Protective Coping Research Articles

Risk Conditions for Stress, its Coping and its Relationship with Trait-State Anxiety in Nursing Students of a Public University in Guadalajara, Mexico

The level of demand during the academic training of nursing students is high and when there is the presence of risk conditions for stress together with the lack of adequate coping styles, it is very likely that they may present high levels of trait-state anxiety, which can affect the academic performance and health of these students, Therefore, the aim of this study was to establish two multiple regression models, one to analyze the relationship of Trait-State Anxiety and the other for Trait-State Anxiety and its relationship with stress risk conditions and coping styles in nursing students at a public university in Mexico. A total of 740 students were assessed, the models were determined by multiple regression analysis. This study established that nursing students at a public university in Mexico, who make negative evaluations have a higher risk of presenting A-State, and that students who present type A behavior and make positive evaluations, as well as those who consume tobacco, alcohol and/or drugs, increase the risk of A-Trait, Therefore, it is recommended to implement educational programs aimed at providing coping strategies that help to lower the levels of Trait-State Anxiety, as well as to create the choice of healthy practices through the use of protective coping styles to prevent these conditions before they have a negative impact on the health, academic performance and university dropout of nursing students in Mexico.

Sexual and Mental Health in Healthcare Workers during the COVID-19 Outbreak: Exploring the Role of Meaning-Centered Coping

IntroductionThe acute phase of the COVID-19 pandemic impacted the sexual function and mental health of healthcare workers worldwide. However, the extent to which sexual health, including its relational dimension, was affected among different healthcare services and the protective coping strategies employed at that time is currently unclear. The present study aimed to investigate these two issues, exploring for the first time the role of meaning-centered coping on sexual health.MethodThe sample consisted of 109 healthcare workers divided into two groups: a high-exposure group (Intensive Care Unit service, 63 participants) and a low-exposure group (gynecology, obstetrics, and pediatrics services, 46 participants). One year after the onset of the COVID-19 pandemic, participants completed an online survey comprised of sociodemographic and COVID-19 exposure variables, the Depression Anxiety and Stress Scale, the New Sexual Satisfaction Scale-Short Form, and the Meaning-Centered Coping Scale.Results(1) High-exposure participants reported more anxiety and depressive symptoms, (2) anxiety, depression and stress were associated with decreased sexual health after the pandemic, (3) High-exposure participants reported a higher decrease in their sexual health, (4) High-exposure workers reported higher levels of meaning-centered coping, and (5) higher levels of meaning-centered coping predicted higher sexual health in both groups.Policy ImplicationsVarious healthcare services pose distinct risks regarding the detrimental effects of collective health crises on mental and sexual health, and therefore they should be differently treated. The promotion of meaning-centered coping is a sensible policy to improve preparedness in healthcare contexts, especially in vulnerable services and subpopulations.

Emotional burnout syndrome among health care workers during the COVID-19 pandemic

The COVID-19 pandemic has presented an unprecedented challenge to society. Supporting the mental health of medical personnel was a critical public health concern. Throughout the pandemic, many tragic deaths from suicide were reported. Consequently, attention to the well-being of healthcare professionals worldwide has become imperative for proper support and monitoring. The specificity of professional activity, which involves risk and situations of uncertainty, contributes to the formation of special forms of protective coping behavior in health care professionals. Nurses approach the problem situation rationally, strive to maintain control over their actions and the situation, and keep their attention on the goals of the activity. They consider the problem as a situation for personal growth, analyze the problem situation and make conscious attempts to get out of it.

Resilient responses to stressful events among chiropractic students: A cross-sectional survey.

