web-based stress management and health behavior change program and were randomly assigned to 1 of the 16 conditions, created from a combination of the 4 candidate components. Assessments included web analytics, surveys, and interviews regarding program recommendations, likes, and dislikes. RESULTS Findings from the interviews provided suggestions to improve the intervention (eg, separating wellness from stress content) and trial conduct (eg, streamlining the onboarding process). On average, participants logged into the wellness program 83 times (range 36-291), with 75% (12/16) participant retention and 67% (8/12) survey completion. There were no reported problems with coaching or obtaining data from interviews or apps. The interview findings suggested potential mediators to include and assess in a future conceptual model. CONCLUSIONS The results provided areas to improve the intervention content and trial methods. Instead of progressing to the next scheduled large-scale optimization phase, our plan to iterate through a second preparation phase after making changes to the protocol, apps, and corporate coaching partner.
Collapse
Affiliation(s)
- Sean Locke
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
| | - Jenna Osborne
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
| |
Collapse
|
23
|
McKinley CE. "We have to … work for wholeness no matter what": Family and culture promoting wellness, resilience, and transcendence. Transcult Psychiatry 2024:13634615241227690. [PMID: 38327166 DOI: 10.1177/13634615241227690] [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] [Indexed: 02/09/2024]
Abstract
Sociocultural, mental, behavioral, and physical factors are interrelated associates of chronic health conditions-such as diabetes, obesity, and cardiovascular disease-all of which are disproportionally high and drive much of the mortality and morbidity for Indigenous peoples. Indigenous worldviews conceptualize health holistically, with inseparability across social, spiritual, cultural, familial, mental, behavioral, physical, and social dimensions of wellness. Food, family, and culture are fundamental to Indigenous wellness. The purpose of this article is to use the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) conceptualization of relational wellness to honor urban and rural U.S. Indigenous perspectives that highlight the intersections of family, culture, physical health, spiritual, and mental health to promote resilience and wellness. This research focused on interconnections between wellness, culture, health, and family. Thirty-one critical ethnographic interviews used a life-history approach with methodology following an Indigenous toolkit for ethical and culturally sensitive research strategies, such as building upon cultural strengths, engaging in long-term, relational commitments with communities, incorporating storytelling and oral history traditions, centering Indigenous methodologies and preferences, working with cultural insiders, and prioritizing the perspectives of Indigenous peoples. Emergent themes included: (a) roots of Indigenous wellness: cultural values promoting balance and connection; (b) practicing resilience: family transmission of health information; and (c) wholistic mental wellness and resilience, with the subtheme culture and wellness. Interventions can be developed in collaboration with tribes for optimum efficacy and cultural relevancy and can approach wellness holistically in culturally relevant ways that center foodways, culture, family, and spirituality.
Collapse
|
24
|
Landman UN, Naeem Z, Chen IL, Naeem A, Jaber R. Implementation and mixed-methods evaluation of "Walk with a Doc" program at Stony Brook. J Osteopath Med 2024; 0:jom-2022-0242. [PMID: 38308334 DOI: 10.1515/jom-2022-0242] [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: 01/06/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024]
Abstract
CONTEXT Walking groups run by trained individuals, lasting under an hour in a natural environment, may be a cost-effective way by which to encourage sustainable changes in physical activity as well as foster companionship and a shared experience of wellness among participants. Walk with a Doc (WWaD) is a national program that provides a platform for medical professionals, including physicians and medical students, to deliver a short talk on a health topic prior to walking side by side with patients and community members. OBJECTIVES To evaluate the WWaD Chapter at Stony Brook following implementation, a questionnaire was designed utilizing a mixed-methods approach (i.e., containing qualitative and quantitative items) and administered to all attendees monthly prior to the health discussion. The aim of the questionnaire was fourfold: first, to obtain participant demographics; second, to obtain information on attendees' own perceptions of their health status and the role exercise plays in their health; third, to gain data on physical activity levels, including lengths of exercise sessions and types of activities performed; and fourth, to learn more about attendees' motivations and goals for participating in the walks. METHODS We received an IRB exemption. Physician and medical student volunteers were recruited from Stony Brook University Hospital, a suburban tertiary care center, to oversee program logistics. WWaD was scheduled to take place on the third Sunday of every month for 1 h at Heritage Park in Mount Sinai, New York. The event was advertised by volunteers to colleagues, peers, patients, and community members utilizing word of mouth, printed flyers, emails to listservs, and social media outlets. Each month, a physician volunteer oversaw a brief discussion (approximately 10 min in length). RESULTS Over the course of the 5 month evaluation period, 91 individuals participated in the walks, including repeat attendees. After excluding duplicate or incomplete entries, data from 30 participants were included in this analysis. The majority of participants were female (n=24) with a mean age of 50 years (range, 23-98 years). Feedback on WWaD program elements was largely positive. Participants commended the monthly speakers for "informative talks" (n=6) on "interesting topics" (n=4), with plans to review the supplemental information in educational pamphlets following the walk (n=4). The brochures were also deemed "helpful." Overwhelmingly, patients referred to the community gathering and team building aspects of WWaD as the "most enjoyable" aspect of the program (n=8) and a key driver for participation. CONCLUSIONS This mixed-methods study of the WWaD chapter at Stony Brook contributes to a growing body of evidence highlighting the value of walking groups as effective avenues for collaboration in producing accessible healthy behavior.
Collapse
Affiliation(s)
- Ursula N Landman
- Department of Anesthesiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Zaina Naeem
- Department of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Ingrid L Chen
- Kaiser Permanente Oakland Medical Center, Oakland, NY, USA
| | - Areeg Naeem
- University of Buffalo School of Dental Medicine, State University of New York, Buffalo, NY, USA
| | - Raja Jaber
- Department of Family, Population & Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
25
|
Skarbek A, Endsley P, Chrisman MS, Hastert M, Stellwagen C. Exploring Wellness Through Concept Analysis. J Sch Nurs 2024; 40:86-96. [PMID: 37070135 DOI: 10.1177/10598405231165510] [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: 04/19/2023] Open
Abstract
Modern wellness is a concept that has been discussed in the literature since the 1960's. To better understand wellness complexities in a school setting, a concept analysis was conducted using a modified version of Walker and Avant's method incorporating the nursing paradigm in the implications. A literature review was conducted and except for background information, the publication dates were limited to 2017-2022. Key search terms included "wellness," "school wellness," "wellness concept." Additional literature reviews were conducted based on data related to the definitions, attributes, antecedents, and consequences of wellness that were collected from the reviewed studies. Defining attributes of wellness included healthy habits, conscientiousness, and optimum state of health. The antecedents, consequences, and empirical referents of wellness were identified with examples from the literature and case exemplars. Wellness is a dynamic process that has unique implications for school health and school nurses. This concept analysis lays the foundation for future research incorporating nursing domains.
