Format
Sort by
Items per page

Send to

Choose Destination

Search results

Items: 1 to 20 of 141

1.
Afr J Prim Health Care Fam Med. 2019 Oct 17;11(1):e1-e10. doi: 10.4102/phcfm.v11i1.1982.

Exploring resilience in family physicians working in primary health care in the Cape Metropole.

Author information

1
Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town. leigh.wagner@hotmail.com.

Abstract

BACKGROUND:

Despite the high prevalence of burnout among doctors, studies have shown that some doctors who choose to remain in primary healthcare (PHC) survive, even thrive, despite stressful working conditions. The ability to be resilient may assist family physicians (FPs) to adapt successfully to the relatively new challenges they are faced with. This research seeks to explore resilience through reflection on the lived experiences of FPs who have been working in PHC.

AIM:

To explore the resilience of FPs working in PHC in the Cape Metropole.

SETTING:

The study was conducted among FPs in PHC in the Cape Town metropole, Western Cape province, South Africa.

METHODS:

A phenomenological qualitative study involved interviewing 13 purposefully selected FPs working in the public sector PHC in the Cape Metropole. Data were analysed using the framework method.

RESULTS:

The mean resilience scale was moderate. Six key aspects of resilience were identified: having a sense of purpose, 'silver lining' thinking, having several roles with autonomy, skilful leadership, having a support network and self-care.

CONCLUSION:

The aspects that contribute to FP resilience are multi-faceted. It entails having a sense of purpose, 'silver lining' thinking, having several roles with autonomy, skilful leadership, having a support network and valuing self-care. Our exploration of resilience in FPs in the Cape Metropole corroborates the findings of previous studies. To ensure physician wellness and improved patient outcomes, we recommend that individual and organisational strategies should be implemented in the absence of long-term policy changes.

KEYWORDS:

family medicine; family physicians; physician well-being; primary healthcare practice; resilience; work satisfaction

2.
Curr Probl Pediatr Adolesc Health Care. 2019 Sep 26:100663. doi: 10.1016/j.cppeds.2019.100663. [Epub ahead of print]

Cultivating a way of being and doing: Individual strategies for physician well-being and resilience.

Author information

1
Department of Pediatrics, School of Medicine, University of California Davis, Sacramento, California, United States. Electronic address: agogo@ucdavis.edu.
2
Department of Pediatrics, College of Medicine, University of Illinois, Chicago, Illinois, United States.
3
Department of Medicine, College of Medicine, University of Arizona, Tucson, Arizona, United States.
4
Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, San Diego, California, United States.

Abstract

The practice of medicine is rewarding on many levels, but demands of the work can result in mental and emotional exhaustion, self-isolation, burnout, depression, suicidal ideation and tragically, completed suicide. It is critical to have effective strategies to address the unique stressors of a medical career, mitigate burnout, and buffer the physiologic toll of chronic stress. Using Zwack and Schweitzer's widely published description of approaches to maintaining resilience and approaches to wellness, we have organized these strategies into three broad domains relevant to medical practice: (1) gratification (connection and communication, meaning and purpose); (2) resilience building practices (self-reflection, time for oneself, self-compassion, spirituality); and (3) useful attitudes (acceptance, flexibility, self-awareness). Several techniques are described including mindfulness-based stress reduction, narrative medicine, skillful communication, and practices in self-compassion, gratitude, and spirituality. The focus of the work is to introduce a spectrum of resilience strategies for individual consideration that can be tailored and combined to meet a physician's changing needs over the course of medical training and practice.

3.
Explore (NY). 2019 Aug 12. pii: S1550-8307(19)30448-3. doi: 10.1016/j.explore.2019.08.005. [Epub ahead of print]

Interventions to increase resilience in physicians: A structured literature review.

Author information

1
Murdoch University, 90 South Street, Murdoch, Western Australia 6150, Australia. Electronic address: cmoorfield@ranzcog.edu.au.
2
College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, Western Australia 6150, Australia. Electronic address: v.cope@murdoch.edu.au.

