scholarly journals What Protects Youth Residential Caregivers from Burning Out? A Longitudinal Analysis of Individual Resilience

2020 ◽  
Vol 17 (7) ◽  
pp. 2212 ◽  
Author(s):  
Nina Kind ◽  
David Bürgin ◽  
Jörg M. Fegert ◽  
Marc Schmid
Keyword(s):  
Longitudinal Analysis ◽  
Self Efficacy ◽  
Proportional Hazards ◽  
Multiple Stressors ◽  
Self Care ◽  
Cox Proportional Hazards ◽  
Prospective Longitudinal Study ◽  
Work Related ◽  
Individual Resilience ◽  
Prospective Longitudinal

Background: Professional caregivers are exposed to multiple stressors and have high burnout rates; however, not all individuals are equally susceptible. We investigated the association between resilience and burnout in a Swiss population of professional caregivers working in youth residential care. Methods: Using a prospective longitudinal study design, participants (n = 159; 57.9% women) reported on burnout symptoms and sense of coherence (SOC), self-efficacy and self-care at four annual sampling points. The associations of individual resilience measures and sociodemographic variables, work-related and personal stressors, and burnout symptoms were assessed. Cox proportional hazards regressions were calculated to compute hazard ratios over the course of three years. Results: Higher SOC, self-efficacy and self-care were related to lower burnout symptoms in work-related and personal domains. Higher SOC and self-efficacy were reported by older caregivers and by those with children. All three resilience measures were highly correlated. A combined model analysis weakened the protective effect of self-efficacy, leaving only SOC and self-care negatively associated with burnout. Conclusion: This longitudinal analysis suggests that SOC and self-caring behaviour in particular protect against burnout. Our findings could have implications for promoting self-care practices, as well as cultivating a meaningful, comprehensible and manageable professional climate in all facets of institutional care.

scholarly journals Risk of Type 2 Diabetes among Osteoarthritis Patients in a Prospective Longitudinal Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
M. Mushfiqur Rahman ◽  
Jolanda Cibere ◽  
Aslam H. Anis ◽  
Charlie H. Goldsmith ◽  
Jacek A. Kopec
Keyword(s):  
Longitudinal Study ◽  
Older Women ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Prospective Longitudinal Study ◽  
Younger Women ◽  
Administrative Records ◽  
Cox Proportional Hazards Models ◽  
Younger Men ◽  
Prospective Longitudinal

Objectives. Our aim was to determine the risk of diabetes among osteoarthritis (OA) cases in a prospective longitudinal study.Methods. Administrative health records of 577,601 randomly selected individuals from British Columbia, Canada, from 1991 to 2009, were analyzed. OA and diabetes cases were identified by checking physician’s visits and hospital records. From 1991 to 1996 we documented 19,143 existing OA cases and selected one non-OA individual matched by age, sex, and year of administrative records. Poisson regression and Cox proportional hazards models were fitted to estimate the effects after adjusting for available sociodemographic and medical factors.Results. At baseline, the mean age of OA cases was 61 years and 60.5% were women. Over 12 years of mean follow-up, the incidence rate (95% CI) of diabetes was 11.2 (10.90–11.50) per 1000 person years. Adjusted RRs (95% CI) for diabetes were 1.27 (1.15–1.41), 1.21 (1.08–1.35), 1.16 (1.04–1.28), and 0.99 (0.86–1.14) for younger women (age 20–64 years), older women (age ≥ 65 years), younger men, and older men, respectively.Conclusion. Younger adults and older women with OA have increased risks of developing diabetes compared to their age-sex matched non-OA counterparts. Further studies are needed to confirm these results and to elucidate the potential mechanisms.

scholarly journals Central Blood Pressure and Cardiovascular Outcomes in Chronic Kidney Disease

2018 ◽  
Vol 13 (4) ◽  
pp. 585-595 ◽  
Author(s):  
Mahboob Rahman ◽  
Jesse Yenchih Hsu ◽  
Niraj Desai ◽  
Chi-yuan Hsu ◽  
Amanda H. Anderson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Confidence Interval ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cardiovascular Outcomes ◽  
Hazard Ratio ◽  
Cardiovascular Outcome ◽  
Prospective Longitudinal Study ◽  
Disease Outcomes ◽  
Prospective Longitudinal