Collapse
Affiliation(s)
- A Skarbek
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - P Endsley
- School Nurse, Wells High School, Wells, ME, USA
| | - M S Chrisman
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - M Hastert
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - C Stellwagen
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| |
Collapse
|
26
|
Mulder L, Garcia E, Sirintrapun SJ, Kundu I, Soles R. Examining the role of diversity, equity, and inclusion in mitigating workforce burnout in laboratory medicine. Am J Clin Pathol 2024; 161:130-139. [PMID: 37793038 DOI: 10.1093/ajcp/aqad123] [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: 04/17/2023] [Accepted: 08/29/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVES The clinical laboratory workforce plays a crucial role in health care delivery, yet little is known about the unique pressures and challenges this workforce faces. The objective of this study was to identify factors that contribute to burnout, discrimination, exclusion, and inequity in pathology and laboratory medicine. METHODS A nationwide survey was conducted in 2 phases. In phase 1, 2391 laboratory professionals were surveyed over a 1-week period about their experiences with burnout, discrimination, and work-related stress. In phase 2, the survey was extended to 1 month and questions were added to elicit more detailed information about diversity, equity, and inclusion (DEI) as well as wellness. RESULTS Results showed a high prevalence of burnout, discrimination, and stress among laboratory professionals, with significant differences among certain demographic groups. Women, Black, indigenous, or people of color individuals and those with disabilities reported higher rates of discrimination. The study also showed a need for mentorship and resources to address educational barriers. CONCLUSIONS Findings from this study highlight the urgent need for interventions to address burnout, discrimination, exclusion, and inequity in the laboratory workforce. Initiatives to increase workforce diversity, promote mentorship and diversity training programs, and improve recognition of the laboratory workforce are recommended. The results underscore the pressing need to addressing the challenges and apprehensions laboratory professionals face, including enhancing recognition of their role in patient care, tackling systemic problems related to discrimination and equity, and enhancing the provision of support and resources for managing burnout and fostering well-being.
Collapse
Affiliation(s)
- Lotte Mulder
- Department of Organizational Development and Leadership, American Society for Clinical Pathology, Chicago, IL, US
| | - Edna Garcia
- Institute of Science, Technology and Policy, American Society for Clinical Pathology, Washington, DC, US
| | - S Joseph Sirintrapun
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Iman Kundu
- Institute of Science, Technology and Policy, American Society for Clinical Pathology, Washington, DC, US
| | - Ryan Soles
- Department of Learning and Educational Research, American Society for Clinical Pathology, Chicago, IL, US
| |
Collapse
|
27
|
Warren J. Routine. Acad Emerg Med 2024; 31:198-199. [PMID: 37656896 DOI: 10.1111/acem.14801] [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: 07/31/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/03/2023]
Abstract
Written a year and a half into the pandemic during a particularly difficult week, this poem explores the moral injury and emotional distress that emergency physicians encounter and must process daily. These repeated microtraumas throughout our day frequently contribute to depersonalization and it is important to recognize those factors that "break the routine" and help to improve physician well-being.
Collapse
Affiliation(s)
- Jonathan Warren
- Department of Emergency Medicine, Harbor-UCLA, Torrance, California, USA
| |
Collapse
|
28
|
Pitts LN, Woods B, Polen M, Nichols LS, Ladores S. Transcending Limitations: A Phenomenological Exploration of How Hygge Practices Enrich the Lived Experiences of Adults with Cystic Fibrosis. Creat Nurs 2024; 30:74-86. [PMID: 38291619 DOI: 10.1177/10784535241228522] [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: 02/01/2024]
Abstract
Hygge practices embody joy, peace, mindfulness, coziness, and conviviality. Cystic fibrosis (CF) is a progressive condition with complex therapies and physical limitations. Little is known about how hygge practice may impact individuals living with CF. A qualitative study explored how adults with CF use hygge practices to promote wellness and cope with their disease. A purposive network sample of 15 adults with CF who utilized hygge practices completed semistructured audio-recorded telephone interviews. Recordings were transcribed and analyzed using Colaizzi's thematic analysis approach. Results reveal that hygge practices influenced individuals' aesthetics, attitudes, and activities, deeply impacting the physical and emotional experience of living with CF. Incorporating hygge into CF care may improve psychological well-being and quality of life for members of this community.
Collapse
Affiliation(s)
- Leslie N Pitts
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittany Woods
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Lynn S Nichols
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
- School of Nursing, Boise State University, Boise, ID, USA
| | - Sigrid Ladores
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
29
|
Gao N, Eissenstat SJ, Wacha-Montes A, Wang Y. The experiences and impact on wellness among international students in the United States during the COVID-19 pandemic. J Am Coll Health 2024; 72:361-365. [PMID: 35427219 DOI: 10.1080/07448481.2022.2052077] [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] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/30/2021] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
Objective Assessing experiences and impact on wellness among international students during the COVID-19 pandemic. Participants: 405 undergraduate and graduate international students from 65 countries studying at a large public university. Methods: An online, voluntary and anonymous survey consisting of 50 quantitative and qualitative questions was conducted through Qualtrics. Descriptive and frequency analyses were used. Results: 27% of the students had concerns about the changes in student visa status that could seriously disrupt their studies in the U.S. 66.2% of them reported a moderate level, 18.8% reported a high level of stress related to the pandemic. Students identified the highest confidence in getting tested for infection but the lowest confidence in getting treatment if infected. They preferred telehealth for mental health services. Conclusions: Universities can best help international students by assisting with student visa and international travel issues, access to treatment for COVID-19 infection and developing telehealth for mental health services.