Abstract

AIMS AND OBJECTIVES:

To critically appraise available literature on interventions to increase resilience in physicians.

BACKGROUND:

The increasing rate of burnout in physicians has sparked interest in interventions that increase their resilience. Research on improving resilience among health professionals is still in its infancy, yet understanding what interventions are effective in counteracting burnout is vital to ensuring a resilient medical workforce.

DESIGN:

A focused review of research literature.

METHODS:

The review used key terms and Boolean operators across a five-year time frame in PsycINFO, MEDLINE, CINAHL and Google Scholar for relevant articles. Ten articles are included in the structured literature review.

RESULTS:

Interventions were tested in eight of the 10 studies, with mindfulness a common theme. Results for effectiveness of training programs were mixed, with some studies reporting significant improvements in resilience and others not. Some group, online and coaching interventions were found to be effective in increasing resilience. The percentage of physicians participating in these studies varied, and results regarding physicians were not always reported separately.

CONCLUSIONS:

This review examined a range of interventions, with varying measures of effectiveness. Common limitations in the reviewed studies included self-selection bias, lack of a control group, and uncertainty over whether changes could be attributed to the intervention. The findings presented were not limited to physicians, but included a broader range of health professionals. It is not possible to generalize the results of these studies to physicians. Further research is needed to refine interventions and pinpoint precisely what increases resilience in physicians.

KEYWORDS:

Coaching; Mindfulness; Physician; Resilience; Self-care

Publication type

Publication type

4.
Clin Obstet Gynecol. 2019 Sep;62(3):480-490. doi: 10.1097/GRF.0000000000000444.

Moving From Physician Burnout to Resilience.

Author information

1
Sotile Center for Resilience, Center for Physician Resilience.
2
Wellness Services, Sotile Center for Resilience, Center for Physician Resilience, Davidson, North Carolina.
3
Neurosurgery, Carillon Clinic, Virginia Tech Carillon School of Medicine, Roanoke, Virginia.

Abstract

We contend that work ambivalence is a key building block in fostering physician burnout and its sequalae, while engagement in meaningful work and receiving family support for that work enhances resilience. No singular approach to curbing burnout in OBGYN physicians has received empirical support. Clinical experience suggests that curbing physician burnout requires a combination of workplace redesigns, positive leadership behaviors, and resilience training that teaches practical applications from the fields of resilience, emotional intelligence, positive psychology, and relationship systems. This paper highlights organizational and leadership interventions that foster physician engagement, and describes how physicians can foster personal and family resilience.

5.
J Urol. 2019 Aug;202(2):220. doi: 10.1097/01.JU.0000576804.44936.d2. Epub 2019 Jul 8.

How I Maintain Resilience in an Era of Physician Burnout.

Author information

1
University of Texas Health Center San Antonio , San Antonio , Texas.
[Indexed for MEDLINE]
Icon for Wolters Kluwer
6.
Fam Med. 2019 Sep 6;51(8):657-663. doi: 10.22454/FamMed.2019.424025. Epub 2019 Jul 2.

Family Physician Burnout and Resilience: A Cross-Sectional Analysis.

Author information

1
John Peter Smith Family Medicine, Residency, Ft Worth, TX.
2
Texas A&M Health Science Center, College of Medicine, Department of Primary Care Medicine, College Station, TX.
3
Departments of Family & Community Medicine and Psychiatry, University of Texas Health, San Antonio.
4
John Peter Smith Family Medicine Residency, Ft Worth, TX.

Abstract

BACKGROUND AND OBJECTIVES:

Current physician burnout levels are at historically high levels, especially in family medicine, with many factors playing a role. The goal of this study was to understand demographic, psychological, environmental, behavioral, and workplace characteristics that impact physician wellness and burnout, focusing on family medicine physicians and residents.

