Mental Health, Psychosocial Characteristics, and Well-Being among Healthcare Trainees Open Access
Wallace, Amanda (Spring 2021)
Abstract
Background: Burnout is a critical concern among healthcare providers with detrimental effects on provider health, patient care, and economic consequences. However, medical residents and physician assistant (PA) students remain understudied. Using the “Coping Reservoir” conceptual model, this study examined the associations between mental health symptoms and psychosocial characteristics with well-being among healthcare trainees.
Methods: Fifty-nine participants completed a self-reported questionnaire consisting of personal demographic information and baseline levels of sleep disturbance, loneliness, depressive symptoms, anxiety, stress, mindfulness, and well-being. Analysis included descriptive statistics, Pearson’s chi-squared tests, between-subjects independent samples t-tests, and between-subjects one-way ANOVAs examining differences between trainee and specialty types, and Pearson’s R and Spearman’s Rho correlations. Multivariate logistic regressions were performed to assess the association between demographics, mental health symptoms, and psychosocial characteristics with well-being.
Results: Slightly over half (n=32; 55.2%) of healthcare trainees were categorized as flourishing. Strong and statistically significant associations between personal characteristics, mental health symptoms, psychosocial characteristics, and well-being were present, including being a primary caregiver, exercise, number of days sick, and mindfulness. Loneliness (AOR=.76; 95% CI=.63, .91; p=.003) and stress (AOR=.67; 95% CI=.45, .99; p=.05) were associated with decreased odds of flourishing while each unit increase depressive symptoms was associated with more than 1.5 the odds of flourishing (AOR=1.53; 95% CI=1.01, 2.32; p=.05) when controlling for other variables. Trainee type was not significantly associated with well-being (p=.66). However, the presence of depressive symptoms was higher among residents (n=16, 37.2%) than PA students (n=2, 13.3%) while PA students had higher scores in the observation facet of mindfulness (mean=14.67; sd =2.29) compared to residents (mean=11.84; sd=3.14) (t=3.20, df=56, p=.002).
Conclusion: Healthcare training programs must create social support and personal time for healthcare trainees to focus on their well-being without repercussions. More research is needed to understand the role of depressive symptoms in multivariate analyses and longitudinal interventions reducing deleterious psychosocial characteristics and mental health symptoms. These approaches will inform best practices to improve well-being and positive psychology among healthcare trainees.
Table of Contents
Table of Contents
Chapter 1: Introduction
Introduction and Literature Review
1
Statement of Problem and Research Questions
5
Study Purpose
6
Study Significance
6
Conceptual Model
7
Goals
8
Summary
9
Chapter 2: Review of the Literature
Introduction
10
Burnout
10
Background
10
Causes
12
Consequences
14
Mental Health Symptoms, Psychosocial Characteristics, and Well-Being
16
Sleep
16
Loneliness
17
Depression
18
Anxiety
18
Stress
19
Mindfulness
19
Well-Being
20
Summary
21
Chapter 3: Methods
Introduction
22
Human Subjects Approval
22
Participant Recruitment and Sampling
23
Measures
24
Demographics
24
Sleep Disturbance
24
Loneliness
25
Depression, Anxiety, Stress
25
Mindfulness
27
Well-Being
29
Data Collection Procedures
30
Data Analysis Description
31
Treatment of Data
31
Preliminary Analyses
33
Analyses by Research Question
34
Research Question 1
34
Research Question 2
34
Chapter 4: Results
Introduction
35
Participant Characteristics
36
Mental Health Symptoms, Psychosocial Characteristics, and Well-Being
37
Bivariate Analyses Regarding Participant Characteristics and Mental Health Symptoms, Psychosocial Characteristics, and Well-Being
39
Results from Multivariate Logistic Regression of Participant Characteristics, Mental Health Symptoms, and Psychosocial Characteristics with Well-Being
42
Research Question 1
43
Research Question 2
44
Summary
45
Chapter 5: Discussion
Introduction
46
Discussion
47
Strengths and Limitations
51
Implications
51
References
54
Tables
Table 1: Participant Characteristics
80
Table 2: Participant Mental Health Symptoms, Psychosocial Characteristics, and Well-Being
81
Table 3: Bivariate Analyses Regarding Participant Characteristics and Mental Health Symptoms, Psychosocial Characteristics, and Well-Being
83
Table 4: Mental Health Symptoms, Psychosocial Characteristics, and Well-Being Correlation Matrix
85
Table 5: Results from Multivariate Logistic Regression of Participant Characteristics, Mental Health Symptoms, and Psychosocial Characteristics with Well-Being
87
Table 6: Results from Multivariate Logistic Regression of Participant Characteristics, Mental Health Symptoms, and Psychosocial Characteristics with Well-Being with Trainee Type
88
Figures
Figure 1: A Conceptual Model of Medical Student Well-Being: The “Coping Reservoir”
89
Figure 2: Study Sample, Stratified by Participant Cohort and Specialty
90
Appendices
Appendix A: Emory IRB Approval
91
Appendix B: Survey Forms
B.1 PROMIS Sleep Disturbance Short Form
93
B.2 Revised UCLA Loneliness Scale
94
B.3 DASS21 Short Form
95
B.4 Mental Health Continuum Short Form
96
B.5 Five Facet Mindfulness Questionnaire Short Form
97
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