Resilient students may better navigate the challenges of chiropractic training. This study explored the relationships between response to stressful experiences, perceived stress, and quality of life among students at 1 US chiropractic college campus. A cross-sectional survey was conducted with 873 students. The anonymous online questionnaire included demographics, quality of life, perceived stress, and the Response to Stressful Events Scale (RSES). Hierarchical multiple regression analyses assessed for significant relationships among variables. A sample of 221 students (60% female) completed the survey (25% response rate). Male respondents reported greater psychological health. Participants reporting high quality of life exhibited higher resiliency on the RSES flat score and many RSES domains. Respondents who rated greater psychological health and social relationships exhibited greater spiritual resiliency. Respondents reporting higher psychological health and lower levels of perceived stress exhibited higher self-efficacy resilience. Psychological health was the most important predictor for RSES flat score and domains, except for spiritual resilience, for which social relationships were most important. Male gender was predictive of 3 RSES domains: meaning making, active coping, and cognitive flexibility. More resilient responses to stressful events were reported by male chiropractic students and those who reported greater psychological health, higher quality of life, or lower perceived stress. Female students and those experiencing psychological challenges or lower quality of life might consider resilience training to increase the use of protective coping strategies. These findings may permit academic institutions to identify students at highest risk and employ interventions to prevent program withdrawal.

Associations between Gender Expression, Protective Coping Strategies, Alcohol Saliency, and High-Risk Alcohol Use in Post-Secondary Students at Two Canadian Universities.

This study, conducted in October 2017 at two Canadian universities, aimed to explore the relationships between gender expression, protective coping strategies, alcohol saliency, and high-risk alcohol use. Validated scales were employed to assess these variables using survey data. Multivariate analyses were conducted to investigate the associations between these factors and high-risk drinking. This study revealed significant associations between high-risk drinking and androgynous gender roles (OR = 1.58, 95% CI: 1.19-2.10) as well as among self-reported males (OR = 2.21; 95% CI: 1.77-2.75). Additionally, protective behavioural strategies were inversely related to high-risk drinking (OR = 0.95; 95% CI: 0.94-0.96), while higher alcohol saliency exhibited a positive correlation with high-risk drinking (OR = 1.12; 95% CI: 1.11-1.14). These findings underscore the importance of considering gender, alcohol saliency beliefs, and protective behavioural strategies in the development and refinement of interventions aimed at reducing high-risk alcohol use on Canadian campuses.

Examining the Effect of Virtual Learning on Canadian Pre-Clerkship Medical Student Well-Being During the COVID-19 Pandemic

Introduction: The restrictions of the COVID-19 pandemic resulted in the broad and abrupt incorporation of virtual/online learning into medical school curricula. While current literature explores the effectiveness and economic advantages of virtual curricula, robust literature surrounding the effect of virtual learning on medical student well-being is needed. This study aims to explore the effects of a predominantly virtual curriculum on pre-clerkship medical student well-being. Methods: This study followed a constructivist grounded theory approach. During the 2020-2021 and 2021-2022 academic years, students in pre-clerkship medical studies at Western University in Canada were interviewed by medical student researchers over Zoom. Data was analyzed iteratively using constant comparison. Results: We found that students experiencing virtual learning faced two key challenges: 1) virtual learning may be associated with an increased sense of social isolation, negatively affecting wellbeing, 2) virtual learning may impede or delay the development of trainees’ professional identity. With time, however, we found that many students were able to adapt by using protective coping strategies that enabled them to appreciate positive elements of online learning, such as its flexibility. Discussion: When incorporating virtual learning into medical education, curriculum developers should prioritize optimizing existing and creating new ways for students to interact with both peers and faculty to strengthen medical student identity and combat feelings of social isolation.

Bipolar Coping Strategies of Nurses in Facing the COVID-19 Pandemic: A Meta-synthesis Review.

