Journal of Clinical Psychology in Medical Settings最新文献

Mentoring plays an integral role in the success of faculty. This study explores faculty access to formal and informal mentorship and how mentorship impacts faculty engagement. Data are from 2020 to 2023 administrations of the StandPoint Faculty Engagement Survey. We compare clinically active faculty with a PhD or other health doctorate (OHD) in departments of psychiatry and neurology (Doctoral-PN) with both faculty with an MD or equivalent degree in those departments (Physician-PN), and with faculty with a PhD or OHD in other clinical departments (Doctoral-Other). Psychologists who are active in clinical care are represented in these departments although their representation likely varies by institution. Forty-four percent of Doctoral-PN faculty received formal mentoring and 65% received informal mentoring. Those receiving formal mentoring were more satisfied with professional development opportunities and reported increased understanding of promotion than those who were not. They were also more satisfied with their department and would recommend their medical school to others. The literature to date acknowledges the challenges to professional growth and advancement faced by Doctoral-PN faculty, including psychologists, practicing in academic health centers. This paper adds to previous research by presenting data on organizational outcomes associated with mentoring for these faculty.

Caregiving is a complex occupation, with a significant impact for informal caregivers (IC). Stress-process models propose a framework that considers that this impact depends on primary and secondary stressors, but also on the IC situation appraisal. This work aimed to verify: whether being, or not, an IC of an individual with dementia influenced the relationship between family functioning and burnout; the association between neuropsychiatric symptoms of the individual with dementia and IC burnout and whether the IC burden and perceived family functioning had a mediating role in such relationship. This cross-sectional study investigated differences in family functioning and its association with burnout between IC and non-IC. For IC specifically, the study examined a mediation model to explore the possibility of neuropsychiatric symptoms indirectly affecting IC burnout through the impact on family functioning and burden. Measures included the Copenhagen Burnout Inventory, the McMaster Family Assessment Device, the Neuropsychiatric Inventory, and the Zarit Burden Interview. Results showed an association between poorer family function and high burnout, specifically in IC. They also showed that burden mediated the relationship between neuropsychiatric symptoms and burnout. The findings offer a significant contribution to the growing knowledge about the relationship between stressors associated with informal caregiving in dementia context, such as neuropsychiatric symptoms and its outcomes, like burnout.

Healthcare leaders must increasingly attend to the monumental challenges facing their organizations (Angood and Falcone, American Association for Physician Leadership, 2023). As such, leadership in healthcare settings demands new skills sets amongst healthcare professionals that transcend the technical skills of any given profession. Academic health center psychologists are well-positioned to contribute to the leadership of academic health centers due to knowledge, skills, and attitudes fostered in doctoral psychology education, practice, and research through the focus on Profession-Wide Competencies. This article calls for psychologists to pursue more leadership opportunities within academic health centers. The article starts by identifying parallels between psychology's Profession-Wide Competencies and needed leadership skills/concepts for healthcare leaders. An example of an academic health center psychologist's leadership in a cohort-based physician leadership program illustrates how Profession-Wide Competencies were used in three structural elements of the leadership program. The article identifies particular leadership opportunities for psychologists within academic health centers.

Virtual reality (VR) and hypnosis (H) are useful pain management tools, but the potential benefit of their combination (VRH) has yet to be studied. This study examines the user experience of VRH, compared to H and VR alone, using interviews following an experimental study examining the effect of the three interventions on pain perception. Following a within-subjects repeated measures experimental design, 16 participants received the three interventions during which they received painful electrical stimuli. Following each intervention, explanatory interviews were conducted to allow participants to elaborate on their user experience. A thematic analysis was conducted on the data collected. Three themes emerged from the interviews: (1) satisfaction: participants mostly had positive feelings toward the three modalities, with the most beneficial effects on relaxation expressed for H. (2) Body perception and attention focus: immersion in the VR and VRH conditions was appreciated. Participants described their perceptions of pain perception during the 3 conditions. (3) Device acceptability: H was the most liked, followed by VRH, and then VR alone. Intention of use was reported following the same order. The data collected highlighted participants' opinions of these different interventions and suggested adjustments for future development of the VRH intervention in pain management.

