Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Participant Characteristics
3.2. Mental Health Symptoms, Psycho-Social Characteristics, and Well-Being
3.3. Bivariate Analyses Regarding Participant Characteristics and Mental Health Symptoms, Psycho-Social Characteristics, and Well-Being
3.3.1. Research Question 1: What are the Associations Between Mental Health Symptoms and Psycho-Social Characteristics with Flourishing?
3.3.2. Research Question 2: Are Mental Health Symptoms, Psycho-Social Characteristics, or Flourishing Associated with Pro-Inflammatory Gene Expression?
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total Sample (n = 59) | Residents (n = 44) | PA Students (n = 15) | Test Statistic (Degrees of Freedom), p-Value | |
---|---|---|---|---|
Age | 27.8 (SD = 3.03) | 30.13 (SD = 2.85) | 28.74 (SD = 3.42) | T(df = 57) = −1.55, p = 0.13 |
Sex | X2(df = 1) = 0.07, p = 0.80 | |||
Female | 45 (76.3%) | 33 (75.0%) | 12 (80.0%) | |
Male | 13 (22.0%) | 10 (22.7%) | 3 (20.0%) * | |
Nonbinary ** | 1 (1.7%) | 1 (1.7%) | 0 (0.0%) | |
Relationship Status | X2(df = 2) = 1.39, p = 0.50 | |||
Single | 16 (27.1%) | 11 (25.0%) | 5 (33.3%) * | |
Relationship | 24 (40.7%) | 17 (38.6%) | 7 (46.7%) | |
Married | 19 (32.2%) | 16 (36.4%) | 3 (20.0%) * | |
Primary Caregiver | 8 (13.6%) | 7 (15.9%) | 1 (6.7%) * | X2(df = 1) = 0.82, p = 0.37 |
Race | X2(df = 3) = 3.42, p = 0.33 | |||
White | 37 (62.7%) | 25 (56.8%) | 12 (80.0%) | |
AA/Black | 8 (13.6%) | 7 (15.9%) | 1 (6.7%) * | |
Asian | 9 (15.3%) | 7 (15.9%) | 2 (13.3%) * | |
Other | 5 (8.5%) | 5 (11.4%) * | 0 (0.0%) * | |
Hispanic or Latino | X2(df = 1) = 0.08, p = 0.78 | |||
Yes | 3 (5.2%) | 2 (4.5%) * | 1 (6.7%) * | |
No | 54 (93.1%) | 40 (90.9%) | 14 (93.3%) | |
Unknown ** | 1 (1.7%) | 1 (2.3%) | 0 (0.0%) | |
Days Sick/month | 1.06 (SD = 1.64) | 1.14 (SD = 1.83) | 0.80 (SD = 0.94) | T(df = 47.49) = −0.92, p = 0.36 |
Exercised/month | 6.61 (SD = 6.73) | 5.73 (SD = 6.41) | 9.20 (SD = 7.20) | T(df = 57) = 1.76, p = 0.084 |
Total Sample (n = 58) | Residents (n = 43) | PA Students (n = 15) | Test Statistic (Degrees of Freedom), p-Value | |
---|---|---|---|---|
Sleep Disturbance | 20.74 (SD = 5.70) | 20.07 (SD = 5.36) | 22.67 (SD = 6.38) | T(df = 56) = 1.54, p = 0.13 |
Sleep Categories | X2(df = 1) = 1.12, p = 0.29 | |||
None to Slight | 41 (70.7%) | 32 (74.4%) | 9 (60.0%) | |
Sleep Disturbance Present | 17 (29.3%) | 11 (25.6%) | 6 (40.0%) * | |
Mild | 14 (24.1%) | 10 (23.3%) | 4 (26.7%) | |
Moderate | 3 (5.2%) | 1 (2.3%) | 2 (13.3%) | |
Severe | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | |
Loneliness | 35.77 (SD = 9.81) | 36.44 (SD = 9.57) | 33.87 (SD = 10.57) | T(df = 56) = −0.87, p = 0.39 |
Depression | 3.43 (SD = 3.21) | 3.86 (SD = 3.54) | 2.20 (SD = 1.57) | T(df = 52.59) = −2.46, p = 0.02 |
Depression Categories | X2(df = 1) = 2.96, p = 0.09 | |||
Normal | 40 (69.0%) | 27 (62.8%) | 13 (86.7%) | |
Depression Symptoms Present | 18 (31.0%) | 16 (37.2%) | 2 (13.3%) * | |
Mild | 9 (15.5%) | 7 (16.3%) | 2 (13.3%) | |
