A qualitative exploration of the National Academy of medicine model of well-being and resilience among healthcare workers during COVID-19.
Ontology highlight
ABSTRACT:
SUBMITTER: Munn LT
PROVIDER: S-EPMC9111620 | biostudies-literature | 2022 Aug
REPOSITORIES: biostudies-literature
Publications
A qualitative exploration of the National Academy of medicine model of well-being and resilience among healthcare workers during COVID-19.
Munn Lindsay T LT Huffman Carolyn S CS Connor C Danielle CD Swick Maureen M Danhauer Suzanne C SC Gibbs Michael A MA
Journal of advanced nursing 20220314 8
Similar Datasets
Project description:ObjectivesSchwartz Rounds are forums that enable healthcare staff to reflect on emotional and social dimensions of their work. In this study, we aimed to explore the experiences of Schwartz Rounds on emotional aspects of care and practice within a clinical environment.DesignUsing qualitative methods, we interviewed participants individually and in focus groups. Interviews were recorded, transcribed and analysed by thematic analysis.SettingThe study was based at a public health service Te Whatu Ora Counties Manukau in Auckland, New Zealand's largest, most ethnically diverse population.ParticipantsParticipants were panellists who took part in successive Schwartz Rounds over a 10-month period. There were 17 participants with a range of experience (1-30 years) and occupations including clinical, allied, technical and administrative staff from medical specialties of plastic surgery, pain services, emergency medicine, intensive care, organ donation services, COVID-19 response and palliative care services.ResultsThree themes were identified: the need for emotional processing, valuing guided reflection and realising our humanity. The third theme 'realising our humanity' comprised altruism, connection and compassion. Schwartz Rounds provided staff with clear benefits: emotionally resonant experiences within an environment of psychological safety and connection to the wider organisation. The daunting nature of emotional disclosure was mitigated by a supportive audience.ConclusionThere is an organisational imperative to ensure that staff have opportunities to process intense emotions associated with healthcare work. Schwartz Rounds are one means to attend to the emotional welfare of healthcare staff, enabling them to gain different perspectives in the care of their patients and colleagues within system constraints.
| S-EPMC10083799 | biostudies-literature
Project description:Healthcare workers are at a high risk of psychological morbidity in the face of the COVID-19 pandemic. However, there is significant variability in the impact of this crisis on individual healthcare workers, which can be best explained through an appreciation of the construct of resilience. Broadly speaking, resilience refers to the ability to successfully adapt to stressful or traumatic events, and thus plays a key role in determining mental health outcomes following exposure to such events. A proper understanding of resilience is vital in enabling a shift from a reactive to a proactive approach for protecting and promoting the mental well-being of healthcare workers. Research in the past decade has identified six areas that provide promising leads in understanding the biological basis of individual variations in resilience. These are: (1) the key role played by the monoamines noradrenaline and serotonin, (2) the centrality of the hypothalamic-pituitary-adrenal axis in influencing stress vulnerability and resilience, (3) the intimate links between the immune system and stress sensitivity, (4) the role of epigenetic modulation of gene expression in influencing the stress response, (5) the role played by certain neuropeptides as a natural "brake" mechanism in the face of stress, and (6) the neurobiological mechanisms by which environmental factors, such as exercise, diet, and social support, influence resilience to subsequent life events. Though much of this research is still in its early stages, it has already provided valuable information on which strategies - including dietary changes, lifestyle modification, environmental modification, psychosocial interventions, and even pharmacological treatments - may prove to be useful in fostering resilience in individuals and groups. This paper examines the above evidence more closely, with a specific focus on the challenges faced by healthcare workers during the COVID-19 pandemic, and provides suggestions regarding how it may be translated into real-world interventions, as well as how the more tentative hypotheses advanced in this field may be tested during this critical period.
