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  1. Article ; Online: The Potential Protective Effect of Hope on Students' Experience of Perceived Stress and Burnout during Medical School.

    Duncan, Ashten R / Hellman, Chan M

    The Permanente journal

    2021  Volume 24, Page(s) 1

    Abstract: Background: A major problem facing today's physicians and medical students is burnout. Christina Maslach and fellow researchers have described burnout as a product of chronic stress and a lack of protective psychological factors like hope. The purpose ... ...

    Abstract Background: A major problem facing today's physicians and medical students is burnout. Christina Maslach and fellow researchers have described burnout as a product of chronic stress and a lack of protective psychological factors like hope. The purpose of this study was to explore the relationships between hope, stress, and burnout among medical students.
    Methods: This study involved an online survey of 329 first- through fourth-year allopathic and osteopathic medical students. Validated psychometric scales were used to measure the primary variables. We conducted Pearson correlation, hierarchical regression, and mediation analyses to test the relationships between hope, stress, and burnout and to determine whether hope directly impacts stress and burnout.
    Results: We found significant correlations between hope, stress, and burnout. Hierarchical regression revealed that hope accounted for significant variance in burnout over and above psychological stress and that stress and hope together accounted for 48% of this variance. We discovered that hope may be partially mediating the relationship between stress and burnout.
    Conclusion: Hope may play a significant protective role in the stress-burnout relationship in the context of medical students: higher levels of hope are associated with lower levels of stress and burnout. Our study supports the idea of using hope-based interventions in medical student populations and investing more resources into this area of research.
    MeSH term(s) Burnout, Professional/prevention & control ; Burnout, Psychological/prevention & control ; Humans ; Schools, Medical ; Stress, Psychological ; Students, Medical ; Surveys and Questionnaires
    Language English
    Publishing date 2021-01-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2062823-7
    ISSN 1552-5775 ; 1552-5775
    ISSN (online) 1552-5775
    ISSN 1552-5775
    DOI 10.7812/TPP/19.240
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Psychosocial factors associated with dispositional hope, agency thinking, and pathways thinking in a homeless adult population.

    Duncan, Ashten R / Bell, Sarah Beth / Salvatore, Alicia L / Hellman, Chan M

    Journal of community psychology

    2022  Volume 50, Issue 7, Page(s) 3196–3209

    Abstract: Adults facing homelessness often perceive themselves to be at the bottom of society, which has implications for their current and future well-being. Snyder's hope theory, which posits that agency thinking and pathways thinking are necessary for achieving ...

    Abstract Adults facing homelessness often perceive themselves to be at the bottom of society, which has implications for their current and future well-being. Snyder's hope theory, which posits that agency thinking and pathways thinking are necessary for achieving a hopeful outlook on life, may be helpful for understanding drivers of well-being among individuals experiencing homelessness. In this study, we examined dispositional hope, perceived goal attainment, social support, and perceived standing in society among 123 adults experiencing homelessness who were attending a support group at a daytime drop-in center in the United States. Participants completed self-report measures related to the aforementioned variables of interest. We discovered that higher levels of self-reported goal attainment, independent of the type of goal identified, were significantly associated with total hope and both its subscales, that social support was significantly associated with total hope and pathways thinking, and that perceived standing in society was significantly associated with total hope and agency thinking.
    MeSH term(s) Adult ; Attitude ; Homeless Persons ; Humans ; Motivation ; Social Support ; United States
    Language English
    Publishing date 2022-03-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1491194-2
    ISSN 1520-6629 ; 0090-4392
    ISSN (online) 1520-6629
    ISSN 0090-4392
    DOI 10.1002/jcop.22828
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  3. Article: An Emerging Preventive Mental Health Care Strategy: The Neurobiological and Functional Basis of Positive Psychological Traits.

    Duncan, Ashten R / Daugherty, Grant / Carmichael, Gabrielle

    Frontiers in psychology

    2021  Volume 12, Page(s) 728797

    Abstract: Even with the expanding burden of the COVID-19 pandemic on mental health, our approach to mental health care remains largely reactive rather than preventive. This trend is problematic because the majority of outpatient visits to primary care providers ... ...

