The international journal of health, wellness & society最新文献

{"title":"Graduate Medical Education on the Frontlines during the COVID-19 Pandemic in New York City- A Response to Promote Well-being","authors":"S. Akhtar, S. Dua, Paula Rosenfield, Frank H. Basloe, Muhammad Khalid, J. Ripp, M. Leitman","doi":"10.18297/jwellness/vol3/iss2/9","DOIUrl":"https://doi.org/10.18297/jwellness/vol3/iss2/9","url":null,"abstract":"Introduction: The COVID-19 pandemic has driven many health care institutions in the United States beyond their capacity. Physicians-in-training in graduate medical education programs have suffered the strain of providing patient care during this unprecedented time of crisis. The significant prevalence of pre-existing resident and fellow burnout and depression makes the need for action by institutions to support the well-being of residents and fellows even more urgent. We aim to describe innovative adaptations our Office of Graduate Medical Education implemented with the support of institutional leadership as responses to promote the well-being of residents and fellows on the frontlines during the COVID-19 pandemic. Methods: The Office of Graduate Medical Education (GME), in collaboration with the Office of Well-being and Resilience, developed a set of resources and interventions to support trainees during the pandemic based on four major categories: workplace culture, personal factors and health, mental health support, and workplace efficiency and function. Examination of the capacity of existing services and gaps that needed to be filled in the rapidly evolving early days of the COVID pandemic led to a robust growth in resources. For example, the already established Student and Trainee Mental Health program was able to expand and adapt its role to serve trainee needs more effectively. Results: We expanded resources to target trainee well-being across a broad array of domains within a short time frame. With investment in access to the Student and Trainee Mental Health program, utilization increased by 25.7%, with 1,231 more visits in 2020 compared to the number of visits in 2019, prior to the COVID-19 pandemic. The creation of Recharge Rooms had a positive impact on the well-being of health care workers. After a single fifteen-minute experience in the Recharge Room, an average 59.6% reduction in self-reported stress levels was noted by users. Other interventions were noted to be helpful in regular town hall meetings with trainees. Conclusion: Addressing trainee well-being is an essential aspect of a crisis response. The Mount Sinai Health System was able to care for the physical, mental, psychosocial, and safety needs of our trainees thanks to the collaborative effort of a pre-existing institutional well-being program and the GME Office. The ability to implement such a response was enabled by our well-being foundation, which allowed leadership at the highest institutional level and the Office of GME to provide support in response to this unprecedented crisis.","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87510844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographics, Activities, and Environmental Factors Impact Burnout in a National Survey of Emergency Medicine Residents","authors":"N. Battaglioli, T. Moran, S. Li-Sauerwine","doi":"10.18297/jwellness/vol3/iss2/2","DOIUrl":"https://doi.org/10.18297/jwellness/vol3/iss2/2","url":null,"abstract":"Introduction: Burnout in emergency medicine and in residency training has been well-described. The impact of demographic, individual, and programmatic factors on burnout have not previously been determined in a national survey of emergency medicine residents. This study aimed to identify personal and environmental factors impacting resident burnout in a national sample of emergency medicine residents. Methods: A prospective Emergency Medicine Resident Wellness Survey was administered in 2017. We surveyed Respondents on demographic, personal, and environmental factors; each Respondent also completed the Maslach Burnout Inventory - Human Services Survey. Linear regressions were used to identify variables associated with the Maslach Burnout Inventory’s subscales of burnout (depersonalization, emotional exhaustion, and personal achievement). Results: The survey was completed by 1,522 of 7,186 (21.2%) eligible EM residents. Respondents represented 193 of 247 (78.1%) Emergency Medicine residency programs. Increased levels of depersonalization were associated with graduation from a US medical school, female gender, and increase in respondent age. Trainees who were parents and who graduated from an osteopathic (vs. allopathic) medical school were found to have decreased levels of depersonalization. Emotional exhaustion was decreased in respondents who took breaks while on shift and who engaged in regular studying. Conclusion: While some individual characteristics impact burnout, environmental factors also play a significant role, and should be a target of system-level interventions to improve trainee well-being.","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85764261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Resources, Affective Reactions, and Risk Taking Following Academic Stress among University Students","authors":"H. Ben-Zur","doi":"10.18848/2156-8960/CGP/V11I01/119-131","DOIUrl":"https://doi.org/10.18848/2156-8960/CGP/V11I01/119-131","url":null,"abstract":"","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"47 