Well-being for trainees caring for homeless veterans. 2019

Elizabeth Moore, and Michael Soh, and Margaret Stuber, and Carole Warde
UCLA Neuropsychiatric Institute, Los Angeles, California, USA.

Health care trainees caring for homeless patients may experience stress and burnout. Reasons for this include high rates of medical and psychiatric illness and complex social needs within this patient population. This can lead to feelings of inadequacy and exhaustion among health care trainees. To address this, we developed a toolkit for trainees from multiple professions caring for homeless veterans and examined its impact on trainee well-being. Fifteen trainees and six faculty members participated in a half-day workshop given by a national expert that demonstrated a variety of well-being practices. Trainees and faculty members then identified 14 evidence-based practices relevant to the clinic for inclusion in the well-being toolkit. Half of the tools were for personal use and half were intended for teams. We developed simple graphics demonstrating each tool, and these were displayed as posters throughout the clinic. Tools were reviewed through workshops and handouts. To assess the trainee response to the toolkit, we used validated measures of burnout, stress, resilience and mindfulness at the beginning and at the end of the academic year. Trainees also rated the value of each tool. Trainees did not experience burnout during the year, and nor did the stress levels change. Both resilience and mindfulness trended towards improvement. Trainees rated the team-based tools as more important than the personal tools; they were also more confident in using the team-based tools. Burnout among physicians caring for marginalised patients can originate from a sense of futility and from witnessing needless suffering DISCUSSION: Team-based well-being tools may represent a better avenue for residency programmes and training sites to pursue well-being programmes, especially for trainees caring for marginalised populations.

UI MeSH Term Description Entries
D007396 Internship and Residency Programs of EDUCATION, MEDICAL, GRADUATE training to meet the requirements established by accrediting authorities. House Staff,Internship, Dental,Residency, Dental,Residency, Medical,Dental Internship,Dental Internships,Dental Residencies,Dental Residency,Internship,Internship, Medical,Internships, Dental,Medical Residencies,Medical Residency,Residencies, Dental,Residencies, Medical,Residency,Residency and Internship,Internships, Medical,Medical Internship,Medical Internships,Residencies,Staff, House
D008605 Mental Health Services Organized services to provide mental health care. Mental Hygiene Services,Health Services, Mental,Services, Mental Health,Services, Mental Hygiene,Health Service, Mental,Hygiene Service, Mental,Hygiene Services, Mental,Mental Health Service,Mental Hygiene Service,Service, Mental Health,Service, Mental Hygiene
D002055 Burnout, Professional An excessive stress reaction to one's occupational or professional environment. It may be characterized by feelings of emotional and physical exhaustion, coupled with a sense of frustration and failure. Career Burnout,Occupational Burnout,Burnout, Career,Burnout, Occupational,Professional Burnout
D006703 Ill-Housed Persons Persons without adequate housing or without permanent residence. The concept excludes nomadic peoples. Homeless Persons,Homeless Shelters,Shelterless Persons,Shelters for Homeless Persons,Street People,Unhoused Persons,Homelessness,Homeless Person,Homeless Shelter,Ill Housed Persons,Ill-Housed Person,People, Street,Person, Homeless,Person, Ill-Housed,Person, Shelterless,Person, Unhoused,Persons, Homeless,Persons, Ill-Housed,Persons, Shelterless,Persons, Unhoused,Shelter, Homeless,Shelterless Person,Shelters, Homeless,Unhoused Person
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013315 Stress, Psychological Stress wherein emotional factors predominate. Cumulative Stress, Psychological,Emotional Stress,Individual Stressors,Life Stress,Psychological Cumulative Stress,Psychological Stress Experience,Psychological Stress Overload,Psychologically Stressful Conditions,Stress Experience, Psychological,Stress Measurement, Psychological,Stress Overload, Psychological,Stress Processes, Psychological,Stress, Emotional,Stressful Conditions, Psychological,Psychological Stress,Stress, Psychologic,Stressor, Psychological,Condition, Psychological Stressful,Condition, Psychologically Stressful,Conditions, Psychologically Stressful,Cumulative Stresses, Psychological,Experience, Psychological Stress,Individual Stressor,Life Stresses,Measurement, Psychological Stress,Overload, Psychological Stress,Psychologic Stress,Psychological Cumulative Stresses,Psychological Stress Experiences,Psychological Stress Measurement,Psychological Stress Measurements,Psychological Stress Overloads,Psychological Stress Processe,Psychological Stress Processes,Psychological Stresses,Psychological Stressful Condition,Psychological Stressful Conditions,Psychological Stressor,Psychological Stressors,Psychologically Stressful Condition,Stress Experiences, Psychological,Stress Processe, Psychological,Stress, Life,Stress, Psychological Cumulative,Stressful Condition, Psychological,Stressful Condition, Psychologically,Stressor, Individual
D014728 Veterans Former members of the armed services. Veteran
D015141 Los Angeles City in California.
D055500 Resilience, Psychological The human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing significant life stressors. Psychological Resilient Responses,Resilience,Resiliency,Resiliency, Psychological,Resilient Responses, Psychological,Stress Immunity,Immunity, Stress,Psychological Resilience,Psychological Resiliency,Psychological Resilient Response,Resiliences,Resiliencies,Resilient Response, Psychological,Response, Psychological Resilient,Stress Immunities

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