Article

Cultivating mindfulness in health care professionals: A review of empirical studies of mindfulness-based stress reduction (MBSR)

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  • Park-Saltzman Psychological Services, LLC
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Abstract

Demands faced by health care professionals include heavy caseloads, limited control over the work environment, long hours, as well as organizational structures and systems in transition. Such conditions have been directly linked to increased stress and symptoms of burnout, which in turn, have adverse consequences for clinicians and the quality of care that is provided to patients. Consequently, there exists an impetus for the development of curriculum aimed at fostering wellness and the necessary self-care skills for clinicians. This review will examine the potential benefits of mindfulness-based stress reduction (MBSR) programs aimed at enhancing well-being and coping with stress in this population. Empirical evidence indicates that participation in MBSR yields benefits for clinicians in the domains of physical and mental health. Conceptual and methodological limitations of the existing studies and suggestions for future research are discussed.

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... Results were promising, with most interventions showing a decrease in HCPs' anxiety, depression, stress, and burnout symptoms [12,13]; some studies also analysed indirect elements, highlighting positive results for example on patients' satisfaction [13,14]. There is evidence, based on systematic reviews already published, that MBSR and MBI interventions are useful tools able to reduce perceived stress symptoms, to improve mental health outcomes [9,10,15,16] and positive results are reported on the prevention of burnout syndrome [17]. ...
... Due to high demand and workplace stress, HCPs and healthcare students may experience high levels of stress, and mindfulness-based interventions were generally found to reduce symptoms and to improve mental health outcomes [14,[25][26][27]. Other MBIs and stress management interventions also led to a better mental health state in participants [15,16]. The most overall evaluated outcome was perceived stress,that was most often measures using the PSS. ...
... Several limitations must be acknowledged in this review. First of all, most studies included in the single reviews had small sample sizes, and a grade of heterogeneity varying from moderate to high for different outcomes, having the potential for bias [15,25]. In many studies there a control group was lacking, making it difficult to provide evident outcomes. ...
Article
Background: Health care providers (HCPs) and health care students experience a huge amount of stress due to high workloads and pressure to perform and are likely to develop anxiety, depression and burnout. Objective: The objective was to carry out an umbrella review of systematic and narrative reviews on the effectiveness of mindfulness-based interventions in reducing stress and improving well-being in HCPs and health care students. Methods: Systematic and narrative reviews that examined the impact of mindfulness-based interventions on HCPs and healthcare students' perceived stress were identified through a systematic search of three electronic databases: PubMed, Scopus and Web of Science. Results: Fifteen articles were included in the analysis: eleven systematic and four narrative reviews. Studies' quality varied from critically low to high. The different interventions showed positive results in reducing stress in both HCPs and students, with mindfulness-based stress reduction (MBSR) course having the major impact. Conclusions: MBSR techniques and other Mindfulness Based Interventions resulted to be potentially effective in reducing stress. However, despite the vast amount of data collected by the studies and the promising results, several limitations affected the validity of the studies. Therefore, more research that considers the critical aspects of this field is required, in order to provide more reliable results.
... Health care professionals face a multitude of challenges on a daily basis when it comes to their workload, long hours, and dealing with upper level administration. This continually leads to chronic stress, professional burnout, and poorer quality of life [70]. Over 40% of nurses suffer occupational burnout, 28% of physicians endure symptoms of burnout, and 60% of psychologists acknowledge to being so distressed that they feel clinically ineffective [71][72][73]. ...
... Mindfulness can help healthcare professionals become more 'affectionate, compassionate, and friendlier," towards the patient. Practicing mindfulness-based stress reduction (MBSR) appears to improve well-being and dealing with pressure in these professionals [70]. One particular study taught participants different types of meditation practices, while incorporating more mindful tasks when eating, driving, walking, cleaning, and socializing with others. ...
... Although the findings for the clinical and non-clinical groups were promising, MBSR programs can have systematic issues. For example, the quantitative studies held small sample sizes and the practice time for meditation, whether at home or elsewhere, is very variable depending on the individual [70]. Also, there is no 'dose' that can be measured when it comes to mindful-based meditation, just the amount of mindfulness practice reported and expected results from it [70]. ...
... [17] Mindfulness has been shown to be an effective approach for decreasing distress and improving well-being across a wide variety of clinical and non-clinical populations [18][19][20]. Within healthcare settings in particular, MBSR programs can be applied to teach healthcare employees how to better manage chronic occupational stress in order to avoid or reverse symptoms of professional burnout [21,22]. Indeed, such programs have been shown to be beneficial for healthcare employees' symptoms of stress [21][22][23][24] as well as for quality of patient care [25]. ...
... Within healthcare settings in particular, MBSR programs can be applied to teach healthcare employees how to better manage chronic occupational stress in order to avoid or reverse symptoms of professional burnout [21,22]. Indeed, such programs have been shown to be beneficial for healthcare employees' symptoms of stress [21][22][23][24] as well as for quality of patient care [25]. ...
... Although we had a small sample size, our preliminary outcome measures showed evidence of positive psychosocial changes consistent with the literature [21][22][23][24]. We observed positive changes in depressive symptoms and overall distress, which offers initial support for the premise that a telephone-based MBSR program can be beneficial for alleviating mood symptoms in healthcare professionals. ...
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Healthcare employees often experience high stress and may benefit from accessible psychosocial interventions. In this pilot study, we explored preliminary feasibility, acceptability, and psychological effects of a telephone-based adaption of mindfulness-based stress reduction (MBSR) for healthcare employees. Eleven participants (M age = 49.9; 27.3% ethnic/racial minority) were enrolled in an eight-session group-based MBSR program adapted for telephone delivery. Feasibility was assessed using rates of program attrition and session completion; acceptability was explored qualitatively via participants’ responses to an open-ended item about their program experience. Participants also completed pre-and post-program assessments on psychosocial outcomes (distress (overall distress, depression, anxiety, somatization), mindfulness, and self-compassion). We characterized mean change scores, 95% confidence intervals, and effect sizes to explore preliminary program effects. With regard to preliminary feasibility, one participant dropped out prior to the intervention; of the remaining 10 participants, 90% completed at least half (≥4) of the sessions; 70% completed at least three-quarters (≥6 sessions). Feedback reflected positive experiences and included suggestions for program delivery. Participants reported reductions in distress post-program (M difference range = −5.0 to −9.4), showing medium to large effect sizes (d range = 0.68 to 1.11). Mindfulness scores increased from pre- to post-intervention (M difference range = 1.0 to 10.4), with small-to-medium effects (d range = 0.18 to 0.55). Almost all aspects of self-compassion remained stable over time, with the exception of common humanity, which increased post-program (M difference = 2.9, CI 95% 0.5 to 5.4, d = 0.91). Preliminary findings from our small pilot trial suggest that telephone-based adaptations of MBSR may be a useful mode of delivery for healthcare employees; however, larger studies are needed to provide further evidence of feasibility, acceptability, and program effects.
... Several review studies [2,3] concluded that trait mindfulness was negatively associated with many health issues such as chronic pain, depression, social anxiety, and emotion regulation and that mindfulness training could bring about positive psychological effects. As promoted by the growing evidence and consensus on their effectiveness, mindfulness-based therapies have been applied more widely both in clinical practice [4] and in non-clinical settings that aimed to improve physical and mental health of the general population [5][6][7][8][9][10][11][12][13]. These wide applications of mindfulness in turn have advocated for a more refined understanding and a better measurement of this *Correspondence: ntmhang@vnu.edu.vn ...
... Total denotes a total sum score. α denotes Cronbach's alpha, λ 6 denotes Guttman's λ 6 , ω denotes McDonald's ω, and N denotes sample size. * denotes p < .001, ...
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Background Although recent decades have witnessed a growing interest in mindfulness with the development of many mindfulness scales and their adaptation to different cultures, there has been no attempt at developing or adapting a mindfulness scale for Vietnamese people. To fill this gap and encourage the study of mindfulness in Vietnam, we adapted a 20-item short-form of the Five Facet Mindfulness Questionnaire (FFMQ-20) into Vietnamese, which we called the FFMQ-V, and examined its psychometric properties in a series of three independent studies. Methods In Study 1, using a college sample ( N = 412) we conducted several exploratory factor analyses to elucidate the factor structure of the FFMQ-V. In Study 2, using an independent college sample ( N = 344) we performed a confirmatory factor analysis (CFA) to test the goodness-of-fit for all obtained factor models from Study 1. In this study, we also examined the discriminant validities of the FFMQ-V by correlating mindfulness and other related psychological constructs, including acceptance, nonattachment, depression, anxiety, and stress. In Study 3, we replicated all data analyses in Study 2 using a community sample of young adults ( N = 574). Results Across all Studies, our results indicated that the hierarchical five-factor model with method factors best captured the latent structure of the FFMQ-V. Our results also showed that the mindfulness facets met our expectations as they correlated positively with the acceptance and nonattachment and negatively with the depression, anxiety, and stress. Conclusions In aggregate, our EFA and CFA results provided strong evidence for the hierarchical five-factor model with method factors in both community and college samples, suggesting that the FFMQ-V can be used to measure trait mindfulness of the Vietnamese young adults.