METHODS:

Survey respondents were 295 family medicine residents and faculty members across 11 residency programs within the Residency Research Network of Texas (RRNeT). Subjects completed multiple measures to assess resilience, burnout, psychological flexibility, and workplace stress. Respondents also reported personal wellness practices and demographic information. The primary outcome variables were burnout (depersonalization, emotional exhaustion, and personal achievement) and resilience.

RESULTS:

The predictor variables contributed significant variance (depersonalization=27.1%, emotional exhaustion=39%, accomplishment=37.7%, resilience=37%) and resulted in large effect sizes (depersonalization f²=.371, emotional exhaustion f²=.639, accomplishment f²=.605, resilience f²=.587) among the three burnout models and the resilience model for the sample. Similar variance and effect sizes were present for independent resident and program faculty samples, with resilience being the only outcome variable with significant differences in variance between the samples.

CONCLUSIONS:

This study demonstrates the roles of both individual and organization change needed to impact provider wellness, with special attention to resilience across faculty and residents. The results of this study may inform workplace policies (ie, organizational practice change) and wellness programming and curricula (ie, individual level) for family medicine residents and program faculty.

7.
Psychol Health Med. 2019 Dec;24(10):1220-1234. doi: 10.1080/13548506.2019.1619785. Epub 2019 May 24.

Self-reported modifying effects of resilience factors on perceptions of workload, patient outcomes, and burnout in physician-attendees of an international emergency medicine conference.

Author information

1
Rutgers-Robert Wood Johnson Medical School , New Brunswick , NJ , USA.
2
Director of Research, Department of Emergency Medicine at Rutgers-Robert Wood Johnson Medical School , New Brunswick , NJ , USA.

Abstract

Emergency medicine has one of the highest rates of burnout of all medical specialties. Recent research has identified putative sources of burnout in emergency medicine, including stress of overnight shifts, psychological demands of handling emergency patients, and perceived poor departmental support systems. This burnout is detrimental to the quality of patient care, and thus represents an important target to simultaneously improve both physician wellness and patient outcomes. We lack consensus on the best way to combat the impacts of physician burnout in part, because we do not know the protective factors that best enable individuals to manage their burnout and be resilient to its impacts on their patient care. The goal of this study was to identify the resilience factors that have the greatest influence on the relationship between physician burnout symptoms and perceptions of workload impact on patient outcomes. We conducted a cross-sectional web-based anonymous survey of full-time attending emergency medicine physicians and measured self-reported responses about perceived impacts of workload on patient care and symptoms of burnout. Additionally, we measured resilience factor-related items (such as shift length/type, spirituality, home life, etc.), stratified the responses by level of agreement with the statements, and assessed how each impacted the relationship between burnout domains and perceived workload/patient outcomes. The level of agreement with five resilience factor statements influenced the magnitude of correlation between workload's effects on patient outcomes and burnout. These factors included personal spirituality, utility of mindfulness techniques, sleep quality, perceptions of home life, and the presence of institutional debriefing procedures. This work identified five resilience factors that may enable emergency medicine physicians to mitigate the impact of their burnout on their work and patient care. Promoting these resilience factors represent targets for institutional-level interventions to improve both physician wellness and patient outcomes.

KEYWORDS:

Emergency Medicine; burnout; resilience; wellness; workload

8.
Postgrad Med J. 2019 Mar;95(1121):140-147. doi: 10.1136/postgradmedj-2018-136135. Epub 2019 Mar 29.

Resilience in medical doctors: a systematic review.

Author information

1
General Surgery, Ulster Hospital, Dundonald, UK nmckinley01@qub.ac.uk.
2
Royal Victoria Hospital, Belfast, UK.
3
General Surgery, Ulster Hospital, Dundonald, UK.
4
Queen's University Belfast Centre for Public Health, Belfast, UK.

Abstract

INTRODUCTION:

Resilience can be difficult to conceptualise and little is known about resilience in medical doctors.

AIMS:

This systematic review discusses the existing literature on influences on resilience levels of medical doctors.