Background and objectivesCentral BP measurements provide noninvasive measurement of aortic BP; our objectives were to examine the association of central and brachial BP measurements with risk of cardiovascular outcomes and mortality in patients with CKD and to determine the role of central BP measurement in conjunction with brachial BP in estimating cardiovascular risk.Design, setting, participants, & measurementsIn a prospective, longitudinal study (the Chronic Renal Insufficiency Cohort), central BP was measured in participants with CKD using the SphygmoCorPVx System. Cox proportional hazards models were used for analyses.ResultsMean age of the participants (n=2875) was 60 years old. After a median follow-up of 5.5 years, participants in the highest quartile of brachial systolic BP (≥138 mm Hg) were at higher risk for the composite cardiovascular outcome (hazard ratio, 1.59; 95% confidence interval, 1.17 to 2.17; c statistic, 0.76) but not all-cause mortality (hazard ratio, 1.28; 95% confidence interval, 0.90 to 1.80) compared with those in the lowest quartile. Participants in the highest quartile of central systolic BP were also at higher risk for the composite cardiovascular outcome (hazard ratio, 1.69; 95% confidence interval, 1.24 to 2.31; c statistic, 0.76) compared with participants in the lowest quartile.ConclusionsWe show that elevated brachial and central BP measurements are both associated with higher risk of cardiovascular disease outcomes in patients with CKD. Measurement of central BP does not improve the ability to predict cardiovascular disease outcomes or mortality in patients with CKD compared with brachial BP measurement.

Investigation of the role of anxiety and depression on the formation of phantom vibration and ringing syndrome induced by working stress during medical internship (Preprint)

2019 ◽  
Author(s):  
Yu-Hsuan Lin ◽  
Kuan-I Lin ◽  
Yuan-Chien Pan ◽  
Sheng-Hsuan Lin
Keyword(s):  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Prospective Longitudinal Study ◽  
Work Related ◽  
Working Stress ◽  
Causal Mediation Analysis ◽  
Accompanying Symptoms ◽  
Prospective Longitudinal ◽  
The Relationship

BACKGROUND Phantom vibrations syndrome (PVS) and phantom ringing syndrome (PRS) are prevalent hallucinations during medical internship. Depression and anxiety are probably understudied risk factors of PVS and PRS. OBJECTIVE The aim of this study was to investigate the role of anxiety and depression on the relationship between working stress during medical internship and PVS and PRS. METHODS A prospective longitudinal study of 74 medical interns was carried out using repeated investigations of the severity of phantom vibrations and ringing, as well as accompanying symptoms of anxiety and depression as measured by Beck Anxiety Inventory and the Beck Depression Inventory before, at the 3rd, 6th, and 12th month during internship, and 2 weeks after internship. We conducted a causal mediation analysis to investigate the role of depression and anxiety in the mechanism of working stress during medical internship inducing PVS and PRS. RESULTS The results showed that depression explained 21.9% and 8.4% for stress-induced PRS and PVS, respectively. In addition, anxiety explained 15.0% and 7.8% for stress-induced PRS and PVS, respectively. CONCLUSIONS Our findings showed both depression and anxiety can explain a portion of stress-induced PVS and PRS during medical internship and might be more important in clinical practice and benefit to prevention of work-related burnout.

scholarly journals The Stress of Caring—Resilience and HPA-Axis Activity in Hair Samples of Youth Residential Caregivers

2020 ◽  
Vol 11 ◽  
Author(s):  
David Bürgin ◽  
Nina Kind ◽  
Martin Schröder ◽  
Vera Clemens ◽  
Jörg M. Fegert ◽  
...  
Keyword(s):  
Residential Care ◽  
Hpa Axis ◽  
Self Efficacy ◽  
Multiple Stressors ◽  
Self Care ◽  
Positive Association ◽  
Well Being ◽  
Linear Regression Models ◽  
Residential Care Institutions ◽  
Hair Samples

Background: Professional caregivers in youth residential care institutions experience frequent verbal and physical aggression as well as multiple stressors as part of their everyday work, leading to high levels of burnout and staff turnover. Resilience might buffer against psychophysiological stress response and therefore be crucial for well-being in professional caregivers.Objectives: We aimed to investigate if measures related to resilience [sense of coherence (SoC), self-efficacy and self-care] and attachment security of caregivers were cross-sectionally associated with stress markers in hair samples [cortisol and dehydroepiandrosterone (DHEA)].Method: Participants (n = 134; 64.2% women) reported on individual resilience measures and provided hair samples for cortisol and DHEA assays. Attachment was assessed in a subsample using the Adult Attachment Projective Picture System (AAP, n = 69). Linear regression models were fitted to estimate the association between resilience measures and the Cortisol:DHEA ratio, cortisol and DHEA, controlling for gender and age.Results: SoC was associated with a lower Cortisol:DHEA ratio (β = −0.36, p < 0.001), driven by a positive association between SoC and DHEA levels (β = 0.28, p = 0.002). Self-care was also associated with lower Cortisol:DHEA ratios (β = −0.24, p = 0.005), due to self-care being associated with higher DHEA (β = 0.21, p = 0.016). HPA-axis measures were not associated with self-efficacy nor with attachment patterns in a subsample.Conclusions: Our findings imply that youth residential care institutions might benefit from programs focusing on enhancing SoC and self-care practices. Fostering a meaningful, comprehensible and manageable professional climate in caregiving environments and implementing self-care in routine practices might enhance not only well-being but also physical health of professional caregivers and in this way buffer adverse health effects of chronic stressors.