... The term "meditation" encompasses a variety of techniques, including but not limited to mantra-based meditation such as transcendental meditation, mindfulness-based stress reduction, yoga, qi gong, tai chi, and passage meditation. [19][20][21] Mantra-based meditation is one such technique in which a sound, word, or phrase (called "mantra") is recited either aloud or silently during meditation. It has been established by experiences, as well as experiments, that the correct frequency of mantra sound, along with the correct intent, helps the practitioner oxygenate the brain, reduce heart rate and blood pressure, get cured of many ailments, create calm brainwave activity, and achieve immunity from outside mental disturbances. ...
... It has been established by experiences, as well as experiments, that the correct frequency of mantra sound, along with the correct intent, helps the practitioner oxygenate the brain, reduce heart rate and blood pressure, get cured of many ailments, create calm brainwave activity, and achieve immunity from outside mental disturbances. 21,22 Mindfulness-based stress reduction practices such as mantra-based meditation have demonstrated many interesting therapeutic effects were nurses, and the rest were hospital staff. Burnout was not specifically addressed; the items measured were perceived stress, anxiety as both a trait and a state, anger as both a trait and a state, quality of life, existential well-being, religious well-being, and total spiritual wellbeing. ...
Article
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There is an abundance of research demonstrating the growing challenge of burnout in healthcare professionals. This has been further exacerbated by the COVID‐19 pandemic. The use of meditation using various techniques has shown promising results in the reduction of stress and its sequelae. To determine the efficacy of a mantra‐based meditation protocol developed by the American Meditation Institute to reduce caregiver stress by evaluating changes in burnout and secondary traumatic stress (components of compassion fatigue) and compassion satisfaction with the application of the meditation protocol. This pre–post cohort analysis was conducted on prospective enrollees of the Continuing Medical Education (CME)‐accredited American Meditation Institute's annual Heart and Science of Yoga® Conference, a comprehensive training in Yoga Science as Holistic Mind/Body Medicine for physicians and other healthcare providers held in October in Lenox, Massachusetts. Enrollees were trained in mantra‐based AMI Meditation at the conference and monitored during the 6‐month period following the conference. The mantra‐based AMI Meditation intervention included a 5‐day in‐person training, a daily practice of a guided mantra‐based AMI Meditation using a 20‐min CD or MP3 recording, and receipt of a monthly motivational letter. Study participants completed the Professional Quality of Life (ProQOL) Measure (a survey) and a demographic survey at baseline, and the ProQOL Measure and an informational survey at 3 and 6 months. The primary outcome was a change from baseline in participants’ level of burnout using the ProQOL assessed at baseline and 3 and 6 months. Secondary outcomes included change from baseline in participants’ level of secondary traumatic stress and compassion satisfaction assessed at 3 and 6 months using the ProQOL Measure. Qualitative data were also collected from participant feedback, via the informational surveys, at 3 months and after completion of the program at 6 months. Of the 54 participants who enrolled and completed a baseline survey, 30 completed the follow‐up at 3 months and 21 participants completed the follow‐up at 6 months. From baseline to 6 months, there were statistically significant improvements in the scores for all three ProQOL scales. Using paired t‐test, burnout scores were reduced by 23.2% (p < 0.0001), secondary traumatic stress scores were reduced by 19.9% (p = 0.001), and compassion satisfaction scores improved by 11.2% (p < 0.0001). For secondary traumatic stress and compassion satisfaction scores, most improvements were seen at 3 months. For burnout, the improvements were constant across the 3‐ and 6‐month follow‐ups. In this small cohort of healthcare professionals, the mantra‐based AMI Meditation program significantly improved all three domains of caregiver stress with improvements in burnout and secondary traumatic stress as well as improvements in feelings of compassion. This adds to a rapidly growing body of research supporting the critical importance of these tools and skills in the mitigation of caregiver stress.
... When physicians persevere through burnout, there are several implications for patient care. Chronic stress reduces concentration during clinical decision-making and erodes communication skills in the doctor-patient relationship (Irving et al., 2009). As a result, healthcare professionals (HCP) struggle to meet work demands. ...
... The literature observes a trend toward mindfulness being a significant deterrent against physician mental health concerns. In their comprehensive review, Irving et al. (2009) surmised that mindfulness interventions can significantly reduce rumination and encourage reflection. Bedolla and Andrew (2018) suggest that mindfulness is a natural remedy for physician burnout by improving performance, emotional stability, and global cognitive function. ...
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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.MethodologyA 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.Results31 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 most commonly researched emotion in the context of second or foreign language learning is anxiety (Dewaele & MacIntyre, 2014). Anxiety is the response of individuals when there is a demand exceeding their resources for handling it (Irving, Dobkin & Park, 2009). Also, Morgan (2020) states that anxiety is an emotion with stressed thoughts and is marked by physiological and psychological symptoms. ...
... The physiological signs of anxiety can be increasing in pulse rate, sweating, cold fingers, insomnia, hyperventilation, and dyspepsia (Morgan, 2020). The psychological symptoms of anxiety can be agitation, problems focusing, and derealization (Irving, Dobkin & Park, 2009;Morgan, 2020). ...
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This study aims to investigate the foreign language anxiety (FLA) level among learners of German as a foreign language and discover the relationship between FLA and students’ variables that are gender, year of study, achievement in German classes, experience staying in Germany for more than six months, weekly contact hours, and course load of the term. The study used a quantitative research method using a survey approach. The Foreign Language Classroom Anxiety Scale (FLCAS), developed by Horwitz (1986), was administered to 246 German language learners in Jordan. Descriptive statistics, Chi-Squared, and univariate and multivariate ordinal logistic regression analysis were used to analyse the collected data then fitted on a regression model. The results suggest that the participants’ level of FLA was on a moderate level, with the anxiety of the German Class as the most dominant aspect and Text Anxiety as the least aspect. The gender of the participants and their weekly contact hours of the German language did not determine their level of anxiety in learning German as a foreign language. The variables that significantly affected the participants’ language anxiety, whether high or low anxiety, were the year of study, the German-language assessment score, staying for more than six months in Germany studying or field training, and the total number of credit hours registered for the term. It is recommended that language instructors create a positive and friendly attitude towards students to reduce language anxiety in the classroom.
... [8] This issue should be taken into concerns, as there appears to be negative impact on a humanized care paradigm in dental profession. This leads to a rising trend in the implementation of contemplative practice in healthcare education and continuing studies [9,10] where the focus is move to the quality of personal and professional life as well as the efficacy of patient care. ...
... [16] According to current evidence, most of the studies regarding impact of contemplative practice on stress reduction and empathy improvement were conducted using quantitative methods. [9,12] However, there may be difficulties in constructing comprehensive explanations of association between contemplative practice and humanized care paradigm with a quantitative research design. Consequently, this research was conducted qualitatively to evaluate the impact of contemplative practice on dental practice in an aspect of patient care among dental postgraduates. ...
Article
Aim: This study explored perceptions of dental postgraduates regarding the impact of contemplative practice in a patient care aspect. Materials and methods: The qualitative research approach using semi-structured interview was employed. Postgraduate students from the General Dentistry Residency Training Program were selected by purposive sampling by considering sex and working experience. The retrieved data were transcribed using a verbatim technique and analyzed using framework analysis. Results: There were 12 students participating in this research. The retrieved data were analyzed and categorized into two main themes, which were mindfulness and humanized patient-centered care paradigm. Mindfulness can be categorized into four subthemes to represent its required skills, including concentration, deep listening, emotional regulation, as well as critical thinking and problem-solving skill. There were six subthemes for humanized patient-centered care paradigm, which were understanding in patients' context, development of individualized comprehensive treatment planning, treatment with humanization and compassion, management with phycological integrated care, rapport establishment with patients, and good attitudes toward special care needs patients. These skills are considered necessary for patient-centered dental practice, which could be expected from the learning process through contemplative practice. Conclusion: This research supports the implementation of contemplative practice in dental education, as the data demonstrated the positive impact of contemplative practice in both personal and professional perspectives. These included the cultivation of mindfulness and other relevant skills, which were required for humanized patient-centered care in dental practice.
... Healthcare professionals for instance, seem to be a logical target group for MBPs due to their exposure to high interpersonal demands and physical stress (Burton et al., 2017). At the same time, this group of professionals might be particularly inclined to cultivating mindfulness skills (Irving et al., 2009). A less favorable climate might prevail in the context of 'tough, male'-oriented occupations, such as police officers or firefighters, including social norms, attitudes and expectations that possibly lower the acceptance and effects of MBPs (see e.g., Krick & Felfe, 2020). ...