METHODS:

The bibliographic databases PubMed, MEDLINE, EMBASE and PsycINFO were searched from 2008 to November 2018 using keyword search terms resilience* AND ("medical physician*" OR doctor* OR surgeon* OR medical trainee* or clinician*).

RESULTS:

Twenty-four studies were deemed eligible for inclusion. A narrative synthesis was performed. The following influences on resilience in doctors were identified: demographics, personality factors, organisational or environmental factors, social support, leisure activities, overcoming previous adversity and interventions to improve resilience.

CONCLUSIONS:

Resilience is not limited to a doctor's own personal resource. Published studies also highlight the influence of other modifiable factors.

KEYWORDS:

clinician; doctor; physician; psychological wellbeing; resilience (psychological)

[Indexed for MEDLINE]
Icon for HighWire
9.
10.
Br J Anaesth. 2019 Jul;123(1):74-80. doi: 10.1016/j.bja.2019.01.034. Epub 2019 Mar 6.

Grief reactions and coping strategies of trainee doctors working in paediatric intensive care.

Author information

1
Anaesthetic Department, Our Lady's Children's Hospital Crumlin, Dublin, Ireland. Electronic address: robffrench@gmail.com.
2
Anaesthetic Department, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
3
Department of Human Factors in Patient Safety, Royal College of Surgeons of Ireland, Dublin, Ireland.

Abstract

BACKGROUND:

The death of a child can have significant emotional effects on doctors responsible for their care. Trainee doctors working in the paediatric intensive care unit (PICU) may be particularly vulnerable. The aim of this study was to examine the emotional impact of, and grief reactions to, a child's death in PICU trainee doctors, along with coping strategies they used.

METHODS:

In a prospective, cross-sectional, observational study, qualitative and quantitative data were recorded on anonymised, written questionnaires. Grief severity was assessed using the Texas Revised Inventory of Grief. Emotional impact was assessed using the shortened Impact of Event Scale. The BriefCOPE tool was used to assess coping strategies. Qualitative data was analysed using conventional content analysis. Data are presented as median (inter-quartile range) or number (%).

RESULTS:

All invited trainee doctors (23 anaesthetists; 5 paediatricians) completed the questionnaire (age, 30 [29-34] yr; 13/28 [46%] female). Two (7%) doctors experienced severe grief (Texas Revised Inventory of Grief score <39), with five (18%) doctors severely affected by the deaths as measured by the Impact of Event Scale. Qualitative analysis revealed prominent themes of sadness, helplessness, guilt, shock, and concern for the bereaved family. There was limited use of coping strategies. Speaking with another trainee doctor was the principal coping strategy. Requests for debriefing sessions, greater psychological support and follow-up with the patient's family were frequently suggested.

CONCLUSIONS:

Paediatric deaths evoke significant grief and emotional reactions in a subset of PICU trainee doctors. Trainee PICU doctors highlighted a lack of professional support and tailored debriefs.

KEYWORDS:

adaptation; attitude to death; coping; grief; intensive care units; paediatric; post-traumatic stress disorder

PMID:
30916024
DOI:
10.1016/j.bja.2019.01.034
[Indexed for MEDLINE]
Icon for Elsevier Science
11.
Aktuelle Urol. 2019 Apr;50(2):190-194. doi: 10.1055/a-0834-5954. Epub 2019 Mar 21.

[Starting points for resilience promotion in medical education: What keeps future doctors healthy?]

[Article in German; Abstract available in German from the publisher]

Author information

1
Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Institut für Sozialmedizin und Epidemiologie, Lübeck.

