2023-09-28 14:46:10 +00:00
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abstract: 'IMPORTANCE Physician well-being is a critical component of sustainable
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health care. There are few data on the effects of multilevel well-being
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programs nor a clear understanding of where and how to target resources.
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OBJECTIVE To inform the design of future well-being interventions by
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exploring individual and workplace factors associated with surgical
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trainees'' well-being, differences by gender identity, and end-user
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perceptions of these initiatives.
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DESIGN, SETTING, AND PARTICIPANTS This mixed-methods study among
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surgical trainees within a single US academic surgical department
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included a questionnaire in January 2019 (98 participants, including
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general surgery residents and clinical fellows) and a focus group (9
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participants, all clinical residents who recently completed their third
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postgraduate year {[}PGY 3]) in July 2019. Participants self-reported
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gender (man, woman, nonbinary).
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EXPOSURES Individual and organizational-level initiatives, including
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mindfulness-based affective regulation training (via Enhanced Stress
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Resilience Training), advanced scheduling of time off, wellness
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half-days, and the creation of a resident-driven well-being committee.
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MAIN OUTCOMES AND MEASURES Well-being was explored using validated
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measures of psychosocial risk (emotional exhaustion, depersonalization,
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perceived stress, depressive symptoms, alcohol use, languishing,
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anxiety, high psychological demand) and resilience (mindfulness, social
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support, flourishing) factors. End-user perceptions were assessed
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through open-ended responses and a formal focus group.
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RESULTS Of 98 participants surveyed, 64 responded (response rate, 65\%),
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of whom 35 (55\%) were women. Women vs men trainees were significantly
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more likely to report high depersonalization (odds ratio {[}OR], 5.50;
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95\% CI, 1.38-21.85) and less likely to report high mindfulness
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tendencies (OR, 0.17; 95\% CI, 0.05-0.53). Open-ended responses
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highlighted time and priorities as the greatest barriers to using
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well-being resources. Focus group findings reflected Job Demand-Resource
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theory tenets, revealing the value of individual-level interventions to
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provide coping skills, the benefit of advance scheduling of time off for
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maintaining personal support resources, the importance of work quality
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rather than quantity, and the demoralizing effect of inefficient or
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nonresponsive systems.
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CONCLUSIONS AND RELEVANCE In this study, surgical trainees indicated
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that multilevel well-being programs would benefit them, but tailoring
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these initiatives to individual needs and specific workplace elements is
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critical to maximizing intervention effects.'
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affiliation: 'Lebares, CC (Corresponding Author), Univ Calif San Francisco, Dept Surg,
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513 Parnassus Ave,HSW 1601, San Francisco, CA 94143 USA.
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Lebares, Carter C.; Greenberg, Anya L.; Ascher, Nancy L.; Reilly, Linda M.; O''Sullivan,
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Patricia, Univ Calif San Francisco, Dept Surg, 513 Parnassus Ave,HSW 1601, San Francisco,
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CA 94143 USA.
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Delucchi, Kevin L., Univ Calif San Francisco, Dept Psychiat, San Francisco, CA USA.
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Van der Schaaf, Marieke, Univ Med Ctr Utrecht, Ctr Res \& Dev Hlth Profess Educ,
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Utrecht, Netherlands.
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Baathe, Fredrik, Univ Gothenburg, Inst Care \& Hlth Serv, Gothenburg, Sweden.
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Baathe, Fredrik, Inst Stress Med, Gothenburg, Sweden.
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Baathe, Fredrik; Isaksson Ro, Karin, Univ Oslo, Inst Studies Med Profess, Oslo,
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Norway.'
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article-number: e2032676
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author: Lebares, Carter C. and Greenberg, Anya L. and Ascher, Nancy L. and Delucchi,
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Kevin L. and Reilly, Linda M. and Van der Schaaf, Marieke and Baathe, Fredrik and
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O'Sullivan, Patricia and Isaksson Ro, Karin
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author-email: carter.lebares@ucsf.edu
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author_list:
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- family: Lebares
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given: Carter C.
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- family: Greenberg
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given: Anya L.
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- family: Ascher
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given: Nancy L.
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- family: Delucchi
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given: Kevin L.
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- family: Reilly
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given: Linda M.
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- family: Van der Schaaf
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given: Marieke
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- family: Baathe
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given: Fredrik
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- family: O'Sullivan
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given: Patricia
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- family: Isaksson Ro
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given: Karin
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da: '2023-09-28'
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doi: 10.1001/jamanetworkopen.2020.32676
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files: []
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issn: 2574-3805
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journal: JAMA NETWORK OPEN
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keywords-plus: 'TRAIT ANXIETY; JOB DEMANDS; BURNOUT; DEPRESSION; MINDFULNESS;
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RESILIENCE; STRESS; MODEL; ENGAGEMENT; RESOURCES'
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language: English
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month: JAN 6
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number: '1'
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number-of-cited-references: '53'
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orcid-numbers: 'Edwards, Anya/0000-0002-6174-5976
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Baathe, Fredrik/0000-0002-3799-1077'
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papis_id: 235977e4a3b7bede4318dfd7da346a12
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ref: Lebares2021explorationindividua
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times-cited: '15'
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title: Exploration of Individual and System-Level Well-being Initiatives at an Academic
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Surgical Residency Program A Mixed-Methods Study
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000610371200007
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usage-count-last-180-days: '1'
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usage-count-since-2013: '13'
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volume: '4'
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web-of-science-categories: Medicine, General \& Internal
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year: '2021'
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