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Comparison of Psychological and Physiological Measures of Stress in Health Care Professionals during an Eight-Week Mindfulness Meditation Program
Abstract
Work stress, burnout, and diminished empathy are prevalent issues for health‐care professionals. Mindfulness meditation (MM) is one commonly used strategy to manage stress. Measuring salivary cortisol allows for the assessment of serum cortisol level, a known stress level indicator. This study evaluated the association of subject‐reported stress symptoms and salivary cortisol in health‐care professionals, in an 8‐week MM program, with data collected prospectively at baseline and 8 weeks after program completion. Questionnaires [Profile of Mood States—Short Form (POMS‐SF), Maslach Burnout Inventory (MBI), and Interpersonal Reactivity Index (IRI)] measured mood, burnout and empathy.
A paired t ‐test between groups for pre/post‐salivary cortisol yielded no significant change. The POMS‐SF was most sensitive to change (mean increase 12.4; p = 0.020). Emotional exhaustion, measured in the MBI, was also affected by MM (mean decrease 4.54; p = 0.001). Changes in empathy may not have been captured due to either absence of effect of MM on empathy, subject number or scale sensitivity. Baseline and 8‐week correlations between salivary cortisol and survey results, and correlations between changes in these measures, were weak and not statistically significant. Nevertheless, psychometric results present a strong case for additional clinical trials of MM to reduce stress for health‐care professionals. Copyright © 2005 John Wiley & Sons, Ltd.
... Prior interventions have looked at a range of other wellbeing outcome measures including burnout, resilience, vitality, and vigor, often using participants working in healthcare, such as physicians and nurses, and have reported that mindfulness interventions reduce burnout, and increase resilience, vigor, and vitality (Galantino et al., 2005;Mackenzie et al., 2006;Krasner et al., 2009;Bazarko et al., 2013;see Virgili, 2015 for a meta-analysis). We were interested in whether employees in a non-healthcare setting, who were also not employed in the service industry (which can require large amounts of emotion regulation and surface acting, e.g., Michel et al., 2014;Hülsheger et al., 2013) would show improvements in self-reported resilience following the mindfulness intervention. ...
... Further, if mindfulness enhances the ability to pay attention as evidenced by Jha et al. (2007) and based on accounts of how mindfulness interventions enhance attention and awareness (Shapiro et al., 2006), we expected that the intervention could also increase selfperceived recognition of emotion in others and potentially selfperceived regulation of emotion in others. Prior research on the impact of mindfulness interventions on self-reported empathy has been mixed (Shapiro et al., 1998;Beddoe and Murphy, 2004;Galantino et al., 2005), so our inclusion and examination of this component was more exploratory, as was the inclusion of selfperceived non-verbal emotional expression. It is possible that some interventions highlight the importance of empathy more than others, for instance, those conducted in healthcare with "helping" occupations such as nurses may be more successful in enhancing empathy than those conducted in office-based organizational settings. ...
... The results show that in addition to enhancing the self-perceived recognition and regulation of emotions in the self, people who completed the mindfulness intervention were more likely to feel they were more likely to display how they were feeling through body language and facial expressions (i.e., non-verbal emotional expression), and more likely to feel they were paying attention to and attempting to regulate the emotions of others (i.e., regulation of emotion in others). Prior research has shown inconsistent effects of mindfulness training on empathy, with some studies reporting increases (Shapiro et al., 1998;Birnie et al., 2010), and others reporting null results (Beddoe and Murphy, 2004;Galantino et al., 2005). In the present research self-perceived trait empathy (the tendency to draw upon empathy at work), did not change following the intervention. ...
A randomized waitlist-controlled trial was conducted to assess the effectiveness of an online 8-week mindfulness-based training program in a sample of adults employed fulltime at a Fortune 100 company in the United States. Baseline measures were collected in both intervention and control groups. Following training, the intervention group (N = 37) showed statistically significant increases in resilience and positive mood, and significant decreases in stress and negative mood. There were no reported improvements in the wait-list control group (N = 65). Trait mindfulness and emotional intelligence (EI) were also assessed. Following the intervention mindfulness intervention participants reported increases in trait mindfulness and increases on all trait EI facets with the exception of empathy. The control group did not report any positive changes in these variables, and reported reductions in resilience and increases in negative mood. Finally, both self and colleague ratings of workplace competencies were collected in the intervention group only and provided preliminary evidence that mindfulness training enhanced performance on key leadership competencies including competencies related to decisiveness and creativity. The present study demonstrates the effectiveness of an online-based mindfulness training program for enhancing well-being, self-perceptions of emotional intelligence, and workplace performance.
... Mindfulness training teaches children and teenagers to become aware of the unconscious processes of their mind and to respond to thoughts, feelings and bodily senses in effective ways. The results of previous studies show that this method is an effective intervention for the treatment of psychological symptoms (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), which showed that mindfulness can be effective on emotion regulation and self-concept. ...
... The results showed that child-based mindfulness therapy has a positive and significant effect on the emotion regulation and self-concept of children. The first findings of the research in terms of the effect of child-centered mindfulness on emotion regulation are in line with the findings of previous studies (24)(25)(26)(27)(28). In treatments based on the presence of mind, the goal is that a person can consider his thoughts only as pure thoughts and see them as testable mental events and be able to change their meaning. ...
... Furthermore, stress negatively affects the quality of health care delivery to the extent that caregivers themselves report an increase in medical errors, a decrease in positive emotions, and a loss of work motivation (Galantino et al., 2005). In contrast, increased emotional intelligence is associated with decreased stress, increased job satisfaction, and increased patient satisfaction (Galantino et al., 2005). ...
... Furthermore, stress negatively affects the quality of health care delivery to the extent that caregivers themselves report an increase in medical errors, a decrease in positive emotions, and a loss of work motivation (Galantino et al., 2005). In contrast, increased emotional intelligence is associated with decreased stress, increased job satisfaction, and increased patient satisfaction (Galantino et al., 2005). In the present study, the PSS-CP and EIS factors show a strong statistically significant correlation. ...
Background: Mindfulness-based stress reduction has been shown to be effective in reducing stress levels and developing emotional competencies in nursing students, however, in some countries such as Morocco, this practice remains unexplored. The purpose of this study is to examine the effect of a mindfulness-based stress reduction program on nursing students.
Material/ Methods: The study used a quasi-experimental design in a single pretest-post-test group with 42 nursing students from the Higher Institute of Nursing Professions and Health Techniques of Tetouan. Data were collected using a personal information form, the Perceived Stress Scale in Clinical Practicum (PSS-CP), and the Emotional Intelligence Scale (EIS).
Results: The results of the study indicate that the students' mean score on the PSS-CP scale was 2.19 ± 1.35 in the pretest, but decreased to 1.89 ± 1.28 in the posttest (p < .05). While the students' mean EIS score was 3.44 ± 1.26 in the pretest, it increased to 3.76 ± 1.19 in the posttest (p < 0.05). A statistically significant relationship was found between perceived stress and EIS scores (r = 0.864, p < 0.05).
Conclusions:Mindfulness-based stress reduction program training can improve psychological health by developing emotional competence and reducing stress in nursing students. Key words: emotional intelligence, mindfulness, nursing students, perceived stress.
... Furthermore, stress negatively affects the quality of health care delivery to the extent that caregivers themselves report an increase in medical errors, a decrease in positive emotions, and a loss of work motivation (Galantino et al., 2005). In contrast, increased emotional intelligence is associated with decreased stress, increased job satisfaction, and increased patient satisfaction (Galantino et al., 2005). ...
... Furthermore, stress negatively affects the quality of health care delivery to the extent that caregivers themselves report an increase in medical errors, a decrease in positive emotions, and a loss of work motivation (Galantino et al., 2005). In contrast, increased emotional intelligence is associated with decreased stress, increased job satisfaction, and increased patient satisfaction (Galantino et al., 2005). In the present study, the PSS-CP and EIS factors show a strong statistically significant correlation. ...
Mindfulness-based stress reduction has been shown to be effective in reducing stress levels and developing emotional competencies in nursing students, however, in some countries such as Morocco, this practice remains unexplored. The purpose of this study is to examine the effect of a mindful-ness-based stress reduction program on nursing students. The study used a quasi-experimental design in a single pre-test-post-test group with 20 nursing students from the Higher Institute of Nursing Professions and Health Techniques of Te-touan. Data were collected using a personal information form, the Perceived Stress Scale in Clinical Practicum (PSS-CP), and the Emotional Intelligence Scale (EIS). The results of the study indicate that the students' mean score on the PSS-CP scale was 2.19 ± 1.35 in the pretest, but decreased to 1.89 ± 1.28 in the posttest (p < .05). While the stu-dents' mean EIS score was 3.44 ± 1.26 in the pretest, it in cre as ed to 3.76 ± 1.19 in the posttest (p < 0.05). A statistically significant relationship was found between perceived stress and EIS scores (r = 0.864, p < 0.05). Mindfulness-based stress reduction program training can improve psychological health by developing emotional competence and reducing stress in nursing students.
... Duration Intervention Main results Galantino et al. (2005) US ( A study in Spain on 68 PCPs found a slight, sixpoint reduction in emotional exhaustion and depersonalization subscales and an increase in personal accomplishment (Asuero et al., 2014). The authors also reported significant decreases in mood disturbances such as depression, fatigue, and anger in the intervention group, with improvements in participants' attitudes. ...
... Shapiro et al. (2005) reported lack of time and increasing obligations as the main reasons participants dropped out of the MBSR program. Furthermore, Galantino et al. (2005) suggest that various other commitments in the HCPs' lives may have affected study outcomes. Participants in the study by Beckman et al. (2012) cited perceived work and home responsibilities as the most common factor in missing sessions of the mindfulness communication program. ...
Background
Physician burnout is a growing phenomenon in current health systems worldwide. With the emergence of COVID-19, burnout in healthcare is progressively becoming a serious concern. Increasing emotional exhaustion, depersonalization, and reduced personal accomplishment threaten the effective delivery of healthcare. Compassion fatigue and moral injury are a considerable risk to the doctor-patient relationship. These issues can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in physicians.
Methodology
A scoping review was conducted to investigate the effects of mindfulness practice on physician burnout. High-ranking journals were targeted to analyze high-quality studies and synthesize common themes in the literature. Studies conducted on current practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Gray literature and studies conducted only on allied health personnel were excluded from this review.
Results
31 studies were included in this scoping review. Mindfulness practice decreased emotional exhaustion and depersonalization while improving mood, responses to stress, and vigor. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to physician mindfulness practice.
Conclusion
Mindfulness was widely reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate physician leader will play a crucial role in addressing current practice gaps, prioritizing staff mental health, and providing a supportive platform for innovation.
