Coaching for Optimal Energy: A Guide for Executive Coaches
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As the COVID-19 global health disaster continues to unfold across the world, calls have been made to address the associated mental illness public crisis. The current paper seeks to broaden these calls by considering the role that positive psychology factors can play in buffering against mental illness, bolstering mental health during COVID-19 and building positive processes and capacities that may help to strengthen future mental health. The paper explores evidence and applications from nine topics in positive psychology that support people through a pandemic: meaning, coping, self-compassion, courage, gratitude, character strengths, positive emotions, positive interpersonal processes and high-quality connections. In times of intense crisis, such as COVID-19, it is understandable that research is heavily directed towards addressing the ways in which people are wounded and weakened. However, this need not come at the expense of also investigating the ways in which people are sustained and strengthened.
The dimensionality of Maslach's (1982) 3 aspects of job burnout—emotional exhaustion, depersonalization, and personal accomplishment—was examined among a sample of supervisors and managers in the human services. A series of confirmatory factor analyses supported the 3-factor model, with the first 2 aspects highly correlated. The 3 aspects were found to be differentially related to other variables reflecting aspects of strain, stress coping, and self-efficacy in predictable and meaningful ways. Implications for better understanding the burnout process are discussed.
b>BACKGROUND: Evidence supports music-based oncologic support interventions including music therapy. By comparison, little is understood about music-based self-care. This meta-ethnography examined five published qualitative studies to extend understanding of music's relevance, including helpfulness, for people affected by cancer; including children, adolescents, and adults with cancer, carers, and the bereaved.
OBJECTIVE: To improve understanding of music's broad relevance for those affected by cancer.
METHODS: Meta-ethnography strategies informed the analysis. Five studies were synthesized that included 138 participants: 26 children and 28 parents of children with cancer; 12 adolescents and young adults with cancer; 52 adults with cancer; 12 carers; and 8 bereaved. Studies' category and thematic findings were compared and integrated into third-order interpretations, and a line of argument. Perspectives from the five studies that illuminated the line of argument were developed.
RESULTS: Music usage can remain incidental, continue normally, and/or change because of cancer's harsh effects. Music can be a lifeline, support biopsychosocial and spiritual well-being, or become elusive, that is, difficult to experience. Music helps or intrudes because it extends self-awareness and social connections, and prompts play, memories, imageries, and legacies. Music therapists may help patients and carers to recover or extend music's helpful effects.
CONCLUSIONS: Cancer care can be improved through offering music-based resources/services, which give cancer patients and carers opportunities to extend music usage for personal support and, for carers, to support patients. Music therapists can advocate for such resources and educate health professionals about assessing/recognizing when patients' and carers' changed music behaviors signify additional support needs.
The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally-specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.
p> Introduction: To evaluate sleep deprivation and its effects on young physicians in relation to concentration capacity and psychomotor performance.
Material and Methods: Eighteen physicians aged 26 - 33 years were divided into 2 groups: non-sleep deprived group (with no night work) and sleep deprived group (minimum 12 hour of night work/week). We applied Pittsburgh Sleep Quality Index to screen the presence of sleep pathology and Epworth Sleepiness Scale to evaluate subjective daytime sleepiness; we used actigraphy and sleep diary to assess sleep hygiene and standard sleep-wake cycles. To demonstrate the effects of sleep deprivation, we applied Toulouse-Piéron’s test (concentration test) and a battery of three reaction time tasks after the night duty.
Results: Sleep deprived group had higher daytime sleepiness on Epworth Sleepiness Scale (p < 0.05) and during week sleep
deprivation was higher (p < 0.010). The mean duration of sleep during the period of night duty was 184.2 minutes to sleep deprived group and 397.7 minutes to non-sleep deprived group (p < 0.001). In the Toulouse-Piéron´s test, the sleep deprived group had more omissions (p < 0.05) with a poorer result in concentration (p < 0.05). Psychomotor tests that evaluated response to simple stimuli revealed longer response latency (p < 0.05) and more errors (p < 0.05) in Sleep deprived group; in reaction to instruction test the sleep
deprived group showed worse perfection index (p < 0.05); in the fine movements test there was no statistically significant difference between the groups.
Discussion: Acute sleep deprivation resulting from nocturnal work in medical professions is associated with a reduction in attention and concentration and delayed response to stimuli. This may compromise patient care as well as the physician’s health and quality of life.