Nurses on the front line of facing the COVID-19 pandemic have applied many coping strategies to adapt to their experienced physical and psychosocial challenges. This review aimed to identify coping strategies of nurses in the face of Covid-19. In this meta-synthesis review, qualitative articles related to the coping strategies published in English in the Google Scholar, PubMed, Web of Science, ScienceDirect, and CINAHL databases were selected and analyzed. The review of selected articles showed nurses have used various coping strategies that can be categorized into one main theme, two themes, and ten sub-themes. The theme of efficient coping strategies includes the sub-themes of spiritual-religious coping, protective coping (protection of family members and colleagues), supportive coping by obtaining support from family, friends, colleagues, society, and government organizations, committed coping, positive mind coping, emotional coping, operational coping, and fun coping. The theme of inefficient coping strategies includes the sub-themes of avoidance and risky behaviors. The strategies lead to the synthesis of bipolar coping strategies of nurses during the COVID-19 pandemic. Therefore, healthcare policymakers should emphasize using efficient strategies and avoiding inefficient ones.

A systematic review of influences and outcomes of body image in postpartum via a socioecological framework

ABSTRACT Background Women in the postpartum period come under multi-level pressure to return to pre-pregnancy body shape and size. This pressure can lead to reduced body image satisfaction, self-esteem, and mood. In this systematic review we explored the influences and outcomes of body dissatisfaction during the postpartum period. Methods Four databases were searched using keywords: postpart* OR postnatal OR peripart* OR ‘new mother’ OR ‘breast feed*’ AND ‘body image’ OR ‘body dissatisf*’ OR ‘body satisf*’ OR ‘body attitude’ OR ‘body shape’. Results The influences and outcomes of body image dis/satisfaction in the postpartum period from 55 international studies were found to align within four of the five factors of the socioecological model. Intrapersonal factors: weight and body shape concerns, mental health and stressors, attitudes and behaviours, and protective coping skills and interventions. Interpersonal factors: social support (partner, family, and friends) and sexual functioning. Institutional factors: experiences with the healthcare system and returning to work. Societal factors: culture and ethnicity, media influences and social norms such as the thin ideal. Conclusions A focus on intrapersonal factors alone is insufficient to understand women’s experiences of body dis/satisfaction during the postpartum period. This suggests a need for better education and policy practices in pre-natal and postpartum care directed at body image and education to dispel societal norms such as the thin ideal. Doing so shifts the focus to include interpersonal, institutional, and societal influences alongside intrapersonal experiences. Research is needed to explore the utility and efficacy of broader approaches for women during this vulnerable life period.

Features of Life Meaning Orientations and Defensive-Coping Behaviour of Russian and Foreign Students

The relevance of the study is due to the need to comprehend the influence of cultural and value orientations on the behavior of Russian and foreign students in difficult situations. Relying on meaningful life guidelines helps to transform and improve one’s own line of response at difficult social crisis conditions and accumulate a baggage of culturally acceptable solutions. The need to understand this problem determined the purpose of the study – to identify features in the manifestation of meaningful life orientations and differences in the strategies of protective coping behavior among Russian and foreign students (from the Republic of Tajikistan). Based on the set goal, using empirical and interpretive research methods, results were obtained for a total sample of 100 people. The subjects were first-year students from Tajikistan and Russia. It was revealed that Russian students in crisis situations actively try to comprehend it and, nevertheless, satisfy their significant needs, while foreign young people, most often, smooth out, mitigate discomfort, their behavior is compensatory in nature. Nevertheless, differences in value-semantic orientations and, in accordance with this, building their own trajectory of protective and coping behavior allow students to adapt in society, coordinating their traditional values with the modern cultural transformation of society.

Discrimination, Depression, and Anxiety Among Sexual Minority and Heterosexual Young Adults: The Role of Self-Compassion.

