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Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity

Author

Listed:
  • Jennifer S. Mascaro

    (Department of Family and Preventive Medicine, Division of Preventive Medicine, Emory University, Atlanta, GA 30329, USA)

  • Amanda Wallace

    (Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA)

  • Brooke Hyman

    (Department of Gynecology and Obstetrics, Emory University, Atlanta, GA 30322, USA)

  • Carla Haack

    (Department of Surgery, Emory University, Atlanta, GA 30322, USA)

  • Cherie C. Hill

    (Department of Gynecology and Obstetrics, Emory University, Atlanta, GA 30322, USA)

  • Miranda A. Moore

    (Department of Family and Preventive Medicine, Division of Preventive Medicine, Emory University, Atlanta, GA 30329, USA
    Department of Medicine, Emory University, Atlanta, GA 30322, USA)

  • Maha B. Lund

    (Department of Family and Preventive Medicine, Physician Assistant Program, Emory University, Atlanta, GA 30322, USA)

  • Eric J. Nehl

    (Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA)

  • Sharon H. Bergquist

    (Department of Medicine, Emory University, Atlanta, GA 30322, USA)

  • Steve W. Cole

    (Department of Psychiatry & Biobehavioral Sciences, Department of Medicine, University of California, Los Angeles, CA 90095, USA)

Abstract

While much attention has been paid to healthcare provider and trainee burnout, less is known about provider well-being (i.e., flourishing) or about the effects of well-being on immune function. This study examined the demographic and psycho-social correlates of well-being among healthcare trainees (resident physicians and physician assistant (PA) trainees) and evaluated the association of well-being with the “conserved transcriptional response to adversity” (CTRA) characterized by up-regulated expression of pro-inflammatory genes and down-regulated expression of innate antiviral genes. Participants (n = 58) completed self-reported assessments of sleep disturbance, loneliness, depressive symptoms, anxiety, stress, and well-being (flourishing). Blood sample RNA profiles were analyzed by RNA sequencing to assess the CTRA. Slightly over half (n = 32; 55.2%) of healthcare trainees were categorized as flourishing. Flourishing was less prevalent among primary caregivers, and more prevalent among trainees who exercised more frequently and those with fewest days sick. Loneliness (AOR = 0.75; 95% CI = 0.61, 0.91; p = 0.003) and stress (AOR = 0.65; 95% CI = 0.45, 0.94; p = 0.02) were associated with decreased odds of flourishing when controlling for other variables. Flourishing was associated with down-regulated CTRA gene expression, whereas loneliness was associated with up-regulated CTRA gene expression (both p < 0.05). Assessing these relationships in a larger, multi-site study is of critical importance to inform policy, curricula, and interventions to bolster sustainable trainee well-being.

Suggested Citation

  • Jennifer S. Mascaro & Amanda Wallace & Brooke Hyman & Carla Haack & Cherie C. Hill & Miranda A. Moore & Maha B. Lund & Eric J. Nehl & Sharon H. Bergquist & Steve W. Cole, 2022. "Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity," IJERPH, MDPI, vol. 19(4), pages 1-18, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:4:p:2255-:d:750989
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    References listed on IDEAS

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    1. Keyes, C.L.M. & Simoes, E.J., 2012. "To flourish or not: Positive mental health and all-cause mortality," American Journal of Public Health, American Public Health Association, vol. 102(11), pages 2164-2172.
    2. Keyes, C.L.M. & Dhingra, S.S. & Simoes, E.J., 2010. "Change in level of positive mental health as a predictor of future risk of mental Illness," American Journal of Public Health, American Public Health Association, vol. 100(12), pages 2366-2371.
    3. Steven W. Cole & Michael J. Shanahan & Lauren Gaydosh & Kathleen Mullan Harris, 2020. "Population-based RNA profiling in Add Health finds social disparities in inflammatory and antiviral gene regulation to emerge by young adulthood," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 117(9), pages 4601-4608, March.
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