... The term mindfulness has been in the literature for several decades, including early mentions in works by Hanh (1987), Langer (1989), Bain (1995), and Kabat-Zinn (1991), but in the common vernacular for over three centuries (Dhiman, 2009). Most commonly, the research surrounding mindfulness has been clinical in nature (Brefczynski- Lewis, Lutz, Schaefer, Levinson, & Davidson, 2007;Chambers, Chuen Yee Lo, & Allen, 2008;Chan et al., 2008;Chang et al., 2004;Christopher & Gilbert, 2010;Davidson et al., 2003;Fernandez, Wood, Stein, & Rossi, 2010;Galantino, Baime, Maguire, Szapary, & Farrar, 2005;Jha et al., 2010;Sasser, 2008;Shapiro, 2009;Way et al., 2010) with only a few organizational studies emerging in recent years (Lewis, 2014;Love, 2008;Roche et al., 2014;Salmon, Hanneman, & Harwood, 2010;Walach et al., 2007). ...
... of mindfulness is still in its infancy. In a 2005 study, researchers examined salivary cortisol (stress hormone) levels before and after a mindfulness meditation and showed no change in cortisol levels in participants despite subjective measurements showing improved mood states and decreases on the Maslach Burnout Inventory (Galantino et al., 2005). More complex biologically-based studies have supported that mindfulness affects the amygdala, the brain component involved in stress conditions. ...
Objectives:
The purpose of this study was to address military leader perceptions of their resilience, transformational leadership behaviors, and leadership effectiveness before and after experiencing Mindfulness-Based Attention Training (MBAT).
Methods:
Participants were formal and informal leaders in the Kansas Air National Guard. The study used a mixed-methods sequential exploratory design. Phase I involved analyzing pretest and posttest results obtained from a Jha Lab study for three self-report assessments in an intervention group (n = 36) vs a control group (n = 37). The qualitative data in phase II was obtained from individual interviews of participants (n = 12) following the Jha Lab study.
Results:
The phase I quantitative results confirmed the null hypotheses-no significant differences found-for all research questions. Phase II resulted in eight thematic codes, six of which were central to the experiences described by participants (Halting, Sensing, Being, Shielding, Considering, and Engaging) and two that were not (Obstructing, and Escaping).
Conclusions:
The key finding was that the descriptions of mindful thoughts and behaviors were consistent across participants indicating that MBAT accurately presents mindfulness during the course and the training had positive effects on participant mindfulness, primarily in the areas of being present to self, shielding the self through reperceiving, and then consciously altering behavior based on the new perspective. Results should direct future resiliency course development, leadership course curricula, and aid understanding of how leaders mentally conceptualize stress, incorporate resilient behaviors and then apply that knowledge to their own leadership behaviors.
... Kubo et al., 2008)(Nagai et al.as mental fatigue assessment, is sensitive to subjective stress and mood disorder levels and measures emotional state(Galantino et al., 2005) The POMS2 was used, which consists of the following ve items: anger-hostility (AH), confusion-bewilderment (CB), depression-dejection (DD), fatigue-inertia (FI), tension-anxiety (TA), vigor-activity (VA), and friendliness (F). The scale consisted of ve items in each of the lower ve items of the scale and is rated on a ve-point scale ranging from 0 (not at all) to 4 (very much). ...
A new nursing care delivery model has been developed in Japan in which all nurses, including experienced nurses, work in pairs to provide daily nursing care for multiple patients. This study aimed to confirm the effectiveness of the paired system by comparing physical changes and mental fatigue before and after work with the conventional system in which one nurse is responsible for several patients. Physical and mental fatigue levels were measured before and after for 675 nurses working at two hospitals with >400 beds. Repeated measures of two-way analysis of variance for changes over time before and after work revealed no interaction. In the paired system, self-negativity was significantly decreased after than before work. This is because, in the paired system, two workers always communicate and consult with each other while performing their work; thus, emotional stress may less accumulate. The system remains not fully established because it has only been implemented for a short time. Strengthening pair relationships was considered an innovative model.
... Overall, our findings suggest that online interventions based on mindfulness and DRAMMA (Newman et al., 2014) might complement existing onsite workplace health promotion programs (Galantino et al., 2005;Wolever et al., 2012). Online-based interventions have been researched extensively in recent years (e.g., Ebert et al., 2016). ...
Recovering from work is essential for maintaining occupational well-being, health, motivation, and performance, but recovery is often difficult to achieve. In this study, we evaluated and compared the effectiveness of two (parallel) interventions aimed at promoting recovery: one based on mindfulness and one involving applying cognitive–behavioral strategies. Both interventions were embedded in a measurement burst design, which allowed us to examine the mechanisms underlying change or intervention success. To explore mechanisms of change, we used the stressor-detachment model as a theoretical framework. We operationalized the interventions’ effects in three ways: as changes from pretest to posttest, as changes in daily states, and as changes in daily associations. To this end, we used intensive longitudinal data to examine the roles that daily negative activation plays in detachment and strain. In a randomized controlled trial (N = 393), we administered three assessments of traits: pretest, posttest (8 weeks later), and follow-up (3 months after the posttest). We also administered 2 work weeks of experience sampling questionnaires (preintervention and postintervention). Latent change models and Bayes factor equivalence tests revealed that both interventions substantially—and to a similar extent—increased detachment. Bayesian multilevel path models showed improvements in all state variables, including improvements in negative activation, and provided some evidence that mindfulness-based and cognitive–behavioral approaches might tackle different processes at the daily level. We discuss theoretical implications for the literature on recovery from work and specifically for the stressor-detachment model.
... Overall, our findings suggest that online interventions based on mindfulness and DRAMMA (Newman et al., 2014) might complement existing onsite workplace health promotion programs (Galantino et al., 2005;Wolever et al., 2012). Online-based interventions have been researched extensively in recent years (e.g., Ebert et al., 2016). ...
Recovering from work is essential for maintaining occupational well-being, health, motivation, and performance, but recovery is often difficult to achieve. In this study, we evaluated and compared the effectiveness of two (parallel) interventions aimed at promoting recovery: one based on mindfulness and one involving applying cognitive-behavioral strategies. Both interventions were embedded in a measurement burst design, which allowed us to examine the mechanisms underlying change or intervention success. To explore mechanisms of change, we used the stressor detachment model as a theoretical framework. We operationalized the interventions' effects in three ways: as changes from pretest to posttest, as changes in daily states, and as changes in daily associations. To this end, we used intensive longitudinal data to examine the roles that daily negative activation plays in detachment and strain. In a randomized controlled trial (N = 393), we administered three assessments of traits: pretest, posttest (8 weeks later), and follow-up (3 months after the posttest). We also administered 2 work weeks of experience sampling questionnaires (preintervention and postintervention). Latent change models and Bayes factor equivalence tests revealed that both interventions substantially—and to a similar extent—increased detachment. Bayesian multilevel path models showed improvements in all state variables, including improvements in negative activation, and provided some evidence that mindfulness-based and cognitive-behavioral approaches might tackle different processes at the daily level. We discuss theoretical implications for the literature on recovery from work and specifically for the stressor detachment model.
... Eles concluem que esse efeito pode ter surgido porque os enfermeiros eram muito empáticos inicialmente. Outros estudos usando cursos de meditação de oito semanas também não encontraram impactos nas medidas de empatia (Galantino, Baime, Maguire, Szapary & Farrar, 2005;Pearl & Carlozzi, 1994), mas fizeram uso de delineamentos relativamente fracos. Finalmente, Plummer (2008) coletou dados de terapeutas e de seus clientes e descobriu que aqueles que meditavam eram menos propensos a serem percebidos como empáticos por seus clientes e esse efeito era maior para aqueles que passavam mais tempo meditando. ...
Decety e Lamm argumentam que empatia é a “habilidade de experienciar e entender o que outros sentem sem confusão entre si mesmo e outros” (itálico adicionado; 2006, p. 1146). Identificação excessiva com outros que estejam sofrendo parece levar a sofrimento pessoal e evitação, em vez de preocupação empática. Isso é particularmente problemático para funções que envolvem ajuda ou outras formas de trabalho emocional. Há ainda um potencial paradoxo aqui, já que a empatia parece ser motivada por um sentimento de conexão entre o eu e o outro. Como podemos entender a diferenciação eu-outro de forma que nos permita melhorá la nas organizações? Neste capítulo, apresento uma abordagem contextual, comportamental que explica por que programas de Mindfulness ajudam a melhorar a diferenciação eu-outro. Nós podemos ver o eu e o outro tanto em termos de a) conceitualizações, b) como um fluxo de experiências ou c) como a consciência em si. Responder a conceitualizações sobre o eu e o outro pode ser útil, mas também pode impedir a empatia. A diferenciação eu-outro no nível do conteúdo geralmente cria mais separações e julgamentos do que empatia. Responder no nível da experiência do momento presente é a essência do responder a experiências alheias, mas é aqui que a diferenciação eu-outro é essencial para uma empatia madura e sustentável. No nível da consciência em si, um senso estável de self que está além da ameaça pode ser contatado de maneira a apoiar a empatia. Além disso, em casos raros pode-se experimentar uma sensação de consciência compartilhada que transcende diferenças. O treinamento em Mindfulness parece dar suporte ao desenvolvimento de todos esses três sentidos de tomada de perspectiva, de forma a aumentar a empatia, mas também melhorar os resultados organizacionais em outras áreas, como liderança autêntica.
... Furthermore, deploying mindfulness-based stress reduction (MBSR) programs may be a strategic manoeuvre to bolster well-being and resilience in this context. Empirical substantiation affirms the efficacy of MBSR interventions in enhancing the management of distressing scenarios [42,45]. Notably, a concise MBSR regimen tailored for primary care clinicians, orchestrated by Lee and colleagues, yielded discernible reductions in markers of job burnout, depression, anxiety, and stress [46]. ...
Introduction: The present research aims to investigate the relationship between mindfulness, work-related stress management, and job satisfaction in the correctional context. Methods: The study enlisted the participation of 131 Italian correctional officers (F = 72,5%) in working age. The quantification of mindfulness levels was achieved by implementing the Five Facets Mindfulness Questionnaire-short form (FFMQ-SF). A subset of the Organizational-Emotional Intelligence Questionnaire (ORG EIQ) facilitated the assessment of work-related stress management. A 5-item Likert scale was employed to gauge job satisfaction. Descriptive statistics (mean and standard deviation) of the sample were analyzed. Subsequently, reliability analyses were performed using Cronbach's alpha. Finally, a simple mediation analysis was conducted to define the role of work-related stress management, and the direct, indirect, and total effects were calculated.
Results: Concerning the indirect effect, mindfulness had a significant impact on work-related stress management [β=0.42; p<.05], which, in turn, showed a significant effect on job satisfaction [β=0.26; p<.001].
Discussion and Conclusion: Our findings highlight mindfulness's potential and beneficial effects within social and occupational contexts, especially in the case of high-risk populations such as correctional officers.
Keywords: Correctional Officers; Mindfulness; Organizational Contexts; Stress; Job Satisfaction; Well-being
... POMS2-adult short [16,17] was translated and used to assess psychological conditions [18][19][20][21][22][23]. The Functional Independence Measure (FIM) was used to assess the motor and cognitive function related to medical rehabilitation [24,25]. ...