... The strong interest in MBPs in workplace settings is reflected by a growing number of systematic reviews. Qualitative reviews have provided an overview of empirical studies across occupational groups(Eby et al., 2019;Jamieson & Tuckey, 2017;Janssen et al., 2018;Lomas et al., 2017a) and in specific settings, such as teaching/education(Hwang et al., 2017;Lomas et al. 2017b), health care (Boellinghaus et al., 2014Escuriex & Labbé, 2011;Irving et al., 2009;Lomas et al., 2019b;Luken & Sammons, 2016; Morgan et al., 2015;Rudaz et al., 2017; Smith, 2014), social workers(Trowbridge & Mische-Lawson, 2016) and managers(Donaldson-Feilder et al., 2019). Although most authors draw encouraging conclusions, the inclusion of uncontrolled studies with a varying methodological quality impede the evaluation to which extent effects can be achieved.Most previous meta-analyses either refer to a specific occupational group, such as teachers(Iancu et al., 2018; Klingbeil & Renshaw, 2018) and mental health professionals(Barns, 2017; Burton et al., 2017;Lomas et al., 2019b), or to specific outcome variables, e.g., psychological distress(Slemp et al., 2019;Virgili, 2015) or burnout (Iancu et al., 2018; Slemp et al., 2019). ...
Thesis
Im Zuge der Globalisierung, Digitalisierung und des gesellschaftlichen Wandels, hat sich die Arbeitswelt in den letzten Jahren stark verändert. Diese Veränderungen stellen erhöhte Anforderungen an die psychische Gesundheit der Beschäftigten. Die Prävention psychischer Störungen am Arbeitsplatz und die Frage, wie Arbeit gesund gestaltet werden kann, gewinnt daher zunehmend an Bedeutung. Eine zentrale Rolle nimmt dabei die Führungskraft ein, da diese maßgeblich die Arbeitsumgebung und die Arbeitsprozesse gestaltet und im direkten Kontakt mit ihren Mitarbeitenden steht. Zudem haben in den letzten Jahren achtsamkeitsbasierte Programme zur Prävention psychischer Störungen enorm an Bedeutung gewonnen, deren Wirksamkeit im Arbeitskontext jedoch oft in Frage gestellt wurde. Ziel dieser Dissertation ist es, die Wirksamkeit und potentielle Wirkmechanismen achtsamkeitsbasierter Programme in der Arbeitswelt zu prüfen und deren Integration im Rahmen der gesunden Führung zu untersuchen. Zu diesem Zweck ist die vorliegende Dissertationsarbeit in insgesamt vier Abschnitte gegliedert. In Abschnitt 1 wird der Effekt psychischer Belastungen von N = 2.287 Studienteilnehmenden im Hinblick auf deren Arbeitsunfähigkeitstage und Krankheitskosten in den folgenden zwei Jahren geprüft, um die langfristigen ökonomischen Folgen psychischer Belastungen zu erörtern und die Relevanz von Präventionsangeboten aus einer sozioökonomischen Perspektive zu beurteilen. Die Ergebnisse zeigen einen signifikanten Zusammenhang zwischen subjektiv erlebter psychischer Belastung und späteren Arbeitsunfähigkeitstagen bzw. Krankheitskosten. So zeigt sich, dass schwer belastete Personen 27mal so viele Arbeitsunfähigkeitstage im ersten Jahr und 10mal so viele Arbeitsunfähigkeitstage im zweiten Jahr aufweisen, verglichen mit Personen ohne psychische Belastungen. Außerdem zeigten schwer belastete Personen 11fach erhöhte Krankheitskosten im ersten Jahr und 6fach erhöhte Krankheitskosten im zweiten Jahr, verglichen mit nicht belasteten Personen. Auch schon bei leichten und mittleren psychischen Belastungen zeigten sich signifikant erhöhte Arbeitsunfähigkeitstage und Krankheitskosten (2fach bis 11fach erhöht). Diese Ergebnisse verdeutlichen die sozioökonomische Relevanz psychischer Belastungen und bilden eine empirische Grundlage für die Annahme, dass durch effektive Präventionsmaßnahmen sowohl individuelles Leid gelindert als auch sozioökonomische Kosten reduziert werden können. In Abschnitt 2 wird in Form einer Übersichtsarbeit der aktuelle Forschungsstand zu achtsamkeitsbasierten Programmen in der Arbeitswelt skizziert und deren Wirksamkeit und potentielle Wirkmechanismen metaanalytisch geprüft. Über k = 56 randomisiert-kontrollierte Interventionsstudien hinweg zeigen sich kleine bis mittlere Effekte (g = 0,32 bis 0,77) auf unterschiedlichen gesundheitsbezogenen Variablen (z.B. Wohlbefinden, Stress, subsyndromale Symptome, Burnout und somatische Beschwerden) sowie arbeitsbezogenen Variablen (z.B. Arbeitsengagement, Arbeitszufriedenheit und Produktivität), die bis zu 12 Wochen nach der Intervention bestehen bleiben. Diese Ergebnisse legen nahe, dass achtsamkeitsbasierte Programme effektiv in verschiedenen Arbeitskontexten eingesetzt werden können und somit eine gute Grundlage zur Prävention psychischer Störungen in der Arbeitswelt bilden. In Abschnitt 3 wird der Zusammenhang zwischen gesunder Führung und psychischer Gesundheit aus Perspektive von Führungskräften und deren Mitarbeitenden in einem querschnittlichen Studiendesign mit Hilfe von Mehrebenenanalysen untersucht, um den komplexen Zusammenhang zwischen Führung und Gesundheit besser zu verstehen. Dabei zeigt sich, dass die Einschätzungen der gesunden Führung zwischen Führungskräften und ihren Mitarbeitenden deutlich abweichen und nur auf konkreten Verhaltensdimensionen signifikante Zusammenhänge aufweisen. Die subjektive Wahrnehmung der gesunden Führung durch die Mitarbeitenden zeigt einen signifikanten Zusammenhang mit deren psychischer Gesundheit, nicht aber die Selbsteinschätzungen der Führungskräfte. Insgesamt weisen diese Ergebnisse darauf hin, dass die subjektive Wahrnehmung gesunder Führung eine wichtige Determinante für die psychische Gesundheit bei der Arbeit darstellt, dass das Thema gesunde Führung jedoch expliziter im Arbeitskontext ausgestaltet werden sollte, um ein gemeinsames Verständnis von gesunder Führung zwischen Führungskräften und Mitarbeitenden zu schaffen. In Abschnitt 4 wird dargestellt, wie die gesunde Führung mit Hilfe einer gezielten Intervention gefördert werden kann und welche Rolle das Konzept der Achtsamkeit dabei einnimmt. Die achtsamkeitsbasierte Intervention umfasst drei Seminartage (à 8 Stunden) zu i) gesunder Selbstführung, ii) gesunder Mitarbeiterführung und iii) Umgang mit psychisch belasteten Mitarbeitenden sowie zwei Nachhaltigkeitstermine (à 3 Stunden). Anschließend werden die Wirksamkeit sowie potentielle Wirkmechanismen der Intervention in einem quasiexperimentellen Studiendesign sowohl auf Ebene der Führungskräfte als auch auf Ebene der Mitarbeitenden empirisch geprüft. In 12 Unternehmen nahmen insgesamt 117 Führungskräfte an der Intervention teil. Die Führungskräfte und deren 744 Mitarbeitende machten Angaben zu ihrer psychischen Belastung sowie zur gesunden Führung zu drei Messzeitpunkten (Prä, Post, 3 Monate Follow-Up). Diese Angaben wurden mit einer passiven Kontrollgruppe, basierend auf Propensity Score Matching, verglichen. Hierarchische lineare Modelle ergaben, dass die Führungskräfte, die an der Intervention teilgenommen haben, eine signifikant stärkere Abnahme der psychischen Belastung und eine Zunahme der gesunden Selbst- und Mitarbeiterführung im Zeitverlauf aufzeigen als die gematchten Kontrollpersonen (g = 0,27 bis 0,55). Der signifikante Interventionseffekt auf die psychische Belastung der Führungskräfte wird durch die Häufigkeit der selbstständig durchgeführten Achtsamkeitsübungen moderiert und durch eine Zunahme der gesunden Selbstführung vermittelt. Auf Mitarbeiterebene ergaben sich keine signifikanten Effekte zwischen den Gruppen im Zeitverlauf. Es zeigte sich jedoch ein signifikanter Zusammenhang zwischen der subjektiv erlebten gesunden Führung und der späteren psychischen Belastung. Dies deutet darauf hin, dass die subjektive Wahrnehmung der gesunden Führung eine wichtige Determinante der psychischen Gesundheit von Mitarbeitenden darstellt. Insgesamt tragen diese Ergebnisse zu unserem Verständnis bei, wie eine gesunde Führung effektiv trainiert werden kann, um die gesunde Selbst- und Mitarbeiterführung der teilnehmenden Führungskräfte zu erhöhen und deren psychische Belastung zu reduzieren. Die Ergebnisse weisen jedoch gleichermaßen auf die Herausforderung hin, Interventionsprogramme weiter zu verbessern, um deren indirekte Effektivität auf Mitarbeiterebene zu erhöhen. Diese Dissertation trägt insgesamt dazu bei, die Bedeutung der Prävention psychischer Störungen in der Arbeitswelt zu verdeutlichen und zeigt Möglichkeiten auf, wie eine effektive Prävention in Unternehmen ausgestaltet werden kann.