    Abstract Even with the expanding burden of the COVID-19 pandemic on mental health, our approach to mental health care remains largely reactive rather than preventive. This trend is problematic because the majority of outpatient visits to primary care providers across the country is related to unmet mental health needs. Positive psychology has the potential to address these issues within mental health care and provide primary care providers with strategies to serve their patients more effectively. Positive psychology has many frameworks like hope, which can be measured using simple questionnaires in the waiting room. Moreover, there is a growing body of neurobiological evidence that lends credence to positive psychology concepts in the context of differential neuronal activation patterns. Many positive psychological instruments not only have high construct validity but also have connections to observable neurobiological differences tied to differences in psychosocial functioning. Despite the current evidence, we still need robust research that explores if such psychometric measurements and related interventions lead to clinically significant and favorable health outcomes in patients outside of controlled environments.
    Language English
    Publishing date 2021-10-22
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2563826-9
    ISSN 1664-1078
    ISSN 1664-1078
    DOI 10.3389/fpsyg.2021.728797
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Positive Psychology and Hope as Lifestyle Medicine Modalities in the Therapeutic Encounter: A Narrative Review.

    Duncan, Ashten R / Jaini, Paresh A / Hellman, Chan M

    American journal of lifestyle medicine

    2020  Volume 15, Issue 1, Page(s) 6–13

    Abstract: The majority of deaths in the United States are attributable to lifestyle-associated chronic diseases. Therapeutic encounters must now routinely address lifestyle-related behavior changes and promote patients' active involvement in self-care and chronic ... ...

    Abstract The majority of deaths in the United States are attributable to lifestyle-associated chronic diseases. Therapeutic encounters must now routinely address lifestyle-related behavior changes and promote patients' active involvement in self-care and chronic disease management. Positive psychology has been recognized in the realm of lifestyle medicine for its potential applications in effecting patient behavior change. One notable framework within positive psychology that is well suited for facilitating specific behavior changes is hope theory, which can be used to elicit change talk and build agency among patients with chronic diseases. This review explores key literature in positive psychology and hope theory and its practical applications to direct patient care, which includes an illustrative case study. There are still many unexplored intersections of health-related variables and hope. The cognitive framework of hope theory lends itself well to a broad range of situations, including brief ambulatory encounters. Clinicians will be instrumental in increasing our understanding of how hope theory can be applied to the therapeutic encounter. There are simple and efficient ways to innovate in this area. Having information about a patient's hope has the potential to make empathic connections easier and create opportunities to ask specific questions to help patients overcome barriers.
    Language English
    Publishing date 2020-03-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2265653-4
    ISSN 1559-8284 ; 1559-8276
    ISSN (online) 1559-8284
    ISSN 1559-8276
    DOI 10.1177/1559827620908255
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Barriers and strategies to integrate medical genetics and primary care in underserved populations: a scoping review.

    Chou, Ann F / Duncan, Ashten R / Hallford, Gene / Kelley, David M / Dean, Lori Williamson

    Journal of community genetics

    2021  Volume 12, Issue 3, Page(s) 291–309

    Abstract: Despite clinical and technological advances, serious gaps remain in delivering genetic services due to disparities in workforce distribution and lack of coverage for genetic testing and counseling. Genetic services delivery, particularly in medically ... ...

    Abstract Despite clinical and technological advances, serious gaps remain in delivering genetic services due to disparities in workforce distribution and lack of coverage for genetic testing and counseling. Genetic services delivery, particularly in medically underserved populations, may rely heavily on primary care providers (PCPs). This study aims to identify barriers to integrating genetic services and primary care, and strategies to support integration, by conducting a scoping review. Literature synthesis found barriers most frequently cited by PCPs including insufficient knowledge about genetics and risk assessment, lack of access to geneticists, and insufficient time to address these challenges. Telegenetics, patient-centered care, and learning communities are strategies to overcome these barriers. Telegenetics supplements face-to-face clinics by providing remote access to genetic services. It may also be used for physician consultations and education. Patient-centered care allows providers, families, and patients to coordinate services and resources. Access to expert information provides a critical resource for PCPs. Learning communities may represent a mechanism that facilitates information exchange and knowledge sharing among different providers. As PCPs often play a crucial role caring for patients with genetic disorders in underserved areas, barriers to primary care-medical genetics integration must be addressed to improve access. Strategies, such as telegenetics, promotion of evidence-based guidelines, point-of-care risk assessment tools, tailored education in genetics-related topics, and other system-level strategies, will facilitate better genetics and primary care integration, which in turn, may improve genetic service delivery to patients residing in underserved communities.
    Language English
    Publishing date 2021-02-01
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2543127-4
    ISSN 1868-6001 ; 1868-310X
    ISSN (online) 1868-6001
    ISSN 1868-310X
    DOI 10.1007/s12687-021-00508-5
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  6. Article ; Online: Promoting nutrition equity for individuals with physical challenges: A systematic review of barriers and facilitators to healthy eating.

