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1.
Adv Health Sci Educ Theory Pract ; 23(5): 977-993, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30088186

RESUMO

The well-being of residents, our future medical specialists, is not only beneficial to the individual physician but also conditional for delivering high-quality patient care. Therefore, the authors further explored how residents experience their own well-being in relation to their professional and personal life. The authors conducted a qualitative study based on a phenomenological approach. From June to October 2013, 13 in-depth interviews were conducted with residents in various training programs using a semi-structured interview guide to explore participants' experience of their well-being in relation to their professional life. The data were collected and analyzed through an iterative process using the thematic network approach. Effort-reward balance and perceived autonomy were dominant overarching experiences in influencing residents' well-being. Experiencing sufficient autonomy was important in residents' roles as caregivers, as learners and in their personal lives. The experienced effort-reward balance could both positively and negatively influence well-being. We found two categories of ways that influence residents' experience of well-being; (1) professional lives: delivering patient care, participating in teamwork, learning at the workplace and dealing with the organization and (2) personal lives: dealing with personal characteristics and balancing work-life. In residents' well-being experiences, the effort-reward balance and perceived autonomy are crucial. Additionally, ways that influence residents' well-being are identified in both their professional and personal lives. These dominant experiences and ways that influence well-being could be key factors for interventions and residency training adaptations for enhancing residents' well-being.


Assuntos
Internato e Residência , Médicos/psicologia , Autonomia Profissional , Recompensa , Local de Trabalho/psicologia , Atitude do Pessoal de Saúde , Humanos , Entrevistas como Assunto , Equipe de Assistência ao Paciente/organização & administração , Papel do Médico , Equilíbrio Trabalho-Vida
2.
World J Surg ; 40(1): 29-37, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26482362

RESUMO

BACKGROUND: Residents' well-being is essential for both the individual physician and the quality of patient care they deliver. Therefore, it is important to maintain or possibly enhance residents' well-being. We investigated (i) the influence of mind fitness training (MFT) on quality of care-related well-being characteristics: work engagement, empathy, work satisfaction and stress perception and explored (ii) residents' perceptions of MFT. METHODS: A multicenter study was conducted in eight Dutch teaching hospitals, from September 2012 to February 2014, using mixed methods­that is, quantitative and qualitative approaches to data collection and analysis. Eighty-nine surgical residents were invited to participate in pre- and post-intervention questionnaire surveys. Twenty-two residents participated in MFT and were additionally invited to evaluate the training by post-intervention interviews including open questions. RESULTS: At baseline 22 (100%) residents in intervention group and 47 (70.2%) residents in control group, and postintervention 20 (90.9 %) residents in intervention group and 41 (66.1%) residents in control group completed the questionnaires. In intervention-group, residents' specialty satisfaction increased by 0.23 point on 5-point Likert scale (95% CI 0.23­0.24, P < 0.001) while stress scores decreased by -0.94 point on 10-point scale (95% CI -1.77 to -0.12, P = 0.026). No substantial changes were observed in control group. Participation in MFT was positively associated with residents' empathy (b = 7.22; 95% CI 4.33­10.11; P < 0.001) and specialty satisfaction scores (b = 0.42; 95% CI 0.18­0.65; P = 0.001). Residents positively evaluated MFT with median scores of 6.80 for training design and 7.21 for outcome (10-point scale). Residents perceived improvement in focusing skills and reported being more aware of their own state of mind and feeling calmer and more in control. CONCLUSION: Mind fitness training could improve residents' empathy, specialty satisfaction, stress perception, and focusing skills, and was positively received by surgical residents.


Assuntos
Atitude Frente a Saúde , Competência Clínica , Empatia/fisiologia , Hospitais de Ensino , Internato e Residência/métodos , Médicos/psicologia , Adulto , Humanos , Projetos Piloto , Inquéritos e Questionários
3.
Ann Surg ; 261(2): 276-81, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24983993

