OA05.02. Relationships among well-being and wellness behaviors over time in residents in eight family medicine residencies

Purpose

To present findings on relationships among dimensions of well-being and wellness behaviors in family medicine residents participating in the Integrative Medicine in Residency (IMR) program through the last two years of training.

Methods

Residents in the 2011 graduating class of the IMR (n=56) were assessed at the beginning of PGY2 and PGY3 and at graduation. Measures were self-administered online and included established measures of well-being: perceived stress, burnout (emotional exhaustion, depersonalization), depression, and satisfaction with life. Wellness behaviors assessed included restful sleep, nutrition, physical activity, mind-body activities, being in nurturing relationships, being outdoors in nature, and alcohol use. Stepwise regression analysis examined relationships between wellness behaviors and each well-being measure at each timepoint.

Results

In both PGY2s (n=52) and PGY3s (n=38), restful sleep was associated with less perceived stress (p=0.003; p=0.01), greater life satisfaction (p=0.007; p=0.007), less depression (p=0.002; p=0.041), and less emotional exhaustion (p=0.001; p<0.001). In PGY2s, more time in nurturing relationships was associated with greater life satisfaction (p=0.039). In PGY3s, more frequent exercise was associated with less depression (p=0.003) and greater life satisfaction (p=0.014). By graduation (n=42), sleep was associated with less emotional exhaustion (p=0.006). Spending more time outdoors in nature was associated with lower perceived stress (p=0.002), less depression (p=0.026), and lower depersonalization (p=0.003). Nurturing relationships were associated with greater life satisfaction (p<0.001). More alcohol use was associated with less perceived stress (p=0.001). Using a variety of mind-body wellness behaviors was associated with greater depression in PGY2s (p=0.015), and with emotional exhaustion at graduation (p=0.045).

Conclusion

Sleep, nurturing relationships, exercise, and time outdoors in nature were most frequently associated with well-being among Family Medicine residents. This study is the first to describe these relationships for residents who participated in the IMR, and points to the importance of addressing well-being and wellness behaviors during the formative time of graduate medical education.