Purpose: The objectives of this study were to examine whether self-compassion may be a protective coping resource against depression and anxiety symptoms for young adults experiencing discrimination and to explore the protective influence of self-compassion among sexual minority young adults (SMYAs) relative to heterosexual peers. Methods: Undergraduate college students (N = 251; 189 heterosexual and 62 sexual minority individuals) completed online self-report questionnaires related to discrimination experiences, depression, anxiety, and self-compassion. Two moderated moderation analyses were conducted to (1) identify whether self-compassion buffered the relationship between discrimination and depression and between discrimination and anxiety and (2) whether this buffering effect varied by sexual identity (i.e., heterosexual vs. sexual minority). Results: Self-compassion significantly moderated the relationship between discrimination and depression for the full sample. Further examination revealed that self-compassion significantly moderated the relationship between discrimination and depression among SMYAs, but not among heterosexual young adults. SMYAs with higher self-compassion reported fewer depression symptoms than SMYAs with lower self-compassion, even when reporting more frequent experiences of discrimination. Self-compassion did not moderate the relationship between discrimination and anxiety for the full sample, nor did this relationship vary by sexual identity. Conclusions: Self-compassion may be a particularly important coping resource to protect against depression symptoms among SMYAs experiencing discrimination. These findings provide an impetus for SMYA-tailored intervention and prevention efforts that incorporate cultivating self-compassion as a protective coping resource to buffer deleterious effects of discrimination.

Predictors of Students’ Mental Health during the COVID-19 Pandemic: The Impact of Coping Strategies, Sense of Coherence, and Social Support

Young people and women seem to suffer more from social restrictions due to the COVID-19 pandemic than do others. Findings from pre-pandemic surveys identified students as a specific risk group for developing anxiety and depressive symptoms. Recent studies have indicated that students especially denoted a decrease in mental health during the pandemic. In a sample of n = 1938 university students (67.6% female), we investigated protective factors that are associated with mental health (defined as the absence of any mental disorder) and more specifically, the absence of major depression during the pandemic despite social restrictions. Investigated protective factors were social support, sense of coherence and situational coping strategies. The results of the multiple logistic regression analyses revealed that male gender, high sense of coherence and specific coping strategies could be identified to be associated with mental health in general and the absence of major depression. Protective coping strategies that were related to mental health in general were lower substance use, lower behavioral disengagement, higher positive reframing and lower self-blame. Protective coping strategies that were associated with the absence of major depression specifically were higher use of instrumental support, lower substance use, lower behavioral disengagement, higher positive reframing, higher emotional support, lower self-blame and lower humor. Social support was related to the absence of major depression, but not to mental health in general. Higher age in university students was associated with better mental health, but not with the absence of major depression specifically. These findings indicate that sense of coherence and situational coping strategies can buffer the adverse effect of social restrictions on mental health and thus, can serve as important resilience factors. Moreover, they highlight the political relevance of promoting specific coping strategies to foster mental health in students encompassing adverse events and social restrictions.

Schützende Bewältigung: Das unentdeckte Phänomen

The following article presents the core phenomenon studied in a forthcoming dissertation entitled “Protective Coping – A grounded theory on experiences of discrimination made by professionals in the field of social work”. The primary question of this qualitative study was what role experiences of discrimination play in the everyday life of Muslim women engaged in social work. The study’s goal was to develop an object-based theory of action in regard to experiences of discrimination. For this purpose, the methodology of Grounded Theory as laid out by Strauss and Corbin was used. A total of nine problem-centred interviews (following Witzel’s method) were conducted with social work professionals. Based on the data from these interviews, it was possible to develop a theoretical model of protective coping. This article outlines the core phenomenon of protective coping. For people who have experienced discrimination, this phenomenon arises as soon as they try to cope with the discriminatory situation or to process the experience they had.

The association between gender expression, beliefs about alcohol, coping skills, and alcohol consumption in post-secondary students at two Canadian universities

