National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (3)
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- Behavioral Health (20)
- Burnout (12)
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- (-) Stress (71)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 50 of 71 Research Studies DisplayedKroth PJ, Morioka-Douglas N, Veres S
Association of electronic health record design and use factors with clinician stress and burnout.
The authors sought to determine which electronic health record (EHR) design and use factors are associated with clinician stress and burnout and to identify other sources that contribute to this problem. Surveying ambulatory primary care and subspecialty clinicians from 3 institutions, they found that, although EHR design and use factors are associated with clinician stress and burnout, other challenges, such as chaotic clinic atmospheres and workload control, explain considerably more of the variance in these adverse clinician outcomes.
AHRQ-funded; HS022065.
Citation: Kroth PJ, Morioka-Douglas N, Veres S .
Association of electronic health record design and use factors with clinician stress and burnout.
JAMA Netw Open 2019 Aug 2;2(8):e199609. doi: 10.1001/jamanetworkopen.2019.9609..
Keywords: Burnout, Stress, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider: Clinician, Provider: Physician, Provider: Nurse
Papaleontiou M, Reyes-Gastelum D, Gay BL
Worry in thyroid cancer survivors with a favorable prognosis.
Researchers investigated cancer-related worry in thyroid cancer survivors with favorable prognosis. A diverse cohort of patients diagnosed with differentiated thyroid cancer, selected from the Surveillance, Epidemiology, and End Results (SEER) Program registries were surveyed for two to four years after diagnosis. The researchers recommended that physicians be aware that worry is a major issue for thyroid cancer survivors with favorable prognosis. Efforts should be undertaken to alleviate worry, especially among vulnerable groups, including female patients, younger patients, those with lower education, and racial/ethnic minorities.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Reyes-Gastelum D, Gay BL .
Worry in thyroid cancer survivors with a favorable prognosis.
Thyroid 2019 Aug;29(8):1080-88. doi: 10.1089/thy.2019.0163..
Keywords: Cancer, Anxiety, Stress, Health Status
Anton NE, Mizota T, Whiteside JA
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
The authors hypothesize that surgery residents trained on mental skills would outperform controls under increased stress conditions in the simulated operating room. They find that their comprehensive mental skills curriculum implemented with surgery residents at two institutions was effective at minimizing the deterioration of resident technical performance under stressful conditions compared with controls. They conclude that their results provide further evidence for the effectiveness of mental skills training to optimize surgery trainees' technical performance during challenging clinical situations.
AHRQ-funded; R18 HS022080.
Citation: Anton NE, Mizota T, Whiteside JA .
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
Surgery 2019 Jun;165(6):1059-64. doi: 10.1016/j.surg.2019.01.011..
Keywords: Surgery, Education: Continuing Medical Education, Stress, Provider Performance, Training, Provider: Physician, Provider
Nocon RS, Fairchild PC, Gao Y
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
This study examined the impact of adopting the patient-centered medical home (PCMH) on clinicians and staff at primary care practices. A longitudinal study was done comparing baseline (201) and post-intervention (2013-2014) survey results. Five-hundred thirty-six providers and staff at baseline and 589 were surveyed post-intervention. Almost half of all clinics reported improved better job morale, job satisfaction, and freedom from burnout. However, there were some clinics that saw a decrease in the percentage of providers reporting high job satisfaction and freedom from burnout. Control clinics were not used in this study, so it is impossible to know if results were similar in non-PCMH primary care practices.
AHRQ-funded; HS000084.
Citation: Nocon RS, Fairchild PC, Gao Y .
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
J Gen Intern Med 2019 Jun;34(6):952-59. doi: 10.1007/s11606-019-04893-z..
Keywords: Burnout, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Provider, Provider: Clinician, Stress
Baskind MJ, Taveras EM, Gerber MW
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Psychosocial stress is associated with obesity in adult and pediatric populations, but few studies have examined the relationship between parent-perceived stress and risk of child obesity and related behaviors. In this study, the investigators studied 689 pairs of parents and children aged 2 to 12 in Massachusetts with a body mass index (BMI) at or above the 85th percentile. The investigators found that among children with overweight or obesity, parent-perceived stress was associated with fast-food consumption and physical activity.