Moderate | 8 (13.8%) | 8 (18.6%) | 0 (0.0%) | |
Severe | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | |
Extremely Severe | 1 (1.7%) | 1 (2.3%) | 0 (0.0%) | |
Anxiety | 3.17 (SD = 3.29) | 2.91 (SD = 2.29) | 3.93 (SD = 2.60) | T(df = 56) = 1.44, p = 0.15 |
Anxiety Categories | X2(df = 1) = 1.88, p = 0.17 | |||
Normal | 32 (55.2%) | 26 (60.5%) | 6 (40.0%) | |
Anxiety Symptoms Present | 26 (44.8%) | 17 (39.5%) | 9 (60.0%) | |
Mild | 16 (27.6%) | 12 (27.9%) | 4 (26.7%) | |
Moderate | 8 (13.8%) | 4 (9.3%) | 4 (26.7%) | |
Severe | 2 (3.4%) | 1 (2.3%) | 1 (6.7%) | |
Extremely Severe | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | |
Stress | 6.33 (SD = 3.34) | 6.58 (SD = 3.58) | 5.60 (SD = 2.47) | T(df = 56) = −0.98, p = 0.33 |
Stress Categories | X2(df = 1) = 2.96, p = 0.09 | |||
Normal | 40 (69.0%) | 27 (62.8%) | 13 (86.7%) | |
Stress Symptoms Present | 18 (31.0%) | 16 (37.2%) | 2 (13.3%) * | |
Mild | 8 (13.8%) | 7 (16.3%) | 1 (6.7%) | |
Moderate | 7 (12.1%) | 6 (14.0%) | 1 (6.7%) | |
Severe | 3 (5.2%) | 3 (7.0%) | 0 (0.0%) | |
Extremely Severe | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | |
Emotional Well-Being | 11.36 (SD = 2.48) | 11.05 (SD = 2.65) | 12.27 (SD = 1.71) | T(df = 1) = 1.66, p = 0.10 |
Social Well-Being | 14.48 (SD = 4.87) | 14.77 (SD = 5.03) | 13.67 (SD = 4.42) | T(df = 56) = −0.75, p = 0.46 |
Psychological Well-Being | 22.50 (SD = 4.95) | 22.35 (SD = 5.35) | 22.93 (SD = 3.69) | T(df = 56) = 0.39, p = 0.70 |
Mental Health | X2(df = 1) = 0.19, p = 0.66 | |||
Flourishing | 32 (55.2%) | 23 (53.5%) | 9 (60.0%) | |
Non- Flourishing | 26 (44.8%) | 20 (46.5%) | 6 (40.0%) | |
Moderate | 25 (43.1%) | 19 (44.2%) | 6 (40.0%) | |
Languishing | 1 (1.7%) | 1 (2.3%) | 0 (0.0%) |
Sleep Disturbance r (p-Value) | Loneliness r (p-Value) | Depression r (p-Value) | Anxiety r (p-Value) | Stress r (p-Value) | Emotional Well-Being r (p-Value) | Social Well-Being r (p-Value) | Psychological Well-Being r (p-Value) | |
---|---|---|---|---|---|---|---|---|
Age | 0.06 (0.64) | −0.04 (0.79) | 0.21 (0.12) | −0.03 (0.83) | 0.03 (0.80) | −0.25 (0.06) | 0.01 (0.94) | 0.06 (0.64) |
Sex | 0.006 (0.96) | −0.11 (0.41) | 0.08 (0.54) | 0.09 (0.53) | 0.12 (0.39) | −0.05 (0.71) | 0.08 (0.54) | 0.01 (0.97) |
Relationship Status | −0.02 (0.87) | −0.13 (0.32) | 0.20 (0.14) | −0.09 (0.49) | 0.31 (0.02) | −0.06 (0.63) | −0.03 (0.82) | 0.006 (0.97) |
Primary Caregiver | 0.21 (0.10) | 0.26 (0.05) | 0.42 (0.001) | 0.21 (0.11) | 0.18 (0.18) | −0.15 (0.26) | −0.17 (0.21) | −0.20 (0.12) |
Race | 0.12 (0.39) | 0.20 (0.14) | 0.18 (0.17) | 0.18 (0.19) | 0.11 (0.41) | −0.25 (0.06) | −0.09 (0.51) | −0.25 (0.06) |
Hispanic or Latino | 0.17 (0.23) | −0.07 (0.63) | −0.17 (0.20) | −0.20 (0.14) | −0.13 (0.36) | 0.03 (0.84) | −0.01 (0.94) | −0.002 (0.99) |
Specialty | −0.20 (0.12) | 0.11 (0.43) | 0.13 (0.35) | −0.13 (0.32) | 0.09 (0.51) | −0.11 (0.40) | 0.08 (0.54) | −0.12 (0.38) |
No. of Days Sick in Previous 30 Days | 0.25 (0.06) | 0.28 (0.04) | 0.11 (0.43) | 0.34 (0.008) | 0.24 (0.07) | −0.08 (0.54) | −0.11 (0.43) | −0.17 (0.21) |