IntroductionUnlike sex, the association between gender and high-risk drinking has been relatively understudied in post-secondary students. Gender expression may influence the use of protective coping strategies and beliefs about alcohol.ObjectivesThis study evaluated associations between gender expression, protective coping strategies, beliefs about alcohol, and high-risk alcohol use in post-secondary students.MethodsWe analyzed data from a cross-sectional study of 3,446 undergraduate students at two Canadian universities in October 2017. The primary outcome was high-risk drinking during the previous month, measured by the Alcohol Use Disorders Identification Test (AUDIT) score. We evaluated gender expression (masculine, feminine, androgynous, and undifferentiated), protective coping strategies, and beliefs about alcohol using validated scales. Multivariable logistic regression models were used to test the association between gender expression and AUDIT scores.ResultsThe most prevalent gender expression was androgynous (35.1% overall), while the undifferentiated role was the least prevalent (17.4% overall). Those who adhered to an androgynous gender role (OR = 1.45, 95% CI: 1.10, 1.90) were significantly more likely to engage in problem drinking. In addition, greater scores on the protective behavioural strategies scale were associated with reduced odds of problem drinking (OR = 0.96; 95% CI: 0.95, 0.97) while higher alcohol saliency scores were associated with higher odds of problem drinking (OR = 1.12; 95% CI: 1.10, 1.13).ConclusionsHigher protective behavioural strategies and lower alcohol salience beliefs were associated with lower alcohol use. Androgynous gender roles were associated with high-risk alcohol use.DisclosureNo significant relationships.

Analyzing Risk Communication, Trust, Risk Perception, Negative Emotions, and Behavioral Coping Strategies During the COVID-19 Pandemic in China Using a Structural Equation Model.

ObjectiveRisk communication and the degree of trust are major factors that affect the public's behavioral coping strategies and play an important role in emergency risk management. However, the internal formation mechanism involved in the public's psychological behavior remains unclear. This study aimed to investigate the association among risk communication, trust, risk perception, negative emotions, and behavioral coping strategies during the coronavirus disease 2019 (COVID-19) pandemic, and to identify and quantify the factors that influence public behavior.MethodsWe launched an online survey through social media from April to July 2020 in China. Relevant data were elicited using a self-designed questionnaire that mainly examined respondent characteristics, risk communication, trust, risk perception, negative emotions, protective coping behavior, and excessive coping behavior in the context of the COVID-19 pandemic. A total of 735 valid responses were obtained. A structural equation model was then used to explore relationship pathways among the components.ResultsThe higher the degree of risk communication (β = −0.10, p < 0.05) and trust (β = −0.22, p < 0.001), the lower the public risk perception. Risk communication and trust had a direct effect on public behavioral coping strategies during the COVID-19 pandemic. The higher the level of risk communication (β = 0.14, p < 0.001) or trust (β = 0.48, p < 0.001), the more likely it was that this would encourage the public to adopt protective coping behaviors, while the public was less likely to engage in excessive coping behaviors as the degree of trust increased (β = −0.12, p < 0.01). Risk perception influenced by poor risk communication and trust generated negative emotions (β = 0.31, p < 0.001), and such negative emotions further positively influenced public behavioral coping strategies (whether protective [β = 0.09, p < 0.05] or excessive [β = 0.24, p < 0.001] behaviors).ConclusionRisk communication, trust, risk perception, and negative emotions were significantly directly or indirectly related to public behavior. The findings provide useful information for emergency risk management and a theoretical basis for follow-up research on public coping behavior during the COVID-19 pandemic.

A Window Into Mental Health: Developing and Pilot-Testing a Mental Health Promotion Intervention for Mexican Immigrants Through the Ventanilla de Salud Program.