Conclusion: It is essential to study the effects of acute sleep deprivation on the cognitive abilities and performance of health
professionals.</p
Context:
Neuroendocrine and immune stresses imposed by chronic sleep restriction are known to be involved in the harmful cardiovascular effects associated with poor sleep.
Objectives:
Despite a well-known beneficial effect of napping on alertness, its effects on neuroendocrine stress and immune responses after sleep restriction are largely unknown.
Design:
This study was a strictly controlled (sleep-wake status, light environment, caloric intake), crossover, randomized design in continuously polysomnography-monitored subjects.
Setting:
The study was conducted in a laboratory-based study.
Participants:
The subjects were 11 healthy young men.
Intervention:
We investigated the effects on neuroendocrine and immune biomarkers of a night of sleep restricted to 2 h followed by a day without naps or with 30 minute morning and afternoon naps, both conditions followed by an ad libitum recovery night starting at 20:00.
Main outcome measures:
Salivary interleukin-6 and urinary catecholamines were assessed throughout the daytime study periods.
Results:
The increase in norepinephrine values seen at the end of the afternoon after the sleep-restricted night was not present when the subjects had the opportunity to take naps. Interleukin-6 changes observed after sleep deprivation were also normalized after napping. During the recovery day in the no-nap condition, there were increased levels of afternoon epinephrine and dopamine, which was not the case in the nap condition. A recovery night after napping was associated with a reduced amount of slow-wave sleep compared to after the no-nap condition.
Conclusions:
Our data suggest that napping has stress-releasing and immune effects. Napping could be easily applied in real settings as a countermeasure to the detrimental health consequences of sleep debt.
Organizational researchers and practitioners are increasingly interested in self-regulatory strategies employees can use at work to sustain or improve their occupational well-being. A recent cross-sectional study on energy management strategies suggested that many work-related strategies (e.g., setting a new goal) are positively related to occupational well-being, whereas many micro-breaks (e.g., listening to music) are negatively related to occupational well-being. We used a diary study design to take a closer look at the effects of these energy management strategies on fatigue and vitality. Based on conservation of resources theory, we hypothesized that both types of energy management strategies negatively predict fatigue and positively predict vitality. Employees (N = 124) responded to a baseline survey and to hourly surveys across one work day (6.7 times on average). Consistent with previous research, between-person differences in the use of work-related strategies were positively associated with between-person differences in vitality. However, results of multilevel analyses of the hourly diary data showed that only micro-breaks negatively predicted fatigue and positively predicted vitality. These findings suggest that taking micro-breaks during the work day may have short-term effects on occupational well-being, whereas using work-related strategies may have long-term effects.
Abrasive leaders rub their coworkers the wrong way. Their words and actions create interpersonal friction, friction that grates on subordinates, peers, and even superiors, eroding employee motivation and organizational productivity. In its more extreme forms, abrasive behavior constitutes workplace psychological harassment, also known as workplace bullying. This article describes a coaching method—boss whispering—that engages abrasive leaders in action research with the objective of developing less destructive, more productive leadership styles. The method is based upon sociobiological and psychoanalytic concepts of threat, anxiety, and defense, the concept of emotional management, and findings from empathy research.
Background:
Attitudes influence how people make decisions. In an effort to decrease pilot judgment-related accidents, the Federal Aviation Administration teaches new pilots about hazardous attitudes that are believed to be incompatible with safe flight: macho, impulsive, worry, resignation, self-confidence, and antiauthority. If these attitudes are hazardous for pilots and their passengers, they may also be incompatible with the reliable and safe delivery of surgical care.
Questions/purposes:
The purposes of this study were (1) to ascertain to what extent surgeons harbor hazardous attitudes; and (2) to determine their relationship, if any, to reoperation and readmission rates.
Methods:
We selected validated aviation psychology tools that are used to measure these attitudes in pilots. We converted the aviation scenarios to analogous situations for surgeons and invited all surgeons from one academic program to participate in this study. A total of 41 surgeons were eligible to participate; 37 (90%) completed the attitude prevalence protocol and 31 (76%) had complete reoperation and readmission data for the correlation and regression analysis. Attending orthopaedic surgeons completed the Modified Surgeon Hazardous Attitude Scale as well as a series of additional instruments.
