Relationship Between Depression and Stress Coping Ability Among Residents in Japan: A Two-Year Longitudinal Study

Abstract

BackgroundDepression among medical residents is a critical issue. The early detection of depression and provision of appropriate care is necessary for fostering healthy conditions during clinical training. To investigate whether Sense of Coherence (SOC), an indicator of stress coping ability, could be a predictor of depression 2 years after the start of clinical training, we conducted a national longitudinal study.MethodsWe distributed self-administered questionnaires to residents in 251 postgraduate educational hospitals just before the start of their clinical training. The questionnaire contained the Center for Epidemiologic Studies Depression (CES-D) scale (a screening tool for depression), the SOC scale, and demographic factors. After 2 years, we distributed questionnaires to residents who responded to the first survey. The second questionnaire contained the CES-D scale and questions about working conditions. We categorized respondents into three groups according to their SOC score and analyzed the relationship between SOC groups (low, middle, high) and depressive symptoms on the follow-up survey.ResultsIn total, 1,738 of 2,935 residents (59.2%) responded to the first survey. Of these, 1,169 residents (67.3%) also responded to the follow-up survey. A total of 169 residents were excluded because they screened positive for depressive symptoms at the time of the first survey. On the follow-up survey, 187 residents (19.5%) had new-onset depressive symptoms: 33.3% in the low SOC group, 18.2% in the middle SOC group, and 11.4% in the high SOC group (P < 0.01). Compared with the high SOC group, the odds ratio for new-onset depressive symptoms in the low SOC group was 2.04 (95% confidence interval, 1.02 - 4.05) after adjusting for demographic factors, baseline CES-D score, and mean working time.ConclusionsSOC score is significantly associated with future depressive symptoms among residents after 2 years. Residents in the low SOC group had a 2-fold higher risk of future depressive symptoms than those in the high SOC group. The SOC scale might be a useful predictor of future depression and allow for the provision of appropriate support to residents during clinical training.

Sense of Coherence and Work Stress or Well-Being in Care Professionals: A Systematic Review

“…Lindmark et al [ 42 ] explored the work environment and psychosocial health of Public Dental Service employees in a Swedish county. The results showed higher scores for SOC and job satisfaction in staff in small-sized clinics, and those younger than 40 years had higher scores for meaningfulness, happiness, job satisfaction, and autonomy.…”

Assessment of Clinical Leadership Training Needs in Senior Pediatric Residents

“…1 - 7 Resident responses also indicate an overall desire for applied leadership skills training in the content areas covered by the 4 themes. Additionally, the high prevalence of depression and burnout within graduate medical education 32 - 36 is often attributed to the “hidden curriculum,” 37 , 38 which involves implicit standards of conduct that govern behaviors, beliefs, and attitudes that have been deemed inappropriate yet perpetuated. 38 - 41 Clinical leadership skills training would address the hidden curriculum by explicitly redefining appropriate standards of conduct and actively engaging physicians, ultimately leading to improved clinical outcomes.…”

Análise do Senso de Coerência, ansiedade e depressão em alunos de pós-graduação: Estudo follow up

“…Em relação ao senso de coerência, o presente estudo apresentou um aumento de valor dos participantes da primeira coleta (48,8%) para o segundo momento (55,1%). Ito et al (2018) realizou um estudo follow-up em estudantes japoneses onde na primeira coleta de dados, dos 1.738 respondentes iniciais, 169 residentes testaram positivo para sintomas depressivos, na segunda coleta de dados 187 residentes (19,5%) reportaram sintomas depressivos, dos quais 33,3% apresentaram um baixo SOC e 11,4% alto. Ainda nesse estudo, o escore SOC estava significativamente relacionado a depressão entre médicos residentes 2 anos após o início de treinamento clínico (Ito et al, 2018).…”

“…Ito et al (2018) realizou um estudo follow-up em estudantes japoneses onde na primeira coleta de dados, dos 1.738 respondentes iniciais, 169 residentes testaram positivo para sintomas depressivos, na segunda coleta de dados 187 residentes (19,5%) reportaram sintomas depressivos, dos quais 33,3% apresentaram um baixo SOC e 11,4% alto. Ainda nesse estudo, o escore SOC estava significativamente relacionado a depressão entre médicos residentes 2 anos após o início de treinamento clínico (Ito et al, 2018). Na avaliação da resiliência, Garista et al (2019), em seu estudo apresentou uma interpretação da aprendizagem acadêmica com fundamentos da teoria salutogênica em um curso de pós-graduação em Promoção e Educação para a Saúde, da Universidade de Perugia, Itália no qual estudantes pós-graduandos desenharam como se sentiam no início e final do curso e explanaram sobre os desenhos, associando a reflexões sobre o que era a salutogênese e o que podiam considerar uma aplicação clara para o processo de aprendizagem.…”