scholarly journals Medical errors during training: how do residents cope?: a descriptive study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saba Fatima ◽  
Stefania Soria ◽  
Nora Esteban- Cruciani
Keyword(s):  
Coping Strategies ◽  
Medical Errors ◽  
Medical Center ◽  
Academic Medical Center ◽  
Institutional Support ◽  
Well Being ◽  
Maladaptive Coping ◽  
Targeted Interventions ◽  
Brief Cope ◽  
The Impact

Abstract Background Physicians’ self-perceived medical errors lead to substantial emotional distress, which has been termed the “second victim phenomenon.” Medical errors during residency are associated with increased burnout and depression. It is important to know how residents cope with self-perceived medical errors and how they gain personal and emotional support in order to develop effective interventions. Objective To assess the impact of self-perceived medical errors on residents’ well-being, the range of coping strategies during training, and the extent of personal and institutional support. Methods An online cross-sectional survey was administered via email in October 2018 to 286 residents across all specialties in a 548-bed single urban academic medical center. The survey covered three domains focusing on residents’ most serious self-perceived medical error: (1) emotional response, (2) coping strategies using the BRIEF COPE Inventory, and (3) personal and institutional support. Results 109/286 residents from various specialties responded. Internal Medicine, Pediatrics and Emergency Medicine constituting 80 % of respondents. Self-perceived medical errors during residency were widespread (95 %). One in five medical errors was classified as moderate to severe. Most residents acknowledged a sense of guilt, remorse and/or inadequacy. Use of maladaptive coping strategies was high. Open-ended responses pointed to fear of retaliation, judgement, shame and retribution. Most residents disclosed their error to a senior resident but did not discuss it with the patient’s family. Only 32 % of residents participated in a debriefing session. Conclusions Most residents were directly involved in medical errors, which affected their emotional well-being. The use of maladaptive coping strategies was high. Residents’ fear of consequences prevented disclosure and discussion of self-perceived medical errors. This information is relevant to implement targeted interventions.

scholarly journals THE FEATURES OF COPING STRATEGIES IN ADOLESCENCE

2021 ◽  
Vol 7 (1) ◽  
pp. 82-98
Author(s):  
Olesia Prokofieva ◽  
◽  
Olga Prokofieva ◽  
Bogdan Smirnov ◽  
◽  
...  
Keyword(s):  
Social Support ◽  
Coping Strategies ◽  
Coping Behavior ◽  
Delinquent Behavior ◽  
Well Being ◽  
Self Control ◽  
Maladaptive Coping ◽  
Normative Behavior ◽  
The Impact ◽  
Difficult Situations