... 2,4 There is substantial evidence in the extant literature that the incidence and prevalence of compassion fatigue and burnout are high in acute care nurses regardless of specialty. 3,5 A systematic review 6 found that 40% of nurses experienced general occupational burnout while another study found that 82% of nurses surveyed exhibited moderate-to-high levels of burnout. 5 For nurses, the personal cost of caring can have severe and lasting consequences. ...
... 11 Research has demonstrated that MBSR is an effective intervention for managing stress, enhancing resilience, reducing compassion fatigue, and limiting the effects of burnout in nurses, among other health care disciplines. 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. ...
Article
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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.
... The usage of mindfulness exercise in the workplace as part of staff development and well-being efforts is rising. It can reduce stress associated to work and enhance job performance (Irving et al., 2009;lsheger et al., 2013), improve one's ability for attention and self-awareness, enabling one to better understand the "early warning" symptoms of stress and find solutions to strengthen their own resources (Lindsay and Creswell, 2017;Hugh-Jones et al., 2018). ...
... Thus, HCPs experiencing burnout become no longer able to have a meaningful relationship with their patients (Gueritault-Chalvin et al., 2000;Penson et al., 2000;Merlani et al., 2011;Lemoine et al., 2017;Lazarescu et al., 2018;Braun et al., 2019). Fortunately, a large body of literature has shed light on the positive effects of mindfulness on well-being and burnout prevention (Epstein, 1999;Epstein, 2003b;Hassed et al., 2009;Irving et al., 2009;Newsome et al., 2012;Conversano et al., 2020;Petitta et al., 2022), indicating that it leads to a feeling of being able to perceive the return of dysfunctional coping patterns and take a step back from negative events. Thus, empathy, compassion and metacognition seem to be at the core of an optimized mindfulness practice. ...
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Background Compassion is a key component of quality care. Encouraging Health Care Professionals (HCPs) to develop a patient-centered care relationship through mindfulness and compassion training may be beneficial for both patients and HCPs.Method We assessed the impact of a compassion-centered mindfulness program [i.e., the Mindfulness Based (MB) CARE program] on healthcare practice conducting 10 phone interviews with HCPs who experienced the program.ResultsThe training had an overall positive impact on the HCPs ability to feel compassion toward their patients and themselves, helped them develop kindness toward themselves and their patients, and enhanced their attention to their patient’s needs and theirs. Participants were better able to accept the difficult work experiences or those their patients experienced, with more perceived equanimity and less reactivity.Conclusion Professional mindfulness and compassion training programs could be operational levers for institutions aiming at fostering more compassionate HCPs–patients relationships.
... [23,24]. In addition, systematic reviews of healthcare providers reveal that practitioners who incorporate mindfulness into their personal and professional lives demonstrate an improved sense of well-being and ability to employ self-care strategies [25,26]. ...
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The purpose of this study was to examine the mediating effects of mindfulness on the relationships between stress and quality of life among shift nurses. A descriptive cross-sectional survey design was conducted using purposive sampling of 206 shift nurses in a tertiary general hospital in Korea. Data were analyzed with descriptive statistics, Pearson correlation and multiple regression analysis using SPSS/WIN 26.0 program. There were significant correlations among stress, mindfulness and quality of life. The quality of life had a positive correlation with mindfulness (r = 0.52, p < 0.001) and a negative correlation with stress among nurses. Mindfulness acts as a mediator in explaining relationship between stress and quality of life. This study provide evidence for the role of mindfulness in the relationship between stress and quality of life in shift nurses. Mindfulness appears to be a protective factor against nurses’ stress. If mindfulness-based interventions are developed and applied to improve the quality of life of shift nurses based on this study, it can help reduce their stress and improve the quality of life, which could ultimately improve the quality of nursing care for patients.
... While mindfulness meditation training, e.g., an 8-week MBSR course or yoga, is beneficial in expediting BCI learning, such training is time-consuming and requires guidance from experienced meditation instructors (Irving et al., 2009); thus, it is not an ideal option to enhance BCI performance for those requiring the use of an SMR-based BCI immediately (or within a very short period). Therefore, it is of interest to investigate the potential immediate effects of short-term meditation in a form that can be easily practiced by those that are unable to participate in active and regular meditation courses, such as taking routine yoga classes or enrolling in an 8-week MBSR course. ...
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IntroductionMeditation has been shown to enhance a user’s ability to control a sensorimotor rhythm (SMR)-based brain-computer interface (BCI). For example, prior work have demonstrated that long-term meditation practices and an 8-week mindfulness-based stress reduction (MBSR) training have positive behavioral and neurophysiological effects on SMR-based BCI. However, the effects of short-term meditation practice on SMR-based BCI control are still unknown.Methods In this study, we investigated the immediate effects of a short, 20-minute meditation on SMR-based BCI control. Thirty-seven subjects performed several runs of one-dimensional cursor control tasks before and after two types of 20-minute interventions: a guided mindfulness meditation exercise and a recording of a narrator reading a journal article.ResultsWe found that there is no significant change in BCI performance and Electroencephalography (EEG) BCI control signal following either 20-minute intervention. Moreover, the change in BCI performance between the meditation group and the control group was found to be not significant.DiscussionThe present results suggest that a longer period of meditation is needed to improve SMR-based BCI control.
... Efforts to minimize burnout resulting from individual level factors need to integrate various approaches for healthcare professionals. There is growing evidence that mindfulness-based interventions among healthcare professionals can be beneficial by reducing stress and the burnout experienced and improving job satisfaction and patient health outcomes [48,49]. Mindfulness is commonly defined as the quality of awareness that occurs through purposely focusing on current moment experiences in an accepting manner [50]. ...
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Objectives: The study objectives were to examine the prevalence of burnout among healthcare professionals, analyze the association of depression and burnout among healthcare professionals, and explore the factors related to burnout. Methods: A prospective cross-sectional study using a validated questionnaire was conducted among healthcare professionals in a tertiary teaching hospital in Saudi Arabia's central region. The Maslach Burnout Inventory (MBI) questionnaire was used to measure burnout through emotional exhaustion, depersonalization, and personal accomplishment. Descriptive and inferential statistics were carried out using SAS version 9.4. Results: The study sample was composed of 139 healthcare professionals. Around 48% of the study sample were nurses, 26% were physicians, 19% were pharmacists, and 6% were other healthcare professionals. About 61% screened positive for depression. Overall, one third of the participants had a high risk of burnout. Around 61.8% of the participants were in the high-risk group of the EE, 58.3% of the DP, and 41.0% of the PA subscales. Scores for the overall MBI were significantly different between various age groups, gender, those with social and financial responsibility, income, job titles, or years of experience. A higher risk of burnout in all subscales was observed among those with depression. Conclusions: A high risk of burnout was observed among healthcare professionals. The level of burnout was connected to workplace factors and the presence of depression. The burnout suffering among these healthcare professionals underlines the need to study further how to reduce the factors that contribute to burnout and the impact of interventions to reduce healthcare professionals' burnout levels. The burnout scientific literature would benefit from further high-quality research with larger samples using longitudinal study designs to identify the causal risk factors.
... All these resources might have an important role during the discharge, particularly at the coronavirus time. Mindfulness-based interventions might be helpful in strengthening these resources, reducing the distress in the post-emergency phase and preventing a range of long-term psychopathological outcomes in both the offenders and healthcare professionals, as suggested by previous reviews and well-conducted randomized controlled trials (Banks et al. 2015;Burton et al. 2017;Irving et al. 2009). ...
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Italy is the first European country severely hit by the COVID-19 pandemic after the outbreak in Wuhan. In our healthcare context, the closing of forensic psychiatric hospitals in 2014 completed the long transition from a containment approach for offenders with severe mental disorders to a model oriented to recovery and community reintegration. High-Security Forensic Psychiatry Residences (REMS) were implemented by regional health authorities. Within these settings, inpatients with severe psychiatric disorders who committed a criminal offense, without criminal responsibility but still considered socially dangerous, are held, and treated. The current COVID-19 emergency represents a severe stressful event which has a potentially negative impact on the recovery process of the inpatients and on the work-related health of the psychiatric professionals. The present paper consists of two sections. In the first one, we discuss the organizational and clinical issues emerged in the forensic psychiatry system in Italy. We identify vulnerable groups and processes and suggest long-term prevention strategies at both clinical and organizational levels. Within the second section, we present the findings of a qualitative exploratory survey conducted in four different REMS immediately after the stop of the lockdown. Based on a qualitative approach, this survey explored the COVID-19 effects on mental health of REMS inpatients and healthcare workers. Thematic analysis showed five key themes: “Intervention and prevention strategies during the lockdown decision making”; “Inpatients’ reactions to the pandemic”; “Psychological reactions of the healthcare staff”; “Recovery process and relations with community mental health services”; “Lessons for the future learned from the COVID-19”.
