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

Jennifer S. Mascaro, Amanda Wallace, Brooke Hyman, Carla Haack, Cherie C. Hill, Miranda A. Moore, Maha B. Lund, Eric J. Nehl, Sharon H. Bergquist and Steve W. Cole
Additional contact information
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
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

IJERPH, 2022, vol. 19, issue 4, 1-18

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.

Keywords: well-being; flourishing; loneliness; inflammation; resident physicians; physician assistants (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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