1","pages":"119-131"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79934172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a “Network of Champions” in implementing a program to address physician well-being","authors":"K. Palamara","doi":"10.18297/jwellness/vol3/iss3/2","DOIUrl":"https://doi.org/10.18297/jwellness/vol3/iss3/2","url":null,"abstract":"Introduction: Healthcare leaders have been challenged to mitigate burnout and foster well-being among physicians. Professional societies are beginning to address this in a systematic manner. Methods: In 2014, the American College of Physicians (ACP) endeavored to improve well-being for its 160,000 members of internists and trainees through a Well-being Champion (WBC) program based in the majority of its 85 national and international chapters. The program was supported by an evidence-based curriculum, chapter volunteers who served as champions, and in-person and virtual trainings. Training included a 1-2 day program in 2018 and 2019, focused on educating champions on causes of burnout, means of systematically collecting well-being data, and methods for using data for system change to reduce burnout and improve well-being. Results: Training included 158 WBCs in 8 countries. After training, over 90% of champions in both years of the program felt able to articulate the evidence for burnout prevention and suggest interventions, access resources, and administer well-being surveys. While 58% of champions noted high interest in wellness, only 26% had a budget allocated for this, and most budgets were small. Ninety-one percent in both years felt able to analyze survey data and 90% in both years felt able to enhance their own well-being. Eighty-eight to 90% felt able to foster a well-being community and importantly, 85% felt comfortable engaging leadership in this topic. Since 2017, 639 activities were recorded, accounting for 87/158 Champions in 69 Chapters. Annual direct costs varied each year but remained <1% of aggregate member dues. Conclusion: This report describes a model for building regional networks to address physician burnout while promoting well-being and professional fulfillment. After training, champions felt capable of performing key aspects of burnout reduction, including survey administration, data analysis and engaging leadership in systems change. To our knowledge, this is the first model to scale burnout prevention throughout an entire professional society. Using the included program descriptions and curricula, this program may be generalizable for other large professional groups wishing to measure and enhance well-being among their membership.","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84903924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wellness Review 2021, Part 1","authors":"M. Huecker, B. Ferguson, J. Shreffler","doi":"10.18297/jwellness/vol3/iss2/7","DOIUrl":"https://doi.org/10.18297/jwellness/vol3/iss2/7","url":null,"abstract":"Introduction: This article presents a curated selection of the wellness literature from January to June of 2021. JWellness editors offer a summary of recent publications within the wellness domain to seek an understanding of both burnout prevention and, more importantly, thriving in the medical profession. Methods: For the interval of Jan 1 to June 30, 2021, a UofL librarian queried PubMed for empirical research studies, review articles, and editorials related to healthcare professional wellness. Excluding papers related to COVID-19 (due to extensive prior coverage) and editorials/commentaries, the editors narrowed to 43 articles (systematic reviews, meta-analyses, general reviews, and clinical trials) for this review. Literature in Review: Six chief themes emerged: general wellness / burnout, technology, training, nursing professional wellness, mindfulness and resilience, and physician specialty-specific considerations. We note the predominance of descriptive articles, though this round included more clinical trials and reviews of clinical trials. Overall quality of evidence remains low, however the conglomerate multinational dataset is expanding rapidly. Innovations in electronic documentation, early educational interventions, and diverse studies from various medical specialties converge to provide insight into a state of thriving among healthcare professionals. Conclusion: Current literature into healthcare professional wellness continues to describe burnout, but increasingly includes dedicated wellness interventions. Resilience and mindfulness training work, but system level interventions must accompany efforts. All medical specialties are affected, and the continuing conversation should include healthcare executives and other leadership.","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89156908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing \"Treble\" with Performance Focused Music Programs in Medical School","authors":"Alexander Tu, Tiffany N. Truong, K. Carlson, Matthew Brooks, J. Dowdall","doi":"10.18297/jwellness/vol3/iss2/5","DOIUrl":"https://doi.org/10.18297/jwellness/vol3/iss2/5","url":null,"abstract":"Introduction: The beneficial impact of performing arts involvement within undergraduate medical education, such as music, has been studied, but support for the arts varies significantly by institution. Research has suggested that medical student involvement in the arts can help develop their identities as physicians and may reduce stress and burnout, an increasingly difficult problem within the medical student community. Methods: We used a mixed-method cross-sectional study design, using a questionnaire and semi-structured interview designed amongst a team of music professionals and healthcare providers with music backgrounds. Out of 511 enrolled medical students, 93 students participated in the study for a response rate of 18.2%. Questions were piloted among eight medical students, with modifications made in response to feedback. Participants were recruited to participate in an online survey via social media. Results: Within our sample, the most popular background instrument was piano (58.5%) and voice (50.0%). Of those who responded, most preferred to perform alone (85.7%) or in small groups (51.4%). 