AHRQ-funded; HS024332; HS022986.
Citation: Baskind MJ, Taveras EM, Gerber MW .
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Prev Chronic Dis 2019 Mar 28;16:E39. doi: 10.5888/pcd16.180368..
Keywords: Children/Adolescents, Family Health and History, Lifestyle Changes, Obesity, Obesity: Weight Management, Risk, Stress
Gowey MA, Khodneva Y, Tison SE
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
The purpose of this study was to describe the relationship between metabolic health parameters and depressive symptoms and perceived stress, and determine whether the co-occurrence of these two psychological stressors had an additive influence on metabolic dysregulation in adults at different levels of body mass index (BMI) without diabetes. The investigators found that elevated depressive symptoms in conjunction with high levels of perceived stress were more strongly associated with several parameters of metabolic health than only one of these psychological constructs in a large, diverse cohort of adults.
AHRQ-funded; HS023009; HS013852.
Citation: Gowey MA, Khodneva Y, Tison SE .
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
Int J Obes 2019 Mar;43(3):615-32. doi: 10.1038/s41366-018-0270-3..
Keywords: Depression, Behavioral Health, Obesity, Stress
Abelson JS, Chait A, Shen MJ
Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: a qualitative study.
This study researched the role that surgeons can play in managing stress in patients undergoing colorectal cancer surgery. Patients were interviewed in-depth using open-ended questions. While patients did not believe surgeons are responsible for helping them cope, they do believe that they can play a role in managing their distress.
AHRQ-funded; HS000066.
Citation: Abelson JS, Chait A, Shen MJ .
Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: a qualitative study.
Surgery 2019 Feb;165(2):461-68. doi: 10.1016/j.surg.2018.06.005..
Keywords: Cancer: Colorectal Cancer, Clinician-Patient Communication, Provider: Physician, Stress, Surgery
Brunwasser SM, Slavich GM, Newcomb DC
Sex-specific association between prenatal life stress exposure and infant pro-inflammatory cytokine levels during acute respiratory infection.
Prenatal life stress exposure is linked to dysregulated immune function and chronic inflammatory disease in offspring, but little is known about its effects on infant immune response during viral infection. To address this issue, the investigators examined associations between prenatal life stress exposure and infant upper-airway inflammatory markers during acute respiratory infection (ARI) using data from a prospective, population-based birth-cohort study (N=180).
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Slavich GM, Newcomb DC .
Sex-specific association between prenatal life stress exposure and infant pro-inflammatory cytokine levels during acute respiratory infection.
Brain Behav Immun 2019 Feb;76:275-79. doi: 10.1016/j.bbi.2018.12.002..
Keywords: Respiratory Conditions, Stress, Women
Elm JHL, Walls ML, Aronson BD
Sources of stress among Midwest American Indian adults with type 2 diabetes.
Investigators analyzed focus group transcripts of American Indian adults with type 2 diabetes from five tribal communities and classified stressors using an inductive/deductive analytical approach. They identified poverty, genocide, and colonization as fundamental causes of contemporary stress and health outcomes for American Indians and concluded that stressors are generally experienced as chronic, regardless of the duration of the stressor.
AHRQ-funded; HS024180.
Citation: Elm JHL, Walls ML, Aronson BD .
Sources of stress among Midwest American Indian adults with type 2 diabetes.
Am Indian Alsk Native Ment Health Res 2019;26(1):33-62. doi: 10.5820/aian.2601.2019.33..
Keywords: Diabetes, Chronic Conditions, Stress, Racial and Ethnic Minorities, Vulnerable Populations
Kim DH, Bassett SM, So S
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
This study assessed whether future orientation and self-esteem affected the relationship between family stress and mental health problems among African American youth in predominantly low-income neighborhoods. Youths (mainly female, average age 15.83 years old) were sampled for family stress, self-esteem, future orientation, mental health and other covariates such as gender and sexual orientation. A correlation was found between future orientation and self-esteem levels and family stress and mental health problems.