Abstract

A trend towards reduced resilience to stress and impaired psychosocial well-being begins early on in medical education. Our own results confirm the early deterioration of the psychosocial health of medical students observed internationally. Students who simultaneously demonstrate high levels of perfectionism, an insufficient ability to distance themselves from work, as well as a lack of regular physical activity appear to form a special risk group. Therefore, it seems rational to implement interventions that counteract this development by enhancing individual resources and preventing harmful curriculum-associated influences as early as possible during medical education. Interventions should target both individual behaviour and experience patterns of students as well as the setting. The medical curriculum itself was viewed as a priority starting point for resilience-promoting interventions by the students. It should be in the interest of all parties involved to enable all students to stay well during their medical education and to provide them with resources for their work like, e. g. good resilience, which, in turn, will have a sustainable positive effect on the quality of patient care. To date, the evidence base with regard to protective factors for medical students' health and effective resilience-promoting interventions is insufficient in terms of quantity and quality. Moreover, there are only a few meaningful studies that deal specifically with German-speaking areas. Our own studies show that the willingness to participate in resilience-promoting interventions is high in spite of the additional expenditure of time because students consider such interventions to be helpful. Interventions employing the concepts of Mind Body Medicine seem to be especially promising in the context of medical education.

PMID:
30897639
DOI:
10.1055/a-0834-5954
[Indexed for MEDLINE]
Icon for Georg Thieme Verlag Stuttgart, New York
12.
PLoS One. 2019 Jan 17;14(1):e0210512. doi: 10.1371/journal.pone.0210512. eCollection 2019.

Interventions to improve resilience in physicians who have completed training: A systematic review.

Author information

1
School of Epidemiology, University of Ottawa, Ottawa, Ontario, Canada.
2
Department of Educational Studies, University of South Carolina, Columbia, South Carolina, United States of America.
3
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
4
Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.

Abstract

BACKGROUND:

Resilience is a contextual phenomenon where a complex and dynamic interplay exists between individual, environmental, and socio-cultural factors. With growing interest in enhancing resilience in physicians, given their high risk for experiencing prolonged or intense stress, effective strategies are necessary to improve resilience and reduce negative outcomes including burnout. The objective of this review was to identify effective interventions to improve resilience in physicians who have completed training, working in any setting.

METHODS AND FINDINGS:

We included randomized controlled trials (RCT), and observational studies (including pilot studies) published in English, French, and Spanish that included an intervention to improve resilience in physicians who have completed training. We included studies that implemented interventions to reduce burnout, anxiety, and depression or to improve empathy to ultimately enhance resilience, rather than studies designed solely to reduce stress or trauma-induced stress. We performed a systematic search of Medline, EMBASE, PsychInfo, CINAHL and Cochrane Library with no publication year limit. The last search was conducted on March 29, 2017. We used random effect models to calculate pooled standardized mean differences. Resilience was the primary outcome measure using validated resilience scores. Secondary outcome measures included proxy measures of resilience such as burnout, empathy, anxiety and depression. Our search strategy identified 7,579 records;74 met the criteria for full-text review. Seventeen studies were included in the final review published between 1998 and 2016 of which 9 (4 RCT, 5 observational) had physician data extractable. Interventions varied greatly regarding their approach, duration, and follow-up. Two RCTs measured resilience using validated scales; both found a significant improvement. No meta-analysis for resilience was conducted due to the presence of high clinical and methodological heterogeneity.

CONCLUSIONS:

Our systematic review demonstrates that there is weak evidence to support one intervention over another to improve resilience in physicians who have completed training. The quality of evidence for the outcomes ranged from very low to low. There is a need for a consensus on the definition of resilience and how it is measured. Longer follow-up is required to ensure any intervention effects are sustained over time.

PMID:
30653550
PMCID:
PMC6336384
DOI:
10.1371/journal.pone.0210512
[Indexed for MEDLINE]
Free PMC Article
Icon for Public Library of Science Icon for PubMed Central
13.
Educ Prim Care. 2019 Mar;30(2):96-101. doi: 10.1080/14739879.2018.1563502. Epub 2019 Jan 17.

Supporting trainees in challenging learning environments - is there a way?