Collapse
Affiliation(s)
- Ni Gao
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - SunHee J Eissenstat
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Annmarie Wacha-Montes
- Rutgers Health Services Counseling & Psychological Services, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Yushi Wang
- Rutgers Health Services Counseling & Psychological Services, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| |
Collapse
|
30
|
Morgan T, Torkian P, Awan OA. Mandatory Wellness Lectures and Exercises: Helpful or Harmful? Acad Radiol 2024; 31:747-749. [PMID: 38401991 DOI: 10.1016/j.acra.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 02/26/2024]
Affiliation(s)
- Tyler Morgan
- Texas Tech University, Health Sciences Center School of Medicine, Lubbock, Texas
| | - Pooya Torkian
- Vascular and Interventional Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Omer A Awan
- University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD 21201.
| |
Collapse
|
31
|
Kauppi K, Roos E, Borg P, Torkki P. Building Consensus on Domains of Wellness Using Finnish and International Expert Panels: A Delphi-Method Study. Am J Health Promot 2024; 38:228-237. [PMID: 37770022 PMCID: PMC10802088 DOI: 10.1177/08901171231204147] [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: 10/03/2023]
Abstract
PURPOSE The paper investigates whether we can build consensus on wellness domains and create a more universal conceptual framework for wellness. DESIGN A modified ranking type of Delphi method. PARTICIPANTS Two separate panels consisting of 23 Finnish and 11 international experts. METHODS Panels were asked to rate the importance of 61 systematic review-based wellness domains and to eventually form a wellness model in both panels. The similarities between the resulting models were investigated and a new conceptual framework for wellness was created. RESULTS The Finnish model included 8 themes and 20 domains, and the international model 5 themes and eleven domains. Eight of the eleven domains were an exact match for the Finnish model (namely mental health, cognitive health, exercise, nutrition, community, life satisfaction, meaningfulness, work-life balance). There were also 2 similar domains that could be found in both models (namely self-care and lifestyle habits, social networks). A new conceptual framework for wellness was created based on these ten domains. CONCLUSION The lack of consensus on the wellness construct has made it difficult to find comparable measures that could assess and improve the level of wellness of individuals, organizations, and society. This study offers a conceptual framework that can be further validated and turned into a more universal measurement instrument.
Collapse
Affiliation(s)
- Krista Kauppi
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Aisti Health Ltd., Helsinki, Finland
| | - Eira Roos
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Medical Center Aava, Helsinki, Finland
| | | | - Paulus Torkki
- Department of Public Health, University of Helsinki, Helsinki, Finland
| |
Collapse
|
32
|
Maragha T, Garcia AP, Shuler C, von Bergmann H. The six-domain well-being framework in oral health sciences: A pathway from theory to practice. J Dent Educ 2024; 88:157-168. [PMID: 37904583 DOI: 10.1002/jdd.13401] [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: 05/14/2023] [Revised: 08/01/2023] [Accepted: 10/20/2023] [Indexed: 11/01/2023]
Abstract
OBJECTIVES Well-being is a complex and multifaceted construct that has gained popularity in oral health sciences education. Maintaining students' well-being is essential for their academic performance and quality of life. While many definitions and frameworks of well-being exist, their applicability to oral health sciences education remains unknown. This study aimed to evaluate the applicability of the Feeney and Collins's framework of well-being to oral health sciences education by exploring students' perceptions and experiences in the University of British Columbia METHODS: An Interpretive Description approach was used to conduct semi-structured interviews with dental and dental hygiene students. Interviews were transcribed, and transcripts were coded and analyzed with guidance from Feeney and Collins's well-being and thriving framework using content analysis. Domains were inductively developed within and beyond the organizing categories of the chosen framework. RESULTS Thirty-one oral health sciences students participated in the study. Study data can largely be explained by the five well-being domains suggested by Feeney and Collins: physical, psychological, eudaimonic, subjective, and social. Spirituality and gratitude emerged as an additional domain that contributes to students' well-being. Interdomain relationships were observed. The social domain seemed to contribute to all other well-being domains; while the subjective domain seemed to be shaped by all other domains CONCLUSIONS: Feeney and Collins's framework seemed to be useful to understand and conceptualize well-being in oral health sciences education but needed to be expanded to include spirituality and gratitude. Further evidence is needed to explore the applicability of this framework in other health professional education disciplines.
Collapse
Affiliation(s)
- Tala Maragha
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Arnaldo Perez Garcia
- Educational Research and Scholarship Unit, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, British Columbia, Canada
| | - Charles Shuler
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - HsingChi von Bergmann
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
33
|
Maragha T, Shuler C, Walker J, von Bergmann H. Thriving in foreign learning environments: The case of hands-on activities in early years of dental education. J Dent Educ 2024; 88:176-189. [PMID: 37953678 DOI: 10.1002/jdd.13412] [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: 07/01/2023] [Revised: 09/28/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Hands-on learning environments can challenge learners' wellbeing in dental education, given their unfamiliarity with students. As today's learners are more aware about their wellbeing needs, it is important to explore the depth and complexity of the challenges they experience and provide them with the necessary support strategies. This study aims to identify the challenges and sources of cognitive overload of early years' dental students across two time-points: 2012 and 2022. We also aim to describe the students' recommendations for future program revision considerations to support students' wellbeing. METHODS This study employs both qualitative and quantitative methods. Qualitatively, we utilized an Interpretive Description approach and conducted focus groups with first-year dental students in 2023. Quantitively, we utilized first-year dental students' responses to the Study Habits survey administered in 2012/2013. RESULTS Five main concerns and sources of cognitive load emerged from the focus groups and survey data: steepness of the learning curve, inconsistent feedback, stigma around asking for support, structural and organizational challenges, and lack of resources. Students also identified several suggestions to support their wellbeing, including time, instructor support, non-graded exercises, additional resources, and re-organizing the curriculum. CONCLUSION This study adopts a wellbeing lens to examine students' transition into hands-on learning activities. These findings were utilized to propose the TIPSS Support Framework (Time, Instructor Capacity Building, Peer Learning and Other Resources, Safe Learning Spaces, and Spiraling Curriculum). The proposed model can serve as a prototype for future studies to explore its applicability and effectiveness in other dental programs.
Collapse
Affiliation(s)
- Tala Maragha
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Vancouver, Canada
| | - Charles Shuler
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Vancouver, Canada
| | - Judith Walker
- Department of Educational Studies, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Vancouver, Canada
| | - HsingChi von Bergmann
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Vancouver, Canada
| |
Collapse
|
34
|
Sastre-Munar A, Romero-Franco N. Pain Education in the Wellness, Training Performance, and Pain Intensity of Youth Athletes: An Experimental Study. Healthcare (Basel) 2024; 12:215. [PMID: 38255102 PMCID: PMC10815667 DOI: 10.3390/healthcare12020215] [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: 11/30/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Although pain management programs reduce pain and improve wellness perception in the general population, few studies have explored these effects in athletes. This study evaluated the effects of an educational program about pain neuroscience on wellness, training performance, and pain in youth athletes. Differences according to sex were also explored. METHODS For 12 weeks, 52 athletes were randomly assigned to an intervention group (IG: educational program about healthy sports habits and pain neuroscience) or a control group (CG: education on healthy sports habits only). Before the start of the study and weekly until its end, wellness, training performance, and pain intensity were monitored via a questionnaire. RESULTS After the intervention, IG decreased stress (p = 0.028) compared to the baseline, and a higher number of training sessions were performed without health problems (76.6%) compared to the number in the CG (63.0%) (χ2 = 8.31, p = 0.004). Regarding pain, the IG perceived lower pain than the CG did (p = 0.028). Females in the IG had lower pain than those in the CG did (p < 0.05), without differences in other variables or in males (p > 0.05). CONCLUSIONS An educational program that includes pain neuroscience may help youth athletes improve their wellness status, pain intensity perception, and training session performance.