No. of Times Exercised in Previous 30 Days | −0.07 (0.59) | −0.37 (0.005) | −0.44 (0.001) | −0.21 (0.11) | −0.29 (0.03) | 0.46 (<0.001) | 0.29 (0.03) | 0.32 (0.02) |
Sleep Dist. | Loneliness | Dep | Anxiety | Stress | Emo. WB | Soc. WB | Psych WB | |
---|---|---|---|---|---|---|---|---|
r (p-Value) | r (p-Value) | r (p-Value) | r (p-Value) | r (p-Value) | r (p-Value) | r (p-Value) | r (p-Value) | |
Sleep Dist. | - | 0.22 (0.10) | 0.01 (0.95) | 0.39 (0.003) | 0.02 (0.91) | 0.01 (0.96) | −0.04 (0.76) | −0.12 (0.36) |
Loneliness | - | 0.57 (<0.001) | 0.46 (<0.001) | 0.27 (0.04) | −0.59 (<0.001) | −0.52 (<0.001) | −0.58 (<0.001) | |
Dep | - | 0.33 (0.01) | 0.56 (<0.001) | −0.68 (<0.001) | −0.38 (0.003) | −0.52 (<0.001) | ||
Anxiety | - | 0.39 (0.003) | −0.16 (0.24) | −0.31 (0.02) | −0.35 (0.007) | |||
Stress | - | −0.42 (0.001) | −0.44 (0.001) | −0.56 (<0.001) | ||||
Emo WB | - | 0.50 (<0.001) | 0.66 (<0.001) | |||||
Soc. | - | 0.59 (<0.001) | ||||||
WB | ||||||||
Psych WB | - |
Step 1 | Step 2 | Step 3 | ||||
---|---|---|---|---|---|---|
AOR (95% CI) | p-Value | AOR (95% CI) | p-Value | AOR (95% CI) | p-Value | |
Trainee Type (PA Student = 1) | 1.08 (0.31–3.78) | 0.90 | 0.81 (0.21–3.08) | 0.76 | 0.57 (0.09–3.60) | 0.55 |
Primary Caregiver (Yes = 1) | 0.09 (0.01–0.78) | 0.03 | 0.20 (0.02–2.13) | 0.18 | 0.09 (0.01–1.28) | 0.08 |
# of Days Sick in Previous 30 Days | 0.73 (0.48–1.10) | 0.13 | 0.85 (0.44–1.63) | 0.63 | ||
# of Times Exercised in Previous 30 Days | 1.08 (0.97–1.21) | 0.18 |
0.96 (0.79–1.16) | 0.66 | ||
Loneliness |
0.75 (0.61–0.91) | 0.003 | ||||
Depression |
1.50 (0.99–2.28) | 0.06 | ||||
Anxiety |
1.19 (0.80–1.78) | 0.38 | ||||
Stress |
0.65 (0.45–0.94) | 0.02 | ||||
Nagelkerke R2 | 0.16 | 0.24 | 0.64 |
Model 1 * b (SE) p | Model 2 ** b (SE) p | Model 3 *** b (SE) p | |
---|---|---|---|
Flourishing (1/0) | −0.173 (0.072) p = 0.02 | −0.174 (0.087) p = 0.06 | −0.057 (0.115) p = 0.63 |
Loneliness (z-score) | 0.008 (0.003) p = 0.02 | 0.011 (0.005) p = 0.03 | 0.009 (0.006) p = 0.17 |
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Mascaro, J.S.; Wallace, A.; Hyman, B.; Haack, C.; Hill, C.C.; Moore, M.A.; Lund, M.B.; Nehl, E.J.; Bergquist, S.H.; Cole, S.W. Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity. Int. J. Environ. Res. Public Health 2022, 19, 2255. https://doi.org/10.3390/ijerph19042255
Mascaro JS, Wallace A, Hyman B, Haack C, Hill CC, Moore MA, Lund MB, Nehl EJ, Bergquist SH, Cole SW. Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity. International Journal of Environmental Research and Public Health. 2022; 19(4):2255. https://doi.org/10.3390/ijerph19042255
Chicago/Turabian StyleMascaro, Jennifer S., Amanda Wallace, Brooke Hyman, Carla Haack, Cherie C. Hill, Miranda A. Moore, Maha B. Lund, Eric J. Nehl, Sharon H. Bergquist, and Steve W. Cole. 2022. "Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity" International Journal of Environmental Research and Public Health 19, no. 4: 2255. https://doi.org/10.3390/ijerph19042255