| S-EPMC8012770 | biostudies-literature
Project description:IntroductionHealthcare workers' well-being is of utmost importance given persistent high rates of burnout, which also affects quality of care. Minority healthcare workers (MHCW) face unique challenges including structural racism and discrimination. There is limited data on interventions addressing the psychological well-being of MHCW. Thus, this systematic review aims to identify interventions specifically designed to support MHCW well-being, and to compare measures of well-being between minority and non-minority healthcare workers.MethodsWe searched multiple electronic databases. Two independent reviewers conducted literature screening and extraction. The Mixed Methods Assessment Tool (MMAT) or Joanna Briggs Institute (JBI) criteria were utilized to assess the methodological quality of studies, based on the study design. Total scores as percentages of criteria met were used to determine overall quality as low (<40%), moderate (40-80%), or high (>80%). For conflicts, consensus was reached through discussion. Meta-analysis was not possible due to heterogeneity of study designs.ResultsA total of 3,816 records were screened and 43 were included in the review. The majority of included studies (76.7%) were of moderate quality. There were no randomized control trials and only one study included a well-being intervention designed specifically for MHCW. Most (67.4%) were quantitative-descriptive studies that compared well-being measures between minority and non-minority identifying healthcare workers. Common themes identified were burnout, job retention, job satisfaction, discrimination, and diversity. There were conflicting results regarding burnout rates in MHCW vs non-minority workers with some studies citing protective resilience and lower burnout while others reported greater burnout due to compounding systemic factors.DiscussionOur findings illuminate a lack of MHCW-specific well-being programs. The conflicting findings of MHCW well-being do not eliminate the need for supports among this population. Given the distinct experiences of MHCW, the development of policies surrounding diversity and inclusion, mental health services, and cultural competency should be considered. Understanding the barriers faced by MHCW can improve both well-being among the healthcare workforce and patient care.
| S-EPMC11885290 | biostudies-literature
Project description:PurposeMedical physics residents (MPRs) will define and shape the future of physics in medicine. We sought to better understand the residency experience, as related to resilience and well-being, through the lens of current MPRs and medical physicists (MPs) working with residents.Methods and materialsFrom February-May 2019, we conducted 32, 1-h, confidential, semi-structured interviews with MPs either currently enrolled in an accredited residency (n = 16) or currently employed by a department with an accredited residency (n = 16). Interviews centered on the topics of mentorship, work/life integration, and discrimination. Qualitative analysis methods were used to derive key themes from the interview transcripts.ResultsWith regard to the medical physics residency experience, four key themes emerged during qualitative analysis: the demanding nature of medical physics residencies, the negative impacts of residency on MPRs during training and beyond, strategies MPRs use to cope with residency stress, and the role of professional societies in addressing residency-related change.ConclusionsResidency training is a stress-inducing time in the path to becoming a board-certified MP. By uncovering several sources of this stress, we have identified opportunities to support the resiliency and well-being of MPs in training through recommendations by professional societies, programmatic changes, and interventions at the department and residency program director level for residency programs, as well as strategies that MPRs themselves can use to support well-being on their career journey.
| S-EPMC8906227 | biostudies-literature
Project description:Forensic healthcare workers deal with patients with severe psychiatric and behavioral problems that put them at an increased risk of developing work-related stress and burnout. Working with this target group of patients during the Coronavirus disease 2019 (Covid-19) pandemic with far-reaching restrictive measures can negatively affect the psychological well-being of forensic workers. Research suggests that resilience can buffer workplace stress and contribute positively to psychological well-being. However, research on resilience, psychological well-being and work-related stress among forensic healthcare workers is still lacking. Therefore, in this study, we investigated the interrelations between psychological well-being and resilience on the one hand and work-related stress and Covid-19 fear-related symptoms on the other hand. Self-report data were obtained from 318 healthcare workers (73.9% women) working in three Forensic Psychiatric Centers (M age = 44.20, SD = 14.31) and are in direct contact with forensic patients. The data were analyzed using network analysis. Consistent with previous research, the results showed that workplace stress and fear associated with the Covid-19 pandemic can be detrimental to workers' psychological well-being, while resilience can serve as a protective factor against being personally attacked or threatened by patients at the workplace. Last but not least, we identified highly central symptoms, namely tremors due to the fear of the coronavirus and anxiety when other people coughing, which would be the best candidates for future treatment targets. This knowledge can help clinicians optimize interventions to reduce workplace stress and fear due to the pandemic. Future studies should aim to replicate our findings in a larger and more representative sample of forensic healthcare workers.