... 5,8 There is a lot of research evidence that suggests that mindfulness-based interventions and yoga can help HCPs reduce stress and burnout. 9,10 Although there are varying definitions of mindfulness, it is commonly and operationally defined as the quality of awareness that occurs when one intentionally focuses on present moment experiences in an accepting and non-judgmental manner. 11 Mindfulness-based interventions (MBIs) have emerged as a unique approach for addressing a range of clinical and subclinical difficulties such as stress, chronic pain, anxiety, and recurrent depression. ...
Background: Mental health problems are common in healthcare workers as they are exposed to a variety of risk factors. Healthcare professionals face extraordinary stressors in the medical environment. They demonstrate high levels of stress, anxiety, depression and burnout, and sleep disorders, which inevitably lead to medication errors and lower standards of care. Methods: We conducted a wide-ranging review to analyze how the use of yoga and mindfulness-based interventions reduce stress, anxiety, and burnout in healthcare workers. The main scientific databases we consulted, such as PubMed, Scopus, Cochrane Library, Web of Sciences, APA PsycInfo, and CINAHL, contain all the systematic reviews present in the literature. No restrictions of year, publication, or language were applied. Based on PRISMA guidelines, 12 reviews were included in this paper. Quality assessment of the systematic reviews included in the research was done using the AMSTAR checklist. Results: In accordance with the literature, the study shows that increasing the use of yoga and mindfulness-based interventions can provide support to healthcare workers in achieving stable psycho-physical well-being, which can enhance their value within their work environment. Conclusion: Employers in the healthcare industry should consider implementing workplace wellness programs that integrate these methods to promote the well-being of their staff. MBI and yoga are effective interventions that can help the psychological functioning of healthcare professionals; however, further high-quality research is needed before this finding can be confirmed.
... About the specific types of MBIs included in the study, MBSR (Irving et al., 2009;Kabat-Zinn, 2009), MBCT (Teasdale et al., 2000), MBPBS (Singh et al., 2015), meditation on the soles of the feet (Singh et al., 2003), MBAT (Prioli et al., 2017), and non-standarded formats of MBIs (Müller et al., 2019;Saha et al., 2020;van Dongen et al., 2016) were presented in the analyses. ...
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Objectives This study includes a systematic review of cost-effectiveness analyses (CEAs) and cost–benefit analyses (CBAs) of mindfulness-based interventions (MBIs).MethodsA literature search was conducted using PubMed, Web of Science, JSTOR, and CINAHL for studies published between January 1985 and September 2021, including an original cost-related evaluation of an MBI. A qualitative assessment of bias was performed using the Drummond checklist.ResultsTwenty-eight mindfulness-based intervention studies (18 CEAs and 10 CBAs) were included in this review. Mindfulness-based stress reduction (MBSR) was less costly and more effective when compared with the usual care of cognitive behavioral therapy among patients with chronic lower back pain, fibromyalgia, and breast cancer. MBSR among patients with various physical/mental conditions was associated with reductions in healthcare costs. Mindfulness-based cognitive therapy (MBCT) was also less costly and more effective than the comparison group among patients with depression, medically unexplained symptoms, and multiple sclerosis. MBCT’s cost-effectiveness advantage was also identified among breast cancer patients with persistent pain, non-depressed adults with a history of major depressive disorder episodes, adults diagnosed with ADHD, and all cancer patients. From a societal perspective, the cost-saving property of mindfulness training was evident when used as the treatment of aggressive behaviors among persons with intellectual/developmental disabilities in mental health facilities.Conclusions Based on this review, more standardized MBI protocols such as MBSR and MBCT compare favorably with usual care in terms of health outcomes and cost-effectiveness. Other MBIs may result in cost savings from both healthcare and societal perspectives among high-risk patient populations.
... Specifically, research indicates that MBI with adults can increase awareness of moment-to-moment experience and promote reflection, empathy, and caring for others (Hölzel et al., 2011). Mindfulness training with adults can also improve stress regulation, resilience, anxiety, and depression (Forkmann et al., 2014;Hofmann et al., 2010;Irving et al., 2009;Klatt et al., 2015;Li & Bressington, 2019;Marcus et al., 2003;Morton et al., 2020;Tang et al., 2007). ...
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Objectives The purpose of this systematic review was to assess the current literature on mindfulness-based school interventions (MBSIs) by evaluating evidence across specific outcomes for youth. Methods We evaluated 77 studies with a total sample of 12,358 students across five continents, assessing the quality of each study through a robust coding system for evidence-based guidelines. Coders rated each study numerically per study design as 1 + + (RCT with a very low risk of bias) to 4 (expert opinion) and across studies for the corresponding evidence letter grade, from highest quality (“A Grade”) to lowest quality (“D Grade”) evidence. Results The highest quality evidence (“A Grade”) across outcomes indicated that MBSIs increased prosocial behavior, resilience, executive function, attention, and mindfulness, and decreased anxiety, attention problems/ADHD behaviors, and conduct behaviors. The highest quality evidence for well-being was split, with some studies showing increased well-being and some showing no improvements. The highest quality evidence suggests MBSIs have a null effect on depression symptoms. Conclusions This review demonstrates the promise of incorporating mindfulness interventions in school settings for improving certain youth outcomes. We urge researchers interested in MBSIs to study their effectiveness using more rigorous designs (e.g., RCTs with active control groups, multi-method outcome assessment, and follow-up evaluation), to minimize bias and promote higher quality—not just increased quantity—evidence that can be relied upon to guide school-based practice.
... Equipping the healthcare system to utilize mindfulness to address stress and other healthcare concerns within primary care and other healthcare settings provides a unique strategy for providing mindfulness interventions for individuals who may not receive services within mental health settings. Addressing these issues in healthcare settings also provides an opportunity for prevention and early intervention to help people become well and stay well (Irving et al. 2009). ...
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Spirituality is integral to the provision of high-quality health and mental healthcare. Despite this, there is limited research on how to assess and address spiritual determinants of health within primary care settings. Many individuals initiate care within primary care settings, and several will only receive care from their primary care provider. The high prevalence of individuals receiving care within primary care settings coupled with the positive impact spirituality has on health and mental health reveal the need to care for spiritual needs within primary care settings. Integrated care is a model of treatment that addresses the fragmentation of healthcare by assessing and addressing the psychosocial determinants of health within primary care settings. The structure of integrated care models is designed to treat the biological and psychosocial determinants of health and, as a result, provide suitable context for assessing and addressing spirituality in primary care settings. The purpose of this paper is to (1) summarize the efforts to integrate spirituality within primary care (whole person care models), (2) summarize the integrated care efforts to promote psychosocial integration, (3) highlight Christian mindfulness as a potential form of intervention to address spirituality within integrated care models, and (4) operationalize the delivery of Christian mindfulness within a fully integrated care model. The conclusions from the conceptual review include both practice innovation for the assessment and intervention of spirituality in integrated care as well as potential direction for future research to study Christian mindfulness within integrated care settings.
... There are several challenges to the effectiveness of MBPs for resident physicians. First, the culture of medicine promotes self-neglecting attitudes such as prioritizing work over personal needs and seeing needs as weakness (Irving et al., 2009;Wallace et al., 2009). At the same time, risk-increasing personality traits such as perfectionism and workaholism are prevalent in physicians (Wallace et al., 2009). ...
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Objectives Medical residency is a challenging phase that puts the mental health of resident physicians at risk. This study explores the effects of a tailored mindfulness-based program on the positive mental health of resident physicians. Methods We conducted a longitudinal randomized controlled trial with an active control group. The intervention group took part in an 8-week mindfulness-based program (MBP) that included a course book and was followed by a 4-month maintenance phase. The control group only received the course book for self-study. Participants were assessed at 0, 2, 6, and 12 months. Assessments included self-report measures (positive affect, life-satisfaction, self-compassion, flourishing, self-esteem, feeling loved, self-attributed mindfulness, time perception, “Muße” (i.e., feeling at ease and free of pressure), thriving at work, job satisfaction, self-efficacy, self-esteem), as well as Goal Attainment Scaling. Results A total of 147 resident physicians were randomly assigned to either the intervention or the control group. In linear mixed models, we found small to medium effects for the interaction of time × group across various time points for self-compassion, flourishing, mindfulness, Muße, thriving at work, and indirect negative affect with effect sizes ranging between d = 0.25 and 0.88. Goal Attainment Scaling revealed a greater goal attainment in the intervention group compared to the control group ( d = 1.50). Conclusions We conclude that a tailored MBP may improve certain aspects of resident physicians’ positive mental health. Trial Registration DRKS00014015 05/24/2018.