The aim of this study was to design user-friendly off-line human–robot interactions based on a telephonic conversation database (TCD), and to provide the elderly living alone independently (ELAI) with psychological support. A TCD was established based on phone calls to 170 ELAI, made once every 2 weeks for 10 years. Based on the TCD, conversation flows were continuously analysed through a Question–answer-response format, which was centred on 366 ordinary topics, 291 physical topics, and 322 psychological topics. Usability was evaluated in a trial involving 15 ELAI in their homes over a 4-to-8-week period. Their emotional states were evaluated using the Profile of Mood States (2nd Edition Short Form) and Functional independence measure (FIM) pre- and post-trial. Eighty-seven per cent of the participants indicated that the robots helped them in their daily lives. A close examination of the changes in all participants showed statistically significant improvements in mood and 3 out of 5 FIM cognitive items. Eighty-seven per cent of study participants wished to continue the experiment. We determined that the communication robots, in conjunction with the TCD, improved the psychological well-being of the ELAI.
... Other studies use mental workload tasks to generate fatigue, and stress and identify their effects on performance [59,60]. Interestingly, the evidence of how subjective and objective measures of mood and stress compare is still inconclusive [57,[61][62][63]. ...
Calm and quiet green spaces provide health benefits for urban residents. Yet as cities become more densely populated, increasing public users to green spaces may reduce or moderate these benefits. We examine how increased pedestrian density in a green street changes self-reported wellbeing. We use a between subject experimental design that added public users as confederates in randomly selected periods over three weeks. We collect data on mood and affective response from pedestrians moving through the green street (n = 504), with and without our public user treatment in randomly selected periods. Mood and affective response are improved when experiencing the green street with fewer people. We find that an increased number of public users in the green space has a negative effect on mood, especially among women. We provide experimental evidence that self-reported wellbeing in urban green spaces depends on social context, and that there are gender inequities associated with changes in affective response. Although we only measure immediate impacts, our results imply that the health benefits of green spaces may be limited by the total number of users. This research contributes additional evidence that greener cities are also healthier cities, but that the benefits may not be equally shared between women and men and will depend on the social context of use.
... In relation to perceived stress, the results appear to indicate that there was no reduction in such stress, which is inconsistent with the results obtained in other studies (Baer et al. 2012;Bränström et al. 2010;Eberth and Sedlmeier 2012;Galantino et al. 2005;Greeson and Brantley 2011;Grossman et al. 2004;Keng et al. 2011;Nyklícek and Kuijpers 2008). However, recent research was based on programs aimed at reducing stress, suggesting that stress reduction may not be linked to the practice of MM but to the other practices used or to a combination of these. ...
To study whether an 8-week mindfulness meditation training program truly reduces perceived stress without designing a stress reduction program. An experimental study was performed in which we studied the effects of 8 weeks of MM training on attention and awareness, as measured by the MAAS (mindfulness attention awareness scale) and perceived stress, as measured by the PSQ (perceived stress questionnaire), in 80 volunteers from the general public recruited by email from university centers. An increase in the individual’s dispositional capacity to be attentive and aware of the experience of the present moment in everyday life was observed in the experimental group versus the control group; F (2, 156) = 14.30, p = .000, η 2 partial = .155. Perceived stress showed no significant differences between groups in: social acceptance; F (2, 156) = 2.30, p = .103, overload; F (2, 156) = 2.32, p = .101, irritability, tension and fatigue; F (2, 156) = 2.27, p = .106, energy and joy; F (2, 156) = 2.79, p = .065. MM practice for 8 weeks of training increases the individual’s dispositional capacity to be attentive and aware of the experience of the present moment in everyday life but may not reduce perceived stress.
... The phase can also include activities designed to help individual patients listen to their bodies and nervous systems (sympathetic and parasympathetic) and to naturally manage hormonal stimulation via daily routines [26][27][28][29][30][31][32][33]. International studies show that web-based counseling combined with CBT (in all its forms) and associated decluttering activities such as mindful-walks, yogic breathing, meditation, yoga, yin yoga, yoga nidra, visualization, aroma therapy, hot shows, cold therapy, and much more, can be used effectively for a variety of clinical problems [34][35][36][37]. There are many different relaxation techniques, such as meditation, Tai-Chi, yoga, and qigong [38]; nonetheless, these methods often require long and regular practice before the benefits become apparent. ...
Background:
Burnout is a hidden productivity killer in organizations. Finding a solution to efficiently measure and proactively prevent or rehabilitate employees with burnout is a challenge. To meet this unabated demand, companies and caregivers can focus on proactive measures to prevent "Burnout as an Occupational Phenomenon."
Objective:
We aimed to address effectiveness, reliability, and validity of the empowerment for participation (EFP) batch of assessments to measure burnout risk in relation to the efficacy of web-based interventions using cognitive behavioral therapy (CBT) and floating to improve mental health and well-being. We introduced three risk assessments: risk for burnout, risk of anxiety, and risk for depression.
Methods:
We used an interventional, empirical, and parallel design using raw EFP psychometric data to measure the effectiveness of web-based therapy to reduce the risk of burnout between a control group and web-based therapy group. A total of 50 participants were selected. The rehabilitation and control groups consisted of 25 normally distributed employees each. The rehabilitation group received therapy, whereas the control group had not yet received any form of therapy. IBM SPSS was used to analyze the data collected, and a repeated measures ANOVA, an analysis of covariance, a discriminant analysis, and a construct validity analysis were used to test for reliability and validity. The group was selected from a list of employees within the My-E-Health ecosystem who showed a moderate or high risk for burnout. All assessments and mixed-method CBT were web-based, and floating was conducted at designated locations. The complete EFP assessment was integrated into a digital ecosystem designed for this purpose and therapy, offering a secure and encrypted ecosystem.
Results:
There was a statistically significant difference between pre- and postassessment scores for burnout. The reliability of the burnout measure was good (Cronbach α=.858; mean 1.826, SD 3.008; Cohen d=0.607; P<.001) with a high validity of 0.9420. A paired samples 2-tailed test showed a good t score of 4.292 and P<.001, with a good effect size, Cohen d=0.607. Web-based therapy reduced the risk for burnout in participants compared with the control group. Tests of between-subject effects show F=16.964, a significant difference between the control group and the web-based therapy group: P<.001, with movement between the group variables of 0.261 or 26.1% for the dependent variable.
Conclusions:
This study suggests good reliability and validity of using web-based interventional mixed methods CBT to reduce the risk of burnout. The EFP batch of web-based assessments could reliably identify morbidity risk levels and successfully measure clinical interventions and rehabilitation with consistently reliable results to serve as both a diagnostic and therapeutic tool worthy of major research in the future.
Trial registration:
ClinicalTrials.gov NCT05343208; https://clinicaltrials.gov/ct2/show/NCT05343208.
... The use of more objective methods, like neuropsychological tests for assessing cognitive flexibility and emotion regulation could be considered. Moreover, the analysis of biomarkers (e.g., cortisol level] could be integrated and has already been applied in previous intervention studies to promote resilience in health professions (e.g., [85,86]). Although the sample consisted of nurses from various medical departments, it cannot be clearly determined whether the results are representative of other hospitals or other cultural circumstances. ...
In this study, a new group intervention program to foster resilience in nursing professionals was tested for efficacy. In total, 72 nurses were recruited and randomised to either an intervention condition or to a wait list control condition. The study had a pre-test, post-test, follow-up design. The eight-week program targeted six resilience factors: cognitive flexibility, coping, self-efficacy, self-esteem, self-care, and mindfulness. Compared to the control group, the intervention group reported a significant improvement in the primary outcome mental health (measured with the General Health Questionnaire) from pre-test (M = 20.79; SD = 9.85) to post-test (M = 15.81; SD = 7.13) with an estimated medium effect size (p = 0.03, η2 = 0.08) at post-test. Further significant improvements were found for resilience and other resilience related outcomes measures. The individual stressor load of the subjects was queried retrospectively in each measurement. Stress levels had a significant influence on mental health. The intervention effect was evident even though the stress level in both groups did not change significantly between the measurements. Follow-up data suggest that the effects were sustained for up to six months after intervention. The resilience intervention reduced mental burden in nurses and also positively affected several additional psychological outcomes.
... 1,6,[12][13][14][15] Additionally, studies consistently show that MBSR has numerous health benefits and is effective at improving the physiological indices of stress. [16][17][18][19] Additionally, MBSR is consistent with the humanistic caring paradigm and holistic elements of nursing theory. 12 Of the various types of MBSR, some literature suggests that guided loving kindness meditation, the practice of mentally directing unconditional love and kindness first to oneself and then to others, is potentially the most effective at increasing compassion satisfaction and empathy, which in turn reduces compassion fatigue and burnout, and thus may be especially well-suited to health care professionals. ...
This prospective pre-/posttest pilot studied a mindfulness-based stress reduction (MBSR) intervention first, to reduce self-reported stress and improve compassion satisfaction; and second, to reduce physiological indices of stress. Even small interventions of MBSR before a shift effectively reduces the physiological indices of stress and may help reduce compassion fatigue and burnout in nurses.
... A growing body of research has demonstrated benefits of the eight-week MBSR curriculum among health care providers [9][10][11][12]. Mindfulness training generally improved the psychological functioning of health care staff, increased empathy, and improved the quality of interpersonal relations and interactions with others [13]. ...
Mindfulness-Based Stress Reduction (MBSR) is an evidence-based health education program for medical patients with a variety of chronic conditions. MBSR also benefits health care providers themselves, decreasing work-related stress and preventing burnout. The objectives of this study were to describe an abbreviated MBSR curriculum developed for health care providers and to present initial program evaluation data assessing acceptability and outcomes. This program was implemented outside the research context with an open trial design. Mindfulness training sessions were held in a conference room at the administrative offices of a large, non-profit community health care system. Five clinic providers, three male and two female, included four primary care physicians and one social worker. All five participants participated in and completed the training. A six-session abbreviated MBSR protocol was developed. Participants attended weekly two-hour group sessions scheduled at the end of the workday. Standardized self-report questionnaires included the Perceived Stress Scale (10-item version) and the Copenhagen Burnout Inventory. Participants also completed four rating items designed to assess their personal satisfaction with the program. All five clinicians reported satisfaction with the program and measurable reductions in perceived stress and personal burnout. Statistically significant reductions in perceived stress and personal burnout scores across the group also were found. Abbreviated MBSR programs for clinicians may support clinician welfare by reducing stress and preventing burnout, ultimately impacting the larger health care delivery system in health-promoting ways. Research examining the effectiveness of specific protocols for clinicians is needed to support further dissemination and implementation.
... It should be noted that the picture is not entirely positive; a small number of studies have reported results inconsistent with the generally positive trends. For instance, there were no significant effects of mindfulness in a few studies utilising physiological outcome measures such as cortisol (Galantino et al., 2005;Klatt et al., 2009;Roeser et al., 2013), blood pressure, and heart rate variability (Roeser et al., 2013). It seems likely that changes evident initially in mental and emotional terms take longer to be seen in the body's physiological systems. ...
