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Browsing by Subject "Emotional well-being"

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    A National Survey of Motor Vehicle Crashes Among General Surgery Residents
    (Wolters Kluwer, 2021) Schlick, Cary Jo R.; Hewitt, Daniel Brock; Quinn, Christopher M.; Ellis, Ryan J.; Shapiro, Katherine E.; Jones, Andrew; Bilimoria, Karl Y.; Yang, Anthony D.; Surgery, School of Medicine
    Objectives: Evaluate the frequency of self-reported, post-call hazardous driving events in a national cohort of general surgery residents and determine the associations between duty hour policy violations, psychiatric well-being, and hazardous driving events. Summary of background data: MVCs are a leading cause of resident mortality. Extended work shifts and poor psychiatric well-being are risk factors for MVCs, placing general surgery residents at risk. Methods: General surgery residents from US programs were surveyed after the 2017 American Board of Surgery In-Training Examination. Outcomes included self-reported nodding off while driving, near-miss MVCs, and MVCs. Group-adjusted cluster Chi-square and hierarchical regression models with program-level intercepts measured associations between resident- and program-level factors and outcomes. Results: Among 7391 general surgery residents from 260 programs (response rate 99.3%), 34.7% reported nodding off while driving, 26.6% a near-miss MVC, and 5.0% an MVC over the preceding 6 months. More frequent 80-hour rule violations were associated with all hazardous driving events: nodding off while driving {59.8% with ≥5 months with violations vs 27.2% with 0, adjusted odds ratio (AOR) 2.86 [95% confidence interval (CI) 2.21-3.69]}, near-miss MVCs, [53.6% vs 19.2%, AOR 3.28 (95% CI 2.53-4.24)], and MVCs [14.0% vs 3.5%, AOR 2.46 (95% CI 1.65-3.67)]. Similarly, poor psychiatric well-being was associated with all 3 outcomes [eg, 8.0% with poor psychiatric well-being reported MVCs vs 2.6% without, odds ratio 2.55 (95% CI 2.00-3.24)]. Conclusions: Hazardous driving events are prevalent among general surgery residents and associated with frequent duty hour violations and poor psychiatric well-being. Greater adherence to duty hour standards and efforts to improve well-being may improve driving safety.
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    Factors That Influence The Emotional Impact Of Memory Problems In Older Adults: A Mixed-Methods Study
    (Oxford University Press, 2021) Bratlee-Whitaker, Emily; Hill, Nikki; Mogle, Jacqueline; Wion, Rachel; Madrigal, Caroline; Bhargava, Sakshi; School of Nursing
    Older adults’ experiences with memory problems may be an important indicator of current and future well-being; however, these experiences and their impacts are poorly characterized, particularly in those with co-occurring affective symptoms. The purpose of this mixed-methods study was to examine how the experience of memory problems influences emotional well-being in older adults without dementia, and whether this differs based on cognitive status and current depressive symptoms or anxiety symptoms. A convergent parallel mixed methods design was used in which quantitative and qualitative data were collected simultaneously, analyzed separately, and then integrated to determine how participants’ experiences differed. Community-dwelling older adults (n=49, Mage = 74.5, 63% female) without severe cognitive impairment completed study questionnaires and two individual, semi-structured interviews. Five themes were identified that described the influence of memory problems on emotional well-being: Evoking Emotions, Fearing Future, Undermining Self, Normalizing Problems, and Adjusting Thinking. The extent to which memory problems impacted emotional well-being depended on multiple factors including current affective symptoms (primarily anxiety), characteristics of the experience (such as judgments of its importance), as well as personal experience with dementia. Notably, there were no thematic differences in the emotional impact of memory problems between older adults with normal cognition and those with evidence of mild cognitive impairment. Our findings suggest that thorough assessment of reports of memory problems, regardless of cognitive testing outcomes, should consider co-occurring subsyndromal affective disorders as well as older adults’ evaluations of how memory problems influence their daily lives and well-being.
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    Factors that influence the emotional impact of memory problems in older adults: A qualitative descriptive study
    (Wiley, 2022) Hill, Nikki L.; Bratlee-Whitaker, Emily; Wion, Rachel K.; Madrigal, Caroline; Bhargava, Sakshi; Mogle, Jacqueline; School of Nursing
    Background: Associations among psychological health and memory concerns in older adults are well-established, but much of this research is quantitative. Objectives: This study examined how memory problems influence emotional well-being in older adults without dementia, and whether this differs by cognitive status and current depressive or anxiety symptoms. Methods: A qualitative descriptive design was used to examine our research questions. Community-dwelling older adults without dementia (n = 49, Mage = 74.5[10.1], 63% women) completed a cognitive assessment, questionnaires and two semi-structured interviews. Content analysis was used to code and categorise the transcribed interview data, then identify themes within and across participant groups. Results: Five themes described the influence of memory problems on emotional well-being: Evoking Emotions, Fearing Future, Undermining Self, Normalising Problems and Adjusting Thinking. Memory problems' impact on emotional well-being varied by current anxiety symptoms, characteristics of the problem and personal experience with dementia. Conclusion: The emotional impact of memory problems tended to differ by affective symptoms, not cognitive status. Older adults who report memory concerns without objective evidence of impairment may be at risk for negative impacts to mental health and well-being. Implications for practice: Cognitive screening guidelines should consider best practices for responding to memory concerns when cognitive testing results are normal.
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