    Wetherill, Marianna S / Duncan, Ashten R / Bowman, Hartley / Collins, Reagan / Santa-Pinter, Natalie / Jackson, Morgan / Lynn, Catherine M / Prentice, Katherine / Isaacson, Mary

    Preventive medicine

    2021  Volume 153, Page(s) 106723

    Abstract: Impaired mobility is the most common form of functional disability in the US, affecting one out of every sixteen working-age adults. Little is known about the barriers to and facilitators of healthy eating among people with impaired mobility (PWIM), who ... ...

    Abstract Impaired mobility is the most common form of functional disability in the US, affecting one out of every sixteen working-age adults. Little is known about the barriers to and facilitators of healthy eating among people with impaired mobility (PWIM), who are at increased risk for diet-related chronic disease. The pathways by which impaired mobility influence dietary intake are unclear, yet likely involve a complex interplay between structural determinants of health and individual factors. To help advance nutrition equity initiatives for PWIM, this systematic review aimed to qualitatively synthesize factors associated with dietary intake across four levels of ecologic influence. An interprofessional team devised a comprehensive search strategy to identify these factors among working-age (18-64 years) PWIM. We queried Ovid MEDLINE, Web of Science, Scopus, and Embase via Ovid for articles published between January 1, 1990 and April 25, 2021. Twelve studies met our review criteria. We classified factors within one of four ecologic levels of influence: individual, social, environmental, and policy/program. Most studies disproportionately reported on personal level factors of influence, with less information on other levels of influence. This systematic review is an important first step for informing the design of evidence-based strategies to support healthy eating among PWIM. However, it also reveals a wide chasm in the needed information to adequately bridge structural determinants of this nutrition divide. More studies are needed that include rigorous measures of dietary intake and that aim to elicit how social, environmental, and policy-level factors contribute to dietary disparities among PWIM.
    MeSH term(s) Adolescent ; Adult ; Diet ; Diet, Healthy ; Eating ; Humans ; Middle Aged ; Nutritional Status ; Young Adult
    Language English
    Publishing date 2021-07-14
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 184600-0
    ISSN 1096-0260 ; 0091-7435
    ISSN (online) 1096-0260
    ISSN 0091-7435
    DOI 10.1016/j.ypmed.2021.106723
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  7. Article ; Online: Designing Shift Handoff Software: Clinical Learners and Design Students Collaborate Using the "Design Thinking" Process.

    Lesselroth, Blake / Park, Hannah / Monkman, Helen / Duncan, Ashten / Thompson, Gabriel / Yarnall, Ryan

    Studies in health technology and informatics

    2021  Volume 281, Page(s) 974–978

    Abstract: Handoffs in patient care responsibilities between practitioners are common in the hospital setting. Because inadequate communication can lead to patient harm, professional organizations have published recommendations and practical guides to support ... ...

    Abstract Handoffs in patient care responsibilities between practitioners are common in the hospital setting. Because inadequate communication can lead to patient harm, professional organizations have published recommendations and practical guides to support standardized workflow. However, currently available electronic medical record (EMR) tools rarely provide the requisite functionality to support work and often suffer from major usability flaws. Our internal medicine residency program sponsored a quality improvement initiative to improve the design of handoff tools. To support this initiative, our medical informatics program collaborated with a school of architecture and design to identify requirements and ideate interface prototypes. In this article, we describe how we used Design Thinking principles and methods to inform our product design lifecycle, create novel designs, and teach inter-professional students health systems science concepts.
    MeSH term(s) Electronic Health Records ; Humans ; Patient Handoff ; Software ; Students ; Workflow
    Language English
    Publishing date 2021-05-27
    Publishing country Netherlands
    Document type Journal Article
    ISSN 1879-8365
    ISSN (online) 1879-8365
    DOI 10.3233/SHTI210323
    Database MEDical Literature Analysis and Retrieval System OnLINE

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