Brafford Anne M, Ellis Brendon, Guldner Greg, Riazi Gabrielle, Liu Xitao, Wells Jessica C, Siegel Jason T
Claremont Graduate University, Claremont, CA.
HCA Healthcare Graduate Medical Education, Brentwood, TN.
HCA Healthc J Med. 2024 Jun 1;5(3):313-330. doi: 10.36518/2689-0216.1837. eCollection 2024.
Many studies have documented the epidemic of mental ill-being among resident physicians, but fewer have focused on mental well-being or on guiding intervention design to make progress toward positive change in residency programs to support resident thriving. Informed by the job demands-resources model (JD-R) and positive psychology, the current study examines 4 potential predictors of residents' ill-being (burnout, depression) and well-being (engagement, stay intent) that are malleable and thus capable of change through intervention: psychological capital (PsyCap), supervising physicians' autonomy-supportive leadership style (ASL), social support, and meaningful work.
Three waves of data were collected between November 2017 and September 2018 at a large hospital system in the United States. Due to participant response rates, we were unable to conduct a planned longitudinal analysis. Therefore, for each wave, Bayesian regression analyses were used to examine cross-sectional relationships between the 4 predictors and each outcome.
Although findings varied across the study's 3 waves, the outcomes were largely as expected. With only 1 exception (depressive symptoms in Wave 2), meaningful work significantly predicted all outcome variables in the expected direction across all 3 waves. PsyCap significantly predicted burnout, depressive symptoms, and engagement in the expected direction across all 3 waves. ASL significantly predicted engagement in the expected direction across all 3 waves, as well as depressive symptoms and stay intent in 2 waves, and burnout in 1 wave. Social support significantly negatively predicted depressive symptoms in all 3 waves and burnout in 1 wave.
Applying the JD-R framework and a positive psychology lens can open new pathways for developing programming to support resident thriving. Meaningful work, PsyCap, ASL, and social support all significantly predicted 1 or more outcomes related to resident thriving (burnout, depression, engagement, stay intent) across all 3 waves. Thus, this study provides theoretical and practical implications for future intervention studies and designing current programming for resident thriving.
许多研究记录了住院医师中精神健康不佳的流行情况，但较少有研究关注精神健康，或指导干预设计以在住院医师培训项目中朝着积极变化取得进展，以支持住院医师的蓬勃发展。基于工作需求-资源模型（JD-R）和积极心理学，本研究考察了住院医师健康不佳（职业倦怠、抑郁）和健康良好（投入、留任意向）的4个潜在可塑预测因素，因此能够通过干预发生改变：心理资本（PsyCap）、指导医师的自主支持型领导风格（ASL）、社会支持和有意义的工作。
2017年11月至2018年9月期间，在美国的一个大型医院系统收集了三轮数据。由于参与者的回复率，我们无法进行计划中的纵向分析。因此，对于每一轮，使用贝叶斯回归分析来检验4个预测因素与每个结果之间的横断面关系。
尽管研究的三轮结果各不相同，但结果大体符合预期。除了一个例外（第二轮的抑郁症状），有意义的工作在所有三轮中均显著地按预期方向预测了所有结果变量。心理资本在所有三轮中均显著地按预期方向预测了职业倦怠、抑郁症状和投入。自主支持型领导风格在所有三轮中均显著地按预期方向预测了投入，在两轮中预测了抑郁症状和留任意向，在一轮中预测了职业倦怠。社会支持在所有三轮中均显著地负向预测了抑郁症状，在一轮中预测了职业倦怠。
应用JD-R框架和积极心理学视角可为开发支持住院医师蓬勃发展的项目开辟新途径。有意义的工作、心理资本、自主支持型领导风格和社会支持在所有三轮中均显著地预测了1个或更多与住院医师蓬勃发展相关的结果（职业倦怠、抑郁、投入、留任意向）。因此，本研究为未来的干预研究以及为住院医师蓬勃发展设计当前项目提供了理论和实践意义。