The article considers the features of coping strategies in adolescence. The article aim is to study and analyze adolescents’ coping strategies and the coping features characteristic for delinquent adolescents. To achieve this goal, the authors solved the following tasks: to analyze the peculiarities of coping behavior in adolescence and to determine its connection with behavioral disorders, to identify life situations especially difficult for adolescents, to identify leading coping strategies in adolescents and to conduct comparative analysis of coping strategies used by delinquent adolescents and adolescents with normative behavior. The authors analyzed maladaptive coping strategies: confrontation strategy, escape-avoidance strategy, distancing strategy; as well as adaptive coping strategies: positive reassessment, self-control and responsibility, social support and planning. Overcoming difficult life situations requires mobilization of personal resources, which is manifested in coping strategies. Their features largely depend on personal characteristics, life experience and situational factors that determine the individual uniqueness of mastering strategies. Among the variety of coping strategies, there are emotional, cognitive and behavioral coping. The coping strategies that focus on problem solving, seeking social support and avoidance are basic. The authors conducted the study with two groups of adolescents with normative and delinquent behavior and found that adolescents with normative behavior, unlike delinquents, were not prone to aggressive efforts and risks in solving difficult situations. At the same time, delinquent adolescents were characterized by maladaptive coping strategies. Copings are aimed at adapting a person to the requirements of a situation, mitigating its requirements, avoiding or getting used to them. In general, it reduces the impact of a difficult situation, ensures and maintains an individual’s physical and mental health, well-being, and satisfaction with social relations. The obtained results indicate that adolescents with normative behavior in difficult life situations are more active in making arbitrary, problem-focused efforts to change the situation; they make more efforts to analyze ways to solve the problem than delinquent adolescents. Adolescents with normative behavior are prone to: planning, positive reassessment, self-control, acceptance of responsibility, and also have a low level of stress in copings. Delinquents clearly have a tendency to the maladaptive “avoiding problem” strategy. They are prone to confrontation, avoidance, detonation. Delinquent adolescents experience more difficult situations. The coping system of adolescents with delinquent behavior is more intense, which indicates that they experience higher levels of stress. In adolescence, coping behavior is actively formed and is a prerequisite for psychological well-being. It aims to improve adolescents’ adaptation and is manifested through a set of coping strategies. The studied causes of delinquent behavior show that they are closely related to coping strategies. When delinquency is development, maladaptive behavioral patterns are formed that prevent adequate coping with stressful situations. This is confirmed by the data obtained during the study. A comparison of coping strategies of the studied groups shows a qualitative difference in the structure of coping in difficult life situations for adolescents with normative and delinquent behavior. The data obtained will expand the understanding of the causes underlying adolescents’ destructive behavior. The authors’ study is of practical importance, its results can be used by psychologists and social educators to identify ways to optimize mental development of all adolescents and adolescents with delinquent behavior, in particular through the purposeful formation of more effective coping strategies.

scholarly journals Alcohol Hand Rub Significantly Reduces Overall Bacterial Bioburden on Stethoscopes in a Real-World Clinical Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s114-s115
Author(s):  
Alexandra Johnson ◽  
Bobby Warren ◽  
Deverick John Anderson ◽  
Melissa Johnson ◽  
Isabella Gamez ◽  
...  
Keyword(s):  
Real World ◽  
Medical Center ◽  
Academic Medical Center ◽  
Randomized Study ◽  
Healthcare Providers ◽  
Clinical Workflow ◽  
Provider Type ◽  
Academic Medical ◽  
Rn Students ◽  
The Impact

Background: Stethoscopes are a known vector for microbial transmission; however, common strategies used to clean stethoscopes pose certain barriers that prevent routine cleaning after every use. We aimed to determine whether using readily available alcohol-based hand rub (ABHR) would effectively reduce bacterial bioburden on stethoscopes in a real-world setting. Methods: We performed a randomized study on inpatient wards of an academic medical center to assess the impact of using ABHR (AlcareExtra; ethyl alcohol, 80%) on the bacterial bioburden of stethoscopes. Stethoscopes were obtained from healthcare providers after routine use during an inpatient examination and were randomized to control (no intervention) or ABHR disinfection (2 pumps applied to tubing and bell or diaphragm by study personnel, then allowed to dry). Cultures of the tubing and bell or diaphragm were obtained with premoistened cellulose sponges. Sponges were combined with 1% Tween20-PBS and mixed in the Seward Stomacher. The homogenate was centrifuged and all but ~5 mL of the supernatant was discarded. Samples were plated on sheep’s blood agar and selective media for clinically important pathogens (CIPs) including S. aureus, Enterococcus spp, and gram-negative bacteria (GNB). CFU count was determined by counting the number of colonies on each plate and using dilution calculations to calculate the CFU of the original ~5 mL homogenate. Results: In total, 80 stethoscopes (40 disinfection, 40 control) were sampled from 46 physicians (MDs) and MD students (57.5%), 13 advanced practice providers (16.3%), and 21 nurses (RNs) and RN students (26.3%). The median CFU count was ~30-fold lower in the disinfection arm compared to control (106 [IQR, 50–381] vs 3,320 [986–4,834]; P < .0001). The effect was consistent across provider type, frequency of recent usual stethoscope cleaning, age, and status of pet ownership (Fig. 1). Overall, 26 of 80 (33%) of stethoscopes harbored CIP. The presence of CIP was lower but not significantly different for stethoscopes that underwent disinfection versus controls: S. aureus (25% vs 32.5%), Enterococcus (2.5% vs 10%), and GNB (2.5% vs 5%). Conclusions: Stethoscopes may serve as vectors for clean hands to become recontaminated immediately prior to performing patient care activities. Using ABHR to clean stethoscopes after every use is a practical and effective strategy to reduce overall bacterial contamination that can be easily incorporated into clinical workflow. Larger studies are needed to determine the efficacy of ABHR at removing CIP from stethoscopes as stethoscopes in both arms were frequently contaminated with CIP. Prior cleaning of stethoscopes on the study day did not seem to impact contamination rates, suggesting the impact of alcohol foam disinfection is short-lived and may need to be repeated frequently (ie, after each use).Funding: NoneDisclosures: NoneDisclosures: NoneFunding: None