Results:
Levels of macho thought to be hazardous in pilots were present in nine (24%) surgeons. Similar, elevated levels of self-confidence were found in three (8%) surgeons. High levels of impulsivity were found in 5% (two surgeons) and high levels of antiauthority were found in 3% (one surgeon). Only one (3%) surgeon reported elevated levels of worry and no surgeon reported hazardous levels of resignation. Thirty percent (11 surgeons) of surgeons harbored at least one elevated attitude level. In a regression model, macho attitude levels predicted 19% of the variation in surgeons' rate of readmissions and reoperations.
Conclusions:
High levels of hazardous attitudes may not be consistent with the routine delivery of safe surgical care in a teamwork setting where human factors and safe systems are the key to success. Further research is needed to determine if abnormally high levels of these hazardous attitudes impact patient care.
Level of evidence:
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
We propose a model that explains the complex phenomenon of successful career at work, and focuses on the antecedents of professional vitality at the workplace. The model sheds light on the role of professional vitality as an essential ingredient for successful careers. Using a survey design, we tested our model with a sample of 545 managers and professionals. The findings suggest effects of career attitudes on career outcomes, mediated by professional vitality. The relationship between professional vitality and age at work environment forms an inverse U shape curve, peaking at age of fifties, an optimistic note for the global aging workforce.
Background
It has been argued that the quality of daily interactions within organisations effects the wellbeing of both individuals and the broader organisation. Coaching for leadership development is one intervention often used to create organisation-wide changes in culture and wellbeing. Leadership style has been associated with employee stress and wellbeing. Coaching has also been shown to improve individual level measures of wellbeing. However, almost all the research into the effectiveness of coaching interventions assumes a linear model of change, and expects that any flow-on effects are also linear. In other words, much of the research assumed that any change in the leader has relatively uniform effects on the wellbeing of others, and that these effects can be adequately accessed via standard linear statistical analyses. We argue that linear approaches do not take the complexity of organisations seriously, and that Complex Adaptive Systems theory (CAS) provides a useful non-linear approach to thinking about organisational change and the wellbeing of individuals embedded in these systems. The relatively new methodology of Social Network Analysis (SNA) provides researchers with analytic tools designed to access the relational components of complex systems. This paper reports on changes observed in the relational networks of an organisation following a leadership coaching intervention.
Methods
An AB design coaching intervention study was conducted across an organisation (N = 225). Wellbeing measures were taken for all employees and a social network analysis was conducted on the degree and quality of all organisational interactions. Twenty leaders (n = 20) received 8 coaching sessions. Individual self report measures of goal attainment as well as 360 feedbacks on transformational leadership were assessed in the control, pre and post intervention periods.
Results
A significant increase in the goal attainment, transformational leadership and psychological wellbeing measures were observed for those who received coaching. Average change in the perceived quality of interaction improved for those who received coaching. However there was a decline in the perceived quality of the interaction others believed they were having with those who were coached. It was also found that the closer any member of the network was identified as being connected to those who received coaching, the more likely they were to experience positive increases in wellbeing.
Conclusions
This research highlights the influence of leadership coaching beyond the individual leader, and has important implications for organisational wellbeing initiatives and how we measure the impact of interventions aimed at organisational change. Our findings suggest a more nuanced approach is needed in designing interventions in complex adaptive systems.
Drawing from research on personal resources (e.g., Baumeister, Bratslavsky, Muraven, & Tice, 1998; Fredrickson, 1998) and the episodic nature of work (Beal, Weiss, Barros, & MacDermid, 2005), we examine research and theory relevant to the study of momentary recovery in the workplace. Specifically, we propose that the nature of within workday breaks influences the levels of psychological resources, which in turn influence various workplace outcomes. First, we discuss the momentary approach to studying workplace breaks and consequent resource levels. In doing so, we distinguish between two types of breaks, respites and chores; and we detail two types of psychological resources, regulatory and affective resources. Consequences of psychological resource levels on emotional exhaustion and performance are considered. We also explore possible moderators of the proposed relationships; we discuss job and individual characteristics, and motivation to perform. Finally, we conclude the chapter with a brief discussion on future research and possible applications of the momentary approach to work recovery in organizations.
hriving describes an individual's experience of vitality and learning. The primary goal of this paper is to develop a model that illuminates the social embeddedness of employees' thriving at work. First, we explain why thriving is a useful theoretical construct, define thriving, and compare it to related constructs, including resilience, flourishing, subjective well-being, flow, and self-actualization. Second, we describe how work contexts facilitate agentic work behaviors, which in turn produce resources in the doing of work and serve as the engine of thriving. Third, we describe how thriving serves as a gauge to facilitate self-adaptation at work. We conclude by highlighting key theoretical contributions of the model and suggesting directions for future research.