... The results of this study demonstrated a significant increase in mindfulness skills and orientation, which was correlated with lasting improvements in exhaustion, mood disorders, and empathy [68]. In contrast to these findings, but in line with those obtained by Amutio et al. [74] and Galantino et al. [75], none of the training programs carried out in this study significantly increased the levels of self-perceived empathy of tutors and resident intern specialists. Empathetic ability enables a person to grasp and understand the feelings of others, although mismanagement can lead to compassion or empathetic distress [76]. ...
Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.
... After the intervention, the score of emotional exhaustion was significantly reduced in the participants who did the exercise compared to the control group. Mindfulness-Based Stress Reduction intervention in healthcare professionals has also been shown to be effective in increasing positive variables such as positive emotions and quality of life, and reducing negative ones, such as stress, anxiety and burnout (Galantino, Baime, Maguire Szapary, & Farrar, 2005;Goodman & Schorling, 2012;Shapiro, Astin, Bishop, & Cordova, 2005;Shapiro, Brown, & Biegel, 2007). ...
... These instruments are well-established scales shown to be sensitive to short term mind body and other behavioral interventions, and validated in a wide range of populations, including older adults with memory loss [2,38,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58]. ...
Background
Recent studies suggest meditation and music listening (ML) may improve cognitive and psychosocial outcomes in adults with subjective cognitive decline (SCD). However, lack of a usual care group has limited conclusions.
Objective
To assess the: 1) feasibility of incorporating an enhanced usual care (EUC) comparator in a trial of Kirtan Kriya meditation (KK) and ML for adults experiencing SCD; and 2) preliminary effects of active treatment (KK/ML) versus an EUC program.
Methods
Forty participants with SCD were randomized 1:1:2 to a 12-week KK, ML, or EUC program. KK and ML participants were asked to practice 12 minutes/day; EUC participants were given a comprehensive educational packet regarding healthy aging and strategies for improving/maintaining brain health and asked to record any activities or strategies used. Feasibility was assessed using measures of retention, adherence, treatment expectancies, and participant satisfaction, as well as information from exit questionnaires and daily practice/activity logs. Cognitive functioning, stress, mood, sleep-quality, and health-related quality of life (QOL) were measured pre- and post-intervention using well-validated instruments.
Results
Thirty-two participants (80%) completed the 3-month study, with retention highest in the EUC group (p < 0.05). Active treatment participants averaged 6.0±0.4 practice sessions/week, and EUC participants, 7.5±0.6 brain health activities/week. Treatment expectancies were similar across groups. EUC participants indicated high satisfaction with the program and study. Despite limited study power, the active treatment group showed significantly greater gains in subjective memory functioning (ps≤0.025) and nonsignificant improvements in cognitive performance (TMT-B), perceived stress, QOL, and mood (ps≤0.08) compared to the EUC group.
Conclusion
Findings of this pilot feasibility trial suggest incorporation of an EUC program is feasible, and that participation in a simple 12-week relaxation program may be helpful for adults with SCD versus engagement in an EUC program.
... In a more recent study, Magan et al. demonstrated that long-term meditators have significantly lower plasma cortisol levels when compared to controls [160]. However, it is important to mention that numerous studies have not found any effect of yoga and meditation on cortisol levels [161][162][163]. ...
Alzheimer’s disease (AD) is a complex, multifactorial neurodegenerative disorder that represents a major and increasing global health challenge. In most cases, the first clinical symptoms of AD are preceded by neuropathological changes in the brain that develop years to decades before their onset. Therefore, research in the last years has focused on this preclinical stage of AD trying to discover intervention strategies that might, if implemented effectively, delay or prevent disease progression. Among those strategies, mind-body therapies such as yoga and meditation have gained increasing interest as complementary alternative interventions. Several studies have reported a positive impact of yoga and meditation on brain health in both healthy older adults and dementia patients. However, the underlying neurobiological mechanisms contributing to these effects are currently not known in detail. More specifically, it is not known whether yogic interventions, directly or indirectly, can modulate risk factors or pathological mechanisms involved in the development of dementia. In this article, we first review the literature on the effects of yogic practices on outcomes such as cognitive functioning and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia. Then, we analyze how yogic interventions affect different risk factors as well as aspects of AD pathophysiology based on observations of studies in healthy individuals or subjects with other conditions than dementia. Finally, we integrate this evidence and propose possible mechanisms that might explain the positive effects of yogic interventions in cognitively impaired individuals.
... These findings are also consistent with previous studies. For example, Galantino et al. (2010) observed no significant changes in empathy levels after a mindfulness meditation intervention for healthcare professionals when assessed using the IRI. Birnie et al. (2010) found MBSR to be successful at increasing participants' levels of self-compassion but that this occurred in the absence of significant changes in empathic concern. ...
Objectives
In prior studies, mixed results have been obtained regarding the relations between mindfulness, moral judgment, and prosocial behavior. We conducted two studies to better clarify the connections between mindfulness and several moral variables.Methods
In Study 1, a cross-sectional survey (N = 554) was conducted to test the possible associations between mindfulness, moral sensitivity, moral identity, and prosocial behavior. In Study 2, a randomized controlled experiment was conducted to examine the impact of a mindfulness intervention on moral identity and prosocial behavior. A total of 99 participants (n = 49, mindfulness group; n = 50, wait-list control group), all of whom were undergraduate students on an optional 11-week mindfulness-based self-exploration course, were recruited via the campus network system.ResultsIn Study 1, we found that mindfulness, moral sensitivity, moral identity, and prosocial behavior were all positively correlated. Results of the mediation analysis suggested that dispositional mindfulness had significant effects on prosocial tendencies both directly and indirectly via the mediator variables of moral sensitivity and moral identity. In Study 2, mindfulness practice was found to significantly improve the levels of mindfulness and self-compassion in participants but only had a significant effect on willingness toward prosocial behavior for those participants with existing high moral identity.Conclusions
Study 1 confirmed the predicted links between mindfulness, moral sensitivity, moral identity, and prosocial behavior. Study 2 suggested that moral identity influences the effect of mindfulness practice on willingness toward prosocial behavior. However, the underlying mechanisms and causes of this effect require further study.
... Mindfulness-based practices are thought to encourage the awareness and acceptance of emotions when they arise, so could help improve effective emotion regulation skills in health professionals [21]. Studies have reported a relationship between mindfulness practices and positive results, including increases in empathy, self-awareness, insight, wisdom [22,23]. Moreover, mindful awareness of one's feelings helps to become more aware of emotional processes in general [24]. ...
The aim of this study was to examine the effect of the Mindfulness-Based Empathy Training (MBET) program on nursing students’ empathy and aged discrimination. This study was conducted as a randomized controlled trial (RCT). The 123 participants were randomly allocated to either the training group or the control group in a 1:1 ratio. Participants in the experimental group received the MBET. No intervention was applied to the participants in the control group. “Descriptive Information Form”, “Jefferson Empathy Scale (JSENS)”, and “Age Discrimination Attitude Scale (ADAS)” were used for data collection. General Linear Model repeated measures ANOVAs were used to determine the effect of the MBET on JSENS and ADAS. The analyses revealed that participants in the training group reported a significant increase in empathy level compared to the control group. No significant change in total aged discrimination scores and sub-scale of the ADAS were recorded in either group. This study indicated that empathy can be enhanced over an 8-week duration when mindfulness practices are integrated into a curriculum.
... 12 Indeed, studies reveal benefits for healthcare providers trained in mindfulness, including increased selfcompassion, improved mood state, as well as reduced stress, burnout, distress, emotional exhaustion, anger, anxiety, and depression. [13][14][15][16][17][18] Additionally, it has been posited that clinician mindfulness may reduce medical errors and enhance patient safety. 12,19 Yet how mindfulness in healthcare providers may enhance patient care has not been well-studied. ...
Concern for the high prevalence and pervasive negative effects of clinician burnout has led to greater focus on clinician wellness programs, such as Mindfulness-Based Stress Reduction (MBSR). Our goal was to study MBSR feasibility and potential impact on clinician burnout, clinician–patient communication, and patient care and safety at a community hospital.
Mindfulness is well-established as a viable treatment for job burnout. However, the mechanisms underlying mindfulness’s burnout-reducing effect remain unclear. Drawing on mindfulness-to-meaning theory, the purpose of this study was to explore two potential mediators of the mindfulness-burnout relationship: positive reappraisal and catastrophizing. Participants were 325 Amazon Mechanical Turk workers who completed the Five Facet Mindfulness Questionnaire, the Positive Reappraisal and Catastrophizing subscales of the Cognitive Emotion Regulation Questionnaire, and the Oldenburg Burnout Inventory. Using a cross-sectional design, we tested six mediation models in which the effect of mindfulness or one of its five facets on burnout was mediated by positive reappraisal and catastrophizing. As expected, burnout correlated with mindfulness ( r = − 0.60, p < 0.001), positive reappraisal ( r = − 0.59, p < 0.001), and catastrophizing ( r = 0.36, p < 0.001), while mindfulness correlated with positive reappraisal ( r = 0.58, p < 0.001) and catastrophizing ( r = − 0.47, p < 0.001). Positive reappraisal mediated the mindfulness-burnout relationship for all six mindfulness predictors, while catastrophizing mediated the link for two. Planned contrasts indicated that, for all mindfulness predictors, positive reappraisal had significantly stronger indirect effects on burnout than did catastrophizing. These mediation results suggest multiple pathways by which mindfulness acts to reduce burnout. Thus, individuals experiencing burnout may have flexibility in choosing which mindfulness skills to develop to reduce symptoms. However, positive reappraisal better explained the mindfulness-burnout relationship than did catastrophizing. Future research could focus on mindfulness interventions that target positive reappraisal.
In this chapter, we talk about how you can recognise that there are psychological problems in your organisation. We first provide you with some visualisation tools that can help you identify the problems, their strength, or their nature. Secondly, we present some methods from psychology, anthropology, and our professional lives. We explain why and how they work. We also deliver an overview of the “classical” tool to measure burnout—the Copenhagen Burnout Inventory. Sharing some insights from our lives, we explain what can go wrong and how to avoid the shortcomings. Finally, we talk briefly about how sudden burnout can occur.
Background
Public speaking is an indispensable skill that can profoundly influence success in both professional and personal spheres. Regrettably, managing anxiety during a speech poses a significant challenge for many of the population. This research assessed the impacts of a Corp-Oral program, designed to manage public speaking anxiety in university students, based on, body awareness, embodied message techniques, simulation, embodied visualization, body transformation, and gesture enhancement.
Methods
Thirty-six students (61% women; Mage = 20.22, SD = 1.23 years) were randomly assigned to either an experimental group (n = 18), which underwent the Corp-Oral program, or a control group (n = 18). Self-perceived anxiety, heart rate, and electroencephalography were measured in a pre-test and a post-test.