scholarly journals Investigation of the role of anxiety and depression on the formation of phantom vibration and ringing syndrome caused by working stress during medical internship (Preprint)

2020 ◽  
Author(s):  
Yu-Hsuan Lin ◽  
Kuan-I Lin ◽  
Yuan-Chien Pan ◽  
Sheng-Hsuan Lin
Keyword(s):  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Prospective Longitudinal Study ◽  
Work Related ◽  
Working Stress ◽  
Causal Mediation Analysis ◽  
Accompanying Symptoms ◽  
Prospective Longitudinal ◽  
The Relationship

BACKGROUND Phantom vibrations syndrome (PVS) and phantom ringing syndrome (PRS) are prevalent hallucinations during medical internship. Depression and anxiety are probably understudied risk factors of PVS and PRS. OBJECTIVE The aim of this study was to investigate the role of anxiety and depression on the relationship between working stress during medical internship and PVS and PRS. METHODS A prospective longitudinal study of 74 medical interns was carried out using repeated investigations of the severity of phantom vibrations and ringing, as well as accompanying symptoms of anxiety and depression as measured by Beck Anxiety Inventory and the Beck Depression Inventory before, at the 3rd, 6th, and 12th month during internship, and 2 weeks after internship. We conducted a causal mediation analysis to investigate the role of depression and anxiety in the mechanism of working stress during medical internship inducing PVS and PRS. RESULTS The results showed that depression explained 21.9% and 8.4% for stress-induced PRS and PVS, respectively. In addition, anxiety explained 15.0% and 7.8% for stress-induced PRS and PVS, respectively. CONCLUSIONS Our findings showed both depression and anxiety can explain a portion of stress-induced PVS and PRS during medical internship and might be more important in clinical practice and benefit to prevention of work-related burnout.

Sex and Race Differences in the Risk of Ischemic Stroke Associated With Fasting Blood Glucose in REGARDS

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012296
Author(s):  
Tracy E. Madsen ◽  
D. Leann Long ◽  
April P. Carson ◽  
George Howard ◽  
Dawn O. Kleindorfer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Glucose ◽  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Proportional Hazards ◽  
Fasting Blood Glucose ◽  
Cox Proportional Hazards ◽  
Race Differences ◽  
Prospective Longitudinal

Background:To investigate sex and race differences in the association between fasting blood glucose (FBG) and risk of ischemic stroke (IS).Methods:This prospective longitudinal cohort study included adults age ≥45 years at baseline in the Reasons for Geographic And Racial Differences in Stroke Study, followed for a median of 11.4 years. The exposure was baseline FBG (mg/dL); suspected IS events were ascertained by phone every 6 months and were physician-adjudicated. Cox proportional hazards were used to assess the adjusted sex/race-specific associations between FBG (by category and as a restricted cubic spline) and incident IS.Results:Of 20,338 participants, mean age was 64.5(SD 9.3) years, 38.7% were Black, 55.4% were women, 16.2% were using diabetes medications, and 954 IS events occurred. Compared to FBG <100, FBG ≥150 was associated with 59% higher hazards of IS (95%CI 1.21-2.08) and 61% higher hazards of IS among those on diabetes medications (95%CI 1.12-2.31). The association between FBG and IS varied by race/sex (HR, FBG ≥ 150 vs. FBG <100: White women 2.05 (95% CI 1.23-3.42), Black women 1.71 (95%CI 1.10-2.66), Black men 1.24 (95%CI 0.75-2.06), White men 1.46 (95%CI 0.93-2.28), pFBG*race/sex=0.004). Analyses using FBG splines suggest that sex was the major contributor to differences by race/sex subgroups.Conclusions:Sex differences in the strength and shape of the association between FBG and IS are likely driving the significant differences in the association between FBG and IS across race/sex subgroups. These findings should be explored further and may inform tailored stroke prevention guidelines.

scholarly journals ASSESSMENT OF KNOWLEDGE AND SELF EFFICACY BEFORE AND AFTER TEACHING BASIC LIFE SUPPORT TO SCHOOLCHILDREN

2021 ◽  
Vol 39 ◽  
Author(s):  
Maria de Lurdes Rovisco Branquinho Pais Monteiro ◽  
Ana Isabel Borges Ferraz ◽  
Fernanda Maria Pereira Rodrigues
Keyword(s):  
Medical Students ◽  
Self Efficacy ◽  
Basic Life Support ◽  
Life Support ◽  
Pediatric Population ◽  
Scientific Evidence ◽  
Training Session ◽  
Prospective Longitudinal Study ◽  
Resuscitation Training ◽  
Prospective Longitudinal