AHRQ-funded; HS000078.
Citation: Kim DH, Bassett SM, So S .
Family stress and youth mental health problems: self-efficacy and future orientation mediation.
Am J Orthopsychiatry 2019;89(2):125-33. doi: 10.1037/ort0000371..
Keywords: Children/Adolescents, Family Health and History, Low-Income, Behavioral Health, Racial and Ethnic Minorities, Stress, Vulnerable Populations
Frazier SE, Parker SH
Measurement of physiological responses to acute stress in multiple occupations: a systematic review and implications for front line healthcare providers.
The purpose of this review was to examine and synthesize empirical literature to identify studies assessing physiological responses to acute stress, determine common methods for measuring acute stress in near real-time, and identify common research designs employed across industries. The authors suggest that their review demonstrated that acute stress was primarily assessed retrospectively, and that there was a pragmatic gap in methodological approach, with many data collection methods inappropriate for the healthcare environment.
AHRQ-funded; HS023465.
Citation: Frazier SE, Parker SH .
Measurement of physiological responses to acute stress in multiple occupations: a systematic review and implications for front line healthcare providers.
Transl Behav Med 2019 Jan;9(1):158-66. doi: 10.1093/tbm/iby019..
Keywords: Provider, Stress
Burnett-Zeigler IE, Waldron EM, Hong S
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
In this study the investigators evaluated the feasibility of using an activity monitor to support mindfulness practice, reduce self-reported stress and physiological indicators of stress. They found that there were no significant changes in self-reported stress, depression, post-traumatic stress and mindfulness from baseline to eight-weeks; pulse pressure and standard deviation of pulse pressure increased over time; and those who were high on the non-judge mindfulness subscale had a lower standard deviation pulse pressure and spent less time stressed.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler IE, Waldron EM, Hong S .
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
Complement Ther Clin Pract 2018 Nov;33:93-99. doi: 10.1016/j.ctcp.2018.09.001..
Keywords: Depression, Health Information Technology (HIT), Behavioral Health, Patient-Centered Outcomes Research, Stress
Sutherland S, Brunwasser SM
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
This review evaluates the degree to which recent studies provide evidence that prenatal maternal stress (PNMS) has a varying effect on child health outcomes depending on the child's biological sex. “Stress” includes negative life events, psychological stress, and established stress biomarkers. A review of 50 peer-reviewed articles revealed that most found evidence of either sex-specific associations or significant PNMS (x) stress interactions for at least one outcome. Sex-dependent effects were strongest in the group of studies that evaluated child neural/nervous system development and temperament.
AHRQ-funded; HS022990.
Citation: Sutherland S, Brunwasser SM .
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
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Keywords: Children/Adolescents, Newborns/Infants, Outcomes, Pregnancy, Sex Factors, Stress
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
Garfield CF, Simon CD, Rutsohn J
Stress from the neonatal intensive care unit to home: paternal and maternal cortisol rhythms in parents of premature infants.
The purpose of the study was to examine cortisol diurnal rhythms, a physiologic marker of stress, over the transition from the critical care setting to home for fathers and mothers of very low-birth-weight infants, including how cortisol is associated with psychosocial stress and parenting sense of competence. The investigators noted that fathers may be especially susceptible to stressors during this transition.
AHRQ-funded; HS020316.
Citation: Garfield CF, Simon CD, Rutsohn J .
Stress from the neonatal intensive care unit to home: paternal and maternal cortisol rhythms in parents of premature infants.
J Perinat Neonatal Nurs 2018 Jul/Sep;32(3):257-65. doi: 10.1097/jpn.0000000000000296..
Keywords: Caregiving, Newborns/Infants, Newborns/Infants, Stress, Transitions of Care
Khandelwal N, Hough CL, Downey L
Prevalence, risk factors, and outcomes of financial stress in survivors of critical illness.