BackgroundMexican immigrants in the United States face mental health challenges, disparities, and limited access to healthcare; however, mental health promotion efforts specifically targeting this population have been insufficient. The objective of this study was to develop and test a mental health promotion intervention based on protective mental health factors and coping strategies for Mexican immigrants recruited through a free, consulate-based program in Atlanta.Material and MethodsWorking with the Ventanilla de Salud program, we conducted a longitudinal study in three phases: formative research and design, pre-intervention assessment and post-implementation evaluation. The intervention was designed based on the health promotion model and interviews with stakeholders. Qualitative information was collected by semi-structured interviews with participants before and after the intervention. Quantitative outcomes were knowledge about protective factors and coping mechanisms, and psychosocial distress. Differences were assessed using the Wilcoxon non-parametrical test. Intent-to-treat analysis was conducted with all participants who signed the informed consent (carrying last observation forward), and a complete case analysis was conducted with those who attended at least 70% of the sessions and completed the post- implementation evaluation.ResultsTwenty-five participants were enrolled in the intervention. Mean age was 38 years, and the majority were women. Only nine participants attended at least 70% of the sessions and completed the final evaluation. Men, those who did not complete high school, and workers in service or construction jobs were more likely to drop out. Knowledge about protective factors [pre- vs. post-intervention median (inter-quartile range) = 111 (100, 120) vs. 115 (100, 124)] and coping mechanisms [96 (85, 104) vs. 99 (90, 110)], as well as psychosocial distress [3 (2, 3) vs. 2 (2, 3)] improved after the intervention in both intent-to treat and complete case analyses (p < 0.05). Qualitative results also support improvements in targeted protective factors.DiscussionThe intervention was successful in improving psychological distress among Mexican immigrants. These results support the implementation of evidence-based mental health promotion interventions among Mexican immigrants via free and familiar programs. A limitation was the high attrition; future studies should explore approaches to improve retention in this population.

Religion as Meaning-Making Resource in Understanding Suicidal Behavior in Ghana and Uganda.

Suicidal behavior is condemned by religions and tradition, and suicide attempts are criminalized by law in several African countries, including Ghana and Uganda. Suicide and suicide attempts may have severe consequences for both the entire family and the community. Religion is known to act as a protective coping force that helps people to make meaning and find comfort when dealing with stressful life events or situations like suicide. In this article, we focus on the cultural interpretations of the dominating religion in Ghana and Uganda, Christianity, and whether these affect attitudes toward suicidal behavior, meaning making, and coping possibilities for people who have attempted suicide or are bereaved by suicide. This article is based on data material from previous studies on the mentioned topics by the authors.

PSYCHOLOGICAL FACTORS INFLUENCING DISABLED STUDENTS’ SELF-REALIZATION

The article presents the empirical study on psychological factors influencing disabled students’ self-realization in the integrated educational environment. The aim is to study the psychological factors and predictors of disabled students’ self-realization. Methods. The performed factor analysis revealed the structure of disabled students’ self-realization depending on their self-actualization levels. The indicators predicting disabled students’ self-realization having low and high self-actualization are described according to the performed regression analysis. Results. The self-realization factor structure of students with high self-actualization is characterized by positive self-esteem and balanced time perspective; it includes also nearly all parameters of meaningful life orientations and psychological hardiness. The predictors of self-realization for students with high self-actualization are: challenge, locus of control - Self, values of self-actualisation, rationalization and hypercompensation. The self-realization factor structure of students with low self-actualization includes the indicators of psychological hardiness, psychological protection, protective coping, and the negative past. The model that explains 92% of the variance and predicts most accurately self-realization of students with low self-actualization in based on the predictors: need for knowledge, randomness of events, benevolence of the people, the future, and escape-avoidance. Conclusions. The obtained data allowed us to determine the resources and barriers for disabled students’ self-realization and would be used for development of a comprehensive psychological program assisting to students’ personal development and self-realization in the context of integrated learning.

Coping in families with members suffering from amental disorder

HintergrundBelastungen und Bewältigungen während des Lockdowns in Familien mit psychisch erkrankten Mitgliedern wurden bisher noch nicht beschrieben.Ziel der ArbeitErste Erkenntnisse hierzu sollen gewonnen werden, um Fragestellungen für weitere Forschungen abzuleiten.Material und MethodenNarrative Interviews an einer anfallenden Stichprobe von gesunden Familien (n = 4), Familien mit psychisch erkrankten Kindern (n = 12) und Familien mit psychisch erkrankten Eltern (n = 3). Die quantifizierende Auswertung der von 2 Rater*innen vergebenen In-vivo-Codes in den Kategorien „Probleme“ und „Bewältigung“ erfolgt mithilfe von numerischen Verhältnissen und Detailanalysen der Codes, die zwischen den Familien unterscheiden.ErgebnisseDer Lockdown brachte eine große Zahl von Problemen in allen Familien mit sich. Während bei Familien mit kranken Kindern die Einschränkungen das größte Problem sind, berichten Familien mit kranken Eltern v. a. über einen Mangel an Unterstützung. Familien mit erkrankten Mitgliedern berichten häufiger über riskante Bewältigungsmuster, insbesondere Rumination und Schuldabwehr und seltener über protektive Bewältigung, insbesondere die Mobilisierung sozialer Unterstützung.SchlussfolgerungBeide Risikogruppen bedürfen gezielter Interventionen, die sich insbesondere auf adaptives Elternverhalten und Mobilisierungsstrategien richten sollten.