... In a related vein, mindfulness-based therapy should be provided once the crisis has passed. There is a large body of research suggesting positive effects of mindfulnessbased therapy on burnout, as this therapy allows for acknowledgement and adaptation of emotional and behavioral responses and development of problemfocused strategies rather than avoidance behaviors [25][26][27][28]. ...
... For example, Taylor et al. (2016) found that in a sample of teachers in Canada, there was a greater percentage of positive emotion words used to describe a challenging student among teachers receiving a MBI versus waitlist controls. While there is some evidence that mindfulness can improve other prosocial outcomes such as empathy and compassion in both general populations and helping professionals, results are mixed (Cooper et al., 2020;Fernando et al., 2017;Irving et al., 2009). As helping professionals may express greater moral commitments to values of care and fairness, mindfulness may further enhance their capacity to enact those values and result in greater reductions in intergroup bias (Epstein, 1999). ...
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This study integrates the conceptual and empirical research on mindfulness and intergroup bias to guide a meta-analysis that examines associations between mindfulness and (a) different manifestations of bias, e.g., implicit and explicit attitudes, affect, and behavior, directed towards (b) different bias targets, e.g., outgroup or ingroup (internalized bias), by (c) intergroup orientation, e.g., towards bias or anti-bias. Of 70 independent samples, 42 (178 effect sizes; N = 3,229) were studies of mindfulness-based interventions (MBIs) and 30 (150 effect sizes; N = 6,002) were correlational studies. Unconditional mixed-effects structural equation models showed a large, negative effect of mindfulness on bias for intervention (d = -0.56, CI 95% [-0.72, -0.40]) and correlational (r = -0.17 [-0.27, -0.03]) studies. Effects were comparable for intergroup bias and internalized bias; the largest effects were for behavioral outcomes. We conclude by identifying gaps in the evidence base and outline an agenda for future research.
... Our research contributes to a growing body of research suggesting that self-compassion practices could reduce stress levels, self-criticism, compassion fatigue, and burnout among healthcare professionals and therapists in training, as well as enhancing their self-care skills and psychological well-being (Beaumont et al., , 2017(Beaumont et al., , 2021Boellinghaus et al., 2013Boellinghaus et al., , 2014Finlay-Jones et al., 2015;Irving et al., 2009;Shapiro & Carlson, 2017;Yela et al., 2020a, Yela et al., 2020b. Similar beneficial effects have been found for healthcare professionals who are involved in mindfulness practices, especially the MBSR program. ...
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Objectives This study compares the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) programs in improving mindfulness and self-compassion skills among clinical and health psychology trainees, and analyzes their effects on anxiety and depression. Methods A total of 88 participants were allocated to three conditions: MBSR training (n = 26), MSC training (n = 34), and control group (n = 28). Their levels of mindfulness, self-compassion, anxiety, and depression were measured at pre- and post-intervention. Results Compared to the control group, participants in the MBSR training showed significant improvements in mindfulness and reductions in anxiety and depression from pre to post. Participants in the MSC training, compared to the control group, reported significant increases in mindfulness and self-compassion. We observed that anxiety levels remained stable in the MSC group, while participants in the control group reported an increase in their scores over time. The reduction in depression scores observed among MSC participants did not differ, however, from that observed among members of the control group. Mindfulness, self-compassion, and anxiety scores presented similar trajectories in MBSR and MSC groups, while the MBSR group demonstrated a significantly greater reduction in depression levels compared to the MSC group. Conclusions Incorporating these programs into the psychologists’ training should be considered, as desirable skills such as mindfulness and self-compassion are enhanced. MBSR and MSC could contribute to prevent mental health problems in this population.
... Although most mindfulness research has focused on patient benefits, recent research has found that mindfulness training may be particularly useful for clinical professionals as a means of managing stress and promoting self-care (Irving, Dobkin, & Park, 2009;Shapiro & Carlson, 2009). Studies evaluating the effectiveness of mindfulness-based stress reduction (MBSR) have found decreased anxiety, depression, rumination, and stress, as well as increased empathy, self-compassion, spirituality, and positive mood states among premedical students, nursing students, and therapists in training after completion of the MBSR program (Beddoe & Murphy, 2004 & Shapiro, 2005), and primary care doctors showed improvements in burn-out, depersonalization, empathy, total mood disturbance, consciousness, and emotional stability after an 8-week mindfulness course and a 10-month maintenance phase (2.5 hours per month) (Krasner et al., 2009). ...
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We initiate our exploration of the positive psychology in relation with mindfulness by presenting an operational definition of mindfulness. We review the different psychological applications of mindfulness, basically, into 4 main categories: (a.) Diagnostic disorders, (b.) Prevention and healthy stressed populations, (c.) Positive physiological findings, and (d.) Positive psychological findings. We also dive into future directions in research as well as clinical applications. Last but not least, we hypothesize that mindfulness proposes something distinctive and intensely curative to the mental health professions, through its recognition of negative and positive experiences as uniformly important and legitimate.
... These results do not coincide with those obtained by other authors, who have demonstrated the positive effects of an intervention based on mindfulness in minimizing anxiety symptoms. Irving et al., completed a systematic re-view in which the important benefits of MBSR training program on the improvement of well-being and stress resistance were examined amongst healthcare professionals and concluded that these types of interventions reduced anxiety [73]. In a quasi-experimental trial, Barbosa et al. analyzed the impact of the 8-week MBSR training program on students from five healthcare degrees and observed a significant decline in anxiety levels at weeks 8 and 11 compared with initial evaluation [74]. ...
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In primary health care, the work environment can cause high levels of anxiety and depression, triggering relevant expert and individual change. Mindfulness-Based Stress Reduction (MBSR) programs reduce signs of anxiety and depression. The purpose of this sub-analysis of the total project, was to equate the effectiveness of the standard MBSR curriculum with the abbreviated version in minimizing anxiety and depression. This randomized controlled clinical trial enrolled 112 mentors and resident specialists from Family and Community Medicine and Nurses (FCMN), distributed across six teaching units (TU) of the Spanish National Health System (SNHS). Experimental group participants received a MBRS training (abbreviated/standard). Depression and anxiety levels were measured with the Goldberg Anxiety and Depression Scale (GADS) at three different time periods during the analysis: before (pre-test) and after (post-test) participation, as well as 3 months after the completion of intervention. Taking into account the pre-test scores as the covariate, an adjusted analysis of covariance (ANCOVA) showed significant depletion in anxiety and depression in general (F (2.91) = 4.488; p = 0.014; η2 = 0.090) and depression in particular (F (2, 91) = 6.653; p = 0.002; η2 = 0.128 at the post-test visit, maintaining their effects for 3 months (F (2.79) = 3.031; p = 0.050; η2 = 0.071—F (2.79) = 2.874; p = 0.049; η2 = 0.068, respectively), which is associated with the use of a standard training program. The abbreviated training program did not have a significant effect on the level of anxiety and depression. The standard MBSR training program had a positive effect on anxiety and depression and promotes long-lasting effects in tutors and resident practitioners. New research is needed to demonstrate the effectiveness of abbreviated versions of training programs.
... Mindfulness practices have been discovered to induce brain structure alterations (Fox et al., 2014), associated with improved working memory and attention (Van den Hurk et al., 2010;Mrazek et al., 2013). Mindfulness meditation can improve a practitioner's self-regulation capability by increasing positive affect, life satisfaction, and wellbeing (Brown and Ryan, 2003;Garland et al., 2015) and reducing depression, anxiety (Brown and Ryan, 2003;Davidson et al., 2003), stress (Irving et al., 2009), and even insomnia (Goldstein et al., 2019). Among various types of mindfulness interventions, mindfulness-based stress reduction (MBSR) is a standardized and secularized training program designed to improve mindfulness and coping abilities (Kabat-Zinn, 1994). ...
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Objectives: Mindfulness-based stress reduction has been proven to improve mental health and quality of life. This study examined how mindfulness training and various types of mindfulness practices altered brain activity. Methods : Specifically, the spectral powers of scalp electroencephalography of the mindfulness-based stress reduction (MBSR) group ( n =17) who underwent an 8-week MBSR training—including mindful breathing and body-scan—were evaluated and compared with those of the waitlist controls ( n =14). Results: Empirical results indicated that the post-intervention effect of MBSR significantly elevated the resting-state beta powers and reduced resting-state delta powers in both practices; such changes were not observed in the waitlist control. Compared with mindful breathing, body-scanning resulted in an overall decline in electroencephalograms (EEG) spectral powers at both delta and low-gamma bands among trained participants. Conclusion : Together with our preliminary data of expert mediators, the aforementioned spectral changes were salient after intervention, but mitigated along with expertise. Additionally, after receiving training, the MBSR group’s mindfulness and emotion regulation levels improved significantly, which were correlated with the EEG spectral changes in the theta, alpha, and low-beta bands. The results supported that MBSR might function as a unique internal processing tool that involves increased vigilant capability and induces alterations similar to other cognitive training.