Results
The study reveals that the Corp-Oral program significantly (p < 0.005) reduced both physiological responses (heart rate) and self-reported measures of anxiety. The alteration was more noticeable in self-reported anxiety measures (a decrease of 33.217%) than in heart rate (a decrease of 4.659%). During the speech, the experimental group exhibited increased cortical activation in areas related to emotional regulation, consciousness, sensorimotor integration, and movement control. A significant increase in frontal alpha asymmetry was observed for the experimental group in the post-test, but there were no significant variations in the theta/beta ratio.
Conclusion
These findings underline the benefit of managing public speaking anxiety not merely by reducing it but by channeling it through embodied strategies. These strategies could lead to greater action awareness that would cushion the physiological effect of the anxiety response and help generate a better self-perception of the anxiety state.
Mindfulness-based interventions (MBIs) have a positive effect on biomarkers of inflammation and stress in patients with psychiatric disorders and physical illnesses. Regarding subclinical populations, results are less clear. The present meta-analysis addressed the effects of MBIs on biomarkers in psychiatric populations and among healthy, stressed, and at-risk populations. All available biomarker data were investigated with a comprehensive approach, using two three-level meta-analyses. Pre–post changes in biomarker levels within treatment groups (k = 40 studies, total N = 1441) and treatment effects compared to control group effects, using only RCT data (k = 32, total N = 2880), were of similar magnitude, Hedges g = −0.15 (95% CI = [−0.23, −0.06], p < 0.001) and g = −0.11 (95% CI = [−0.23, 0.001], p = 0.053). Effects increased in magnitude when including available follow-up data but did not differ between type of sample, MBI, biomarker, and control group or duration of the MBI. This suggests that MBIs may ameliorate biomarker levels in both psychiatric and subclinical populations to a small extent. However, low study quality and evidence of publication bias may have impacted on the results. More large and preregistered studies are still needed in this field of research.
Objective: The purpose of this study was to objectively and subjectively evaluate different types of sleep for nurses working in shifts, and to clarify the relationship between each sleep and burnout state.
Methods: The subjects were 20 female shift-working nurses. Actiwatch Spectrum Plus was used for objective evaluation of sleep. The St. Mary’s Hospital Sleep Questionnaire was used for subjective evaluation. In addition, the Maslach Burnout Inventory-HSS Japanese version was used for burnout evaluation.
Results: In objective evaluation, emotional exhaustion was found to have a significant positive correlation with nighttime sleep after the day shift, and a significant negative correlation with the percent sleep of post-night shift sleep. In the subjective evaluation, emotional exhaustion was found to have a significant negative correlation with the depth and soundness of sleep on holidays after the night shift. In the objective evaluation, personal accomplishments were significantly negatively correlated with the percent sleep of sleep after the night shift.
Conclusion: The discrepancy between the subjective and the objective evaluations is suggested to be one characteristic of burnout.
In recent years, the possible benefits of mindfulness meditation have sparked much public and academic interest. Mindfulness emphasizes cultivating awareness of our immediate experience and has been associated with compassion, empathy, and various other prosocial traits. However, neurobiological evidence pertaining to the prosocial benefits of mindfulness in social settings is sparse. In this study, we investigate neural correlates of trait mindful awareness during naturalistic dyadic interactions, using both intra-brain and inter-brain measures. We used the Muse headset, a portable electroencephalogram (EEG) device often used to support mindfulness meditation, to record brain activity from dyads as they engaged in naturalistic face-to-face interactions in a museum setting. While we did not replicate prior laboratory-based findings linking trait mindfulness to individual brain responses (N = 379 individuals), self-reported mindful awareness did predict dyadic inter-brain synchrony, in theta (~5–8 Hz) and beta frequencies (~26-27 Hz; N = 62 dyads). These findings underscore the importance of conducting social neuroscience research in ecological settings to enrich our understanding of how (multi-brain) neural correlates of social traits such as mindful awareness manifest during social interaction, while raising critical practical considerations regarding the viability of commercially available EEG systems.
This Study focused on identifying psychological variables that could predict academic burnout of college students. In detail, We examined whether hypervigilance and stress mediated in sequential manner in the relationship between attentional control and academic burnout. For this, 234 college students completed Attentional Control Questionnaire, Brief Hypervigilance Scale, Perceived Stress Scale, and Korean Academic Burnout Scale. The data was collected for about two weeks from April 1 to 13, 2020, and the collected data was analyzed using SPSS 21.0 and Process Macro 3.4. The results indicate that hypervigilance and stress both mediated the relationship between attentional control and academic burnout. These findings indicate that hypervigilance and stress can be the possible mechanism for linking attentional control and academic burnout. More so, it was also observed that both hypervigilance and stress mediated sequentially. The study suggested that individuals with low attentional control may become hypervigilance and perceive more stress, which in turn may lead to academic burnout. The implications and limitations for future studies are also discussed.
Introduction: The impact of occupational stress on the mental health and well-being of nurses is a growing concern, magnified by the COVID-19 pandemic. Such compromised health is considered an occupational and patient safety risk. Our aim is to critically examine, analyze, and synthesize the evidence regarding MBSR on the perceived stress levels of nurses including overall mental health and well-being. Methods: An integrative review was conducted. Databases included were PubMed, Embase, PsychINFO, CINAHL, and the Cochrane Library. Inclusion criteria were English only, MBSR, and practicing nurses. Results: We identified 833 articles during database searching. After removal of duplicates and two rounds of screening, 15 articles were included in the final analysis. Several themes were derived with 60% of the studies showing a significant effect of MBSR on decreasing stress. Other significant themes were the decrease in burnout and increase in mindfulness. Conclusions: MBSR may be an effective holistic method of improving mental health for nurses during the COVID-19 pandemic. In both the abbreviated and full, 8-week versions of MBSR, the findings indicate the intervention can reduce depression, anxiety, and stress. Future recommendations include larger sample sizes and measurements other than self-reports to promote generalizability.
Very rapid and transforming changes are happening in all fields, thanks to the digital revolution in technology. This has created worldwide challenges as well as opportunities. However, in addition to technical knowledge and efficiency, psychological qualities like well-being, interpersonal skills, self-confidence, remain critically important. This empirical study attempts to measure the effect on employees’ behavior, personality and psychological well-being by using Vipassana meditation as an intervention. For this purpose, 240 meditator and non-meditator employees were administered an instrument comprising of a psychological well-being scale and a specially designed behavior measure scale to study how mindfulness intervention affects personality and behavior. The data was analyzed using SPSS Ver. 20.0. The results indicated higher values for meditator employees on nine measures of behavior, personality and well-being. These scores indicated that they enjoyed higher self-confidence, interpersonal skills, equanimity, empathy, engagement and growth leading to better work ethic, teamwork and growth. It was not possible to adopt a “Before and After” study design due to the limitation of time available for completion of the study. The behavioral and personality changes that take place due to VM practice are subjective. In the future, it will be interesting to study these subjective changes in meditators by using a long-term study spanning over a few years.KeywordsBehaviorEmployeesPersonalityPsychological well-beingVipassana meditation
OBJECTIVE
Physician training is associated with stressors which contribute to burnout. Individual and institutional level strategies can be employed to address resident burnout; however, time is an often-reported barrier in initiating recommended well-being activities. We hypothesize that brief bursts of well-being activities that are conducive to a resident schedule can mitigate burnout.
DESIGN
This is a prospective observational study following burnout after implementation of an institution-wide, well-being initiative called “Take 10.”
SETTING
In the present study, the “Take 10” initiative, meditating or exercising for a minimum of 10 minutes per day 3 times a week, was encouraged at Vanderbilt University Medical Center, a tertiary care center in Nashville, Tennessee.
PARTICIPANTS
Following implementation of the initiative, 254 residents from surgical, procedural, and non-procedural specialties were invited to complete surveys assessing compliance with encouraged “Take 10” activities as well as rates of burnout over a 5-month period. A total of 201 surveys were completed during the study period.
RESULTS
Overall, burnout rates were worse for females (Odds Ratio [OR] = 3.7 | Confidence Interval [CI] = 1.57, 9.05), better for those living with others (OR = 0.22 | CI = 0.07, 0.64), and better for those participating in “Take 10” initiatives (OR = 0.71 | CI = 0.58, 0.86). There was a significant difference in resident-reported burnout (Control = 85.3% vs Intervention = 58.2% | p < 0.01) and Resident Well-Being Index score (Control = 3.73 vs Intervention=2.93 | p < 0.01), when “Take 10” initiatives were employed.
CONCLUSIONS
“Take 10” is a low cost and low intensity initiative for individuals and programs to use to mitigate burnout.
Emeritus Professor Alan Glasper, from the University of Southampton, discusses strategies being employed to alleviate stress among NHS staff during the ongoing COVID-19 pandemic
Background and purpose
Little data is available on the effect of mindfulness amongst pediatric hematology-oncology professionals. The purpose was to further document change in biological and psychological stress following a mindfulness-based stress reduction (MBSR) program.
Materials and methods
We led two pre-post interventional studies (n = 12 and n = 25) and measured changes on hair cortisol concentrations, perceived stress, psychological distress and burnout.
Results
Professionals did not change on biological stress (d = 0.04), but improved on self-reported measures (median d = 0.58). Effects were maintained over 3 months for psychological distress, anxiety, depression, and burnout (median d = 0.66). Effects were larger if trainees participated to the retreat and if they reported higher baseline perceived stress.
Conclusion
In pediatric hematology-oncology professionals, an MBSR program was related with improvements in self-reported stress over 3 months. Components of the program and characteristics of trainees may influence the impact of MBSR.
Purpose
Nationwide, upward trends exist in student issues with anxiety, stress, depression, and lowered classroom performance. As emotional awareness and emotional regulation skills are typically not addressed in professional discipline-specific courses, students experience challenges in their academic performance. This pilot research explored the effect of brief targeted classroom practices within an empowerment-based framework on domains of emotional intelligence.
Method
Twenty-two students in an undergraduate speech-language pathology class received a 13-week, biweekly, 15-min session of empowerment-based worksheet exercises to develop increased self-esteem, emotional awareness and regulation, and communication. Assessments of self-esteem, emotional intelligence, communication competence, and communication apprehension were conducted using validated scales, namely, the Rosenberg Self-Esteem Scale (Rosenberg, 1965), the Quick Emotional Intelligence Self-Assessment (Mohapel, 2015), the Self-Perceived Communication Competence Scale (McCroskey & McCroskey, 2013), and the Personal Report of Communication Apprehension (McCroskey, 1982), respectively. Midsemester and semester-end student reflections were collected.
Results
Paired t tests were significant in self-esteem and emotional quotient, including subdomains of emotional awareness, emotional management, social emotional awareness, and relational management. Significance was noted in communication competence in the subdomains of dyad interaction, stranger interaction, and acquaintance. Students' reflection showed significant improvement in empowerment and self-rated improvements in confidence, communication, connections with peers, and trust with instructor.