The objective was to describe the prevalence of financial stress among critically ill patients and their families and explore associations between financial stress and psychologic distress. It found that factors associated with financial stress included female sex, young children at home, and baseline financial discomfort. Also, financial stress after critical illness was common and associated with symptoms of anxiety and depression.
AHRQ-funded; HS022982.
Citation: Khandelwal N, Hough CL, Downey L .
Prevalence, risk factors, and outcomes of financial stress in survivors of critical illness.
Crit Care Med 2018 Jun;46(6):e530-e39. doi: 10.1097/ccm.0000000000003076.
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Keywords: Critical Care, Healthcare Costs, Risk, Patient-Centered Outcomes Research, Stress
Abelson JS, Chait A, Shen MJ
Sources of distress among patients undergoing surgery for colorectal cancer: a qualitative study.
The objective of this qualitative study was to explore sources of distress among colorectal cancer patients undergoing surgery. The investigators found that patients identified sources of stress at preoperative, in-hospital recovery and postoperative stages. Sources of stress included, but were not limited to: emotional reaction to diagnosis, negative emotional reaction to having a surgery, dealing with distressing physical symptoms and complications after surgery.
AHRQ-funded; HS000066.
Citation: Abelson JS, Chait A, Shen MJ .
Sources of distress among patients undergoing surgery for colorectal cancer: a qualitative study.
J Surg Res 2018 Jun;226:140-49. doi: 10.1016/j.jss.2018.01.017..
Keywords: Adverse Events, Cancer, Cancer: Colorectal Cancer, Stress, Surgery
Muzny CA, Perez AE, Eaton EF
Psychosocial stressors and sexual health among Southern African American women who have sex with women.
This study identifies psychosocial stressors, including sexual health, among Southern African American women who have sex with other women. Stressors included alcohol/drug use at last sexual encounter, and intimate partner violence (IPV). Incarceration was associated with STI history. All these stressors were also associated if they had sex with men.
AHRQ-funded; HS023009.
Citation: Muzny CA, Perez AE, Eaton EF .
Psychosocial stressors and sexual health among Southern African American women who have sex with women.
LGBT Health 2018 May/Jun;5(4):234-41. doi: 10.1089/lgbt.2017.0263..
Keywords: Racial and Ethnic Minorities, Sexual Health, Stress, Women
Anton NE, Beane J, Yurco AM
Mental skills training effectively minimizes operative performance deterioration under stressful conditions: results of a randomized controlled study.
This study demonstrated that giving residents mental skills training significantly increases performance during surgery under stressful conditions. A randomized controlled study was done with twenty-four residents to test laparoscopic suturing skills with and without external stressors. Both groups experienced decreased performance when stress was applied, but the group who had gone through the mental skills curriculum (MSC) significantly outperformed the control group. The researchers feel this finding supports including this training in the curriculum for surgical residents.
AHRQ-funded; HS22080.
Citation: Anton NE, Beane J, Yurco AM .
Mental skills training effectively minimizes operative performance deterioration under stressful conditions: results of a randomized controlled study.
Am J Surg 2018 Feb;215(2):214-21. doi: 10.1016/j.amjsurg.2017.09.039..
Keywords: Education: Continuing Medical Education, Education: Curriculum, Stress, Surgery
Kelley C, Lee B, Wilcox L
Self-tracking for mental wellness: understanding expert perspectives and student experiences.
Recent studies with college student populations have examined the feasibility of collecting everyday mood, activity, and social data. However, these studies do not account for students' experiences and challenges adopting self-tracking technologies to support mental wellness goals. In this paper, the authors present two studies conducted to better understand self-tracking for stress management and mental wellness in student populations.
AHRQ-funded; HS021393.
Citation: Kelley C, Lee B, Wilcox L .
Self-tracking for mental wellness: understanding expert perspectives and student experiences.