Author information

1
a Post CCT GP fellow , Health Education East Midlands , Nottingham , UK.
2
b Salaried GP , Clare House Surgery , Tiverton , UK.
3
c The Research Unit for and Department of General Practice, Department of Public Health, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark.
4
d St. Edmund's College , Cambridge University , Cambridge , UK.

Abstract

The working and learning environment within the NHS is challenging. 46% of GPs report emotional exhaustion, and trainees experience burn-out with higher prevalence than expected. Attending Balint groups (BGs) has been suggested to prevent burnout and compassion fatigue, helping GPs to thrive in their jobs. For this pilot service evaluation of BGs for GP trainees we used qualitative research methodology including surveys, participant observation, and semi-structured interviews. Fonagy's concept of resilience was used as the theoretical frame of reference. The data-led analysis identified trainees having burn-out sensations: un-met expectations for their training; their need for more support and the value of attending the BGs. Trainees experienced BG as a safe place, allowing open discussions and honest accounts of anxieties, facilitating clinical learning and learning skills of reflection as an important supplement to normal training. The theory-led analysis showed that BG sessions taught trainees new approaches to improve elements that are assessed as key in the selection process for GP training and as Fonagy described as characteristic for people with resilience. As a result of this project, a number of trainees expressed interest in continuing Balint group work. Trainees were recruited to an ongoing monthly BG, within the GP training scheme. However, due to budget restraints, difficulties with new interest and failing to find a non-training GP facilitator in the local area, the group has floundered.

KEYWORDS:

Balint groups (BG's); Burnout; GP trainees; general practice (GP); resilience

PMID:
30652934
DOI:
10.1080/14739879.2018.1563502
[Indexed for MEDLINE]
Icon for Taylor & Francis
14.
Orv Hetil. 2019 Jan;160(3):112-119. doi: 10.1556/650.2019.31258.

[Burnout and resilience among Hungarian physicians].

[Article in Hungarian; Abstract available in Hungarian from the publisher]

Author information

1
Magatartástudományi Intézet, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Nagyvárad tér 4., 1089.

Abstract

INTRODUCTION:

The burnout of healthcare workers is of outstanding significance in both national and international studies.

AIM:

Based on a representative, national physician survey (n = 5013), the aim of this study was to describe burnout indicators and the correspondence between them and working conditions. Moreover, we were aiming to compare the results with our 2013 physician survey and to analyze the potential relationship between burnout and resilience.

METHOD:

We analyzed the results of the online quantitative survey with multiple variables descriptively. The connection between the respective dimensions of burnout and resilience was studied with logistic regression.

RESULTS:

In comparison with data from 2013, the medium and high level proportions of depersonalization and personal accomplishment were similar (49% versus 49.9% and 65.1% versus 68.9%). Since 2013 (49%), we experienced a decrease in depersonalization (40.2%). Those working in in-patient care, at multiple workplaces and shift hours regularly have a higher chance of burnout. Our multivariable analysis has shown that the lack of resilience is an important predictor for the medium and high levels of emotional exhaustion, depersonalization and personal accomplishment.

CONCLUSION:

Our results have shown that internal resources, coping strategies and resilience play a key role in burnout and its decrease. Orv Hetil. 2018; 160(3): 112-119.

KEYWORDS:

burnout; kiégés; munkamegterhelés; orvosok; physicians; resilience; reziliencia; workload

PMID:
30640529
DOI:
10.1556/650.2019.31258
[Indexed for MEDLINE]
Icon for Atypon
15.
Ear Nose Throat J. 2018 Dec;97(12):386.

The root cause of physician burnout cannot be solved with resilience efforts [Editorial].

Author information

1
USC Voice Center, Division Director, Laryngology, University of Southern California, Los Angeles, CA, USA.
PMID:
30540882
[Indexed for MEDLINE]
16.
17.
J Evid Based Integr Med. 2018 Jan-Dec;23:2515690X18804779. doi: 10.1177/2515690X18804779.

Variability of Burnout and Stress Measures in Pediatric Residents: An Exploratory Single-Center Study From the Pediatric Resident Burnout-Resilience Study Consortium.