Levels of burnout and its association with resilience and coping mechanisms among orthopaedic surgery residents: a single institution experience from Singapore.

Introduction:Burnout has implications for surgeon wellbeing and patient care. We aimed to: (a) describe burnout levels among orthopaedic surgery residents in an Accreditation Council for Graduate Medical Education-International (ACGME-I) accredited programme; and (b) determine associations between burnout levels and resident characteristics, resilience and coping mechanisms.Methods:This is a grant-funded, cross-sectional questionnaire-based study that included 44 orthopaedic surgery residents. Burnout was measured using Maslach Burnout Inventory and resilience was determined using the Short Grit Scale. Coping mechanisms were determined using the Brief Coping Orientation to Problems Experienced scale.Results:20 (45.5%) residents fulfilled the criteria for burnout. High levels of emotional exhaustion (EE) and depersonalisation (DP) correlated with stressors, such as inadequate sleep (EE: r = 0.43, P <0.01; DP: r = 0.33, P <0.05), conflict between family and work (EE: r = 0.40, P <0.01; DP: r = 0.40, P <0.01), financial pressure (DP: r = 0.46, P <0.01), and conflict with residents (EE: r = 0.35, P <0.05; DP: r = 0.34, P <0.05) and faculty (EE: r = 0.44, P <0.01; DP: r = 0.35, P<0.05). Severe burnout was associated with lower grit scores (p <0.05). Coping mechanisms, such as planning and positive reframing, were protective while behavioural disengagement and substance use may increase burnout risk.Conclusion:Burnout was high in our ACGME-I accredited programme. Stressors associated with higher burnout included feeling of inadequate sleep, poor work-life balance, poor relationships with fellow residents/faculty and financial pressures. Residents should be educated on protective coping mechanisms and regular screening to detect burnout should be performed.

Associations of emotional burden and coping strategies with sick leave among healthcare professionals: A longitudinal observational study

ObjectivesTo investigate 1) whether care-related regrets (regret intensity, number of recent regrets) are associated with sick leave, independently of personality traits, perceived safety climate, and physical activity; and 2) whether these associations were mediated or moderated by coping strategies. MethodsUsing a longitudinal international observational study (ICARUS), data were collected by the means of a weekly web survey. Descriptive and generalized estimation equations were performed. ResultsA total of 276 newly practicing healthcare professionals (nurses, physicians, others) from 11 countries were included in this study. The average proportion of weeks with at least one day of sick leave was 3.2%. Nurses’ sick leave increased with number of care-related regrets (Relative Risk [RR]=1.52; 95% Confidence Interval [CI]=[1.18; 1.95], p=.001), while physicians’ sick leave increased with intensity of care-related regret (RR=1.21; 95%CI=[1.00; 1.21], p=.049). Coping was associated with lower risk of sick leave for nurses (RR problem-focused strategies = 0.53; 95%CI=[0.37; 0.74], p=.001, and RRphysical activity=0.68; 95%CI:[0.54; 0.85], p<.001), but not for physicians. Nevertheless, the association of regret with sick leave remained significant even when adjusting for coping. Finally, this study did not find evidence of moderation by the coping strategies. ConclusionRegrets are associated with increased risks of sick leave, even in young healthcare professionals. Use of coping strategies partially mediated these associations in nurses. The results of this study should be used to inform interventions to reduce emotional burdens and enhance protective coping strategies.