Collapse
Affiliation(s)
- Andreu Sastre-Munar
- Nursing and Physiotherapy Department, University of the Balearic Islands, 07122 Palma de Mallorca, Spain;
- Sport High Performance Centre of Balearic Islands, 07009 Palma de Mallorca, Spain
| | - Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, 07122 Palma de Mallorca, Spain;
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| |
Collapse
|
35
|
Kauppi KJ, Roos ET, Borg PT, Cantell KS, Torkki PM. What is wellness? Investigating the importance of different domains of wellness among laypeople and experts: A survey study. Scand J Public Health 2024:14034948231217360. [PMID: 38217305 DOI: 10.1177/14034948231217360] [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: 01/15/2024]
Abstract
AIMS Lack of consensus on wellness has led to a vast number of different conceptualisations, which hinder international efforts to monitor individual-level wellness and social progress comparably. This study aimed to aid in the harmonisation of the concept by contributing to the scarce research on laypeople's views on wellness. The study investigates whether the importance of different areas of wellness varies depending on age, gender, education or socio-economic position. Furthermore, considering that wellness models are often constructed by expert panels, this study aimed to shed light on how experts' and laypeople's views on wellness vary. METHODS Altogether, 1152 laypeople and 23 Finnish experts rated the importance of 61 systematic review-based wellness domains. Each domain received an ordinal number, which, together with the Mann-Whitney U-test or Kruskal-Wallis test, was used to examine the differences between the groups. RESULTS Thirteen wellness domains were found at the top of the lists, regardless of whether the results were analysed based on gender, age, education or socio-economic position. When looking at the priority order of different domains, we were able to identify several differences between the expert panel and laypeople. CONCLUSIONS To ensure the relevance of wellness models, it is vital to understand the areas that laypeople consider to be important for their comprehensive wellness. This study offers 13 domains that could be combined with an expert view on wellness and used as a starting point for creating a more comprehensive, inclusive and better-suited wellness instrument.
Collapse
Affiliation(s)
- Krista J Kauppi
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Eira T Roos
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
- Aava Medical Centre, Finland
| | | | | | - Paulus M Torkki
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| |
Collapse
|
36
|
Clayton DJ, Burbeary R, Parker C, James RM, Saward C, Procter EL, Mode WJA, Baker C, Hough J, Williams NC, Rossington H, Varley I. Combined Turmeric, Vitamin C, and Vitamin D Ready-to-Drink Supplements Reduce Upper Respiratory Illness Symptoms and Gastrointestinal Discomfort in Elite Male Football Players. Nutrients 2024; 16:243. [PMID: 38257136 PMCID: PMC10819629 DOI: 10.3390/nu16020243] [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: 11/14/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Elite football is associated with the increased risk of illness, although targeted supplementation can reduce illness risk. This study assessed the effects of a supplement containing turmeric root within a black pepper and fat-soluble blend, vitamin C and vitamin D, on upper respiratory symptoms (URS), gastrointestinal symptoms (GIS), muscle soreness, and markers of inflammation and gut permeability in elite male footballers. Twenty-three footballers completed 3 weeks of no intervention (CON), followed by 16 weeks of daily consuming 60 mL of a commercially available supplement containing raw turmeric root (17.5 g, estimated to contain 700 mg of curcumin), vitamin C (1000 mg), and vitamin D3 (3000 IU/75 mcg) (SUP). URS and GIS were measured daily. Immediately (0 h), 40, and 64 h after six competitive matches (two in CON, four in SUP), the subjective soreness and plasma concentrations of creatine kinase [CK], c-reactive protein [CRP], and intestinal fatty-acid binding protein [I-FABP] were assessed. URS incidence (p < 0.001), GIS (p < 0.05), and plasma [I-FABP] at 0 h (p < 0.05) were greater during CON versus SUP. At 40 h, [CRP] was greater than 0 h during CON (p < 0.01) but not SUP (p = 0.204). There were no differences in soreness or [CK]. This study indicates that turmeric root, vitamin C, and vitamin D supplementation over 16 weeks can reduce URS, GIS, and post-match [I-FABP] in elite footballers.
Collapse
Affiliation(s)
- David J. Clayton
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | - Ross Burbeary
- Derby County Football Club, Pride Park, Derby DE24 8XL, UK;
| | - Connor Parker
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | - Ruth M. James
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | - Chris Saward
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | - Eleanor L. Procter
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | - William J. A. Mode
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | - Carla Baker
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | - John Hough
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | - Neil C. Williams
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| | | | - Ian Varley
- Musculoskeletal Research Group, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK; (C.P.); (R.M.J.); (C.S.); (E.L.P.); (W.J.A.M.); (C.B.); (J.H.); (N.C.W.); (I.V.)
| |
Collapse
|
37
|
Ward A, Marinaro L, Nokes R, Erickson H, Kahanov L, Martin M. How traditional undergraduate college students define and perceive wellness: A qualitative phenomenological study. J Am Coll Health 2024:1-7. [PMID: 38165723 DOI: 10.1080/07448481.2023.2299431] [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: 06/02/2023] [Accepted: 12/15/2023] [Indexed: 01/04/2024]
Abstract
OBJECTIVE To understand college students' perceptions and understanding of wellness. PARTICIPANTS A convenience sample of 20 undergraduate students (age 20.6 ± 2.2 years) at a private liberal arts university in Southern California who recently completed a general education health and wellness course. METHOD Five focus group sessions were conducted to explore perceptions of wellness among undergraduate college students. Data was analyzed, themed, and coded. RESULTS A thematic analysis of the descriptions of wellness revealed 2 higher-ordered themes as whole-person and wellbeing, and 3 lower-ordered themes of balance, interconnectedness, and personalized in relation to participants' understanding of wellness. CONCLUSIONS The importance of balance between wellness dimensions and the acknowledgment of the interconnectedness of wellness dimensions are related to quality of life and life satisfaction. A deeper insight is needed to better understand the perceptions of wellness in this population to provide more effective interventions. This can be achieved through the development of enhanced pedagogy, which may improve student health.
