Personality traits and mediating pathways to mortality risk: A systematic review.

OBJECTIVE: Personality traits have been regularly linked with all-cause mortality risk. However, what mechanisms may provide an indirect pathway from personality traits to mortality is unclear. We sought to systematically review the literature and provide an overview of the potential mechanisms that have been identified in the literature. METHOD: Five electronic databases (PubMed, Web of Science, CINAHL, PsycInfo, and PsycArticles) were searched from inception to January 27, 2023. From 611 studies initially identified, seven studies met the final inclusion criteria. These seven papers have a combined sample of 60,104 individuals (M = 8,585, SD = 14,600; range 957-44,094). RESULTS: These papers found that several variables, such as smoking, inflammation biomarkers, blood pressure, and sleep, mediated the relationship between various personality traits and mortality. There was considerable variation in the impact of results across cohorts, even when looking at similar variables, and notable differences in methodological approaches and reporting were discussed. CONCLUSIONS: This review identified a small pool of research looking at a range of indirect pathways (mediating variables). The review identified traits with well-established associations with mortality risk, such as neuroticism, do not have consistent findings in the mediation literature and a high level of variance in the degree to which mediators account for the personality-mortality relation between different cohorts. Despite these limitations, it is clear that examining indirect effects (mediation) has a crucial role to play in developing our understanding of the complex pathways that connect personality-mortality risk. We identify several avenues and considerations for future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-Acceptance and Purpose in Life Are Mechanisms Linking Adverse Childhood Experiences to Mortality Risk.

OBJECTIVE: Adverse childhood experiences (ACEs) are associated with an increased risk of premature mortality, but it is not clear why. Individuals with ACEs tend to have lower self-acceptance and purpose in life, which may be pathways between ACEs and risk of premature mortality. As such, we tested whether purpose and self-acceptance are mechanisms that link ACEs to mortality risk. METHODS: We used the Midlife in the United States Survey ( N = 6218; mean [standard deviation] = 46.89 [12.94] years) to test whether these factors were indirect pathways between ACEs and mortality hazards over 24 years of follow-up. We used a comprehensive ACE measure that included 20 possible childhood adversities including emotional and physical abuse, household instability, socioeconomic climate, and ill health. RESULTS: ACEs significantly increased mortality risk (hazard ratio = 1.028, 95% confidence interval = 1.008-1.047, p = .006). Self-acceptance and purpose accounted for an estimated 15% and 4% of the ACEs-mortality relation, respectively. These effects withstood a range of adjustments and sensitivity analyses. CONCLUSIONS: ACEs may affect mortality risk partially through lower self-acceptance and purpose during adulthood. Given that self-acceptance and purpose may change through intervention, these factors may be useful targets for individuals with ACEs that could lead to a longer life.

Neuroticism facets and mortality risk in adulthood: A systematic review and narrative synthesis.

OBJECTIVE: This systematic review sought to summarize comprehensively the research investigating the association between facets of neuroticism and mortality risk. METHODS: A systematic review of prospective cohort studies utilizing rigorous reporting methods was conducted. Six electronic bibliographic databases, MEDLINE [Ovid], Embase, PsycINFO, CINAHL, Web of Science, and SCOPUS, were searched for eligible studies using keywords encompassing personality traits and mortality. Articles from inception to January 2023 were reviewed. The risk of bias was also assessed. RESULTS: Six of the 2358 identified studies met the inclusion criteria for extraction. Included studies had 335,715 participants, of whom 3.23% died. Participants ages at baseline ranged from 20 to 102, and 54% were female. Five of the six studies reported statistically significant associations between facets of neuroticism and mortality risk. Several underlying facets were reported to be associated with an increased mortality risk, namely vulnerability, cynicism, pessimistic, anxious, and depressive facets. Inadequacy, and worried-vulnerable were reported as protective. One study reported protective effects for impulsiveness, but this was not observed in a further follow-up study. CONCLUSIONS: Various facets related to neuroticism are associated with an increased or decreased mortality risk. Encompassing all facets in a broad trait likely masks very important personality-health relations, which later impact longevity. Based on these findings, recommendations and future considerations are discussed.

Perspectives on the production, and use, of rapid evidence in decision making during the COVID-19 pandemic: a qualitative study.

OBJECTIVES: To describe perceptions of providing, and using rapid evidence, to support decision making by two national bodies (one public health policy and one front-line clinical practice) during the COVID-19 pandemic. DESIGN: Descriptive qualitative study (March-August 2020): 25 semistructured interviews were conducted, transcribed verbatim and thematically analysed. SETTING: Data were obtained as part of an evaluation of two Irish national projects; the Irish COVID-19 Evidence for General Practitioners project (General Practice (GP) project) which provided relevant evidence to address clinical questions posed by GPs; and the COVID-19 Evidence Synthesis Team (Health Policy project) which produced rapid evidence products at the request of the National Public Health Emergency Team. PARTICIPANTS: Purposive sample of 14 evidence providers (EPs: generated and disseminated rapid evidence) and 11 service ssers (SUs: GPs and policy-makers, who used the evidence). MAIN OUTCOME MEASURES: Participant perceptions. RESULTS: The Policy Project comprised 27 EPs, producing 30 reports across 1432 person-work-days. The GP project comprised 10 members from 3 organisations, meeting 49 times and posting evidence-based answers to 126 questions. Four unique themes were generated. 'The Work' highlighted that a structured but flexible organisational approach to producing evidence was essential. Ensuring quality of evidence products was challenging, particularly in the context of absent or poor-quality evidence. 'The Use' highlighted that rapid evidence products were considered invaluable to decision making. Trust and credibility of EPs were key, however, communication difficulties were highlighted by SUs (eg, website functionality). 'The Team' emphasised that a highly skilled team, working collaboratively, is essential to meeting the substantial workload demands and tight turnaround time. 'The Future' highlighted that investing in resources, planning and embedding evidence synthesis support, is crucial to national emergency preparedness. CONCLUSIONS: Rapid evidence products were considered invaluable to decision making. The credibility of EPs, a close relationship with SUs and having a highly skilled and adaptable team to meet the workload demands were identified as key strengths that optimised the utilisation of rapid evidence. ETHICS APPROVAL: Ethical approval was obtained from the National Research Ethics Committee for COVID-19-related Research, Ireland.

A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice.

Quality measurement initiatives promote quality improvement in healthcare but can be challenging to implement effectively. This paper presents a Rapid Realist Review (RRR) of published literature on Quality Care-Process Metrics (QCP-M) implementation in nursing and midwifery practice. An RRR informed by RAMESES II standards was conducted as an efficient means to synthesize evidence using an expert panel. The review involved research question development, quality appraisal, data extraction, and evidence synthesis. Six program theories summarised below identify the key characteristics that promote positive outcomes in QCP-M implementation. Program Theory 1: Focuses on the evidence base and accessibility of the QCP-M and their ease of use by nurses and midwives working in busy and complex care environments. Program Theory 2: Examines the influence of external factors on QCP-M implementation. Program Theory 3: Relates to existing cultures and systems within clinical sites. Program Theory 4: Relates to nurses' and midwives' knowledge and beliefs. Program Theory 5: Builds on the staff theme of Programme Theory four, extending the culture of organizational learning, and highlights the meaningful engagement of nurses and midwives in the implementation process as a key characteristic of success. Program Theory 6: Relates to patient needs. The results provide nursing and midwifery policymakers and professionals with evidence-based program theory that can be translated into action-orientated strategies to help guide successful QCP-M implementation.