Conclusion
Preliminary evidence demonstrates positive outcomes with integration of intentional classroom exercises to build emotional intelligence (including emotional awareness and regulation), self-esteem, and communication. This empowerment model may assist faculty in developing effective pedagogical strategies to build students' self-resiliency.
Background and Objectives
The objective of mindfulness‐based stress reduction (MBSR) programmes is to promote awareness of the present moment without judging, evaluating or reacting to the different thoughts or emotions that may arise. Development of these abilities appears especially important for healthcare professionals. The objective of this study was to evaluate the effectiveness and medium‐ and long‐term effects of a MBSR programme for primary care (PC) health professionals on their health‐related quality of life and quality of work life.
Design
Randomised clinical trial using an intervention and control group with follow‐up of the experimental group.
Setting
Primary Care centres in the Alicante Public Health Service (Spain).
Participants
Participants were PC health professionals (N = 58) divided between an intervention group receiving the 8‐week MBSR programme and a control group receiving a theoretical training session alone.
Method
Both groups were evaluated at baseline and at 8 weeks, and the intervention group was additionally evaluated at 3‐, 6‐, 9‐ and 12‐month postprogramme.
Results
In comparison to the control group, the intervention group obtained higher scores postintervention for mindfulness, health‐related quality of life, mood and compassion satisfaction and a lower score for burnout. Improvements in mindfulness, mood and burnout syndrome persisted at 12 months after the programme.
Conclusions
In conclusion, MBSR is an effective intervention to enhance the health‐related quality of life and quality of work life of Primary Care Health professionals.
Despite a recent surge of interest in physician well-being, the discussion remains diffuse and often scattered. Lingering questions of what wellness entails, how it is personally applicable, and what can be done, remain pervasive. In this review, we focus on policy-level, institutional and personal factors that are both obstacles to wellness and interventions for potential remedy. We outline clear obstacles to physician wellness that include dehumanization in medicine, environments and cultures of negativity, barriers to wellness resources, and the effect of second victim syndrome. This is followed by proven and proposed interventions to support physicians in need and foster cultures of sustained well-being from policy, institutional, and personal levels. These include medical liability and licensure policy, peer support constructs, electronic health record optimization, and personal wellness strategies. Where sufficient data exists, we highlight areas specific to anesthesiology. Overall, we offer a pragmatic framework for addressing this critical concern at every level.
The 8-week mindfulness meditation (MM) trainings have proven to be helpful for reducing burnout due to work-related stress. Most studies reported these positive effects with evaluations made immediately before and immediately after the therapeutic interventions. Little is known, however, about the symptoms of burnout in the months following these interventions. In our exploratory study, the effects of an 8-week MM training were assessed in a group of health care professionals (n = 19) with vulnerability to develop burnout; a 9-month follow-up was conducted on the subjects (n=8) who continued to meditate after the end of the training. Other health care professionals of the same company, who did not meditate during this research, served as control group. Burnout, mindfulness abilities and job satisfaction were evaluated through self-reports. Data showed that during the training the levels of burnout did not decrease, but significant reductions were observed during the follow-up. This indicates the possibility of obtaining results with MM even in subjects who do not have standard response time to the therapy and highlights the importance of monitoring the healing process.
Habilitation, rehabilitation and promotion of well-being is the ultimate goal of the occupational therapy process. Occupational therapy interventions take advantages from interdisciplinary approach, implying that classic rehabilitative models are constantly enhanced by updated evidences in rehabilitation literature and enriched with competences from different fields. Recent literature has showed how music interventions can improve clinical and rehabilitative outcomes at different levels. Physical or occupational therapists, caregivers and care staffs are frequently involved in providing music interventions with or without the support of a music therapist. In particular, occupational therapists can use music as support to the rehabilitation of daily living activities and, in general, as a complementary tool of their work. This paper wants to stress the implementation of music and music therapy techniques and related specific training programs in the field of occupational therapy, pointing and summarizing main workable evidence-based approaches with music in occupational therapy settings.
Much of the burden associated with poor mental health is associated with symptom experience in the general population. We conducted a systematic review and meta-analysis of studies conducted in nonclinical samples, evaluating mindfulness-based programs (MBPs) for outcomes related to psychological health and well-being. We focused on mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) because they have the strongest evidence base. We searched MEDLINE, PsycINFO, EMBASE, and CINAHL (from 2006 to February 2019) for published peer-reviewed journals articles of intervention studies evaluating MBCT or MBSR for psychological health and well-being in nonclinical samples. Data were pooled using a random-effects model, and effect estimates were reported as Hedges’ g. We included 49 studies conducted in nonclinical samples (n = 4,733). When compared with a passive control, MBPs significantly reduced symptoms of rumination/worry (g = −1.13, [−2.17, −0.08]), stress/psychological distress (g = −0.52 [−0.68, −0.36]), depression (g = −0.45 [−0.64, −0.26]), and anxiety (g = −0.44 [−0.65, −0.23]), and significantly improved quality of life/well-being (g = 0.32 [0.10, 0.54]). In general, MBCT generated larger effect sizes than MBSR for all outcomes. This study provides evidence that in nonclinical samples, MBPs are associated with benefits to health and well-being. These findings add to the growing evidence base suggesting that MBSR and MBCT may be effective approaches for subclinical levels of mental ill-health and could form part of the public mental health agenda.
Objectives
Health care professionals have elevated rates of burnout and compassion fatigue which are correlated with poorer quality of life and patient care, and inversely correlated with self-compassion. Primary studies have evaluated the extent to which mindfulness-based interventions increase self-compassion with contradictory findings. A meta-analytic review of the literature was conducted to quantitatively synthesize the effects of mindfulness-based interventions on self-compassion among health care professionals.Methods
Twenty-eight treatment outcome studies were identified eligible for inclusion. Five cumulative effect sizes were calculated using random-effects models to evaluate differences of changes in self-compassion for treatment and control groups. Within and between group comparisons were evaluated. Sub-group and moderator analyses were conducted to explore potential moderating variables.ResultsTwenty-seven articles (k = 29, N = 1020) were utilized in the pre-post-treatment meta-analysis. Fifteen samples (52%) included health care professionals and fourteen (48%) professional health care students. Results showed a moderate effect size between pre-post-treatment comparisons (g = .61, 95% CI = .47 to .76) for self-compassion and a strong effect size for pre-treatment to follow-up (g = .76, 95% CI = .41 to 1.12). The effect size comparing post-treatment versus post-control was moderate. One exploratory moderator analysis was significant, with stronger effects for interventions with a retreat component.Conclusions
Findings suggest mindfulness-based interventions improve self-compassion in health care professionals. Additionally, a variety of mindfulness-based programs may be useful for employees and trainees. Future studies with rigorous methodology evaluating effects on self-compassion and patient care from mindfulness-based interventions are warranted to extend findings and explore moderators.
Background
Stress and compassion fatigue are widely acknowledged as prevalent in workers in ‘caring’ roles, however this has not been widely documented in New Zealand veterinary nurses.
Aim
This project aimed to investigate the prevalence of stress and compassion fatigue in New Zealand veterinary nurses.
Method
Using an online survey, veterinary nurses were asked to self-report their incidence of stress or compassion fatigue felt as a result of their working environment. Veterinary nurses were also asked to report the ways in which they cope with stress and compassion fatigue, and their likelihood of changing jobs.
Results
There were 288 responses to the survey. Of these, 94% of respondents reported feeling stressed and 82% reported experiencing compassion fatigue as a result of their work. 30% of respondents reported an increase in the consumption of alcohol/cigarettes and drugs as a result of stress. Most respondents reported managing their stress and compassion fatigue by talking to colleagues or family. A large number of respondents reported having considered a career change at some stage due to stress or compassion fatigue.
Conclusion
This research demonstrates a high incidence of stress and compassion fatigue in New Zealand veterinary nurses, with a low percentage of those seeking professional support. Further investigation into combatable causal factors for stress as it differs from compassion fatigue is warranted to ultimately offer support to veterinary nurses to continue their vocation.
Can psychotherapy reduce the incidence of health problems? A general model of psychosomatics assumes that inhibiting or holding back one’s thoughts, feelings, and behaviors is associated with long-term stress and disease. Actively confronting upsetting experiences—through writing or talking—is hypothesized to reduce the negative effects of inhibition. Fifty healthy undergraduates were assigned to write about either traumatic experiences or superficial topics for 4 consecutive days. Two measures of cellular immune-system function and health center visits suggested that confronting traumatic experiences was physically beneficial. The implications for psychotherapy as a preventive treatment for health problems are discussed.
The purpose of this study was to examine whether acute relaxation training, conducted on two separate occasions, would be associated with reliable reduction in subjective and physiological indices of stress. Forty-six experimental subjects were led through Abbreviated Progressive Relaxation Training (APRT) exercises during two laboratory sessions spaced exactly 1 week apart. Fifteen control subjects experienced two laboratory sessions where they sat quietly for an equal amount of time. Results indicated that a brief relaxation exercise led to experimental subjects having significantly lower levels of post-intervention heart rate, state anxiety, perceived stress, and salivary cortisol than control subjects, as well as increased levels of self-report levels of relaxation. The results of this study may have implications for the use of relaxation training in enhancing immune function.
There is no evidence that the George Washington Social Intelligence Test measures anything distinct from verbal intelligence, while the Chapin Social Insight Test has insufficient research to make any determination of its validity. Lengthy administration time, inadequate standardized scoring, and questionable validity plague R. F. Dymond's (1949) rating test of insight and empathy. The literature on the Empathy Test suggest that its validity is also questionable. Although the empathy scale developed by R. Hogan (1969) and the questionnaire measure of emotional empathy (QMEE) of A. Mehrabian and N. Epstein (1972) have adequate validity, they seem to measure 2 different aspects of empathy. The literature on the QMEE indicates that it is measuring vicarious emotional arousal and may tap a general tendency to be arousable in various situations. The literature on the Hogan empathy scale, however, indicates that this scale is measuring role-taking ability and may tap an aspect of adequate social functioning. (96 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The concept of mechanisms that protect people against the psychological risks associated with adversity is discussed in relation to four main processes: 1) reduction of risk impact, 2) reduction of negative chain reactions, 3) establishment and maintenance of self-esteem and self-efficacy, and 4) opening up of opportunities. The mechanisms operating at key turning points in people's lives must be given special attention.
A scale designed to assess various aspects of the burnout syndrome was administered to a wide range of human services professionals. Three subscales emerged from the data analysis: emotional exhaustion, depersonalization, and personal accomplishment. Various psychometric analyses showed that the scale has both high reliability and validity as a measure of burnout. Since the publication of this article in 1981, more extensive research was done on the MBI, which resulted in some modifications of the original measure. The present article has been re-edited to reflect those modifications. However, it does not include other new additions (which are contained in the MBI Manual distributed by the publisher, Mind Garden).
