Just how tough are they? GP Registrar Resilience. Georga Cooke, Jenny Doust, Mike Steele Bond University

Transcription

1 Just how tough are they? GP Registrar Resilience Georga Cooke, Jenny Doust, Mike Steele Bond University

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3 resilire positive adaptation to stress or adversity

4 In the context of exposure to significant adversity, whether psychological, environmental, or both, resilience is both the capacity of individuals to navigate their way to health-sustaining resources, including opportunities to experience feelings of well-being, and a condition of the individual s family, community and culture to provide these health resources and experiences in culturally meaningful ways. Ungar, 2008

5 Individual Relationship Cultural Community Physical Ecology Factors Ungar, 2008

6 Individual Assertiveness Ability to solve problems Self-efficacy Ability to live with uncertainty Self-awareness A positive outlook Empathy for others Having goals and aspirations Ability to maintain a balance between independence and dependence on others Appropriate use of or abstinence from substances like alcohol and drugs A sense of humour A sense of duty (to others or self, depending on the culture)

7 Opportunities for age-appropriate work Avoidance of exposure to violence in one's family, community, and with peers Government provision for children's safety, recreation, housing, and jobs when they are at the appropriate age to work Meaningful rights of passage with an appropriate amount of risk Tolerance of high-risk and problem behaviour Safety and security Perceived social equity Access to school and education, information, and learning resources Community

8 Aim To measure the prevalence of resilience in GP registrars and its predictors Method SURVEY - Demographics -Burnout -Response to uncertainty - Resilience - Personal meaning in patient care

9 Recruited from RTP education events, GPRA r-cubed newsletter 144 Surveys distributed 16 Not returned 128 Surveys analysed 90% response rate

10 Resilience Scale (max 98) I usually manage one way or another. I feel proud that I have accomplished things in my life. I usually take things in stride. I am friends with myself. I feel that I can handle many things at a time. I am determined. I can get through difficult times because I've experienced difficulty before. I have self-discipline. I keep interested in things. I can usually find something to laugh about. My belief in myself gets me through hard times. In an emergency, I'm someone people generally can rely on. My life has meaning. When I'm in a difficult situation, I can usually find my way out of it.

11 Low (<61) 10% High (>89) 8% Mean 75 SD 12.5 Moderate (61-89) 82%

12 Personal meaning in patient care Patients entrusting me with their stories Offering patients a protected environment in which to relax and reflect Feeling deep connections with my patients Being with people in their most vulnerable state Bearing witness to events in the lives of my patients and their families Mean 16 SD 3.3

13 Associations with resilience p value ProQOL Compassion Satisfaction <0.001 L < LM < H Burnout <0.001 L > LM > H Secondary Traumatic Stress <0.01 (L ~ LM) > H IUS-12 Prospective anxiety 0.15 Inhibitory anxiety 0.03 L > H Total 0.05 (L ~ LM) > H Personal Meaning in Patient Care <0.01 L < LM < H Physician response to uncertainty scale Anxiety due to uncertainty 0.50 Concern about bad outcomes (L ~ LM) > H Reluctance to disclose uncertainty to patients <0.01 (L ~ LM) > H Reluctance to disclose uncertainty to physicians 0.1

14 Associations with resilience p value ProQOL Compassion Satisfaction <0.001 L < LM < H Burnout <0.001 L > LM > H Secondary Traumatic Stress <0.01 (L ~ LM) > H IUS-12 Prospective anxiety 0.15 Inhibitory anxiety 0.03 L > H Total 0.05 (L ~ LM) > H Personal Meaning in Patient Care <0.01 L < LM < H Physician response to uncertainty scale Anxiety due to uncertainty 0.50 Concern about bad outcomes (L ~ LM) > H Reluctance to disclose uncertainty to patients <0.01 (L ~ LM) > H Reluctance to disclose uncertainty to physicians 0.1

15 I feel honoured to be part of those conversations because they change my life; they change how I live Jensen, /08/2011)

16 Empathic Growth

17 Why Vicarious Resilience is Important Benefits in applying learnings own personal life Increased job satisfaction, workforce wellbeing Ongoing motivation to continue in profession Strategy to promote positive self-care Promote career selection Broader knowledge may promote patients sharing stories Hernández, 2007

18 References Ungar M. Resilience across cultures. British Journal of Social Work 2008;38(2): Jensen PM, Trollope-Kumar K, Waters H, Everson J. Building physician resilience. Can Fam Physician 2008;54(5): WindleG. What is resilience? A review and concept analysis. Reviews in Clinical Gerontology 2011;21(02): Geller G, Bernhardt BA, CarreseJ, Rushton CH, KolodnerK. What do clinicians derive from partnering with their patients? A reliable and valid measure of "personal meaning in patient care". Patient education and counseling 2008;72(2): Wagnild G. A review of the Resilience Scale. J Nurs Meas 2009;17(2): Hernández, P., D. Gangsei, et al. (2007). "Vicarious resilience: A new concept in work with those who survive trauma." Family process 46(2):