Resiliency, Stress, and Culture Shock: Findings from a Global Health Service Partnership Educator Cohort.
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ABSTRACT: Background
Global health field assignments for medical and nursing professionals include a wide variety of opportunities. Many placements often involve individuals practicing in settings very different from their home environments, relying on their professional experience to help bridge cultural and clinical divides.Objectives
There is limited information about the individual factors that might lead to successful longer-term global health experiences in non-disaster settings. In this paper, we report on one cohort of health professionals' experiences of culture shock, stress, and resiliency as volunteers within the Global Health Service Partnership (GHSP), a public-private collaboration between Seed Global Health, the US Peace Corps, and the US Presidents Plan for Emergency Aids Relief (PEPFAR) that placed American medical and nursing educators in five African countries facing a shortage of health professionals.Methods
Using the tools of Project PRIME (Psychosocial Response to International Medical Electives) as a basis, we created the GHSP Educator Support Survey to measure resiliency, stress, and culture shock levels in a cohort of GHSP volunteers during their year of service.Findings
In our sample, participants were likely to experience lower levels of resiliency during initial quarters of global health placements compared to later timepoints. However, they were likely to experience similar stress and culture shock levels across quarters. Levels of preparedness and resources available, and medical needs in the community where the volunteer was placed played a role in the levels of resiliency, stress, and culture shock reported throughout the year.Conclusion
The GHSP Educator Support Survey represented a novel attempt to evaluate the longitudinal mental well-being of medical and nursing volunteers engaged in intense, long-term global health placements in high acuity, low resource clinical and teaching settings. Our findings highlight the need for additional research in this critical area of global health.
SUBMITTER: Mitha K
PROVIDER: S-EPMC8641533 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Abstract Background: Prepulse inhibition (PPI) is a measure of sensorimotor gating shown to be disrupted in schizophrenia. Since dysfunctions of the catecholamine signaling in the cortical circuitry has been associated with reduced PPI, associations between PPI and gene mutations involved in these signaling pathways need to be investigated. The catechol-O-methyltransferase (COMT) Val158Met single nucleotide polymorphism (SNP), which leads to lower COMT enzyme activity in dorsolateral prefrontal cortex of Met/Met carriers, has been shown to modulate PPI disruptions, with higher PPI associated with greater Met load in healthy subjects and schizophrenia patients. Interaction effects with functional SNPs on other catecholamine-related genes, namely norepinephrine transporter (NET), dopamine transporter (DAT), monoamine oxidase A (MAOA), and D2 receptor (DRD2), will shed more light on the specific way in which Val158Met SNP might influence PPI. The current study investigates (1) the association of the Val158Met SNP with PPI; and (2) interaction effects between the Val158Met SNP and other catecholamine-related SNPs. Methods: The Marine Resiliency Study (MRS) is a longitudinal study involving 2593 male active duty Marines recruited in Southern California, and participating in the study before deployment (1 month), and after deployment (1 week, 3 and 6 months). Acoustic startle reflex and PPI were measured on all visits after deployment however only the first visit data will be presented here. Exclusion criteria included low signal to noise, recent traumatic brain injury, poor hearing, inadequate habituation, and non-Caucasian ethnicity. 1193 subjects were included in the final analysis. Results: Following a 2-way ANOVA with the Val158Met SNP (rs4680) as between-subject and interstimulus interval (ISI) as within-subject factors, and controlling for population admixture, no main effect or interaction on PPI was found. For each of the other catecholamine-related SNPs, 3-way ANOVAs with ISI as within-subject factor and Val158Met SNP and the other candidate SNP as between-subject factors were conducted. For the DAT SNP (rs27072), a significant Val158Met SNP × DAT SNP × ISI interaction was found. However, this interaction effect does not survive correction for multiple comparisons and was found only for the ISI = 30 ms condition, not for the other 2 (60 ms and 120 ms), suggesting a type I error. Neither main effect nor interaction with Val158Met SNP was found for the DRD2 (rs1800497), MAOA (rs6323), and NET (rs28386840) SNPs. Conclusion: Despite sufficient power and sample size in the current study, the association between the Val158Met SNP and PPI reported in previous human studies has not been replicated. Also, no interaction effect was found between Val158Met and other candidate SNPs that influence catecholamine signaling. Further investigation will determine if the Val158Met effects on PPI are modulated by trauma history.
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