Describes the Interpersonal Reactivity Index (IRI) and its relationships with measures of social functioning, self-esteem, emotionality, and sensitivity to others. 677 male and 667 female undergraduates served as Ss. Each of the 4 IRI subscales displayed a distinctive and predictable pattern of relationships with these measures, as well as with previous unidimensional empathy measures. Findings provide evidence for a multidimensional approach to empathy. (29 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Thesis--University of Texas at Austin. Vita. Includes bibliographical references (leaves 209-219).
This study was designed to determine the effectiveness of a group stress reduction program based on mindfulness meditation for patients with anxiety disorders.
The 22 study participants were screened with a structured clinical interview and found to meet the DSM-III-R criteria for generalized anxiety disorder or panic disorder with or without agoraphobia. Assessments, including self-ratings and therapists' ratings, were obtained weekly before and during the meditation-based stress reduction and relaxation program and monthly during the 3-month follow-up period.
Repeated measures analyses of variance documented significant reductions in anxiety and depression scores after treatment for 20 of the subjects--changes that were maintained at follow-up. The number of subjects experiencing panic symptoms was also substantially reduced. A comparison of the study subjects with a group of nonstudy participants in the program who met the initial screening criteria for entry into the study showed that both groups achieved similar reductions in anxiety scores on the SCL-90-R and on the Medical Symptom Checklist, suggesting generalizability of the study findings.
A group mindfulness meditation training program can effectively reduce symptoms of anxiety and panic and can help maintain these reductions in patients with generalized anxiety disorder, panic disorder, or panic disorder with agoraphobia.
The measurement of cortisol in saliva provides the basic scientist as well as the clinician with a reliable tool for investigations of hypothalamus-pituitary-adrenal axis activity. Since saliva samples can be obtained stress-free and independent from medically trained personnel this method may be well suited for use in psychobiological studies. This overview intends to give a comprehensive introduction to the method of salivary cortisol assessment and to briefly discuss its application in different scientific disciplines.
Can psychotherapy reduce the incidence of health problems? A general model of psychosomatics assumes that inhibiting or holding back one's thoughts, feelings, and behaviors is associated with long-term stress and disease. Actively confronting upsetting experiences--through writing or talk- ing-is hypothesized to reduce the negative effects of inhibition. Fifty healthy undergraduates were assigned to write about either traumatic experiences or superficial topics for 4 consecutive days. Two measures of cellular immune-system function and health center visits suggested that confronting traumatic experiences was physically beneficial. The implications for psychotherapy as a preventive treatment for health problems are discussed. There is little doubt that psychotherapy reduces subjective distress and yields positive behavioral outcomes. In recent years, a small group of researchers has sought to learn whether psychotherapy can also reduce health problems. Two promising reviews have indicated that the use of mental health services is associated with fewer medical visits, fewer days of hospitaliza- tion, and lower overall medical costs. In a summary of 15 stud- ies published between 1965 and 1980, Mumford, Schlesinger, and Glass (1981) found that individuals who underwent psy- chotherapy evidenced a 13% decrease in medical utilization rel- ative to nonpsychotherapy control subjects. Similarly, in a re- view of 13 studies of mental health services that were intro- duced into organizations, Jones and Vischi (1980) found that psychotherapy was associated with a 20% drop in medical utili- zation.
Our objective was to identify endocrine-related mechanisms capable of mediating preventive effects of stress reduction in hypertensive heart disease. Since beneficial effects of stress reduction accrue over time, this cross-sectional, descriptive study sought differences between healthy students not practicing a systematic technique for reducing stress (the average stress, or AS, group, n = 33) and a similar group who for 8.5 years had practiced the Transcendental Meditation (TM) technique, used widely to reduce stress (the low stress, or LS, group, n = 22). The two groups of students, matched for age and area of study, performed timed collections of urine that included (separately) the entire waking and sleeping portions of 1 day. They also completed the Profile of Mood States and the State-Trait Anxiety Inventory, self-report instruments sensitive to subjective level of stress. Urine samples were analyzed for adrenocortical steroids by radioimmunoassay, for Na+, K+, Mg2+, Ca2+, and Zn2+ by atomic absorption spectrometry, and for neurotransmitter metabolites by reverse-phase, high-performance, liquid chromatography, and spectrophotometry. The two groups differed significantly on most measures. Specifically, the LS group was lower in cortisol and aldosterone and higher in dehydroepiandrosterone sulfate (DS) and the serotonin metabolite, 5-hydroxyindoleacetic acid (5-HIAA). Excretion of sodium, calcium, zinc, and the norepinephrine metabolite, vanillylmandelic acid (VMA), was also lower in this group, as were Na+/K+ ratio, mood disturbance, and anxiety. In women practicing TM, cortisol correlated inversely and DS directly with number of months of TM practice. The results identify improvements in mood state, adrenocortical activity, and kidney function as probable factors in the preventive and treatment effects of stress reduction. Because suboptimal levels of these parameters result from chronic, subjective stress, the findings add mechanistic support to the contention that hypertensive heart disease is avoidable, even in modern industrialized societies.
Several approaches to preventing burnout are compared. One hundred and fifty-four nurses in five Hong Kong hospitals completed the Maslach Burnout Inventory (MBI), the Organizational Socialization Inventory (OSI), and three measures of personal stress management. Results indicated that favourable evaluations on the four OSI domains (job training, organizational understanding, coworker support and future prospects) yielded strong negative correlations with the burnout components. Also, the personal stress management measures had strong negative correlations with depersonalization and decreased personal accomplishment, but none were related to emotional exhaustion. Stepwise regression analyses indicated that training was the only (inverse) predictor of emotional exhaustion, whereas interpersonal skills and understanding were strong (inverse) predictors of depersonalization. Additionally, interpersonal skills and coworker support were excellent (inverse) predictors of decreased personal accomplishment. The findings are discussed in terms of their relevance to nursing administration.
To facilitate a multidimensional approach to empathy the Interpersonal Reactivity Index (IRI) includes 4 subscales: Perspective-Taking (PT) Fantasy (FS) Empathic Concern (EC) and Personal Distress (PD). The aim of the present study was to establish the convergent and discriminant validity of these 4 subscales. Hypothesized relationships among the IRI subscales between the subscales and measures of other psychological constructs (social functioning self-esteem emotionality and sensitivity to others) and between the subscales and extant empathy measures were examined. Study subjects included 677 male and 667 female students enrolled in undergraduate psychology classes at the University of Texas. The IRI scales not only exhibited the predicted relationships among themselves but also were related in the expected manner to other measures. Higher PT scores were consistently associated with better social functioning and higher self-esteem; in contrast Fantasy scores were unrelated to these 2 characteristics. High EC scores were positively associated with shyness and anxiety but negatively linked to egotism. The most substantial relationships in the study involved the PD scale. PD scores were strongly linked with low self-esteem and poor interpersonal functioning as well as a constellation of vulnerability uncertainty and fearfulness. These findings support a multidimensional approach to empathy by providing evidence that the 4 qualities tapped by the IRI are indeed separate constructs each related in specific ways to other psychological measures.
Two hundred twenty-five chronic pain patients were studied following training in mindfulness meditation. Large and significant overall improvements were recorded post-intervention in physical and psychological status. These gains were maintained at follow-up in the majority of subjects. Follow-up times ranged from 2.5-48 months. Status on the McUill Melzack Fain Rating Index (PRI). however, tended to revert to preintervention levels following the intervention. Most subjects reported a high degree of adherence with the meditation techniques, maintenance of improved status over time, and a high degree of importance attributed to the training program. We conclude that such training can have long-term benefit for chronic pain patients.
(C) Lippincott-Raven Publishers.
Two hundred twenty-five chronic pain patients were studied following training in mindfulness meditation. Large and significant overall improvements were recorded post-intervention in physical and psychological status. These gains were maintained at follow-up in the majority of subjects. Follow-up times ranged from 2.5-48 months. Status on the McGill Melzack Pain Rating Index (PRI), however, tended to revert to preintervention levels following the intervention. Most subjects reported a high degree of adherence with the meditation techniques, maintenance of improved status over time, and a high degree of importance attributed to the training program. We conclude that such training can have long-term benefit for chronic pain patients.
Working as doctor or dentist may entail higher levels of burnout than experienced by the general population. Maslach Burnout Inventory, evaluates emotional exhaustion, depersonalization and reduced personal accomplishment.
This article presents data conserning levels and sources of burnout in dental research assistants taking postgraduate education in two dental schools in Turkey. One, a new school and the other, an established school. In this study we aimed to investigate if there was an association between the level of burnout and sociodemographic factors and to measure the level of burnout in dental research assistants.
Seventy-eight dental research assistants working in two different dental schools participated in the study. Sociodemographic data were obtained. Sociodemographic characteristics were not significantly different between the two dental schools.
In addition, there were statistically significant differences between the two schools in personal accomplishment, depersonalization and work related strain, but no significant difference in emotional exhaustion. Copyright
Mindfulness-based stress reduction (MBSR) has grown in popularity over the last two decades, showing efficacy for a variety of health issues. In the current study, we examined the effects of an MBSR intervention on pain, positive states of mind, stress, and mindfulness self-efficacy. These measures were collected before and following an 8-week intervention. Post-intervention levels of stress were significantly lower than pre-intervention levels, while mindfulness self-efficacy and positive states of mind were at significantly higher levels. The findings underscore the potential for stress management, awareness and attention training, and positive states of mind using MBSR. Copyright © 2004 John Wiley & Sons, Ltd.
Recent research indicates that an affective state termed empathic emotion, and characterized by feelings of sympathy and compassion for another, is associated with altruistic responding. That is, persons experiencing high levels of empathic emotion offer help to another even when escape from the situation is easy. Persons experiencing high levels of another emotional state—personal distress—help much less when escape from the situation is easy. A study was conducted to test two related hypotheses. The first was that individual differences in empathy can influence empathic emotion and personal distress, above and beyond the influence of situational factors. The second hypothesis was that this effect of individual differences is due to variation in emotional and not cognitive empathy. The results provide support for both hypotheses. Regarding hypothesis 1, a significantly greater proportion of the variance in emotional reactions was accounted for when individual difference factors were included as predictors. Hypothesis 2 was also supported: It was found that a dispositional measure of emotional empathy was clearly related, and a dispositional measure of cognitive empathy was clearly unrelated, to these emotional reactions. The results provide support for a multidimensional view of empathy.
This study examined salivary cortisol and mood during relaxation training in 30 symptomatic, HIV+ gay men participating in a 10-week, group-based cognitive-behavioral stress management intervention. Cortisol levels and mood were assessed within these sessions just before and after 45-min relaxation exercises given as part of each session. Participants also recorded their stress level and compliance with daily home relaxation practice. Presession cortisol levels decreased across the 10-week period and were related to decreases in global measures of total mood disturbance and anxious mood. Reductions in presession cortisol levels were also associated with decreases in self-reported stress level during home practice. Greater reductions in cortisol during the first three sessions were associated with more frequent relaxation practice at home. These findings suggest that salivary cortisol represents an objective neuroendocrine marker for changes in anxiety and distress observed during relaxation training in symptomatic, HIV-seropositive men.