Although energy is a concept that is implied in many motivational theories, is hardly ever explicitly mentioned or researched. The current article first relates theories and research findings that were thus far not explicitly related to energy. We describe theories such as flow, subjective well-being, engagement and burn-out, and make the link with energy more explicit. Also, we make a first link between personality characteristics and energy, and describe the role of leadership in unleashing followers’ energy. Following, we identify how the topic of energy management can be profitably incorporated in research from a scientific as well as a practitioner viewpoint. Finally, we describe several interventions to enhance energy in individuals and organizations.
Objectives
Prior research has focused on the association between negative affect and eating behaviour, often utilizing laboratory or cross-sectional study designs. These studies have inherent limitations, and the association between positive affect and eating behaviour remains relatively unexplored. Therefore, the objective of this study was to investigate the bidirectional relationships between daily negative and positive affective experiences and food consumption in a naturalistic setting among healthy young adults. DesignDaily diary study across 21days (microlongitudinal, correlational design). MethodsA total of 281 young adults with a mean age of 19.9 (1.2)years completed an Internet-based daily diary for 21 consecutive days. Each day they reported their negative and positive affect, and their consumption of five specific foods. Hierarchical linear modelling was used to test same-day associations between daily affect and food consumption, and next-day (lagged) associations to determine directionality. Moderating effects of BMI and gender were also examined in exploratory analyses. ResultsAnalyses of same-day within-person associations revealed that on days when young adults experienced greater positive affect, they reported eating more servings of fruit (p=.002) and vegetables (p<.001). Results of lagged analysis showed that fruits and vegetables predicted improvements in positive affect the next day, suggesting that healthy foods were driving affective experiences and not vice versa. Meaningful changes in positive affect were observed with the daily consumption of approximately 7-8 servings of fruit or vegetables. Conclusions
Eating fruit and vegetables may promote emotional well-being among healthy young adults.
Compassion, and especially self-compassion, are commonly understood as being antithetical to leadership and organisational success. In this article, a review of research from different scientific disciplines indicates that these positive affiliative emotions are as much a part of human survival and wellbeing, as are the need for personal safety and achievement. Counter-intuitively, this research indicates that allowing for self-compassion can influence increases in personal and organisational achievement. In the second part of the paper, a model of coaching is presented that can support the development of self-compassion, as well as organisation-wide compassion. We propose that experienced executive coaches can enhance business leaders’ self-compassion in three phases. The first gauges and leverages the client’s readiness for increasing self-compassion. In the second phase, noticing, feeling and responding to suffering are applied to the client’s lived experiences. Finally, the executive coach uses four coaching dimensions to inform actions in client meetings that help to enhance self-compassion. In the final section of the paper indications for future research in the area of self-compassion as a leadership asset are provided.
The spread of the SARSCov2 virus presents an unprecedented event that rapidly introduced widespread life threat, economic de-stabilization, and social isolation. The human nervous system is tuned to detect safety and danger, integrating body and brain responses via the autonomic nervous system. Polyvagal Theory provides a perspective to understand the impact of the pandemic on mental and physical health. This perspective highlights the important role of the state of the autonomic nervous system in exacerbating or dampening threat reactions to the pandemic. In addition, the theory alerts us to the impact of clinical history (e.g., trauma) on autonomic regulation as an important compounding risk factor lowering the threshold to behaviorally and physiologically destabilize in response to the pandemic. The theory provides a strategy to dampen the adverse reactions to threat (e.g., acute stress disorders) through portals of social engagement that evolved to downregulate defenses to promote calmness and connectedness.
The power of gender difference, not gender equality, is a secret source for success. Some smart businesses are starting to wake up to this fact. This book explores why and how.
Properly valuing brain gender diversity in the workplace is one of the biggest and largely untapped sources of competitive advantage for modern businesses. Recent advances in neuroscience provide the key to unlocking it.
Modern research shows that there are gender-based differences in the brain – it’s just not as simple as a binary between a ‘male brain’ and ‘female brain’. In fact, our brains are like a mosaic where many of the tiles are available in thousands of shades on a spectrum between pink and blue. The problem is that our workplaces tend to be governed by structures, processes and cultures that are practically pure blue. All the brains in the business that are elsewhere on the spectrum cannot thrive as they might, so sources of productivity, creativity and agility go untapped.