Collapse
Affiliation(s)
- Alisa Ward
- Rocky Mountain University of Health Professions, Provo, Utah, USA
- Point Loma Nazarene University, San Diego, California, USA
| | | | - Ryan Nokes
- Point Loma Nazarene University, San Diego, California, USA
| | | | | | - Malissa Martin
- Rocky Mountain University of Health Professions, Provo, Utah, USA
| |
Collapse
|
38
|
Walia S, Nordenholz KE, Krywko D, Norvell JG, Hewitt KV, Parmele KT, Levin RM, Kennedy J, Manfredi RA. The Chief Wellness Officer: A long overdue catalyst for systemic change in Emergency Medicine. Int J Health Plann Manage 2024; 39:141-151. [PMID: 37823601 DOI: 10.1002/hpm.3714] [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: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023] Open
Abstract
GOALS The American healthcare system is amid a burnout epidemic, worsened by COVID, that must be addressed expeditiously and with high priority. The burden Emergency Physicians encountered before and during the pandemic is well known, with countless healthcare workers exiting the work force. A Chief Wellness Officer (CWO) is a senior leader who works primarily to cultivate organisational wellness and to foster and promote a culture of well-being throughout an institution. Specifically, the CWO assists the health system leadership promote clinician engagement and address clinician burnout. This paper explores the status of existing CWOs, and cites the benefits, impacts, and barriers to implementation of a CWO, with focus on the field of Emergency Medicine (EM). METHODS A steering committee of wellness experts was formed from a national EM organisation. A purposive search and literature review using search terms relating to CWOs was completed. Publications were examined for relevance and recency. The committee created an online questionnaire surveying current US CWOs, conducted personal interviews, and met through regular focused meetings. A framework delineating the role of a CWO as an organisation evolves from instituting novice wellness interventions to expert organisational innovations was created. PRINCIPLE FINDINGS Despite their title, CWOs are not regularly included in c-suite decisions. Barriers to instituting a CWO include perceived financial cost, the medical system itself, and physician resistance. Defining and measuring objective return on investment may be a solution to overcoming barriers. CWOs who create comprehensive institutional wellness innovations bring organisations to the highest proficient and expert levels of wellness practices, positively affecting physician engagement and deflecting burnout. CWOs instituting novice and beginner levels of wellness interventions, especially in EM, only modestly impact individual wellness practices. PRACTICAL APPLICATIONS A CWO and team with an organisational voice and a C-suite stakeholder's seat are essential to centralising and leading effective wellness efforts and innovations in EM and other specialities. This team will improve the work environment and culture and begin to fix our broken healthcare system and providers.
Collapse
Affiliation(s)
- Shabana Walia
- Department of Emergency Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Texas, Houston, USA
| | - Kristen E Nordenholz
- Department of Emergency Medicine, University of Colorado School of Medicine, Colorado, Aurora, USA
| | - Diann Krywko
- Department of Emergency Medicine, Medical University of South Carolina, South Carolina, Charleston, USA
| | - Jeffrey G Norvell
- Department of Emergency Medicine, University of Kansas Medical Center, Kansas, Kansas City, USA
| | - Keia Vr Hewitt
- Medical University of South Carolina, South Carolina, Charleston, USA
| | | | - Randall M Levin
- Aurora West Allis Medical Center, Advocate Aurora Health, West Allis, Wisconsin, USA
| | - Joseph Kennedy
- American College of Emergency Physicians, Texas, Irving, USA
| | - Rita A Manfredi
- The George Washington University School of Medicine and Health Sciences, District of Columbia, Washington, USA
| |
Collapse
|
39
|
Campoli J, Cummings JA. "Becoming a Person Who Does Self-Care": How Health Care Trainees Naturalistically Develop Successful Self-Care Practices. J Med Educ Curric Dev 2024; 11:23821205231223321. [PMID: 38234585 PMCID: PMC10793186 DOI: 10.1177/23821205231223321] [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] [Received: 10/13/2022] [Accepted: 12/11/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Self-care is an ethical imperative for health professionals as it can mitigate the adverse effects of stress on professional functioning and health. Yet, there tends to be a lack of self-care among healthcare trainees and an insufficient focus on self-care in medical education. The objective of this study was to develop a grounded theory of how health trainees become successful self-care users. METHODS Semi-structured interviews were conducted with 17 students in a variety of healthcare disciplines. Data were analyzed using grounded theory methodology. RESULTS Health trainees underwent 4 iterative phases to become successful at self-care: Having a Wake-Up Call, Building Skills, Gaining Confidence, and Building an Identity. Our model also explained why some trainees were unsuccessful at developing self-care practices. CONCLUSION We offer the first theory to explain how health trainees develop effective self-care habits. Understanding how self-care practices naturalistically develop has critical implications for developing interventions and curricula: By basing curricula about self-care on knowledge of what works, we have an opportunity to be more successful as educators. Indeed, other researchers have noted a lack of success in self-care and anti-burnout interventions for healthcare professionals. We conclude by discussing implications and recommendations for medical training and curriculum for health professions, including augmenting naturally occurring processes, linking self-care to personalized values, providing opportunities for deliberate practice, focusing on persistence with self-care, and faculty promotion and acceptance of trainee self-care.
Collapse
Affiliation(s)
- Jessica Campoli
- Department of Psychology & Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jorden A Cummings
- Department of Psychology & Health Studies, University of Saskatchewan, Saskatoon, SK, Canada
| |
Collapse
|
40
|
Rozenberg J, Lynch K, Miner T, Appleton D, Osband AJ. An Easily Implemented, Inexpensive, Useful Novel Surgical Intern Wellness Initiative. Journal of Surgical Education 2024; 81:1-4. [PMID: 37919134 DOI: 10.1016/j.jsurg.2023.09.014] [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: 08/17/2023] [Accepted: 09/20/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Determine whether use of reflective questions asked on a twice monthly basis is a useful addition to our intern wellness curriculum, with a goal of longitudinal development. Prior studies have demonstrated the use of reflection in processing educational experiences toward professional growth at both the medical student and resident level. DESIGN During the first year, every 2 weeks, the 13 interns were asked and answered 2 reflective prompts by email. Their responses went to a single faculty member and were then blinded for analysis. The second year of the program, prompts were discussed by participants in a closed group setting. Participation was voluntary. The questions fell into 6 major categories: role expectations, role assessment, role affirmation, role reflection, emotional self-assessment, work-life integration, and boundaries. Thematic analysis of the responses was performed using an inductive approach by 2 independent expert reviewers. SETTING Brown General Surgery Residency Program, academic years 2021 to 2022 and 2022 to 2023. CONCLUSIONS Use of reflective questions is a valuable tool as part of an intern wellness curriculum and can be easily implemented. It is inexpensive, does not require a huge time commitment, and is easily adaptable to a program's specific needs. It encourages developing surgeons to recognize and share in their emotions as they encounter the new and stressful experiences inherent in residency and may help to prevent burnout. Sustained participation through the year and robust responses suggest good resident engagement and acceptance of the program.
