Healing Medicine's Future: Prioritizing Physician Trainee Mental Health

Baker, Kathryn; Sen, Srijan

doi:10.1001/journalofethics.2016.18.6.medu1-1606

Cited by 36 publications

(8 citation statements)

References 43 publications

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“…Mental health and well-being are important concerns for medical trainees at all levels. Supporting trainees to cope with stress and effectively address mental health problems are important priorities [ 34 ]. The use of research methods that dramatically over-identify depression cases, however, makes it difficult to understand where needs are greatest, identify factors associated with the onset of mental health problems, and find effective solutions.…”

Section: Discussionmentioning

confidence: 99%

Comparison of depression prevalence estimates in meta-analyses based on screening tools and rating scales versus diagnostic interviews: a meta-research review

Levis

Yan

et al. 2019

BMC Med

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BackgroundDepression symptom questionnaires are commonly used to assess symptom severity and as screening tools to identify patients who may have depression. They are not designed to ascertain diagnostic status and, based on published sensitivity and specificity estimates, would theoretically be expected to overestimate prevalence. Meta-analyses sometimes estimate depression prevalence based on primary studies that used screening tools or rating scales rather than validated diagnostic interviews. Our objectives were to determine classification methods used in primary studies included in depression prevalence meta-analyses, if pooled prevalence differs by primary study classification methods as would be predicted, whether meta-analysis abstracts accurately describe primary study classification methods, and how meta-analyses describe prevalence estimates in abstracts.MethodsWe searched PubMed (January 2008–December 2017) for meta-analyses that reported pooled depression prevalence in the abstract. For each meta-analysis, we included up to one pooled prevalence for each of three depression classification method categories: (1) diagnostic interviews only, (2) screening or rating tools, and (3) a combination of methods.ResultsIn 69 included meta-analyses (81 prevalence estimates), eight prevalence estimates (10%) were based on diagnostic interviews, 36 (44%) on screening or rating tools, and 37 (46%) on combinations. Prevalence was 31% based on screening or rating tools, 22% for combinations, and 17% for diagnostic interviews. Among 2094 primary studies in 81 pooled prevalence estimates, 277 (13%) used validated diagnostic interviews, 1604 (77%) used screening or rating tools, and 213 (10%) used other methods (e.g., unstructured interviews, medical records). Classification methods pooled were accurately described in meta-analysis abstracts for 17 of 81 (21%) prevalence estimates. In 73 meta-analyses based on screening or rating tools or on combined methods, 52 (71%) described the prevalence as being for “depression” or “depressive disorders.” Results were similar for meta-analyses in journals with impact factor ≥ 10.ConclusionsMost meta-analyses combined estimates from studies that used screening tools or rating scales instead of diagnostic interviews, did not disclose this in abstracts, and described the prevalence as being for “depression” or “depressive disorders ” even though disorders were not assessed. Users of meta-analyses of depression prevalence should be cautious when interpreting results because reported prevalence may exceed actual prevalence.Electronic supplementary materialThe online version of this article (10.1186/s12916-019-1297-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Comparison of depression prevalence estimates in meta-analyses based on screening tools and rating scales versus diagnostic interviews: a meta-research review

Levis

Yan

et al. 2019

BMC Med

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“…Investing in the health and well-being of medicine’s next generation of practitioners is a recognised priority 21. Better understanding of these stressors and the perception of these stressors is the first (and essential) step to identifying solutions to mitigate the individual, system and cultural factors associated with poor doctors’ health.…”

Section: Discussionmentioning

confidence: 99%

Barriers to the psychological well-being of Australian junior doctors: a qualitative analysis

2019

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ObjectiveTo explore factors associated with the psychological well-being of junior doctors in Australia.DesignQualitative study using semistructured interviews.SettingThree teaching hospitals in Brisbane, Queensland, Australia.ParticipantsFifteen junior medical officers (postgraduate year 2 doctors) employed across three hospitals in Queensland participated in the study.Main outcome measuresFifteen de-identified interviews were analysed. Four key themes emerged—workplace issues impacting on health and well-being; experiences of bullying and harassment; strategies to improve health and well-being; and barriers to seeking healthcare.ConclusionUnderlying system and cultural factors affect the health of junior doctors. Self-stigma particularly affects junior doctors and impacts on their healthcare seeking behaviours.

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“…Studies have shown that burnout negatively affects the ability to provide quality medical care to patients, including effective communication, demonstration of empathy and establishing therapeutic relationships with patients [ 5 – 7 ]. On a personal level, burnout significantly diminishes personal wellbeing and may even lead to suicide [ 8 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Factors influencing resilience and burnout among resident physicians - a National Survey

et al. 2021

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Background Residency training exposes young physicians to a challenging and high-stress environment, making them vulnerable to burnout. Burnout syndrome not only compromises the health and wellness of resident physicians but has also been linked to prescription errors, reduction in the quality of medical care, and decreased professionalism. This study explored burnout and factors influencing resilience among U.S. resident physicians. Methods A cross-sectional study was conducted through an online survey, which was distributed to all accredited residency programs by Accreditation Council of Graduate Medical Education (ACGME). The survey included the Connor-Davidson Resilience Scale (CD-RISC 25), Abbreviated Maslach Burnout Inventory, and socio-demographic characteristics questions. The association between burnout, resilience, and socio-demographic characteristics were examined. Results The 682 respondents had a mean CD-RISC score of 72.41 (Standard Deviation = 12.1), which was equivalent to the bottom 25th percentile of the general population. Males and upper-level trainees were more resilient than females and junior residents. No significant differences in resilience were found associated with age, race, marital status, or training program type. Resilience positively correlated with personal achievement, family, and institutional support (p < 0.001) and negatively associated with emotional exhaustion and depersonalization (p < 0.001). Conclusions High resilience, family, and institutional support were associated with a lower risk of burnout, supporting the need for developing a resilience training program to promote a lifetime of mental wellness for future physicians.

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Healing Medicine's Future: Prioritizing Physician Trainee Mental Health

Cited by 36 publications

References 43 publications

Comparison of depression prevalence estimates in meta-analyses based on screening tools and rating scales versus diagnostic interviews: a meta-research review

Comparison of depression prevalence estimates in meta-analyses based on screening tools and rating scales versus diagnostic interviews: a meta-research review

Barriers to the psychological well-being of Australian junior doctors: a qualitative analysis

Factors influencing resilience and burnout among resident physicians - a National Survey

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