Background:

Physician well-being is critical to optimal learning and performance, yet we remain without validated measures to gauge the efficacy of well-being curricula for trainees. This study evaluates initial evidence of flourishing as a valid measure of global well-being in postgraduate-year-1 residents (PGY-1s), providing a means of assessing well-being intervention efficacy.

Study design:

In this single-site study of PGY-1s participating in Enhanced Stress Resilience Training (ESRT), an online questionnaire of published measures was administered at baseline (T1, just before PGY-1), post-ESRT (T2, 7 weeks later), and at PGY-1 end (T3, 11 months later). The Mental Health Continuum (MHC) was used to assess our primary outcome variable, flourishing, a well-established metric of psychosocial thriving in non-physicians that can be treated continuously or categorically. Correlation between flourishing and both resilience (mindfulness and workplace support) and risk (emotional exhaustion, depersonalization, stress, depressive symptoms, anxiety, and workplace demand) factors was assessed at each time-point and longitudinally.

Results:

Forty-five interns completed the survey at T1, 37 at T2, and 21 at T3; 21 responded at all time points. MHC score was significantly positively correlated with mindfulness (β = 1.47, SE = 0.35, P < .001) and workplace support (β = 2.02, SE = 1.01, P = .05) longitudinally, and at all time points. Flourishing was significantly negatively correlated with depressive symptoms (β = −7.48, SE = 1.68, P < .001), stress (β = −1.28, SE = 0.29, P < .001), and anxiety (β = −1.74, SE = 0.38, P < .001) longitudinally and at all time points, and significantly negatively correlated with emotional exhaustion (β = −2.65, SE = 0.89, P = .003) longitudinally and at T1 (β = −3.36, SE = 1.06, P = .003).

Conclusion:

Flourishing showed appropriate correlation with established resilience and risk factors, thus supporting its concurrent validity as a measure of global well-being in this population. As such, the MHC may provide a simple, meaningful assay of well-being and an effective tool for evaluating the efficacy of well-being interventions. Further validation requires a larger, multi-center study.

中文翻译：

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繁荣作为第一年居民全球福祉的衡量标准：一项纵向队列试点研究

背景：

医师福祉对于最佳学习和表现至关重要，但我们仍然没有经过验证的措施来衡量受训者福祉课程的功效。本研究评估了繁荣的初步证据，作为衡量研究生一年级居民 (PGY-1) 全球幸福感的有效指标，提供了一种评估幸福感干预效果的方法。

学习规划：

在这项针对参与增强压力恢复训练 (ESRT) 的 PGY-1 的单点研究中，在基线（T1，就在 PGY-1 之前）和 ESRT 后（T2，7 周后）进行了已发布测量的在线问卷调查，并在 PGY-1 结束时（T3，11 个月后）。心理健康连续体 (MHC) 用于评估我们的主要结果变量，繁荣，这是一个公认的衡量非医生社会心理繁荣的指标，可以连续或分类治疗。在每个时间点和纵向评估蓬勃发展与复原力（正念和工作场所支持）和风险（情绪衰竭、人格解体、压力、抑郁症状、焦虑和工作场所需求）因素之间的相关性。

结果：

45 名实习生在 T1 完成调查，37 人在 T2 完成调查，21 人在 T3 完成调查；21 人在所有时间点都做出了回应。MHC 评分与正念（β = 1.47，SE = 0.35， P  < .001）和工作场所支持（β = 2.02，SE = 1.01，P  = .05）在纵向和所有时间点均呈显着正相关。蓬勃发展与抑郁症状 (β = -7.48, SE = 1.68, P  < .001)、压力 (β = -1.28, SE = 0.29, P  < .001) 和焦虑 (β = -1.74, SE)呈显着负相关= 0.38, P  < .001) 纵向和所有时间点，并且与纵向和 T1 时的情绪衰竭 (β = -2.65, SE = 0.89, P  = .003) 显着负相关 (β = -3.36, SE = 1.06 ,P  = .003)。

结论：

蓬勃发展与已建立的复原力和风险因素显示出适当的相关性，从而支持其作为该人群全球福祉的衡量标准的同时有效性。因此，MHC 可以提供一种简单、有意义的幸福感测定，以及一种评估幸福感干预效果的有效工具。进一步的验证需要更大规模的多中心研究。