scholarly journals Communications and Screening for 2019 Novel Coronavirus at a Tertiary-Care Medical Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s84-s84
Author(s):  
Lorinda Sheeler ◽  
Mary Kukla ◽  
Oluchi Abosi ◽  
Holly Meacham ◽  
Stephanie Holley ◽  
...  
Keyword(s):  
Screening Tool ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
The United States ◽  
World Health ◽  
Communication Campaign ◽  
Electronic Screening ◽  
Novel Coronavirus ◽  
The Impact

Background: In December of 2019, the World Health Organization reported a novel coronavirus (severe acute respiratory coronavirus virus 2 [SARS-CoV-2)]) causing severe respiratory illness originating in Wuhan, China. Since then, an increasing number of cases and the confirmation of human-to-human transmission has led to the need to develop a communication campaign at our institution. We describe the impact of the communication campaign on the number of calls received and describe patterns of calls during the early stages of our response to this emerging infection. Methods: The University of Iowa Hospitals & Clinics is an 811-bed academic medical center with >200 outpatient clinics. In response to the coronavirus disease 2019 (COVID-19) outbreak, we launched a communications campaign on January 17, 2020. Initial communications included email updates to staff and a dedicated COVID-19 webpage with up-to-date information. Subsequently, we developed an electronic screening tool to guide a risk assessment during patient check in. The screening tool identifies travel to China in the past 14 days and the presence of symptoms defined as fever >37.7°C plus cough or difficulty breathing. The screening tool was activated on January 24, 2020. In addition, university staff contacted each student whose primary residence record included Hubei Province, China. Students were provided with medical contact information, signs and symptoms to monitor for, and a thermometer. Results: During the first 5 days of the campaign, 3 calls were related to COVID-19. The number of calls increased to 18 in the 5 days following the implementation of the electronic screening tool. Of the 21 calls received to date, 8 calls (38%) were generated due to the electronic travel screen, 4 calls (19%) were due to a positive coronavirus result in a multiplex respiratory panel, 4 calls (19%) were related to provider assessment only (without an electronic screening trigger), and 2 calls (10%) sought additional information following the viewing of the web-based communication campaign. Moreover, 3 calls (14%) were for people without travel history but with respiratory symptoms and contact with a person with recent travel to China. Among those reporting symptoms after travel to China, mean time since arrival to the United States was 2.7 days (range, 0–11 days). Conclusion: The COVID-19 outbreak is evolving, and providing up to date information is challenging. Implementing an electronic screening tool helped providers assess patients and direct questions to infection prevention professionals. Analyzing the types of calls received helped tailor messaging to frontline staff.Funding: NoneDisclosures: None

Coping strategies among medical professionals during COVID-19 outbreak

2021 ◽  
Vol 4 (01) ◽  
pp. 28-33
Author(s):  
Vaishali Shanmugam
Keyword(s):  
Coping Strategies ◽  
Online Survey ◽  
Coping Styles ◽  
Well Being ◽  
Sociodemographic Factors ◽  
Medical Professionals ◽  
Stressful Situation ◽  
Sociodemographic Variables ◽  
Factors Affecting ◽  
Brief Cope

