Post-traumatic growth among general surgery residents during the COVID-19 pandemic: Emerging stronger in the face of adversity

Abstract

The life-threatening risk of the COVID-19 pandemic has caused considerable mental health problems including anxiety, depression, and post-traumatic stress disorder in healthcare workers. 1,2 Although people respond to adversity and stress in various ways, there is evidence that people can positively change their perspectives and experience personal growth as a result of major life crisis or traumatic events. This process is known as post-traumatic growth (PTG) and was first described by Tedeschi and Calhoun in 1996. 3 PTG is characterized by positive adjustments that occur following severe traumatic experiences and includes five major aspects: forging stronger relationships with others, increased perception of personal strength, willingness to embrace new possibilities, deeper appreciation of life, and increased spirituality. 3 Since the COVID-19 pandemic, researchers have refocused their lens on assessing the PTG of front-line health care workers such as doctors and nurses. However, research to date has not investigated PTG in general surgery residents during the COVID-19 pandemic. As such, in December of 2020 we conducted an IRB-approved, multi-center survey of general surgery residents from four academic medical centers in Boston, MA. The survey consisted of 23-questions, including a modified Post-Traumatic Growth Inventory (PTGI) (supplement). 4 A total of 75 of 172 surveys were completed, for an overall response rate of 43.6%. Both female (46.7%) and male (53.3%) residents participated. The most positive COVID-19 related change reported by the surveyed general surgery residents was the feeling that they can rely on people in times of trouble, followed by increased compassion for others, greater sense of personal resilience, greater appreciation for their own life's value, greater sense of closeness with others and increased relationship efforts, changed priorities about what is important in life, increased willingness to express emotions and try to change situations that they are unsatisfied with, increased appreciation of each day, and appreciation of new opportunities (Fig. 1). Interestingly, our study showed that female residents reported greater growth than male residents in all components of the PTGI.

Posttraumatic Growth in Radiation Medicine During the COVID-19 Outbreak

“…A wide array of publications on PTG during COVID-19 have appeared in the literature using the PTGI survey instrument. [18][19][20][21][22][23][24][25][26] Given the interest in enhancing coping with future events and the unique challenges in radiation therapy, 27 in this work we sought to assess, using the PTGI instrument, whether our staff members in radiation medicine experienced and maintained such growth at the individual level. Organizational PTG has been recently presented in the literature to suggest that organizations may also exceed prior levels of functioning through cognitive, emotional, and structural responses to a traumatic event that disrupts core activities.…”

Health Behavior Change in Post-Traumatic Stress Disorder: Patient Perspectives

“…Physical health interventions, such as regular exercise and nutrition plans, are also vital, as they directly address the physical symptoms and improve overall well-being (Mottershead & Ghisoni, 2021). Adaptive coping mechanisms, such as developing resilience and positive thinking, further support the maintenance of health behavior changes (Rasic et al, 2022).…”

“…Despite the challenges, many individuals with PTSD experience post-traumatic growth, developing greater P E-ISSN: 3041-8542 resilience and strength as they navigate their recovery. This phenomenon has been observed among healthcare workers during the COVID-19 pandemic, who have reported emerging stronger in the face of adversity (Rasic et al, 2022). Understanding the factors that contribute to posttraumatic growth can inform strategies for promoting health behavior change and improving overall well-being.…”

Physicians' Resilience as a Positive Effect of COVID-19

“…Chinese students after the COVID-19 crisis developed PTG, who showed more positive coping and cognitive strategies and maintained higher levels of resilience (29) . During COVID-19, PTG was observed in nurses, medical students, and residents (30) , (31) , (32) . Subjective well-being was widened by the COVID-19 pandemic in 2020 in Japan through the Online Panel Survey of Social Stratification and Psychology (33) .…”