Anyone who manages people needs to understand how the brain works and the impact it has on how people work together as teams. Anyone who wants to unlock the talent and productivity of all of their people needs to understand how recent findings around male- and female-type brains should shape the way they manage.
Leading applied neuroscientists and international corporate coaches Kate Lanz and Paul Brown show you why and how to access all the brains in your business.
As clinicians, we sometimes fail to look after ourselves properly and do not regularly eat healthy foods or drink enough. Sleep is another factor that we often neglect. A lack of it can compromise our personal health and performance at work, and the "sleep debt" that results when this is chronic can take far longer to recover from than one might think. Now that junior doctors work more shift rotas and senior colleagues have onerous on-call responsibilities, we all need to be aware of the effects of sleep deprivation, which can lower the mood and motivation, weaken leadership, and result in more clinical errors. In this review we consider what might constitute enough sleep, the consequences of inadequate sleep, and how these might be addressed for surgeons.
We live in a time of massive institutional failure that manifests in the form of three major divides: the ecological, the social, and the spiritual. Addressing these challenges requires a new consciousness and collective leadership capacity. In this groundbreaking book, Otto Scharmer invites us to see the world in new ways and in so doing discover a revolutionary approach to learning and leadership.
In most large systems today, we collectively create results that no one wants. What keeps us stuck in such patterns of the past? It’s our blind spot, that is, our lack of awareness of the inner place from which our attention and intention originate. By moving through Scharmer’s U process, we consciously access the blind spot and learn to connect to our authentic Self—the deepest source of knowledge and inspiration. Theory U offers a rich diversity of compelling stories, examples, exercises, and practices that allow leaders, organizations, and larger systems to cosense and coshape the future that is wanting to emerge.
This article provides a theoretical review of the developmental origins of children's “folk theories” about the nature of the self, linking theoretical developments in philosophy with empirical discoveries from developmental psychology. The article first reviews children's views about the material nature of the self, outlining evidence that children naturally think about the self as distinct from the body. It then discusses children's understanding of the persistence of the self over time and, finally, explores children's views about conflict within the self. Together, these findings suggest that preschoolers possess stable, coherent, and predictive theories about the nature of the self that are stable across individuals, early emerging, and in some cases undergo interesting developmental change.
We live in a world that is volatile, uncertain, complex and ambiguous, in which our work and lives are constantly disrupted and changing. But coaches and leaders are still trained to operate within stable models with a uni-focus on performance. Coaches are starting to question the remit of 'raising performance' within existing systems, many of which are outdated, dysfunctional and even toxic. The role of the coach today must evolve to become fit for purpose in challenging times and coaching must re-articulate its values, as the essential compass for navigating turbulent waters. In The Future of Coaching, Hetty Einzig examines the role of coaching and leadership in the twenty-first century, and sets out a compelling vision for its future. Drawing on experience gained over twenty-five years of coaching leaders in the corporate and public sectors, in the UK and globally, she challenges the tenet of coaching neutrality. Rather than simply following the client agenda, she encourages coaches to see themselves as partners in courageous leadership and to work towards building an ethical, holistic and networked coaching approach to help create businesses that serve society and our globalised world. The book asks essential questions of coaches working today: how can leaders and coaches become 'positive deviants' and transform the rules of the game within cultures where denial and group-think are rife? How can coaches work with the anxious and depressed, embracing the dark as well as the light? Are coaches prepared for the rise of Millennials, women leaders and those over sixty (the Third Acters)? Einzig challenges the model of the Strong Leader in favour of Respons-able leadership based on authentic strength, distributed power and responsive thinking. And she shows how this vision of a transformed workplace is essential for the transformations society must undertake to reclaim a positive future. This thought provoking collection of essays, designed to be read in any order, is enlightening and inspiring reading for coaches in practice and in training, HR and L&D professionals and for leaders everywhere.
A leading MIT social scientist and consultant examines five professions--engineering, architecture, management, psychotherapy, and town planning--toshow how professionals really go about solving problems.
The Handbook of Coaching Psychology provides a clear perspective on this emerging area of professional practice. The book begins with a mixture of personal and factual narratives on the historical and current context of coaching and coaching psychology. Stephen Palmer, Alison Whybrow and leading coaching psychologists and coaches outline recent developments in the profession, providing the reader with straightforward insights into the application of eleven different psychological approaches to coaching practice, including:
solution focused coaching
psychodynamic and systems-psychodynamic coaching
narrative coaching
cognitive behavioural coaching.