BACKGROUND: COVID -19 pandemic is a very stressful situation for doctors, who face the risk of infection in daily life. Coping is the process by which a person deals with stressful situations or demands. Identifying the coping strategies of our medical professionals will help us to understand their coping styles and to deliver effective interventions to enhance their mental well-being. METHODS: An online survey form with socio-demographic profile and BRIEF COPE tool for assessing different coping strategies was sent to interns, residents, and teaching faculty. The coping strategies were divided into emotion-based, problem-based, and dysfunctional coping, and spearman's correlation was done to determine any correlation between sociodemographic variables and the coping strategies. RESULTS: A total of 84 valid and complete responses were included in the study. There is a variable distribution of mean scores for problem-focused, emotion-focused, and dysfunctional strategies. Age and marital status had a positive correlation with problem-focused and emotion-focused strategies meaning that older adults and married people used these strategies predominantly. Higher designation used problem-focused coping predominantly. Dysfunctional coping strategies had no correlation with any of the sociodemographic variables. CONCLUSION: Sociodemographic factors affecting the coping mechanisms in medical professionals differ from those of the general population seen in previous studies. Within the group of medical professionals, those with higher age, higher designation and married had predominantly adaptive strategies. Interventions targetting maladaptive components of emotion-focused strategies and dysfunctional strategies should be aimed at a younger age group, unmarried people, interns, and residents among the medical professionals to better cope with this COVID scenario.

scholarly journals Women’s lives in times of Zika: mosquito-controlled lives?

2018 ◽  
Vol 34 (5) ◽  
Author(s):  
Ana Rosa Linde ◽  
Carlos Eduardo Siqueira
Keyword(s):  
Coping Strategies ◽  
Sampling Technique ◽  
Well Being ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
International Agencies ◽  
The Us ◽  
Women's Lives ◽  
Heavy Burden ◽  
The Impact

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies has made governments, national and international agencies issue advices and recommendations to women. There is a clear need to investigate how the Zika outbreak affects the decisions that women take concerning their lives and the life of their families, as well as how women are psychologically and emotionally dealing with the outbreak. We conducted a qualitative study to address the impact of the Zika epidemic on the family life of women living in Brazil, Puerto Rico, and the US, who were affected by it to shed light on the social repercussions of Zika. Women were recruited through the snowball sampling technique and data was collected through semi-structured interviews. We describe the effects in mental health and the coping strategies that women use to deal with the Zika epidemic. Zika is taking a heavy toll on women’s emotional well-being. They are coping with feelings of fear, helplessness, and uncertainty by taking drastic precautions to avoid infection that affect all areas of their lives. Coping strategies pose obstacles in professional life, lead to social isolation, including from family and partner, and threaten the emotional and physical well-being of women. Our findings suggest that the impacts of the Zika epidemic on women may be universal and global. Zika infection is a silent and heavy burden on women’s shoulders.

scholarly journals 154. Antibiotic Use During Three Separate Waves of the COVID-19 Pandemic at a Large Academic Medical Center in Detroit, MI

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S188-S189
Author(s):  
Deepika Sivakumar ◽  
Shelbye R Herbin ◽  
Raymond Yost ◽  
Marco R Scipione
Keyword(s):  
Retrospective Review ◽  
Bacterial Pneumonia ◽  
Medical Center ◽  
Academic Medical Center ◽  
Antibiotic Use ◽  
Percent Change ◽  
Academic Medical ◽  
Days Of Therapy ◽  
Time Periods ◽  
The Impact