| S-EPMC8226029 | biostudies-literature
Project description:IntroductionThere is significant variability in the preparedness of incoming interns at the start of residency training with regard to medical knowledge, procedural skills, and attitudes. Specialty-specific preparatory courses aimed at improving clinical skills exist; however, no preparatory courses targeting wellness promotion or burnout prevention have previously been described. Resident well-being has gained increasing attention from the Accreditation Council for Graduate Medical Education, and numerous studies have demonstrated high levels of burnout among resident physicians. The American Medical Association (AMA) divides resident well-being into the following six categories: nutrition, fitness, emotional health, financial health, preventative care, and mindset and behavioral adaptability. Using the AMA's conceptual framework for well-being in residency, we performed a targeted needs assessment to support the development of a "pre-residency" well-being curriculum. Our aim was to discover what current residents and faculty felt were the perceived areas of under-preparedness, in relation to resident well-being, for incoming interns at the start of their residency training.MethodsUsing a grounded theory approach, we conducted a series of semi-structured, focus group interviews. Focus groups consisted of junior residents (postgraduate years [PGY] 1-3), senior residents (PGY-4), and current faculty members. A standardized interview guide was used to prompt discussion and themes were identified from audio recording. We modified theories based on latent and manifest content analysis, and we performed member checking and an external audit to improve validity.ResultsParticipants noted variable exposure to both formal and informal well-being training prior to residency. Regardless, participants uniformly agreed that their past experiences did not adequately prepare them for the challenges, specific to burnout prevention, faced during residency training. Of the six domains of resident well-being described by the AMA, emotional health, mindset and behavioral adaptability, and financial health were the domains most cited for interns to be underprepared for at the start of residency training.ConclusionDespite variability in prior medical school and life experiences, incoming interns were underprepared in several domains of well-being, including emotional health, mindset and behavioral adaptability, and financial health. Targeted interventions toward these areas of well-being should be piloted and studied further for their potential to mitigate effects of burnout among resident physicians.
| S-EPMC6324710 | biostudies-literature
Project description:Previous research on workplace victimization has often disregarded forensic psychiatric populations and not yet been extended to the coronavirus pandemic. The present study expected the isolation of the government-issued lockdown to increase aggressive behavior in forensic patients, ultimately decreasing the general well-being of victimized forensic workers. Possible buffering protective factors (resilience and active coping) and enhancing risk factors (avoidant coping and passive coping) were investigated with the intention of optimizing the general well-being of at-risk forensic workers. The valid sample (N = 311) consisted of Dutch and Belgian forensic workers (74.6% females) with at least 9 hours of weekly patient contact, and with a mean age of 37.99 (SD = 12.20). Participants reported the number of violent incidents in the past 2 months, as well as completed a questionnaire battery including measures of well-being, resilience, and coping strategies. A significant increase of victimization during the lockdown compared to after it was lifted was found, however, the study did not find evidence to support that this negatively influenced the worker's general well-being. Active coping was found to be a significant moderator and protective factor for the general well-being of victimized forensic workers. In contrast, resilience, avoidant and passive coping were not significant moderators in this association. The present study has valuable clinical implications that could lead to preparatory and preventative measures for forensic workers at risk of being victimized. Future research may investigate constructs such as life satisfaction and post-traumatic growth, as well as be broadened into prison populations.