... On the other hand, there has been an increasing number of psychological interventions developed and studied in order to empower professionals coping with increasing workrelated stress and burnout [17][18][19]. Recent research suggests that mindfulness training can be very promising in reducing stress and promoting self-care and well-being [20]. ...
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Abstract: Introduction: Physician’s burnout has been recognized as an increasing and significant work-related syndrome, described by the combination of emotional exhaustion (EE) and depersonalization (D), together with low personal accomplishment (PA). It has many negative consequences on personal, organizational, and patient care levels. This systematic review aimed to analyze research articles where psychological interventions with elements of mindfulness (PIMs) were used to support physicians in order to reduce burnout and foster empathy and well-being. Methods: Systematic searches were conducted in May 2019, within six electronic databases PubMed, EBSCOhost MEDLINE, PsycArticles, Cochrane Library, JSTOR, and Slovenian national library information system. Different combinations of boolean operators were used—mindfulness, empathy, medicine/family medicine/general practice/primary care, burnout, doctors/physicians, intervention, and support group. Additional articles were manually searched from the reference list of the included articles. Studies with other healthcare professionals (not physicians and residents) and/or medical students, and those where PIMs were applied for educational or patient’s treatment purposes were excluded. Results: Of 1194 studies identified, 786 screened and 139 assessed for eligibility, there were 18 studies included in this review. Regard-less of a specific type of PIMs applied, results, in general, demonstrate a positive impact on empathy, well-being, and reduction in burnout in participating physicians. Compared with other recent systematic reviews, this is unique due to a broader selection of psychological interventions and emphasis on a sustained effect measurement. Conclusion: Given the pandemic of COVID-19, it is of utmost importance that this review includes also interventions based on modern information technologies (mobile apps) and can be used as an awareness-raising material for physicians providing information about feasible and easily accessible interventions for effective burn-out prevention and/or reduction. Future research should upgrade self-reported data with objective psychological measures and address the question of which intervention offers more benefits to physicians.
... 29 Several meta-analyses have been conducted and provide support for the use of mindfulness interventions to reduce stress, anxiety, and burnout and improve well-being among healthcare professionals. 30,31 While healthcare providers have been a primary population of focus in the research on mindfulness, studies specific to military healthcare professionals are lacking. ...
Article
Introduction: A 6-week mindfulness training course, the Mind-Body Medicine (MBM) pilot program for staff, was implemented at a large military treatment facility to examine the preliminary efficacy of the program in reducing stress and burnout in military healthcare professionals. Materials and methods: A retrospective analysis was conducted of data collected from a single-arm prospective MBM pilot program. The program was designed to help staff members increase their awareness of burnout and its consequences and to learn how to utilize mindfulness-based self-care practices as a means for reducing stress and preventing burnout at work. Participants attended a 2-hour MBM group each week for a total duration of 6 weeks. Assessments of stress, resilience, anxiety, somatic symptoms, functional impairment, sleep quality, quality of life, and burnout were administered at baseline (T1), upon completion of the 6-week program (T2), and at least 3 months after program completion (T3). Multilevel modeling was used as the primary statistical model to assess changes in outcomes. Fifty-nine staff members completed assessments at T1, 31 (52.5%) at T2, and 17 (28.8%) at T3. Results: Participants showed improvements on scores of perceived stress, resilience, anxiety, somatic symptoms, quality of life, and burnout variables from T1 to T2 and from T1 to T3 (P < .05). Additionally, they reported improvements in their knowledge, understanding, and utilization of MBM concepts and practices from T1 to T2 and from T1 to T3 (P < .05). Conclusions: Results from this pilot suggest that the MBM program has the potential to reduce occupational stress and burnout and improve well-being in military healthcare professionals.
... Focusing on the present moment may help individuals reduce their anxiety and worrying behavior. An increase in mindfulness could also lead to an increase in coping mechanisms, allowing individuals with anxiety or depression to feel more equipped to deal with everyday stressors (Irving et al., 2009). Studies have shown that higher levels of mindfulness after MBSR were related to lower levels of mood symptoms and stress, and that increased mindfulness predicted stress reduction (Carlson & Brown, 2005;Matousek & Dobkin, 2010). ...
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Objectives Individuals with subjective memory complaints and symptoms of depression and/or anxiety are at high risk for further cognitive decline, and possible progression to dementia. Low-burden interventions to help slow or prevent cognitive decline in this high-risk group are needed. The objective of this study is to assess the feasibility of combining Mindfulness-Based Stress Reduction (MBSR) with transcranial direct current stimulation (tDCS) to increase putative benefits of MBSR for cognitive function and everyday mindfulness in depressed or anxious older adults with subjective cognitive decline. Methods We conducted a two-site pilot double-blind randomized sham-controlled trial, combining active MBSR with either active or sham tDCS. The intervention included weekly in-class group sessions at the local university hospital and daily at-home practice. Anodal tDCS was applied for 30 min during MBSR meditative practice, both in-class and at-home. Results Twenty-six individuals with subjective cognitive complaints and symptoms of depression and/or anxiety were randomized to active (n = 12) or sham tDCS (n = 14). The combination of MBSR and tDCS was safe and well tolerated, though at-home adherence and in-class attendance were variable. While they were not statistically significant, the largest effect sizes for active vs. sham tDCS were for everyday mindfulness (d = 0.6) and social functioning (d = 0.9) (F(1,21) = 3.68, p = 0.07 and F(1,21) = 3.9, p = 0.06, respectively). Conclusions Our findings suggest that it is feasible and safe to combine tDCS with MBSR in older depressed and anxious adults, including during remote, at-home use. Furthermore, tDCS may enhance MBSR via transferring its meditative learning and practice into increases in everyday mindfulness. Future studies need to improve adherence to MBSR with tDCS. Trial Registration ClinicalTrials.gov (NCT03653351 and NCT03680664).
Chapter
This chapter explores the evolution of a mindfulness-based program that began as a patient-focused pilot study and developed into a hospital-wide staff-focused program. Initially, a mindfulness-based program was adapted and studied to measure its impact on stress and coping in a group of adolescents with implanted cardiac devices. The positive outcomes of this study led to a larger randomized study in the same patient population. With continued positive outcomes, a larger, train-the-trainer model was designed and implemented. This program trains hospital staff in mindfulness techniques with the goal of decreasing their own stress and burnout while ultimately reaching and benefitting larger groups of patients and nonclinical staff through greater mindful awareness and education of staff. The program has had a hospital-wide impact including tremendous support from hospital administration. In addition to outlining background and specifics of the nurse-led model, this chapter describes the processes that were undertaken to develop and implement the program.KeywordsAnxietyPediatric cardiologyAdolescentsCliniciansBurnoutMindfulnessStressWell-being
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Many students experience high levels of stress which may adversely impact their health, life satisfaction, and academic performance. In the search for ways to reduce student stress, mindfulness has shown promising results. This article summarises findings on the effects of mindfulness-based interventions on student stress and related outcomes. It also highlights some issues that require further attention in order to advance our understanding of how mindfulness may benefit students experiencing stress.
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This paper introduces a spiritually informed heart led psychotherapy (HLP) model as part of a biopsychosocialspiritual (BPSS) approach in clinical practice. HLP model is based on the premise that everyone is on an individual life journey to understand and experience life lessons such as assertiveness, joy, forgiveness. When clients experience traumas, these can create blocks and restrictions, resulting in repeated cycles of psychological distress in an individual’s life. HLP regards the ego as being responsible for maintaining the psychological distress. HLP teaches clients to recognise the impact of their ego, become an observer to challenges so that they can understand that the challenges are the life lesson. Honouring the ‘heart and soul’ rather than the ego enables clients to experience the lesson, make new choices in keeping with their authentic selves and freedom from suffering. HLP can be integrated into traditional psychotherapies or applied as a standalone therapy as part of the BPSS approach.
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The authors reflect on challenges encountered in taking forward a service development and factors considered important in facilitating change in practice.
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This Element reviews the evidence for three workplace conditions that matter for improving quality and safety in healthcare: staffing; psychological safety, teamwork, and speaking up; and staff health and well-being at work. The authors propose that these are environmental prerequisites for improvement. They examine the relationship between staff numbers and skills in delivering care and the attainment of quality of care and the ability to improve it. They present evidence for the importance of psychological safety, teamwork, and speaking up, noting that these are interrelated and critical for healthcare improvement. They present evidence of associations between staff well-being at work and patient outcomes. Finally, they suggest healthcare improvement should be embedded into the day-to-day work of frontline staff; adequate time and resources must be provided, with quality as the mainstay of professionals' work. Every day at every level, the working context must support the question 'how could we do this better?' This title is also available as Open Access on Cambridge Core.