There is growing recognition of the profound mental health challenges faced by the 53 million U.S. family caregivers, and the need for increased access to psychosocial care for this vulnerable population. Family caregivers are increasingly seeking support from hospital-based counseling centers. This trend-combined with a public policy landscape that promotes the delivery of caregiver-specific supports and services-highlights challenges faced by mental health professionals to provide and bill for psychosocial care to family caregivers. In this paper, we discuss three interrelated challenges that mental health professionals face in providing care to family caregivers and which our field needs to confront as healthcare transfers more responsibilities onto the shoulders of family caregivers: (1) caregiver burden is not recognized as a formal diagnosis; (2) current documentation for caregivers is typically linked to patient encounters; and (3) support for family caregivers occurs within larger systematic barriers to mental health integration. By accurately describing and documenting caregiver burden and advocating for increased parity in mental health coverage, we hope that the field can bridge the gap between emerging research, momentum in policy, and available psychosocial services for this vulnerable population.

Loneliness and low social support are associated with negative health outcomes among adults with asthma or COPD. Although social support is correlated with loneliness, low social support is neither necessary nor sufficient for the experience of loneliness. This study compares the relative association of loneliness and social support on symptom exacerbation (i.e., acute deteriorations in respiratory health) and acute health service utilization (i.e., hospitalizations, emergency department visits) among 206 adults with asthma and 308 adults with COPD. Separate logistic regression models were used to simultaneously examine the association of loneliness and social support with each outcome. Among adults with asthma, loneliness was associated with greater odds of hospitalization (AOR = 2.81, 95%CI [1.13, 7.02]), while low social support was not (AOR = 1.44, 95%CI [0.78, 2.65]). However, neither loneliness nor social support were associated with any other acute health service use or symptom exacerbation among adults with asthma. Among adults with COPD, loneliness, and greater social support were associated with increased odds of symptom exacerbation (AOR = 1.67, 95%CI [1.03, 2.69]; AOR = 1.36, 95%CI 1.02, 1.83]) and hospitalization (AOR = 3.46, 95%CI [1.65, 7.24]; AOR = 1.92, 95%CI [1.15, 3.22]), but only social support was significantly associated with ED visits (AOR = 1.72, 95%CI 1.12, 2.66]). These findings support prior research demonstrating that loneliness and social support are related but separate determinants of patients' physical symptoms and service utilization.

Off-campus (volunteer, community-based) clinical faculty, upon whom medical schools heavily depend, are an integral component of medical education. However, challenges hinder their involvement in medical school governance and other activities, including inadequate communication, lack of recognition, high clinical demands that may preclude teaching, and time-consuming non-clinical tasks. While faculty appointments offer benefits like free CME, access to library resources, and email communications, faculty often prioritize potential contributions to their teaching roles over these benefits. Our medical school launched a new initiative to tackle these issues head-on. We established an Office of Faculty Engagement (OFE) that leverages engagement strategies to enhance communication, broaden access to campus resources, and provide tailored rewards for clinicians. We rebranded volunteer clinical faculty as Off-Campus Faculty (OCF) to foster a more interactive relationship and innovative measures, including personalized welcome emails, a dedicated point of contact for OCF, a user-friendly website, regular orientations, faculty development programs, recognition and appreciation events, and exclusive awards. From August 2021 to December 2023, we contacted 587 OCF members; 85 faculty members experienced improved communication. This innovative approach streamlines and personalizes interactions with OCF, enhances their satisfaction, and represents a transformative opportunity to engage and involve OCF in medical education.

Trends in faculty demographic composition, promotion success, and retention are important considerations in Academic Health Centers (AHC). This paper reviews the design, implementation, and utility of a faculty promotion and tenure (P&T) database (PROMO/TE©) over 12 years in a large southwestern academic health center. Review of the system design, portfolio creation, P&T tracking, interface with other faculty databases, and lessons learned will be offered. PROMO/TE© was developed to improve the P&T packet creation, application, and review process in one College and was expanded to other colleges at the AHC. The PROMO/TE© system is integrated with Workday® and FACFACTS© to track trends in recruitment, attrition, and P&T trends across gender, underrepresented minorities, and other subgroups. PROMO/TE© has several advantages including improving communication, transparency, uniformity, and efficiency in the P&T packet creation, application, and review process. Increased cost savings ($217,198 annually) were noted with elimination of hard copy packets and decreased time spent. The first college reviewed 743 dossiers in the PROMO/TE© system since its creation in 2012 and there has been on average a 10% increase in P&T approvals since its inception. PROMO/TE© facilitates and tracks trends in the P&T process and has many benefits as well as significant cost savings. PROMO/TE© serves as a potential model for other institutions.