Improving the Mental Health of Surgical Teams Through Operating Room Design.

OBJECTIVE: In this study, we aim to develop and propose an evaluation method for analyzing the design of operating rooms (ORs) from the perspective of surgical teams' reported experiences and stress levels. BACKGROUND: Stress and burnout of surgical team members can lead to diminished performance and medical errors, which endangers the safety of both the patients and team members. The design and layout of the OR play a critical role in managing such stress. METHODS: To understand surgical teams' spatial needs related to their experiences and stress, we administered a survey and in-depth focus group discussions to three surgical teams from the same organization. The identified spatial needs were translated into functional scenarios and spatial metrics, essentially viewing the OR through the perspective of users. RESULTS: Our analysis revealed four integral sections-patient flow, room organization, access to facilities/medical equipment/support staff/team members, and staff well-being-identified as critical design factors associated with the experiences and stress levels of the surgical teams in the ORs. CONCLUSIONS: We expect this method to serve as a tool for evaluating the effect of the design of OR layouts on stress, thereby supporting the well-being and resiliency of surgical teams.

Measuring age differences in executive control using rapid motor decisions in a robotic object hit and avoid task.

Age-related declines in executive control are commonly assessed with neuropsychological tests that also rely on sensory and motor processes that are not typically measured in those tasks. It is therefore difficult to isolate the cognitive contributions from sensorimotor contributions to performance impairments. Rapid motor decision-making tasks may also be sensitive to age differences in executive control but allow for the measurement of sensorimotor contributors to task performance. Recently developed object hit (OH) and object hit and avoid (OHA) tasks using a robotic manipulandum are sensitive to motor and cognitive aspects of performance in stroke and Parkinson's disease. However, the impact of healthy aging, and the specific cognitive mechanisms involved in these tasks has not been assessed. We administered the OH and OHA tasks to 77 younger and 59 healthy older adults to evaluate the relative age differences in the perceptual-motor/sensory, movement coordination, and cognitive measures of performance. The Trail Making Test (TMT) Parts A and B were administered to assess the extent to which the cognitive contributors to OHA task performance are associated with executive functioning. After controlling for hand movement speed, age differences were largest for cognitive measures, with smaller differences in perceptual-motor speed and sensory measures, and little differences in bimanual and spatial coordination measures of performance. The cognitive measures were associated with executive functioning measures from the TMT task. These findings provide evidence that rapid motor decision-making tasks are sensitive to age differences in executive control and can isolate the cognitive from the sensorimotor contributions to task performance. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Effectiveness of a Survivorship Program: An Assessment of Patients With Breast Cancer in a Community Setting.

PURPOSE: This study assesses the effectiveness of a single institution's breast cancer survivorship program on patient perceptions, quality of life (QOL), and compliance with National Comprehensive Cancer Network (NCCN) guidelines for follow-up. METHODS: Sampled patients completed all their breast cancer treatment at a single tertiary center. Surveys designed to evaluate QOL were obtained, and retrospective medical record review was conducted to assess NCCN compliance. Survivorship clinic (SC) attendees and nonattendees were matched for age and disease stage for comparison of the outcomes (QOL, NCCN compliance, and overall effectiveness). RESULTS: SC patients (n = 63) tended to perceive their concerns in various categories to be addressed more adequately than did nonattendees (n = 54), with significant differences in the areas of practical concerns (P = .03) and late-term adverse effects (P = .03). There was a significant difference in compliance with three NCCN guidelines (history and physical every 3 to 6 months, annual mammography, and a pelvic examination if on tamoxifen) between survivorship attendees and nonattendees (P < .001, P = .02, and P < .001, respectively). Women who attended an SC used other survivorship support resources more often. CONCLUSION: Survivorship programs can be time and resource consuming, but our study is one of the first to show that a survivorship program effectively changes patient behavior in important ways. Patients who attended an SC were more likely to be compliant with NCCN-recommended follow-up and to use other survivorship resources and felt their concerns were better addressed. These measures can be used to help us improve our survivorship services and by other institutions to measure the quality and effectiveness of their programs.