Texto comprensivo sobre el estrés, cuyo autor busca dar cuenta de los aspectos físicos, psicológicos, sociológicos y espirituales de este mal cotidiano. Tras la exposición de las bases científicas del estrés, son presentadas propuestas de intervención como las técnicas de relajación, la estimulación psicológica y la modificación de conducta, para concluir con una revisión de apliaciones más puntuales concernientes a la tensión en el trabajo, la familia, la educación superior y durante la vejez.
This article reviews the cognitive therapy of depression. The psychotherapy based on this theory consists of behavioral and verbal techniques to change cognitions, beliefs, and errors in logic in the patient's thinking. A few of the various techniques are described and a case example is provided. Finally, the outcome studies testing the efficacy of this approach are reviewed.
It is hypothesized that situations requiring continous behavioral adjustment activate an integrated, hypothalamic response, the emergency reaction. The frequent elicitation of the physiologic changes associated with the emergency reaction has been implicated in the development of diseases such as hypertension. Prevention and treatment of these diseases may be through the use of the relaxation response, an integrated hypothalamic response whose physiologic changes appear to be the counterpart of the emergency reaction. This article describes the basic elements of techniques which elicit the relaxation response and discusses the results of clinical investigations which employ the relaxation response as a therapeutic intervention.
Tai Chi, a moving meditation, is examined for its efficacy in post-stressor recovery. Forty-eight male and 48 female Tai Chi practitioners were randomly assigned to four treatment groups: Tai Chi, brisk walking, mediation and neutral reading. Mental arithmetic and other difficult tests were chosen as mental challenges, and a stressful film was used to produce emotional disturbance. Tai Chi and the other treatments were applied after these stressors. After all treatments, the salivary cortisol level dropped significantly, and the mood states were also improved. In general the stress-reduction effect of Tai Chi characterized moderate physical exercise. Heart rate, blood pressure, and urinary catecholamine changes for Tai Chi were found to be similar to those for walking at a speed of 6 km/hr. Although Tai Chi appeared to be superior to neutral reading in the reduction of state anxiety and the enhancement of vigour, this effect could be partially accounted for by the subjects' high expectations about gains from Tai Chi. Approaches controlling for expectancy level are recommended for further assessment.
The aim of this work was to study the clinical utility of salivary cortisol concentrations in a group of depressed patients undergoing the dexamethasone suppression test (DST) and the correlation of these concentrations with plasma ACTH levels.
Twenty outpatients from the psychiatric department of a Barcelona hospital who were diagnosed as having nonendogenous (N = 9) or endogenous (N = 11) depression according to DSM-III criteria and the Newcastle scale participated in the study. The comparison group consisted of 12 healthy volunteers. Blood and saliva samples were taken before and after administration of 1 mg of dexamethasone Salivary cortisol and plasma ACTH concentrations were determined by direct iodine-125 radioimmunoassay with commercial kit reagents.
Predexamethasone salivary cortisol concentrations were significantly higher in the group with endogenous depression than in the comparison group. A significant correlation was obtained between plasma ACTH and predexamethasone salivary cortisol levels in the group with nonendogenous depression and in the comparison subjects.
These preliminary findings indicate that salivary cortisol could substitute for plasma cortisol in clinical studies in which the DST and hypercortisolemia are evaluated. The lack of correlation between ACTH and cortisol levels in saliva in the group of endogenously depressed patients could indicate a disturbance in the regulation of cortisol secretion in major depression.
Changes in psychological and physiological functioning following participation in Tai Chi were assessed for 33 beginners and 33 practitioners. The variables in the three-way factorial design were experience (beginners vs practitioners), time (morning vs afternoon vs evening), and phase (before Tai Chi vs during Tai Chi vs after Tai Chi). Phase was a repeated measures variable. Relative to measures taken beforehand, practice of Tai Chi raised heart rate, increased noradrenaline excretion in urine, and decreased salivary cortisol concentration. Relative to baseline levels, subjects reported less tension, depression, anger, fatigue, confusion and state-anxiety, they felt more vigorous, and in general they had less total mood disturbance. The data suggest that Tai Chi results in gains that are comparable to those found with moderate exercise. There is need for research concerned with whether participation in Tai Chi has effects over and above those associated with physical exercise.
Salivary cortisol represents a simple, noninvasive, stress-free measure that can greatly facilitate the longitudinal study of hypothalamic-pituitary-adrenal axis activity in patients with psychiatric disorders. By means of a slight modification of a commercially available radioimmunoassay kit, we studied the stability of salivary cortisol under different conditions, as well as the relationship between plasma and salivary cortisol under basal circadian conditions and following stimulation (CRH) and suppression (dexamethasone). We observed that salivary cortisol was quite stable at room temperature without centrifugation and that salivary and plasma cortisol values were highly correlated. Additionally, we observed a close correspondence in circadian and ultradian fluctuations in salivary and plasma cortisol. The salivary cortisol response to ovine and human CRH was similar to that observed with plasma cortisol, but was greater in magnitude. Finally, employing a plasma criterion as the standard, salivary measures identified 48% of the nonsuppressed Dexamethasone Suppression Tests (DSTs) and 97% of the suppressed DSTs.
This important volume presents a definitive review of the origins and implications of developmental psychopathology and what has been learned about the phenomenon of psychosocial resilience in diverse populations at risk. Chapters by distinguished investigators in clinical psychology, psychiatry, and child development, many of whose work led to the new developmental model of psychopathology, provide a unique review of research on vulnerability and resistance to disorder spanning from infancy to adulthood. The volume is a tribute to Professor Norman Garmezy, a pioneer in developmental psychopathology and a renowned researcher of resilience in children at risk. Highlighted throughout the volume is Professor Garmezy's theme that it is as important to understand successful outcomes as it is to study pathology in the search for better treatments and the prevention of developmental behavioural problems.
This article updates and extends Jeannette Gagan's "Methodological notes on empathy," published in the January 1983 issue of ANS. The evolving conceptualization of empathy as a complex, intrapsychic, and interpersonal process suggests that the inconclusiveness and apparent contradictions of research to date might be substantially clarified by considering data from a multidimensional perspective. Attention to the conceptual bases underlying diverse measurement approaches is key to understanding the data produced. Notwithstanding the limitations of their paradigms and models for nursing, the debates and knowledge accumulated in other disciplines can inform a broad range of inquiry relevant to nursing.
A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.
There is encouraging evidence that structured psychological treatments for depression, in particular cognitive therapy, can reduce subsequent relapse after the period of initial treatment has been completed. However, there is a continuing need for prophylactic psychological approaches that can be administered to recovered patients in euthymic mood. An information-processing analysis of depressive maintenance and relapse is used to define the requirements for effective prevention, and to propose mechanisms through which cognitive therapy achieves its prophylactic effects. This analysis suggests that similar effects can be achieved using techniques of stress-reduction based on the skills of attentional control taught in mindfulness meditation. An information-processing analysis is presented of mindfulness and mindlessness, and of their relevance to preventing depressive relapse. This analysis provides the basis for the development of Attentional Control Training, a new approach to preventing relapse that integrates features of cognitive therapy and mindfulness training and is applicable to recovered depressed patients.
Cognitive behavioral treatment has been used extensively in the acute phase of depression. The purpose of this study was to determine the applicability and effectiveness of this treatment modality in addressing the residual symptoms of primary major depressive illness.
The subjects were 40 patients with major depressive disorder who were successfully treated with antidepressant drugs. They were then randomly assigned to either cognitive behavioral treatment or clinical management of residual symptoms. In both subgroups, antidepressant drugs were tapered and discontinued.
The group that received cognitive behavioral treatment had a significantly lower level of residual symptoms after drug discontinuation in comparison with the clinical management group. Cognitive behavioral treatment also resulted in a lower rate of relapse (15%) at a 2-year follow-up than did clinical management (35%), although this difference did not reach statistical significance. Most of the residual symptoms were found to have occurred also in the prodromal phase of illness.
This preliminary study points to the potential clinical advantages of cognitive behavioral treatment targeted to the residual symptoms of depression.
Central nervous, endocrine and immune systems (IS) are all considered to be important regulators of psychological and physical wellbeing. Research into psychoneuroimmunology became relatively widespread in the 1970s. More and more studies considered these systems to be interactive units. Disciplines ranging from anatomy to psychology revealed the IS as the target of brain and endocrine signals. Findings also suggest that the IS is active even in a bidirectional feedback loop. Today the IS is no longer regarded as autonomous and scientists begin to see the emergence of a new psychosomatic paradigm. So far, evidence for the mind-body interaction paradigm has been collected with regard to the role of nerve fibres in lymphatic tissues, the effects of brain lesions on the IS, the interplay of neurotransmitters, hormones and immunotransmitters in a network of bidirectional feedback loops between the brain and the IS, the effects of ontogeny, learning and conditioning on the development of the IS, the impact of experimental and naturally occurring stressors on the IS, the possible immune modulating effects of personality characteristics, life style and psychodynamic processes and the role of the IS in disease. Research findings in most of the mentioned topics are presented.
The present study, aimed at investigating effects of film-induced amusement on saliva cortisol levels, was performed on 52 healthy male volunteers, aged 19-31 years. They were assigned to an amusement or a control condition. Saliva cortisol and affective film ratings were the dependent variables. During amusement 50% of the subjects showed changes in saliva cortisol correlated positively with ratings of funniness. Thus, cortisol secretion may be linked to emotional arousal, regardless of the emotional valence.
The authors' goal was to determine whether cognitive behavioral treatment of residual symptoms of depression might have a significant effect on relapse rate.
In an earlier study, 40 patients with primary major depressive disorder who had been successfully treated with antidepressant drugs were randomly assigned to either cognitive behavioral treatment of residual symptoms or standard clinical management. In both types of treatment, antidepressant drugs were gradually tapered and discontinued. In this study, a 4-year follow-up assessment was performed.
Cognitive behavioral treatment resulted in a substantially lower relapse rate (35%) than did clinical management (70%).
Cognitive behavioral treatment of residual symptoms reduces the risk of relapse in depressed patients, probably by affecting the progression of residual symptoms to prodromes of relapse.
This study examined the effects of an 8-week stress reduction program based on training in mindfulness meditation. Previous research efforts suggesting this program may be beneficial in terms of reducing stress-related symptomatology and helping patients cope with chronic pain have been limited by a lack of adequate comparison control group.
Twenty-eight individuals who volunteered to participate in the present study were randomized into either an experimental group or a nonintervention control group.
Following participation, experimental subjects, when compared with controls, evidenced significantly greater changes in terms of: (1) reductions in overall psychological symptomatology; (2) increase in overall domain-specific sense of control and utilization of an accepting or yielding mode of control in their lives, and (3) higher scores on a measure of spiritual experiences.
The techniques of mindfulness meditation, with their emphasis on developing detached observation and awareness of the contents of consciousness, may represent a powerful cognitive behavioral coping strategy for transforming the ways in which we respond to life events. They may also have potential for relapse prevention in affective disorders.