RESUMO

BACKGROUND: Incisional hernia is one of the most frequent postoperative complications after abdominal surgery. Patients with an abdominal aortic aneurysm and patients with a body mass index of 27 or higher have an increased risk to develop incisional hernia. Primary mesh augmentation is a method in which the abdominal wall is strengthened to reduce incisional hernia incidence. This study focused on the short-term results of the PRImary Mesh Closure of Abdominal Midline Wounds trial, a multicenter double blind randomized controlled trial. METHODS: Between 2009 and 2012 patients were included if they were operated via midline laparotomy, and had an abdominal aortic aneurysm or a body mass index of 27 or higher. Patients were randomly assigned to either receive primary suture, onlay mesh augmentation (OMA), or sublay mesh augmentation. RESULTS: Outcomes represent results after 1-month follow-up. A total of 480 patients were randomized. During analysis, significantly (P = 0.002) more seromas were detected after OMA (n = 34, 18.1%) compared with primary suture (n = 5, 4.7%) and sublay mesh augmentation (n = 13, 7%). No differences were discovered in any of the other outcomes such as surgical site infection, hematoma, reintervention, or readmission. Multivariable analysis revealed an increase in seroma formation after OMA with an odds ratio of 4.3 (P = 0.004) compared with primary suture and an odds ratio of 2.9 (P = 0.003) compared with sublay mesh augmentation. CONCLUSIONS: On the basis of these short-term results, primary mesh augmentation can be considered a safe procedure with only an increase in seroma formation after OMA, but without an increased risk of surgical site infection.


Assuntos
Hérnia Ventral/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Telas Cirúrgicas , Técnicas de Sutura , Adesivos Teciduais , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Feminino , Seguimentos , Hérnia Ventral/etiologia , Humanos , Análise de Intenção de Tratamento , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Complicações Pós-Operatórias/etiologia , Fatores de Risco , Resultado do Tratamento
4.
World J Surg ; 38(11): 2753-60, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25008244

RESUMO

BACKGROUND: Faculty members rely on residents' feedback about their teaching performance. The influence of residents' characteristics on evaluations of faculty is relatively unexplored. We aimed to evaluate the levels of work engagement and empathy among residents and the association of both characteristics with their evaluation of the faculty's teaching performance. METHODS: A multicenter questionnaire study among 271 surgery and gynecology residents was performed from September 2012 to February 2013. Residents' ratings of the faculty's teaching performance were collected using the system for evaluation of teaching quality (SETQ). Residents were also invited to fill out standardized measures of work engagement and empathy using the short Utrecht Work Engagement Scale and the Jefferson Scale of Physician Empathy, respectively. Linear regression analysis using generalized estimating equations to evaluate the association of residents' engagement and empathy with residents' evaluations of teaching performance. RESULTS: Overall, 204 (75.3 %) residents completed 1814 SETQ evaluations of 302 faculty, and 143 (52.8 %) and 140 (51.7 %) residents, respectively, completed the engagement and empathy measurements. The median scores of residents' engagement and empathy were 4.56 (scale 0-6) and 5.55 (scale 1-7), respectively. Higher levels of residents' engagement (regression coefficient b = 0.128; 95 % confidence interval (CI) 0.072-0.184; p < 0.001) and empathy (b = 0.113; 95 % CI 0.063-0.164; p < 0.001) were associated with higher faculty teaching performance scores. CONCLUSIONS: Residents' engagement and empathy appear to be positively associated with their evaluation of the faculty's performance. A possible explanation is that residents who are more engaged and can understand and share others' perspectives stimulate and experience faculty's teaching better than others.


Assuntos
Empatia , Docentes de Medicina , Internato e Residência , Competência Profissional , Ensino , Adulto , Estudos Transversais , Feminino , Cirurgia Geral/educação , Ginecologia/educação , Humanos , Masculino , Inquéritos e Questionários
5.
Ned Tijdschr Geneeskd ; 157(48): A6614, 2013.
Artigo em Holandês | MEDLINE | ID: mdl-24279952

RESUMO

A good level of physical and mental fitness is essential in order to function optimally as a resident. Concerns about residents' mental fitness have recently been raised, based on high percentages of residents suffering from burnout and depression and data on the experience of stress and anxiety. Lack of mental fitness has negative consequences for the individual doctor as well as for the quality of patient care delivered. This is expressed in loss of empathy, delivery of suboptimal care and increased medical errors. Finding solutions for the lack of, or deterioration in, mental fitness is crucial. We discuss two potential strategies: (1) the removal or reduction of obstacles to residents' mental fitness and (2) the provision of resources to improve mental fitness.


Assuntos
Internato e Residência , Saúde Mental , Médicos/psicologia , Esgotamento Profissional , Empatia , Humanos , Erros Médicos/psicologia , Erros Médicos/estatística & dados numéricos , Assistência ao Paciente/psicologia , Assistência ao Paciente/normas , Qualidade da Assistência à Saúde
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