Abstract Background Inpatient antibiotic use early on in the COVID-19 pandemic may have increased due to the inability to distinguish between bacterial and COVID-19 pneumonia. The purpose of this study was to determine the impact of COVID-19 on antimicrobial usage during three separate waves of the COVID-19 pandemic. Methods We conducted a retrospective review of patients admitted to Detroit Medical Center between 3/10/19 to 4/24/21. Median days of therapy per 1000 adjusted patient days (DOT/1000 pt days) was evaluated for all administered antibiotics included in our pneumonia guidelines during 4 separate time periods: pre-COVID (3/3/19-4/27/19); 1st wave (3/8/20-5/2/20); 2nd wave (12/6/21-1/30/21); and 3rd wave (3/7/21-4/24/21). Antibiotics included in our pneumonia guidelines include: amoxicillin, azithromycin, aztreonam, ceftriaxone, cefepime, ciprofloxacin, doxycycline, linezolid, meropenem, moxifloxacin, piperacillin-tazobactam, tobramycin, and vancomycin. The percent change in antibiotic use between the separate time periods was also evaluated. Results An increase in antibiotics was seen during the 1st wave compared to the pre-COVID period (2639 [IQR 2339-3439] DOT/1000 pt days vs. 2432 [IQR 2291-2499] DOT/1000 pt days, p=0.08). This corresponded to an increase of 8.5% during the 1st wave. This increase did not persist during the 2nd and 3rd waves of the pandemic, and the use decreased by 8% and 16%, respectively, compared to the pre-COVID period. There was an increased use of ceftriaxone (+6.5%, p=0.23), doxycycline (+46%, p=0.13), linezolid (+61%, p=0.014), cefepime (+50%, p=0.001), and meropenem (+29%, p=0.25) during the 1st wave compared to the pre-COVID period. Linezolid (+39%, p=0.013), cefepime (+47%, p=0.08) and tobramycin (+47%, p=0.05) use remained high during the 3rd wave compared to the pre-COVID period, but the use was lower when compared to the 1st and 2nd waves. Figure 1. Antibiotic Use 01/2019 to 04/2019 Conclusion Antibiotics used to treat bacterial pneumonia during the 1st wave of the pandemic increased and there was a shift to broader spectrum agents during that period. The increased use was not sustained during the 2nd and 3rd waves of the pandemic, possibly due to the increased awareness of the differences between patients who present with COVID-19 pneumonia and bacterial pneumonia. Disclosures All Authors: No reported disclosures

scholarly journals Validation of Sinhala Version of Brief COPE Scale in Patients with Cancer in Sri Lanka

2021 ◽  
Author(s):  
Eranthi Weeratunga ◽  
Chandanie Senadheera ◽  
Manjula Hettiarachchi ◽  
Bilesha Perera
Keyword(s):  
Sri Lanka ◽  
Coping Strategies ◽  
Cronbach’S Alpha ◽  
Maladaptive Coping ◽  
Retest Reliability ◽  
Patients With Cancer ◽  
Cronbach's Alpha ◽  
Brief Cope ◽  
The Mean ◽  
Test Retest Reliability

Abstract Background Coping strategies are essential in the cancer management/recovery process and show an integral part in patients with cancer globally. In Sri Lanka, validated scales to measure coping are scarce. This study was examined the Sinhalese version of the Brief COPE for its psychometric properties. Methods This scale is self-administered (28 items) and consists of adaptive and maladaptive coping strategies; divided into 14 subscales. Cancer patients were registered ‘first come - first serve’ basis using their appointment register at the Radiotherapy Unit, Oncology ward, Teaching Hospital, Karapitiya, Galle, Sri Lanka. They were requested to complete the Sinhalese version of the Brief COPE and demographic details. Test-retest reliability was checked using the same subjects two weeks later. Factorial validity was performed using exploratory factor and principal component analysis. Results were regarded as statistically significant if p < 0.05. Results The mean (±SD) age of the sample was 61(±12) years. The mean adaptive coping (±SD) and maladaptive coping were 37.50 (±8.14) and 17.10 (±2.44) respectively. The internal consistency of the overall scale was good (Cronbach’s alpha - 0.819). Adaptive and maladaptive coping showed a high Cronbach’s alpha (0.861 and 0.396). The test-retest reliability was found to be 0.66. The Sinhala version of BC was found to have a negative correlation with the CES-D scale but was positively correlated with the WHOQOL-BREF questionnaire. Seven factors were extracted. Conclusion The Sinhala version of the Brief COPE is a valid and reliable tool to assess coping strategies among patients with cancer. The findings of this study would let the health authorities get an understanding of coping strategies among patients with cancer; and the impact on cancer victims and family members to relieve their suffering.