Author information

1
1 The Ohio State University, Columbus, OH, USA.
2
2 Nationwide Children's Hospital, Columbus, OH, USA.
3
3 University of Illinois at Chicago, Chicago IL, USA.
4
4 University of Washington, Seattle, WA, USA.
5
5 Duke University Medical Center, Durham, NC, USA.
6
6 Johns Hopkins University School of Medicine, Baltimore, MD, USA.
7
7 University of Arizona, Tucson, AZ, USA.
8
8 Cincinnati Children's Hospital, Cincinnati, OH, USA.
9
9 University of Cincinnati, Cincinnati, OH, USA.
10
10 Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.

Abstract

Residency is a high-risk period for physician burnout. We aimed to determine the short-term stability of factors associated with burnout, application of these data to previous conceptual models, and the relationship of these factors over 3 months. Physician wellness questionnaire results were analyzed at 2 time points 3 months apart. Associations among variables within and across time points were analyzed. Logistic regression was used to predict burnout and compassionate care. A total of 74% of residents completed surveys. Over 3 months, burnout ( P = .005) and empathy ( P = .04) worsened. The most significant cross-sectional relationship was between stress and emotional exhaustion (time 1 r = 0.61, time 2 r = 0.68). Resilience was predictive of increased compassionate care and decreased burnout ( P < .05). Mindfulness was predictive of decreased burnout ( P < .05). Mitigating stress and fostering mindfulness and resilience longitudinally may be key areas of focus for improved wellness in pediatric residents. Larger studies are needed to better develop targeted wellness interventions.

KEYWORDS:

mindfulness; physician burnout; stress

PMID:
30378438
PMCID:
PMC6238198
DOI:
10.1177/2515690X18804779
[Indexed for MEDLINE]
Free PMC Article
Icon for Atypon Icon for PubMed Central
18.
J Eval Clin Pract. 2018 Dec;24(6):1347-1357. doi: 10.1111/jep.13054. Epub 2018 Oct 18.

A multicountry comparative survey about organizational resilience in anaesthesia.

Author information

1
Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy.
2
Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University of Rome, Rome, Italy.

Abstract

RATIONALE, AIMS, AND OBJECTIVES:

The application of resilience in health care requires the shift from a cause-effect approach to a systemic approach, yet few tools have been developed to measure resilience potential in this specific context. This study tests a resilience assessment grid (RAG) questionnaire to measure the resilience of anaesthesiologists, with a cross-country survey.

METHOD:

A study was conducted with an analytic hierarchy process (AHP) questionnaire containing 57 detailed questions; 16 nations and 172 respondents were involved in the study. The data were statistically analysed to identify insights from the questionnaire, main improvements for further assessment, and confirmation of the design of the questionnaire. The questionnaire reliability was assessed by Cronbach analysis. Weak items were identified by a detailed correlations analysis and through a weight-polarization matrix. Construct validity was confirmed by principal component analysis (PCA) and factor analysis (FA).

RESULTS:

The α level of Cronbach analysis is 0.910. PCA and FA confirmed the absence of underlying unexpected factors, with less than 8% from the first factor and a total of just 54% of variability explained by 17 factors. Suggestions for revising the questionnaire ensue from the analysis, with improvements for the questionnaire's significance.

CONCLUSION:

The questionnaire shows the potential to assess proxy measures of resilience, even confirming the relevance of a structured weighting approach based on the AHP. The exemplar statistical cross-country analyses encourage the widespread use of a centralized resilience questionnaire to support standardized analyses and the diffusion of best practices among organizations.

KEYWORDS:

AHP; RAG; anaesthesia; questionnaire; resilience

PMID:
30334323
DOI:
10.1111/jep.13054
[Indexed for MEDLINE]
Icon for Wiley
19.
Med Educ. 2019 Feb;53(2):184-194. doi: 10.1111/medu.13737. Epub 2018 Oct 16.

