Christopher J. L. Cunningham, PhD, The University of Tennessee at Chattanooga; Katherine A. Werth, Hon. BS, The University of Tennessee at Chattanooga; Mukta Panda, MD MACP FRCP-London, University of Tennessee College of Medicine-Chattanooga
This study was designed before COVID-19 and purposefully undertaken during the pandemic to ensure that participants responded during a time of particularly intense work-related demands. We explored individual differences and experiences in a sample of healthcare workers (HW) recognized for resilience and general healthcare excellence. In this first presentation from this study, we will provide an overview of objectives and methodology, and descriptive details about the sample. We will also address the following research questions (RQ):
RQ1: Is the resilience of this targeted HW sample evident in the data gathered with various theoretically and empirically supported indicators of resilience-related individual differences?
RQ2: To what extent do these resilience-related individual difference explain variance in multiple indicators of positive well-being?
RQ3: Can we improve our ability to understand and potentially predict outcomes indicative of resilience with knowledge of individual differences other than generalized trait resilience?
It is widely understood that many HW experience chronically intense workload and pressure, and limited opportunities for rest and recovery. Consistent with Conservation of Resources theory (Hobfoll, 1989) and Job Demands-Resources theory (Demerouti et al., 2001), workers will experience stress and strain when the demands they must manage exceed or are inadequately matched by the resources needed to effectively meet those demands. Research into HW health and well-being tends to focus on strain-related outcomes associated with working in challenging healthcare environments (e.g., Ripp et al., 2011; van Mol et al., 2015). However, many HW survive and even thrive while working. We need to identify and better understand individual differences in perspective and cognitive, emotional, and behavioral strategies that can explain how some resilient HW can maintain a focus on the positives of meaning, motivation, and joy while working.
Only HW who are psychologically and physically well can best serve their patients, students, colleagues, profession, and society. This assertion is supported by the World Medical Association’s amendment to the Declaration of Geneva (Parsa-Parsi, 2017) and the Charter on Physician Well-being in America (Thomas et al., 2018). Improving health and well-being among HW will require attention to the demands and resources inherent in such work environments, but also to the ways in which HW develop, strengthen, and sustain their personal sense of meaning, purpose, and joy at work. Such meaning and purpose is an important factor influencing HW motivation and quality of care for others (consistent with Job Characteristics Theory; Hackman & Oldham, 1976; see also the Institute for Healthcare Improvement’s Triple Aim framework, http://www.ihi.org/Topics/TripleAim/Pages/default.aspx and Feeley, 2017).
Data were gathered from HW across multiple levels and position types within a variety of healthcare environments in a southeastern metropolitan area. Participants were recruited through professional networks, being identified from peers and supervisors as HW who had consistently demonstrated resilience and/or had been recognized for general excellence in their healthcare-related work. Approximately 60 resilient HW were identified and invited; 54 agreed and completed at least the baseline survey. More than 75% of these participants have remained engaged over a period of 6-8 months, providing monthly follow-up data and in-depth interview responses that will be analyzed and shared in the future. The data for this poster were gathered in late Summer through early Fall 2020 via an internet survey composed of items demographic, individual difference, and health-related outcomes measures (details in Table 1). Preliminary analyses of quantitative data from this survey are complete and are the focus of this poster submission. Analyses of additional qualitative data from this survey is ongoing, as is analysis of data gathered from the monthly follow-up surveys and interviews.
High levels of resilience-related individual differences are evident (Table 2) in the baseline responses of this sample (RQ1). Digging further into these data to address RQ2 and 3, the variance accounted for across multiple positive health and well-being outcomes by this set of individual difference factors ranges from .20 (physical health) to .67 (psychological well-being). Hierarchical regression analyses indicate that there are differential patterns of explanatory relationships depending on outcome and that no single predictor, including trait resilience by itself, explains the whole picture.
These baseline data validate the purposive sampling for this larger scale study and highlight a complex set of individual differences in affect, cognition, and perspective that likely plays a role in explaining the resilience demonstrated by these HW. These data also underscore the importance of not trying to reduce our understanding and study of resilience to a singular trait.
Further analyses of these data and the additional longitudinal and interview data we have gathered will help us to understand factors that promote or impede resilience, including positive motivation and meaning experiences at and about work over time. Ultimately, we hope to use information from this study to develop pragmatic educational resources to help current and future HW better manage the challenging realities of their work.