Part three of the book considers the coach-client relationship, coach development and professional boundaries, together with issues of diversity and sustainability. The final part covers coaching initiatives in organisations and supervision followed by an introduction to professional bodies and available resources.
In this paper we build from the theory of energetic activation to highlight the role energizing interactions play in relation to performance and turnover. We theorize that the association between energizing interactions within organizations and turnover is mediated by individual performance. We test our hypotheses using longitudinal network data collected annually within the IT department of a global engineering consulting firm over a fouryear period. Our study shows that when an individual perceives their interactions with others inside the organization as increasing their level of energetic activation, they have a reduced likelihood of voluntary turnover, but that this relationship is mediated by individual performance. Perceiving interactions as increasing energetic activation results in higher performance, which in turn actually increases voluntary turnover. In contrast, when others perceive interactions with the focal actor as increasing their level of energetic activation it reduces the focal actor's risk of involuntary turnover. This relationship is also mediated by performance. When others within the organization perceive interactions with the focal actor as increasing their level of energetic activation, it results in the focal actor having higher performance, which in turn reduces the focal actor's involuntary turnover. In conclusion, we note that our findings are specific to knowledge workers with IT skills and may not be generalizable to all employees. We also suggest implications for managers and potential areas for future research.
Drawing on gestalt characteristics theory, we advance the literature on the effect of job complexity on employee well-being by considering intra-individual variability of job complexity over time. Specifically, we examine how the trend, or trajectory, of job complexity over time can explain unique variance of employee job strain. Across two longitudinal data sets, we consistently find that, with the average level of job complexity during a given period held constant, a positive job complexity trajectory (i.e., an increasing trend in complexity) is associated with higher employee job strain. Based on job-demand-control theory and the exposure-reactivity model, we further establish that job autonomy and employee emotional stability jointly moderate the relationship between job complexity trajectory and employee job strain. Specifically, for employees with high emotional stability, job autonomy mitigates the job strain brought by positive job complexity trajectory, whereas for employees with low emotional stability, job autonomy does not help to reduce the adverse effect of the increasing trend. These findings not only contribute to extend the understanding of the job complexity – strain relationship, but also suggest a promising, dynamic avenue to study the effects of work characteristics on employee well-being as well as other outcomes. Copyright
Background:
Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practising physicians. The consequences are negative effects on patient care, professionalism, physicians' own care and safety, and the viability of health-care systems. A more complete understanding than at present of the quality and outcomes of the literature on approaches to prevent and reduce burnout is necessary.
Methods:
In this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, and the Education Resources Information Center from inception to Jan 15, 2016, for studies of interventions to prevent and reduce physician burnout, including single-arm pre-post comparison studies. We required studies to provide physician-specific burnout data using burnout measures with validity support from commonly accepted sources of evidence. We excluded studies of medical students and non-physician health-care providers. We considered potential eligibility of the abstracts and extracted data from eligible studies using a standardised form. Outcomes were changes in overall burnout, emotional exhaustion score (and high emotional exhaustion), and depersonalisation score (and high depersonalisation). We used random-effects models to calculate pooled mean difference estimates for changes in each outcome.
Findings:
We identified 2617 articles, of which 15 randomised trials including 716 physicians and 37 cohort studies including 2914 physicians met inclusion criteria. Overall burnout decreased from 54% to 44% (difference 10% [95% CI 5-14]; p<0·0001; I(2)=15%; 14 studies), emotional exhaustion score decreased from 23·82 points to 21·17 points (2·65 points [1·67-3·64]; p<0·0001; I(2)=82%; 40 studies), and depersonalisation score decreased from 9·05 to 8·41 (0·64 points [0·15-1·14]; p=0·01; I(2)=58%; 36 studies). High emotional exhaustion decreased from 38% to 24% (14% [11-18]; p<0·0001; I(2)=0%; 21 studies) and high depersonalisation decreased from 38% to 34% (4% [0-8]; p=0·04; I(2)=0%; 16 studies).
Interpretation:
The literature indicates that both individual-focused and structural or organisational strategies can result in clinically meaningful reductions in burnout among physicians. Further research is needed to establish which interventions are most effective in specific populations, as well as how individual and organisational solutions might be combined to deliver even greater improvements in physician wellbeing than those achieved with individual solutions.
Funding:
Arnold P Gold Foundation Research Institute.
