Arabella L Simpkin1, Alisa Khan2, Daniel C West3, Briana M Garcia4, Theodore C Sectish2, Nancy D Spector5, Christopher P Landrigan6. 1. Department of Medicine, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass; Department of Pharmacology, University of Oxford, Oxford, UK. Electronic address: asimpkin@partners.org. 2. Harvard Medical School, Boston, Mass; Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Mass. 3. Department of Pediatrics, UCSF Benioff Children's Hospital, University of California, San Francisco, Calif. 4. Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Mass. 5. Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pa. 6. Harvard Medical School, Boston, Mass; Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Mass; Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.
Abstract
BACKGROUND: Depression and burnout are highly prevalent among residents, but little is known about modifiable personality variables, such as resilience and stress from uncertainty, that may predispose to these conditions. Residents are routinely faced with uncertainty when making medical decisions. OBJECTIVE: To determine how stress from uncertainty is related to resilience among pediatric residents and whether these attributes are associated with depression and burnout. METHODS: We surveyed 86 residents in pediatric residency programs from 4 urban freestanding children's hospitals in North America in 2015. Stress from uncertainty was measured with the use of the Physicians' Reaction to Uncertainty Scale, resilience with the use of the 14-item Resilience Scale, depression with the use of the Harvard National Depression Screening Scale; and burnout with the use of single-item measures of emotional exhaustion and depersonalization from the Maslach Burnout Inventory. RESULTS: Fifty out of 86 residents responded to the survey (58.1%). Higher levels of stress from uncertainty correlated with lower resilience (r = -0.60; P < .001). Five residents (10%) met depression criteria and 15 residents (31%) met burnout criteria. Depressed residents had higher mean levels of stress due to uncertainty (51.6 ± 9.1 vs 38.7 ± 6.7; P < .001) and lower mean levels of resilience (56.6 ± 10.7 vs 85.4 ± 8.0; P < .001) compared with residents who were not depressed. Burned out residents also had higher mean levels of stress due to uncertainty (44.0 ± 8.5 vs 38.3 ± 7.1; P = .02) and lower mean levels of resilience (76.7 ± 14.8 vs 85.0 ± 9.77; P = .02) compared with residents who were not burned out. CONCLUSIONS: We found high levels of stress from uncertainty, and low levels of resilience were strongly correlated with depression and burnout. Efforts to enhance tolerance of uncertainty and resilience among residents may provide opportunities to mitigate resident depression and burnout.
BACKGROUND:Depression and burnout are highly prevalent among residents, but little is known about modifiable personality variables, such as resilience and stress from uncertainty, that may predispose to these conditions. Residents are routinely faced with uncertainty when making medical decisions. OBJECTIVE: To determine how stress from uncertainty is related to resilience among pediatric residents and whether these attributes are associated with depression and burnout. METHODS: We surveyed 86 residents in pediatric residency programs from 4 urban freestanding children's hospitals in North America in 2015. Stress from uncertainty was measured with the use of the Physicians' Reaction to Uncertainty Scale, resilience with the use of the 14-item Resilience Scale, depression with the use of the Harvard National Depression Screening Scale; and burnout with the use of single-item measures of emotional exhaustion and depersonalization from the Maslach Burnout Inventory. RESULTS: Fifty out of 86 residents responded to the survey (58.1%). Higher levels of stress from uncertainty correlated with lower resilience (r = -0.60; P < .001). Five residents (10%) met depression criteria and 15 residents (31%) met burnout criteria. Depressed residents had higher mean levels of stress due to uncertainty (51.6 ± 9.1 vs 38.7 ± 6.7; P < .001) and lower mean levels of resilience (56.6 ± 10.7 vs 85.4 ± 8.0; P < .001) compared with residents who were not depressed. Burned out residents also had higher mean levels of stress due to uncertainty (44.0 ± 8.5 vs 38.3 ± 7.1; P = .02) and lower mean levels of resilience (76.7 ± 14.8 vs 85.0 ± 9.77; P = .02) compared with residents who were not burned out. CONCLUSIONS: We found high levels of stress from uncertainty, and low levels of resilience were strongly correlated with depression and burnout. Efforts to enhance tolerance of uncertainty and resilience among residents may provide opportunities to mitigate resident depression and burnout.
Authors: Andrzej Piotrowski; Ewa Sygit-Kowalkowska; Ole Boe; Samir Rawat Journal: Int J Environ Res Public Health Date: 2022-06-02 Impact factor: 4.614
Authors: Lauren A Peccoralo; Carly A Kaplan; Robert H Pietrzak; Dennis S Charney; Jonathan A Ripp Journal: J Am Med Inform Assoc Date: 2021-04-23 Impact factor: 4.497
Authors: Ishani Ganguli; Arabella L Simpkin; Claire Lupo; Arlene Weissman; Alexander J Mainor; E John Orav; Meredith B Rosenthal; Carrie H Colla; Thomas D Sequist Journal: JAMA Netw Open Date: 2019-10-02
Authors: Suzanne Reed; Kathi J Kemper; Alan Schwartz; Maneesh Batra; Betty B Staples; Janet R Serwint; Hilary McClafferty; Charles J Schubert; Paria M Wilson; Alex Rakowsky; Margaret Chase; John D Mahan Journal: J Evid Based Integr Med Date: 2018 Jan-Dec