scholarly journals The Impact of COVID-19 Outbreak on Emotional and Cognitive Vulnerability in Iranian Women With Breast Cancer

2021 ◽  
Vol 12 ◽  
Author(s):  
Mohammad H. Choobin ◽  
Vida Mirabolfathi ◽  
Bethany Chapman ◽  
Ali Reza Moradi ◽  
Elizabeth A. Grunfeld ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Cognitive Vulnerability ◽  
Emotional Health ◽  
Breast Cancer Diagnosis ◽  
Well Being ◽  
Emotional Impact ◽  
Targeted Interventions ◽  
Emotional Vulnerability ◽  
The Impact

The psychological cost on emotional well-being due to the collateral damage brought about by COVID-19 in accessing oncological services for breast cancer diagnosis and treatment has been documented by recent studies in the United Kingdom. The current study set out to examine the effect of delays to scheduled oncology services on emotional and cognitive vulnerability in women with a breast cancer diagnosis in Iran, one of the very first countries to be heavily impacted by COVID-19. One hundred thirty-nine women with a diagnosis of primary breast cancer answered a series of online questionnaires to assess the current state of rumination, worry, and cognitive vulnerability as well as the emotional impact of COVID-19 on their mental health. Results indicated that delays in accessing oncology services significantly increased COVID related emotional vulnerability. Regression analyses revealed that after controlling for the effects of sociodemographic and clinical variables, women’s COVID related emotional vulnerability explained higher levels of ruminative response and chronic worry as well as poorer cognitive function. This study is the first in Iran to demonstrate that the effects of COVID-19 on emotional health amongst women affected by breast cancer can exaggerate anxiety and depressive related symptoms increasing risks for clinical levels of these disorders. Our findings call for an urgent need to address these risks using targeted interventions exercising resilience.

scholarly journals Accounting Faculty mental health: coping strategies against stress,

2021 ◽  
Author(s):  
Eduardo Mendes Nascimento ◽  
Marcia Carvalho Garcia ◽  
Edgard Cornacchione
Keyword(s):  
Mental Health ◽  
Higher Education ◽  
Linear Regression ◽  
Coping Strategies ◽  
Well Being ◽  
Active Coping ◽  
Teaching Profession ◽  
Faculty Members ◽  
Accounting Faculty ◽  
Brief Cope

ABSTRACT This study sought to investigate which coping strategies are most frequently used by accounting faculty and how they can modulate the perceived stress. The higher education academic environment is filled with events that are stressful in nature; however, little effort, especially in the area of accounting, has been employed in seeking to understand and propose guidelines that can improve well-being and pleasure in the teaching profession. A coping strategy is a behavior that protects the individual from psychological damage related to problematic social experiences; it is through these behaviors that individuals manage their day-to-day experiences, thus helping to maintain their mental health. The discussion about the use of strategies for coping with stress lacks an approach in higher education institutions (HEIs), as it indicates that various strategies are being employed ineffectively and signals that three of the statistically significant strategies belong to the dimension of those focused on dysfunctional emotions. And, more seriously, of those three strategies, two (self-reproach and denial) have further contributed to increasing the perception of stress. The Teacher Stress Inventory (TSI), composed of 26 questions with a five-point Likert scale, and the Brief COPE (Coping Orientation to Problems Experienced Inventory), with 28 items and a four-point scale, were employed together with sociodemographic questions. An electronic questionnaire was sent to two thousand accounting faculty in Brazil. Altogether, 563 faculty members answered the questions. The analysis was conducted through association and multiple linear regression tests. It was verified that the average stress reported by the faculty members was 63% of the maximum TSI score, and the most prevalent strategies measured by the Brief COPE were planning, active coping, positive reinterpretation, use of instrumental support, self-reproach, and religion. Through linear regression estimation, it was concluded that two coping strategies (active coping and behavioral divestment) negatively moderated the faculty members’ stress, but two others (self-reproach and denial) raised their perception of stress. Moreover, it was discovered that the faculty members who were most vulnerable to stress use less adaptive coping strategies more intensely.

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