Physician resilience: a grounded theory study of obstetrics and gynaecology residents.

Author information

1
Department of Obstetrics and Gynecology, New York University Langone Health, New York, New York, USA.
2
New York University Rory Meyers College of Nursing, New York, New York, USA.

Abstract

OBJECTIVE:

Enhancing physician resilience has the promise of addressing the problem of burnout, which threatens both doctors and patients and increases in residents with each year of training. Programmes aimed at enhancing physician resilience are heterogeneous and use varied targets to measure efficacy, because there is a lack of clarity regarding this concept. A more robust understanding of how resilience is manifested could enhance efforts to create and measure it in physicians in training.

METHODS:

A qualitative study used grounded theory methodology to analyse semi-structured interviews with a purposive, intensity sample of obstetrics and gynaecology residents in an urban academic health centre. Longitudinal engagement through two sets of interviews 3-6 months apart allowed for variations in season and context. Thematic saturation was achieved after enrollment of 18 residents representing all 4 years of postgraduate training. A three-phase coding process used constant comparison, reflective memos and member checking to support the credibility of the analysis.

RESULTS:

A conceptual model for resilience as a socio-ecological phenomenon emerged. Resilience was linked to professional identity and purpose served to root the individual and provide a base of support through adversity. Connections to others inside and outside medicine were essential to support developing resilience, as was finding meaning in experiences. The surrounding personal and professional environments had strong influences on the ability of individuals to develop personal resilience.

CONCLUSIONS:

Physician resilience in this context emerged as a developmental phenomenon, influenced by individual response to adversity as well as surrounding culture. This suggests that both programmes teaching individual skills as well as systematic and cultural interventions could improve a physician's capacity to thrive.

PMID:
30328135
DOI:
10.1111/medu.13737
[Indexed for MEDLINE]
Icon for Wiley
20.
Br J Gen Pract. 2018 Dec;68(677):e819-e825. doi: 10.3399/bjgp18X699401. Epub 2018 Oct 8.

Professional resilience in GPs working in areas of socioeconomic deprivation: a qualitative study in primary care.

Author information

1
Academic Unit of Primary Medical Care, The University of Sheffield, Sheffield.
2
Academic Unit of Primary Medical Care, The University of Sheffield and The Whitehouse Surgery, Sheffield.

Abstract

BACKGROUND:

GPs working in areas of high socioeconomic deprivation face particular challenges, and are at increased risk of professional burnout. Understanding how GPs working in such areas perceive professional resilience is important in order to recruit and retain a GP workforce in these areas.

AIM:

To understand how GPs working in areas of high socioeconomic deprivation consider professional resilience.

DESIGN AND SETTING:

A qualitative study of GPs practising in deprived areas within one primary care region of England.

METHOD:

In total, 14 individual interviews and one focus group of eight participants were undertaken, with sampling to data saturation. A framework approach was used for data analysis.

RESULTS:

Participants described three key themes relating to resilience. First, resilience was seen as involving flexibility and adaptability. This involved making trade-offs in order to keep going, even if this was imperfect. Second, resilience was enacted through teams rather than through individual strength. Third, resilience required the integration of personal and professional values rather than keeping the two separate. This dynamic adaptive view, with an emphasis on the importance of individuals within teams rather than in isolation, contrasts with the discourse of resilience as a personal characteristic, which should be strengthened at the individual level.

CONCLUSION:

Professional resilience is about more than individual strength. Policies to promote professional resilience, particularly in settings such as areas of high socioeconomic deprivation, must recognise the importance of flexibility, adaptability, working as teams, and successful integration between work and personal values.

KEYWORDS:

burnout; general practitioners; primary health care; qualitative research; socioeconomic factors

PMID:
30297436
PMCID:
PMC6255227
[Available on 2019-12-01]
DOI:
10.3399/bjgp18X699401
[Indexed for MEDLINE]
Icon for HighWire

Supplemental Content

Loading ...
Support Center