78.8% of respondents agreed that music was essential to their wellbeing. Only 62.5% of the respondents with musical backgrounds still play music or sing. Of those who no longer play music, 90.5% of respondents reported time constraint as the limiting factor, followed by lack of access to instruments (42.9%). Conclusion: This study suggests there are diverse music backgrounds and interests amongst the medical student population. Although most participants believed music was a form of stress relief, undergraduate medical training demands impose time restrictions on student engagement. Investments in music programs that enable adequate involvement and meet student demand have the potential to improve medical student engagement with the arts, alleviate stress, and may even lead to stronger/more empathetic physicians. Periodic needs assessments may be a powerful tool to better align programming to address student desires and reduce barriers.","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90750973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grit and Flow as Prescriptions for Self-Actualization","authors":"Samuel Dickinson","doi":"10.55504/2578-9333.1039","DOIUrl":"https://doi.org/10.55504/2578-9333.1039","url":null,"abstract":"Psychology as a discipline has historically focused on psychopathology and associated evidence-based modalities to alleviate symptoms of mental illness and distress. In recent decades, however, there has been a shift towards studying the positive aspects of human experience that make life worth living. This Positive Psychological perspective was utilized by Humanistic Psychologist Abraham Maslow when he created his theory of Self-Actualization, in which he postulated that the highest aim a person can strive towards is to become the absolute best version of themselves, and to maximize their abilities and potential to the highest possible degree. Aside from describing a hierarchy of needs required before Self-Actualization could be realized, Maslow left little recommendation for how the phenomenon could be enacted. This article recommends the combined utilization of the non-cognitive trait of Grit along with the implementation of activities that promote the full-immersion state of Flow as prescriptions for Self-Actualization. Additional emphasis is placed on the importance of healthcare professionals utilizing the concepts Grit and Flow in their clinical practice with patients. resources for survival, followed by “Love Needs” of friendship, family, intimacy, and a sense of connection with others. The penultimate level of needs on the hierarchy are “Esteem Needs”, holding our needs for self-esteem, confidence, self-efficacy, achievement, and the respect of others, finally followed by the top level of the pyramid, “Self-Actualization” [4]. According to Maslow, we must satisfy the needs at one level of the hierarchy/pyramid before moving on to the other levels. In other words, we can’t concern ourselves with our sense of achievement or confidence (Esteem Needs) if we don’t have shelter or enough food to stay alive (Physiological Needs); there are priorities. Looking at this hierarchy of needs, we can see how our ancestors with underdeveloped prefrontal cortices who were lower on the food chain were primarily (if not solely) concerned with meeting their Physiological and Safety needs. However, the contemporary human with enhanced cognitive faculties and modern technology ensuring safety from predators has the luxury of being able to climb farther up the hierarchy towards Self-Actualization; we have the capacity to orient ourselves towards thriving, rather than","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84837018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Theory to Practice: Development of Health Promotion Policy for Mothers’ Exercise","authors":"J. Currie","doi":"10.18848/2156-8960/cgp/v10i03/23-29","DOIUrl":"https://doi.org/10.18848/2156-8960/cgp/v10i03/23-29","url":null,"abstract":"","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"6 1","pages":"23-29"},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89349614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Wellness in Academic Emergency Medicine","authors":"K. Nordenholz, A. Alvarez, M. Lall, C. Stehman, C. Bitter, E. Hirsh, R. Manfredi, Rosanna D. Sikora, D. Lu, L. Sanchez, Matthew L Wong, S. Bird, A. Blomkalns","doi":"10.18297/jwellness/vol2/iss2/8","DOIUrl":"https://doi.org/10.18297/jwellness/vol2/iss2/8","url":null,"abstract":"Introduction: Academic Emergency Physicians (EPs) face additional unique challenges in optimizing wellness compared to community EPs. Objective: Our objective was to explore