Background
Fatigue in military operations leads to safety and operational problems due to a decrease in alertness and performance. The primary method of counteracting the effects of sleep deprivation is to increase nightly sleep time, which in operational situations is not always feasible. History has taught us that surgeons and surgical teams are finite resources that cannot operate on patients indefinitely.
Methods
A systematic review was conducted using the search terms ‘sleep’ and ‘deprivation’ examining the impact of sleep deprivation on cognitive performance in military surgical teams. Studies examining outcomes on intensive care patients and subjects with comorbidities were not addressed in this review.
Results
Sleep deprivation in any ‘out-of-hours’ surgery has a significant impact on overall morbidity and mortality. Sleep deprivation in surgeons and surgical trainees negatively impacts cognitive performance and puts their own and patients' health at risk. All published research lacks consensus when defining ‘sleep deprivation’ and ‘rested’ states. It is recognised that it would be unethical to conduct a well-designed randomised controlled trial, to determine the effects of fatigue on performance in surgery; however, there is a paucity between surrogate markers and applying simulated results to actual clinical performance. This requires further research. Recommended methods of combating fatigue include: prophylactically ‘sleep-banking’ prior to known periods of sleep deprivation, napping, use of stimulant or alerting substances such as modafinil, coordinated work schedules to reduce circadian desynchronisation and regular breaks with enforced rest periods.
Conclusions
A forward surgical team will become combat-ineffective after 48 hours of continuous operations. This systematic review recommends implementing on-call periods of no more than 12 hours in duration, with adequate rest periods every 24 hours. Drug therapies and sleep banking may, in the short term, prevent negative effects of acute sleep deprivation.
While several studies show that leaders frequently lack sleep, little is known about how this influences leadership behaviour. The present study encompasses an experiment that investigated how three main types of leadership behaviour: transformational (four sub-facets); transactional (two sub-facets); and passive-avoidant (two sub-facets) leadership differed across a rested and a long-term, partially sleep-deprived condition. A total of 16 military naval officers participated. In both conditions, the leaders managed a team of three subordinates in a navy navigation simulator, instructed to complete a specific mission (A or B). Both sleep state (rested or sleep deprived) and mission were counterbalanced. Leadership behaviour was video recorded and subsequently rated on the three leadership behaviours. Overall, the scores on transformational leadership (and on two of four sub-facets) and transactional leadership (on both sub-facets) decreased from the rested to sleep-deprived condition, whereas scores on passive-avoidant leadership overall (and on both sub-facets) increased from the rested to sleep-deprived condition. This study underscores the importance of including sleep as a potentially important determinant when assessing leadership effectiveness.
Objective:
Caregivers of terminally ill patients may experience anticipatory grief or low levels of preparedness for the patient's impending death. Both concepts are related to a forewarning of the impending loss. Anticipatory grief has been suggested to be grief work before the loss, which would improve bereavement outcome, but recent studies indicate a negative impact. Hence, this review systematically investigates key issues relating to anticipatory grief and preparedness for the death; definitions, measurement tools, and potential effects on caregiver outcome.
Methods:
We used a systematic approach (PRISMA statement). Databases were searched for publications during 1990-2015. Studies on adult caregivers of terminally ill adult patients were included if anticipatory grief or preparedness was assessed by a measurement tool.
Results:
Anticipatory grief was captured in the definition "pre-loss grief." High levels of grief and low levels of preparedness during caregiving were associated with poor bereavement outcome such as complicated grief.
Conclusions:
The assumptions that grief work before the loss would alleviate bereavement outcome was not confirmed. Thus, the concept of anticipatory grief is questioned. High preparedness was associated with improved caregiver outcome. Additional support should be given to caregivers with pre-loss grief and low preparedness.
If you think that intelligence emanates from the mind and that reasoning necessitates the suppression of emotion, you'd better think again-or rather not “think” at all. In his provocative new book, Guy Claxton draws on the latest findings in neuroscience and psychology to reveal how our bodies–long dismissed as mere conveyances–actually constitute the core of our intelligent life. From the endocrinal means by which our organs communicate to the instantaneous decision-making prompted by external phenomena, our bodies are able to perform intelligent computations that we either overlook or wrongly attribute to our brains.Embodied intelligence is one of the most exciting areas in contemporary philosophy and neuropsychology, and Claxton shows how the privilege given to cerebral thinking has taken a toll on modern society, resulting in too much screen time, the diminishment of skilled craftsmanship, and an overvaluing of white–collar over blue–collar labor. Discussing techniques that will help us reconnect with our bodies, Claxton shows how an appreciation of the body's intelligence will enrich all our lives.