Collapse
Affiliation(s)
- Julia Rozenberg
- Department of Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kenneth Lynch
- Department of Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Thomas Miner
- Department of Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Daryl Appleton
- Department of Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Adena J Osband
- Department of Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
| |
Collapse
|
41
|
Burke C, Clark S, Gholson KL, Mazur J. We Care: A Wellness Intervention Project for Palliative Care Physicians. J Pain Symptom Manage 2024; 67:e90-e93. [PMID: 37704116 DOI: 10.1016/j.jpainsymman.2023.08.027] [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: 01/23/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/15/2023]
Abstract
There is a trend toward burnout in palliative care physicians. Due to this, a five-session curriculum has been designed with resiliency tools, coping skills, and spirituality in order to train palliative care fellows in an inpatient setting. More research is needed on this curriculum, but preliminary findings have shown a positive response.
Collapse
|
42
|
Harris D, Baker E, Svacina J, Funderburk L. A Systematic Approach to Evidence-Based Design for Measurable Health and Wellness Outcomes: Curating and Translating Evidence to Practice. HERD 2024; 17:17-29. [PMID: 37919935 DOI: 10.1177/19375867231209335] [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: 11/04/2023]
Abstract
OBJECTIVES Evaluating evidence from peer-review literature for use in evidence-based design is often challenging for the design disciplines, requiring access to the peer-reviewed literature, expertise in evaluating methods and findings, and translating the results into actionable design and operational recommendations. PURPOSE The purpose of this methods paper is to elucidate the process for systematic evaluation of research to translate evidence into practical application to improve design for occupant health and wellness. BACKGROUND Researchers have found strong connections in environmental design influence on health and wellness that have proven to be substantiative in the effort to improve health and well-being. Design has the capacity to encourage healthy choices and decisions within the built environment. Translation of evidence into applied design solutions may improve public health. METHODS A protocol is presented that culminates in the translation of evidence into design recommendations focused on improving occupant health. The protocol includes preparation for the literature search and review, search strategy, study selection, data analysis, and development of the literature review. RESULTS After evaluation of the evidence is completed, there were several positive findings in the example that stakeholders could utilize to improve the health of building occupants with programs and design to support nutrition, physical activity, and circadian entrainment. CONCLUSIONS There are a variety of software tools and processes to utilize in the curation of evidence to improve the built environment with relevant design recommendations and operational considerations affecting the personal, social, and economic health of our society.
Collapse
Affiliation(s)
- Debra Harris
- Interior Design, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Erich Baker
- Department of Computer Science, School of Engineering and Computer Science, Baylor University, Waco, TX, USA
| | | | - LesLee Funderburk
- Nutrition Sciences, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| |
Collapse
|
43
|
Ochoa L, Skubik-Peplaski C. Occupational Therapists' Beliefs and Experiences Managing Chronic Pain, Wellness, and Occupational Performance. OTJR (Thorofare N J) 2024; 44:139-147. [PMID: 37114718 DOI: 10.1177/15394492231164945] [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: 04/29/2023]
Abstract
Chronic disease prevention, health, and wellness have become primary practice areas for occupational therapy. Occupational therapists (OTs) in pain rehabilitation are established as essential members of comprehensive and multidisciplinary pain management teams, focusing on increasing occupational performance through participation. This study's purpose was to investigate OTs' experiences managing chronic pain and to explore OTs' effectiveness in supporting clients' wellness and occupational performance through interventions. Eleven OTs (n = 11) participated with three themes emerging on chronic pain, interventions, and holistic teams. Findings suggest that OTs are successful at treating chronic pain, supporting wellness and occupational performance when their interventions are health-promoting, and clients are enabled to take an active role in their chronic pain management. This study demonstrates the critical impact OTs can have in multidisciplinary teams on clients' outcomes, such as increased occupational performance, wellness, and quality of life (QOL) through engagement in meaningful occupations.
Collapse
|
44
|
Fannin A, Hooley C, Reeves CJ, Marçal K, Treglown R, Woerner R. Occupational burnout and public stigma associated with employee mental well-being: A multi-industry, cross-sectional study during COVID-19. Work 2024; 77:49-59. [PMID: 37483050 DOI: 10.3233/wor-220507] [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: 07/25/2023] Open
Abstract
BACKGROUND While mental illness (e.g., depression, anxiety) has been examined frequently in the workplace, the COVID-19 pandemic has only increased the attention towards mental illness. Mental well-being views mental health as a continuum from ill health to thriving. Few studies have examined factors associated with mental well-being in the workplace. Public stigma for mental illness, the general population's negative attitude towards mental illness, and occupational burnout are examined. OBJECTIVE The purpose of this study was to examine the relationship between burnout and public stigma on mental well-being in a sample of employees across industries in the United States. METHODS Employees surveyed from 16 companies from various industries were assessed. Room Here, a non-profit organization whose goal is to improve employee mental fitness, gathered data from these companies located in the western mountain region of the U.S. Data were collected during the pandemic. Across this portfolio of companies, 259 employees were included in the sample. Survey assesses respondents' mental well-being, stigma towards mental illness, and occupational burnout. Ordinary least squares (OLS) regression was used in this cross-sectional study on secondary data. RESULTS Results suggested occupational burnout was associated with a decrease in mental well-being, while public stigma was associated with an improvement in mental well-being. CONCLUSION This study sought to examine the relationship between mental well-being, burnout, and public stigma. Employee burnout and public stigma were related to mental well-being. Implications for burnout and stigma reduction programs are discussed as well as future research.