| S-EPMC11610200 | biostudies-literature
Project description:Drawing on social cognitive theory (SCT), this study examines the effects of employee resilience, through well-being, on job productivity, and relational satisfaction among extraverted versus introverted workers in Croatia, Thailand, and the United States during the early period of the coronavirus disease 2019 pandemic. Participants included 832 working adults from various industries. Moderated mediation analyses revealed employee resilience positively predicted psychological well-being which, in turn, positively predicted both productivity and relational satisfaction. Regardless of culture, extraverted workers reported less productivity but greater satisfaction with coworkers compared to introverted workers. Also, resilience dampened the negative effects of introversion on relational satisfaction. The findings support the multilevel perspective of resilience and SCT assertion that behavioral outcomes are determined by an interaction between personal and environmental factors and highlight the need to promote employee resilience and well-being during times of crisis. Recommendations on how managers can support employees during this unprecedented global health crisis are provided.
| S-EPMC8593378 | biostudies-literature
Project description:ObjectivesProviding clinical performance feedback to physicians is an established method to improve care, but the impact on physician well-being is unclear. This evaluation aimed to better understand physician perspectives on clinical feedback and its potential impact on well-being.DesignA qualitative design using semi-structured interviews was undertaken. Data were analysed via consensus coding using an inductive-deductive approach informed by Clinical Performance Feedback Intervention Theory. Findings were used to develop a novel framework describing the relationship between feedback and well-being.SettingInterviews were conducted in a large academic medical centre from June-September 2021.ParticipantsWe conducted 25 semi-structured interviews with general outpatient and inpatient paediatricians and internists.ResultsPhysicians felt that feedback supported well-being based on its perceived purpose (intended to promote professional growth vs serving an alternative purpose), which they discerned based on feedback content (aligned with physician priorities vs not aligned), validity (accurate vs inaccurate), actionability (specific vs not, within a physician's sphere of control vs not) and delivery (supportive vs punitive). The Clinical Performance Feedback Well-Being Model is presented to understand how feedback and recipient variables impact well-being.ConclusionsAttention to the process and content of physician clinical performance feedback may advance both the quality of care and physician well-being.
| S-EPMC11551979 | biostudies-literature
Project description:IntroductionThis study examined the psychological wellbeing of Healthcare Workers (HCWs) during COVID-19 in a mental health setting, associations of psychosocial wellbeing with coping style, and ways that organisations can mitigate the psychosocial burden on HCWs.MethodsThirty-seven Mental HCWs (MHCWs) from infected and non-infected wards (control group), were recruited and assessed at three timepoints. Psychological wellbeing, perceived cohesion, and coping style (Brief-COPE) were assessed. Reports on individual coping and feedback on the organisation were collected through in-depth interview. Comparison between infected and non-infected wards, as well as comparison of psychosocial measures and perceived cohesion, across the three timepoints were made. As there were no significant changes in coping styles across the timepoints, Timepoint 1 (T1) coping style was used to correlate with the psychosocial measures across all timepoints. Thematic analysis was used for qualitative data.ResultsMHCWs from infected wards reported significantly higher levels of stress, χ2(1) = 6.74, p = 0.009, effect size: medium (ε2 = 0.198), and more severe sleep disturbance (PSQI), χ2(1) = 6.20, p = 0.013, effect size: medium (ε2 = 0.182), as compared to the control group at T2. They also engaged in more problem-focused coping (T2 and T3) and emotion-focused coping (T2). As expected, negative coping style was correlated with negative outcomes except problem-focused coping that was correlated with both negative (sleep disturbance and anxiety symptoms) and positive outcomes (wellbeing). Emotion-focused coping was moderately correlated (Tb = 0.348, p<0.017) with higher levels of wellbeing at T2. Thematic analyses revealed MHCWs felt supported by the responsiveness of the institution, emotional and informational support, and the availability from direct leaders, presence of team and hospital leaders on the ground, helped build trust and confidence in the leadership.ConclusionsMHCWs experienced significantly higher levels of stress and sleep disturbance during COVID-19. The ways that organizations can offset the psychological burden of pandemics on MHCWs are discussed.
| S-EPMC10947715 | biostudies-literature