Although it has been suggested that many in the general population are dehydrated to the extent that mood and cognition are disrupted, there has been little research investigating mild levels of dehydration. When dehydration reduces body mass by more than 2%, it has been consistently reported that mood is influenced, fatigue is greater, and alertness is lower. In contrast, the effects on cognition have been less consistent. Only a few studies have looked at females and these studies made little attempt to consider hormones that influence kidney functioning. In particular, there has been virtually no attempt to look at changes in hydration status in the range that occurs in individuals with a sedentary lifestyle in a temperate climate. There is a consequent need to study individuals who have lost up to 1% of body mass due to dehydration. While 4 intervention trials have found that the cognition of children improved in response to water consumption, the effects of water consumption on cognition in older adults, another high-risk group, have been largely ignored.
We examined energy management during work, recovery experiences after work and their connections to health, work engagement, and job performance.
An online survey was completed by 1208 Finnish employees. Energy management was assessed through 13 strategies and recovery experiences through four experiences. As outcomes of recovery, we examined self-reported health, work engagement, and job performance.
On average, employees applied three energy management strategies. The most beneficial strategies were work-related: shifting focus, goal setting, and helping coworkers. Both energy management and recovery experiences contributed to the outcomes.
Employees benefit in terms of energy from shifting their focus to positive aspects of their jobs and demonstrating proactive social behavior at work. Recovery processes during and after work are closely connected to each other, to well-being and performance at work.
Physical activity may regulate affective experiences at work, but controlled studies are needed and there has been a reliance on retrospective accounts of experience. The purpose of the present study was to examine the effect of lunchtime walks on momentary work affect at the individual and group levels. Physically inactive employees (N = 56; M age = 47.68; 92.86% female) from a large university in the UK were randomized to immediate treatment or delayed treatment (DT). The DT participants completed both a control and intervention period. During the intervention period, participants partook in three weekly 30-min lunchtime group-led walks for 10 weeks. They completed twice daily affective reports at work (morning and afternoon) using mobile phones on two randomly chosen days per week. Multilevel modeling was used to analyze the data. Lunchtime walks improved enthusiasm, relaxation, and nervousness at work, although the pattern of results differed depending on whether between-group or within-person analyses were conducted. The intervention was effective in changing some affective states and may have broader implications for public health and workplace performance.
Rapidly emerging evidence continues to describe an intimate and causal relationship between sleep and emotional brain function. These findings are mirrored by long-standing clinical observations demonstrating that nearly all mood and anxiety disorders co-occur with one or more sleep abnormalities. This review aims to (a) provide a synthesis of recent findings describing the emotional brain and behavioral benefits triggered by sleep, and conversely, the detrimental impairments following a lack of sleep; (b) outline a proposed framework in which sleep, and specifically rapid-eye movement (REM) sleep, supports a process of affective brain homeostasis, optimally preparing the organism for next-day social and emotional functioning; and (c) describe how this hypothesized framework can explain the prevalent relationships between sleep and psychiatric disorders, with a particular focus on posttraumatic stress disorder and major depression. Expected final online publication date for the Annual Review of Clinical Psychology Volume 10 is March 20, 2014. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
The present study examined the link between self-compassion and concern for the well-being of others. Other-focused concern variables included compassion for humanity, empathetic concern, perspective taking, personal distress, altruism and forgiveness. Participants included 384 college undergraduates, 400 community adults, and 172 practicing meditators. Among all participant groups, higher levels of self-compassion were significantly linked to more perspective taking, less personal distress, and greater forgiveness. Self-compassion was linked to compassion for humanity, empathetic concern, and altruism among community adults and meditators but not college undergraduates. The strength of the association between self-compassion and other-focused concern also varied according to participant group and gender. The strongest links tended to be found among meditators, while women tended to show weaker associations than men.
Leistung, Gesundheit und Glück beruhen auf dem ausgewogenen und geschickten Einsatz von Energie: Mit dieser klaren Prämisse
vereinfacht und revolutioniert das Autorenduo die Art und Weise, wie wir mit Hindernissen und Leistungsbarrieren in unserem
persönlichen wie beruflichen Umfeld umgehen. Das „Power of Full Engagement-Trainingsystem“ ist denn auch weniger eine Arbeitsweise
als vielmehr eine elementare Lebensphilosophie.