Collapse
Affiliation(s)
- Austin Fannin
- Industrial/Organizational Psychology, University of Tulsa, Tulsa, OK, USA
| | - Cole Hooley
- School of Social Work, Brigham Young University, Provo, UT, USA
| | - Cody J Reeves
- Marriott School of Business, Brigham Young University, Provo, UT, USA
| | - Katherine Marçal
- School of Social Work, Rutgers University, NewBrunswick, NJ, USA
| | | | | |
Collapse
|
45
|
Briles B, Kahl A, Anaissie J, Brettmann L, Pathak U, Staggers KA, Popat S, Agrawal A, Rose S, Taylor J. Levels and drivers of burnout during the COVID-19 pandemic among a diverse group of resident physicians. Postgrad Med 2024; 136:44-51. [PMID: 38193442 DOI: 10.1080/00325481.2024.2303974] [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: 04/19/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVES Evidence has shown significant impacts of the COVID-19 pandemic on physicians. We hypothesized that these effects would impact surgical and non-surgical resident education differently, with non-surgical specialties being more heavily impacted by frontline work and surgical specialties losing elective cases. METHODS We examined well-being and burnout among resident physicians in surgical and non-surgical specialties during the peak of the COVID-19 pandemic using the Mayo Physician Well-Being Index (WBI). RESULTS Completed surveys were received from 110 residents, 55% of whom were in a surgical training program. 35% of respondents were identified as 'at risk' for burnout. Increased demands from work (adj. OR 3.79, 95% CI 1.50, 9.59, p = 0.005) was associated with an increased likelihood for being 'at risk' compared to those without increased demands. Odds of having increased stress level were higher amongst residents with fear/anxiety of the unknown (adj. OR 4.21, 95% CI 1.63, 10.90, p = 0.003) and more demands outside work (adj. OR 10.54, 95% CI 2.63, 42.16, p = 0.001) but lower amongst residents with more time for studying (OR 0.23, 95% CI 0.09, 0.64, p = 0.005). Risk for burnout was not significantly different between surgical and non-surgical specialties when adjusting for increased demands from work (adj. OR 1.43, 95% CI 0.60, 3.37, p = 0.0.418). CONCLUSION Perceived effects of the COVID-19 pandemic upon residents' educational experience was mixed: reduced clinical volume had a negative impact, while increased time for study was perceived favorably. These findings suggest potential strategies and targets to mitigate the stress and burnout of a future crisis, whether large or small, among surgical and non-surgical trainees.
Collapse
Affiliation(s)
- Brenna Briles
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Alyssa Kahl
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - James Anaissie
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Lindsay Brettmann
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Ujval Pathak
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Shreeya Popat
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Anoop Agrawal
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Stacey Rose
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer Taylor
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
46
|
Riley TD, Parascando JA, VanDyke E, Stuckey HL, Dong H, Pasha-Razzak O, Kass LE, McCall-Hosenfeld J, Bronson SK. How Does a Junior Faculty Development Program Affect Burnout? A Mixed Methods Assessment. J Med Educ Curric Dev 2024; 11:23821205231223294. [PMID: 38322705 PMCID: PMC10846043 DOI: 10.1177/23821205231223294] [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] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/07/2023] [Indexed: 02/08/2024]
Abstract
OBJECTIVES Burnout is common among junior faculty. Professional development has been proposed as a method to improve engagement and reduce burnout among academic physicians. The Penn State College of Medicine Junior Faculty Development Program (JFDP) is a well-established, interdisciplinary program. However, an increase in burnout was noted among participants during the program. The authors sought to quantify the change in burnout seen among JFDP participants across 3 cohorts, and to explore sources of well-being and burnout among participants. METHODS Through a sequential explanatory mixed methods approach, participants in the 2018/19, 2019/20, and 2020/21 cohorts took a survey assessing burnout (Copenhagen Burnout Inventory), quality of life (QoL), job satisfaction, and work-home conflict at the start and end of the course. Descriptive statistics were generated as well as Pearson χ2 test/Fisher exact test for categorical variables and Wilcoxon rank sum tests for continuous variables for group comparisons. To better understand the outcome, past participants were invited to interviews regarding their experience of burnout during the course. Inductive thematic analysis (kappa = 0.86) was used to derive themes. RESULTS Start- and end-of-course surveys were completed by 84 and 75 participants, respectively (response rates: 95.5% and 85.2%). Burnout associated with patient/learner/client/colleague increased (P = .005) and QoL decreased (P = .02) at the end compared with the start. Nonsignificant trends toward worsening in other burnout categories, work-home conflict, and job satisfaction were also observed. Nineteen interviews yielded themes related to risks and protective factors for burnout including competing demands, benefits of networking, professional growth, and challenges related to diverse faculty roles. CONCLUSION Junior Faculty Development Program participants demonstrated worsening of burnout and QoL during the program while benefiting from opportunities including skill building and networking. The impact of Junior Faculty Development Programs on the well-being of participants should be considered as an element of their design, evaluation, and refinement over time.
Collapse
Affiliation(s)
- Timothy D Riley
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Jessica A Parascando
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Erika VanDyke
- Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Heather L Stuckey
- Division of General Internal Medicine, Department of Medicine, Humanities and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Huamei Dong
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | | | - Lawrence E Kass
- Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
- Department of Emergency Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Jennifer McCall-Hosenfeld
- Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Sarah K Bronson
- Department of Cellular and Molecular Physiology, Penn State College of Medicine, Hershey, PA, USA
| |
Collapse
|
47
|
Abstract
In response to concerns regarding numerous complex issues facing the veterinary specialty profession, several organizations, including the American College of Veterinary Internal Medicine, have made a clarion call to the American Veterinary Medical Association to begin discussions surrounding the formation of an accrediting body for internships, residencies, and fellowships. A proposed name for such a body is the Accreditation Council on Graduate Veterinary Medical Education, in alignment with the Accreditation Council on Graduate Medical Education (ACGME); the term "graduate" refers to specialty education that occurs after the first 4 years of the MD or DVM degree. Although the structure and financing of graduate education differ between the human medical and veterinary professions, we can nevertheless learn much from the history of evolution of human medical specialization as we navigate the path ahead.