specific individual and systems challenges that academic EPs encounter that affect their wellbeing and professional fulfillment in emergency medicine (EM). Methods: An expert group of academic EPs convened in 2019 at the annual meeting of the Society of Academic Emergency Medicine to investigate the overall causes of burnout in healthcare providers, the effects of burnout on the healthcare system, specific causes of burnout in EM, and the distinct challenges facing academic emergency physicians. Results: We outline specific causes of burnout in EM and the effects of burnout on the healthcare system. Scholarly productivity pressures, variable reimbursement gaps, time allotment, and work-life balance are challenges facing academic EPs. Conclusion: Understanding the unique challenges of academic EPs in optimizing wellness is vital to inform future research and effective interventions. Kristen E. Nordenholz, MD, MSc1, Al'ai Alvarez, MD2*, Michelle D. Lall, MD, MHS3, Christine Stehman, MD4, Cindy C. Bitter, MD, MA, MPH5, Emily L. Hirsh, MD6, Rita Manfredi, MD7, Rosanna D. Sikora, MD8, Dave W. Lu, MD, MS, MBE9, Leon D. Sanchez, MD, MPH10, Matthew L. Wong, MD, MPH10, Steven Bird, MD11, Andra L. Blomkalns, MD, MBA2 and their patients. Burned-out physicians enjoy their jobs less [16] and likely intend to leave[17-19], and demonstrate both decreased productivity [20, 21]and a higher prevalence of substance abuse disorders [22, 23]. These physicians also practice less cost-effective medicine. That is, they order more laboratory and imaging tests, consultations, and spend increased time charting [24]. They also make more medical errors[25, 26], have worse patient outcomes, and poorer patient adherence to recommendations [27, 28] than their non-burned out peers. Fully understanding physician burnout involves understanding its definition, effects, and causes.","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89793275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal, randomized and controlled study of app-delivered mindfulness in the workplace","authors":"Jennifer S. Mascaro, Kathryn Wehrmeyer, V. Mahathre, Alana Darcher","doi":"10.18297/jwellness/vol2/iss1/4","DOIUrl":"https://doi.org/10.18297/jwellness/vol2/iss1/4","url":null,"abstract":"Background: Workplace mindfulness meditation programs are of great interest for improving employee wellbeing and job performance, fueled in part by the apparent effectiveness of mindfulness meditation as well as by the recent proliferation of mobile mindfulness applications (apps) that can be incorporated into a workplace setting. It is critical to examine the facilitators and barriers to engaging with app-delivered mindfulness in the workplace to understand how biological, psychological, and socio-demographic variables impact practice time. Methods: Using a longitudinal and randomized controlled design, we explored facilitators of and barriers to practicing app-delivered mindfulness in the workplace among predominately non-white call center employees. Mindfulness engagement was operationalized as practice time during a prescriptive study period as well as during the entire 1-year duration of the app subscription. In addition, we made preliminary estimates of the impact of app-delivered mindfulness, compared to wait-list open relaxation, on job performance, negative symptoms, well-being, and social connectedness. Results: Employee C-reactive protein levels were positively correlated with subsequent meditation practice time. Employees who reported wanting to use the app to manage stress were most likely to use it, and women practiced significantly more than men. No other psychological resources were significantly correlated with practice time. Employees randomized to mindfulness had a significant increase in self-reported mindfulness scores, but did not have significant improvements in any other psychological or performance domains. Conclusion: Together these data expand what is known about engagement with, and impact of, mindfulness on a population that is under-represented in the research on mindfulness meditation. As mindfulness proliferates beyond the biomedical contexts and populations in which it has been traditionally popular within modern Western contexts, it is crucial to examine its acceptability and gain an understanding of the personality and demographic variables that predict engagement. While it is clear from previous research that engagement with mindfulness varies based on demographic [18, 29] and individual differences [30], a challenge of interpreting these data is understanding causal mechanisms that render meditation accessible and acceptable to some populations and not to others. This is a particularly obfuscating challenge, since previous research points to logistical or practical barriers to meditation practice, including time commitments [28], and lack of access [18]. To overcome this challenge, the current study was designed to provide 1-year subscriptions to a popular mindfulness meditation app and to reduce logistic barriers by providing employees with a break to use the app. In addition, we examined the impact of app-delivered mindfulness on both self-reported and job performance outcomes. The study had two specific aim","PeriodicalId":90738,"journal":{"name":"The international journal of health, wellness & society","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91199693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}