ABSTRACT Objective: Teaching basic life support to schoolchildren is well established as one of the most effective strategies in increasing bystander CPR rates. However, there is a lack of scientific evidence concerning the Portuguese pediatric population. The present study aims to evaluate the outcome of a basic life support training session on theoretical knowledge and self-efficacy, immediately after the training and 6 months later, in a pediatric population. Methods: A total of 392 schoolchildren, aged seven to 12 years old, participated in this prospective longitudinal study, answering a questionnaire before, immediately after, and six months after receiving 120 minutes of resuscitation training from medical students. Results: There was a significant increase in the knowledge and self-efficacy after one single training session. Both decreased over a period of six months but remained significantly higher than the baseline. These results were homogeneous across classes. Conclusions: Medical students provided adequate basic life support training to a group of Portuguese schoolchildren, with effects in the knowledge and self-efficacy lasting for at least six months.

scholarly journals Life events as predictors for disability pension due to musculoskeletal diagnoses: a cohort study of Finnish twins

2019 ◽  
Vol 93 (4) ◽  
pp. 469-478
Author(s):  
Sanna Kärkkäinen ◽  
Karri Silventoinen ◽  
Pia Svedberg ◽  
Annina Ropponen
Keyword(s):  
Life Events ◽  
Proportional Hazards ◽  
Positive Change ◽  
Cox Proportional Hazards ◽  
Discordant Pair ◽  
Familial Factors ◽  
Work Related ◽  
Diagnosis Codes ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios

Abstract Purpose Musculoskeletal diagnoses (MSD) are one of the largest diagnostic groups for disability pensions (DP). This study investigated the associations between life events and DP due to MSD, considering sociodemographic, health, and familial factors. Methods The study sample included 18,530 Finnish twins, 24–64 years old at baseline, who responded to a questionnaire in 1981 including a 21-item life event inventory. Information on DP with diagnosis codes (ICD codes: M00–M99) were obtained from the official national pension registers. Life events were divided into family- and work-related events. “Positive change in life” was analyzed separately. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results During the follow-up of 23 years, 1273 (7%) individuals were granted DP due to MSD. In discordant pair analysis, family-related events (≥ 4 events) increased (HR 1.63, 95% CI 1.31, 2.03) and the absence of such events decreased (HR 0.68, 95% CI 0.48, 0.95) the risk of DP due to MSD. For work-related events (≥ 3 events), the risk estimates were non-significant when controlling for familial factors. Having had a positive change in life decreased the risk of DP due to MSD (HR 0.79, 95% CI 0.65, 0.96) while controlling for familial confounding, but were non-significant in the full model controlling for various covariates (HR 0.91, 95% CI 0.75, 1.12). Conclusions The associations between life events and the risk of DP due to MSD are complex and potentially affected by familial and other confounding factors including sociodemographics and health.

scholarly journals Investigation of the Role of Anxiety and Depression on the Formation of Phantom Vibration and Ringing Syndrome Caused by Working Stress during Medical Internship

2020 ◽  
Vol 17 (20) ◽  
pp. 7480
Author(s):  
Yu-Hsuan Lin ◽  
Kuan-I Lin ◽  
Yuan-Chien Pan ◽  
Sheng-Hsuan Lin
Keyword(s):  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Vibration Syndrome ◽  
Prospective Longitudinal Study ◽  
Work Related ◽  
Working Stress ◽  
Causal Mediation Analysis ◽  
Prospective Longitudinal ◽  
The Relationship

Phantom vibration syndrome (PVS) and phantom ringing syndrome (PRS) are prevalent hallucinations during medical internship. Depression and anxiety are probably understudied risk factors of PVS and PRS. The aim was to evaluate the role of anxiety and depression on the relationship between working stress during medical internship and PVS and PRS. A prospective longitudinal study, consisted of 74 medical interns, was carried out. The severity of phantom vibrations and ringing, as well as anxiety and depression as measured before, at the third, sixth, and 12th month during internship, and two weeks after internship. We conducted a causal mediation analysis to quantify the role of depression and in the mechanism of working stress during medical internship inducing PVS and PRS. The results showed that depression explained 21.9% and 8.4% for stress-induced PRS and PVS, respectively. In addition, anxiety explained 15.0% and 7.8% for stress-induced PRS and PVS, respectively. Our findings showed both depression and anxiety can explain a portion of stress-induced PVS and PRS during medical internship and might be more important in clinical practice and benefit to prevention of work-related burnout.

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