Collapse
Affiliation(s)
- Jane E. Sykes
- Department of Medicine & Epidemiology, School of Veterinary MedicineUniversity of California‐DavisDavisCaliforniaUSA
| |
Collapse
|
48
|
Haun JN, Schneider T, Ballistrea LM, McMahon-Grenz J, Melillo C, Benzinger R, Paykel JM. Veterans' lived experiences with the VA's Whole Health system and perceived impact on dimensions of wellness. Explore (NY) 2023:S1550-8307(23)00285-9. [PMID: 38184376 DOI: 10.1016/j.explore.2023.12.013] [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: 09/21/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/08/2024]
Abstract
RESEARCH QUESTION What are the lived experiences and wellness related outcomes of veterans engaged in the Department of Veterans' Affairs (VA) Whole Health (WH) system of care? THEORETICAL FRAMEWORK This qualitative work was conducted with a pragmatic phenomenological approach to understand patients' lived experience within the WH system of care. Data were contextualized within a multi-dimensional wellness model. METHODOLOGY This descriptive quality improvement project used semi-structured telephone interviews. Interview script elicited veterans' WH participation experiences and perceived wellness related outcomes. CONTEXT Data were collected within a WH Service, at a large Veterans Health Administration Hospital in the Southeast United States. SAMPLE SELECTION Data were collected with a purposive sample of veterans that participated in at least 2 WH activities. DATA COLLECTION Patients were recruited by WH clinical team collaborators to participate in qualitative data collection. ANALYSIS AND INTERPRETATION Rapid content analysis and interpretation of results were conducted in alignment with dimensions of wellness constructs. MAIN RESULTS WH offers veterans' non-pharmacological tools to improve mental, physical, and social wellness. Participants (n = 50) represented the larger veteran population. Most veterans perceived a positive WH experience with improvement of three primary dimensions including mental and emotional, physical, and social wellness - impacts on other dimensions gleaned less perceived impact. Veterans reported adopting mindfulness and coping strategies, better mobility, pain management, and sleep quality, and enhanced social engagement. Even those who did benefit personally from all aspects of WH, felt the services are needed to support the larger veteran population. Reduced suicidal ideation and pain medication use emerged as a WH effect among approximately 10% of the sample.
Collapse
Affiliation(s)
- Jolie N Haun
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, United States
| | - Tali Schneider
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States
| | - Lisa M Ballistrea
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States
| | - Julie McMahon-Grenz
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States
| | - Christine Melillo
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States
| | - Rachel Benzinger
- Research and Development Service, James A. Haley Veterans' Hospital, Research Service, 8900 Grand Oak Circle, Tampa, FL 33637, United States.
| | - Jacquelyn M Paykel
- Whole Health Service, James A. Haley Veterans Hospital, Tampa, FL 33637, United States
| |
Collapse
|
49
|
Fitterman-Harris HF, Davis GG, Bedard SP, Cusack CE, Levinson CA. Digital Mental Health Interventions: Differences in Diet Culture Intervention Framing. Int J Environ Res Public Health 2023; 21:24. [PMID: 38248489 PMCID: PMC10815398 DOI: 10.3390/ijerph21010024] [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] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
Diet culture is a societal norm that ranks thin bodies as superior to other body types and has been associated with negative outcomes, such as eating disorders. Wellness has evolved into a term that is often used to promote diet culture messages. One possible way to combat diet culture is through single-session, digital mental health interventions (DMHIs), which allow for increased access to brief public health treatments. The framing of DMHIs is critical to ensure that the target population is reached. Participants (N = 397) were enrolled in a single-session DMHI, which was framed as either a Diet Culture Intervention (n = 201) or a Wellness Resource (n = 196). Baseline group differences in eating disorder pathology, body image, weight stigma concerns, fat acceptance, and demographic characteristics were analyzed. Across groups, participants reported moderately high eating disorder pathology, low-to-moderate levels of body dissatisfaction, moderate levels of fat acceptance, and either very low or very high weight stigma concerns. Participants in the Diet Culture Intervention group reported higher levels of fat acceptance than those in the Wellness Resource group (p < 0.001). No other framing group differences were identified, though post hoc analyses revealed differences based on recruitment source (i.e., social media versus undergraduate research portal). This study found that framing a DMHI as targeting diet culture or as a Wellness Resource can result in the successful recruitment of individuals at risk of disordered eating. Framing a DMHI as a Wellness Resource may increase recruitment of individuals with low levels of fat acceptance, which may be particularly important for dismantling diet culture, disordered eating, and weight stigma concerns. Future research should assess DMHI framing in other populations, such as men and adolescents.
Collapse
Affiliation(s)
- Hannah F. Fitterman-Harris
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA; (S.P.B.); (C.E.C.); (C.A.L.)
| | - Gabrielle G. Davis
- College of Education and Human Development, University of Louisville, Louisville, KY 40292, USA;
| | - Samantha P. Bedard
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA; (S.P.B.); (C.E.C.); (C.A.L.)
- Department of Psychology, University of Wyoming, Laramie, WY 82071, USA
| | - Claire E. Cusack
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA; (S.P.B.); (C.E.C.); (C.A.L.)
| | - Cheri A. Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA; (S.P.B.); (C.E.C.); (C.A.L.)
- Department of Pediatrics, Division of Child and Adolescent Psychiatry and Psychology, University of Louisville, Louisville, KY 40292, USA
| |
Collapse
|
50
|
Lanzi RG, Modi RA, Rimmer J. A Disability-Inclusive Healthcare-to-Well-Being Translational Science Framework. Int J Environ Res Public Health 2023; 21:18. [PMID: 38248483 PMCID: PMC10815666 DOI: 10.3390/ijerph21010018] [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: 10/16/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024]
Abstract
The recent World Health Organization report on disability noted that people with disabilities (PWD) have many unmet health and rehabilitation needs, face numerous barriers to accessing healthcare and specialized services, and have overall worse health than people without disability. In view of this urgency to better identify and address health inequities systematically, we convened an expert panel of 14 stakeholders to develop a strategic plan that addresses this issue. The panel identified two major obstacles to quality healthcare services for PWD: (1) lack of coordination between the various healthcare sectors and community well-being programs and (2) substantial challenges finding and accessing healthcare services that meet their specific needs. The expert stakeholder panel noted that well-being self-management programs (both online and in person) that are easily accessible to PWD are critically needed. PWD must transition from being cared for as patients to individuals who are able to self-manage and self-advocate for their own health and well-being plans and activities. The proposed strategic plan offers providers and local communities a framework to begin addressing accessible and appropriate healthcare-to-well-being services and programs for PWD in managing their health in partnership with their healthcare providers.
Collapse
Affiliation(s)
- Robin G. Lanzi
- School of Public Health—Health Behavior, The University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL 35294, USA;
| | - Riddhi A. Modi
- School of Public Health—Health Behavior, The University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL 35294, USA;
| | - James Rimmer
- School of Health Professions—Occupational Therapy, National Center on Health, Physical Activity and Disability (NCHPAD), The University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL 35209, USA;
| |
Collapse
|