Proc SIGCHI Conf Hum Factor Comput Syst 2017 May 2;2017:629-41. doi: 10.1145/3025453.3025750..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health, Stress, Young Adults
Sawchuk CN, Roy-Byrne P, Noonan C
Panic attacks and panic disorder in the American Indian community.
The purpose of this study is to describe the epidemiology, clinical features, and comorbidities of panic attacks and panic disorder in two large American Indian tribes. It found that the prevalence and clinical features of panic attacks and panic disorder in American Indians were similar to epidemiologic studies with majority populations. However, in contrast to earlier research, panic symptoms were similar in both males and females, and different patterns of comorbidity emerged.
AHRQ-funded; HS010854.
Citation: Sawchuk CN, Roy-Byrne P, Noonan C .
Panic attacks and panic disorder in the American Indian community.
J Anxiety Disord 2017 May;48:6-12. doi: 10.1016/j.janxdis.2016.10.004.
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Keywords: Anxiety, Behavioral Health, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Stress
Krishnan S, York MK, Backus D
Coping with caregiver burnout when caring for a person with neurodegenerative disease: a guide for caregivers.
It is important for you to know if you have caregiver burnout, or the common triggers that may cause your burnout. By recognizing and addressing these factors, you will be able to take healthy and manageable control over your caregiver duties. The authors offer a number of specific recommendations to relieve caregiver stress and burden.
AHRQ-funded; HS022134.
Citation: Krishnan S, York MK, Backus D .
Coping with caregiver burnout when caring for a person with neurodegenerative disease: a guide for caregivers.
Arch Phys Med Rehabil 2017 Apr;98(4):805-07. doi: 10.1016/j.apmr.2016.11.002.
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Keywords: Caregiving, Neurological Disorders, Stress
Curtin CM, Kenney D, Suarez P
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
This trial tested whether perioperative administration of minocycline reduced time to pain resolution (TPR) after standardized hand surgeries with known prolonged pain profiles: carpal tunnel release and trigger finger release. It found that oral administration of minocycline did not reduce TPR after minor hand surgery. There was evidence that minocycline might increase length of pain in those with increased posttraumatic stress disorder symptoms.
AHRQ-funded; HS024096.
Citation: Curtin CM, Kenney D, Suarez P .
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
J Hand Surg Am 2017 Mar;42(3):166-74. doi: 10.1016/j.jhsa.2016.12.011.
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Keywords: Neurological Disorders, Medication, Pain, Stress, Surgery
Musey PI, Jr., Kline JA
Emergency department cardiopulmonary evaluation of low-risk chest pain patients with self-reported stress and anxiety.
This study aimed to was to measure the frequency of self-identified stress or anxiety among chest pain patients, and compare their pretest probabilities, care processes, and outcomes. It concluded that without prompting, 8 percent of patients self-identified "stress" or "anxiety" as the etiology for their chest pain. Most had low pretest probability, were over-investigated for acute coronary syndrome and pulmonary embolism and not investigated for anxiety syndromes.
AHRQ-funded; HS018519.
Citation: Musey PI, Jr., Kline JA .
Emergency department cardiopulmonary evaluation of low-risk chest pain patients with self-reported stress and anxiety.
J Emerg Med 2017 Mar;52(3):273-79. doi: 10.1016/j.jemermed.2016.11.022.
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Keywords: Anxiety, Emergency Department, Health Services Research (HSR), Pain, Stress
Stefanidis D, Anton NE, Howley LD
Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: results of a randomized controlled trial.
The researchers hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. They found that, compared to controls, the intervention group significantly improved their mental skill use, demonstrated higher laparoscopic skill improvement during retention, and reported less stress during the transfer test.
AHRQ-funded; HS022080.
Citation: Stefanidis D, Anton NE, Howley LD .
Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: results of a randomized controlled trial.
Am J Surg 2017 Feb;213(2):318-24. doi: 10.1016/j.amjsurg.2016.10.016.
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Keywords: Surgery, Training, Stress, Patient Safety