Article
It is of interest to investigate the effectiveness of a mindfulness-based stress reduction program on stress and salivary cortisol among substance abuse patients. There were 60 drug addicts who were receiving treatment at the addiction centre. Samples are divided into 30 drug abuse patient experimental and 30 substance abuse patient control groups using the simple random sampling approach. Salivary cortisol, a pre-test stress biomarker, was measured and used to analyse the results. The MBSR programme was administered over the course of eight weeks, with two 1-hour sessions held each day, with a cap of 15 participants. The biomarker for stress (salivary cortisol) will be obtained once again at the end of the program to assess the post-test level of perceived stress and compare it to the results. Patients showed improvements in stress level (p < 0.05) following the 8-week MBSR program. The mean level of blood cortisol in the experimental group was 18.08 (3.62), which was dropped to 7.54 (1.29) before the intervention. The mean cortisol level in the experimental group differs by 10.54 (3.45) between pre and post intervention following the intervention (p value is < 0.005). Thus, there is a difference between the experimental conditions before and after the intervention. The mean serum cortisol level in the pre-test is 17.30 (2.34) and the mean serum cortisol level in the post test is 17.15 (2.31) in the control group (p value is > 0.005). Data shows that there is a significant difference between the groups. MBSR may be a beneficial intervention for reducing stress, in Patients taking treatment in de addiction centre.
Article
This paper reports a study on the impact of a smartphone meditation app (M-App) in building resilience and competencies among social workers with aging in place (AIP) initiatives. Compared to a control group who used the leisure app (L-App), M-App users reported greater resilience and gerontological social work competencies 6 months posttest (T2). Women social workers, Christians, who specialized in home-based care, and whose core clientele comprised older adults with acquired disability and long-term illness, reported greater resilience at T2. Women social workers and those who specialized in home-based care exhibited greater gerontological competencies at T2. Disciplined M-App usage and self-practice mediated the association between socio-demographic moderators and outcomes. Clients of women and Christian social workers, home-based care specialists and those who diligently adhered to the intervention reported higher satisfaction. The interesting finding was that this satisfaction was reported by Christian clients and those who lived with family members as compared to Hindu and Muslim clients and those who lived alone with formal caregivers. For gerontological social workers with AIP initiatives, the M-App could be used in a continuing education training with some refinements for men, non-Christian social workers and engaged in AIP programs through community and neighborhood support practice.
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Healthcare Worker Burnout (HCWB) has become a global and national phenomenon. Amplified by the COVID-19 pandemic, and further exacerbated by the healthcare worker shortage, healthcare institutions and policy makers find themselves in a unique position to incorporate creative solutions to address this seemingly monumental issue. The World Health Organization classifies burnout as an occupational phenomenon due to its causes being rooted in the work environment, rather than the individual. Caused by chronic workplace stress, burnout is characterized by mental exhaustion, feeling depleted, having mental distance from the job at hand, feeling negative or cynical as well as experiencing decreased professional efficacy (World Health Organization, 2019, May 28). HCWB will require a multifaceted evidenced based approach to effectively target and modify the diverse root causes leading to its detrimental effects. The COVID-19 pandemic has been traumatic, for many, on an individual, organizational and societal level. The concept of posttraumatic growth, which is defined as the lasting internal positive transformation that occurs in response to a traumatic event, can be extended from the individual to that of the organization and even to society. The COVID-19 pandemic can be viewed as the traumatic event that has the potential to catapult organizations and policy makers into creating lasting structural changes that have a positive impact on all levels of society. This paper will introduce just such an organizational intervention that addresses HCWB on multiple levels. Informed by literature reviews on the topic, current evidenced based interventions, as well as interviews with emergency room nursing staff directly impacted by HCWB.
Article
Introduction: Protecting health-care provider (HCP) well-being is imperative to preserve health-care workforce capital, performance, and patient care quality. Limited evidence exists for the long-term effectiveness of HCP well-being programs, with less known about physiotherapists specifically. Purpose: To review and synthesize qualitative research describing experiences of HCP, generate lessons learned from the greater population of HCP participating in workplace well-being programs, and then to inform programs and policies for optimizing psychological well-being in an understudied population of physiotherapists. Methods: This qualitative meta-synthesis included a systematic literature search conducted in September 2020; critical appraisal of results; and data reduction, re-categorizing, and thematic extraction (reciprocal translation) with interpretive triangulation. Results: Twenty-five papers met the inclusion criteria. Participants included physicians, nurses, and allied health providers. All programs targeted the individual provider and included psychoeducational offerings, supervision groups, coaching, and complementary therapies. Four themes were constructed: 1) beneficial outcomes across a range of programs; 2) facilitators of program success; 3) barriers to program success; and 4) unmet needs driving recommendations. Conclusions: The findings enhance our understanding of diverse individual-level programs to address HCP well-being. Beneficial outcomes were achieved across program types with system-level support proving critical; however, HCP described barriers to program success (HCP characteristics, off-site programs, institutional culture) and remaining needs (resources, ethical dissonance) left unaddressed. Organizations should offer individual-level programs to support physiotherapists in the short term while pursuing long-term, system-level change to address drivers of well-being.
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Mindfulness has emerged as one of the major strategies for the well-being of employees in the current corporate world. As the workspace continues to evolve due to technological and structural advancement, employees face difficulty coping and lack the desired agility. The present study is a systematic review of around a hundred scientific papers and various books and business research articles from the period of 2000–2021 focusing on mindfulness and employee wellness research from various journals such as Jama Psychiatry, Applied Psychology: Health and Well-being, journals from Frontier Psychology and Emerald Publications, and others. The study aims to explore mindfulness and its applications across various vocational sectors, with particular emphasis on its potential relevance to the Indian population. The study also discusses the evolution of mindfulness, its implications for improving work culture and leadership, and its application in various workplaces. As there are very few mindfulness-based studies conducted on the Indian working population, the present study helps to bridge the gap and recommends future studies to be conducted on the Indian population to establish concrete scientific evidence on the possible impact of mindfulness on employees' vocational lives. The paper makes a unique contribution by analyzing the potential for enhancement through mindfulness in various vocational sectors and also identifies a strong scope for research in the emerging areas of corporate agility and robot-assisted interventions.
Article
Objectives: This prospective cohort study assessed the impact of a 12-h mindfulness-based wellness curriculum on OB-GYN residents' burnout, mindfulness, and self-compassion. Methods: Fourteen 1st year OB-GYN residents at the University of California, Irvine (n = 7 in two separate cohorts) were eligible and participated in a 12-h, in-person wellness curriculum between January 2017 and May 2018 emphasizing meditation training, present moment emotional awareness, and self-compassion. The curriculum included didactic and experiential components and home-based exercises. Participants were assessed before starting the curriculum (T1), after finishing the curriculum (T2), and 6-9-months later (T3) using the Maslach Burnout Inventory (MBI), the Five Facet Mindfulness Questionnaire (FFMQ), and the Self-Compassion Scale (SCS). Results: Fourteen residents (100%) completed the survey at T1, 13 residents (93%) completed the survey at T2, and 12 residents (86%) completed the survey at T3. Levels of burnout did not change significantly. Overall mindfulness increased from T1 to T3 (p < .05), as did non-judging inner experiences (p < .01). Overall levels of self-compassion increased from T1 to T3 (p < .05), with self-kindness and self-judgment improving from T1 to T3 (both p < .05). The vast majority of improvements were evident at the 6-9-month follow-up. Conclusions: This study provides preliminary support that a mindfulness-based wellness curriculum may improve overall levels of mindfulness and self-compassion in 1st year OB-GYN residents.
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Background : This study examines the effectiveness of a pilot Mindful Caring workshop in improving self-compassion, mindfulness, and empathy, while reducing stress. Methods : Year 3 and 4 medical students from the National University of Singapore underwent 16 hours of online workshops over 4 days with didactic and experiential learning activities on self-compassion and mindfulness. Primary outcomes of self-compassion were measured with the Self-Compassion Scale (SCS). Secondary outcomes include mindfulness measured with the Five Facet Mindfulness Questionnaire-15 (FFMQ-15), empathy and stress levels. Qualitative comments were also sought in the feedback. Results : Out of 21 participants, 90.5% (n =19) completed both pre- and post-intervention questionnaires. Participants experienced significant mean improvements in self-compassion (p<0.05) and mindfulness (p<0.05), while improvements in empathy and stress levels did not reach statistical significance. Conclusions : A short online Mindful Caring workshop could be an avenue to improve self-compassion and mindfulness, which may have a downstream effect on burnout.
Thesis
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Contemporary mindfulness is a contentious topic in scholarship. Buddhist traditionalists argue that right mindfulness entails ethical considerations that are absent from contemporary versions of practice. Others believe mindfulness can be secularized without issue. The media presents mindfulness as a scientific cure-all for mental and physical ailments, but mindfulness studies are plagued with problematic methods and inconclusive results. Some therapists also worry that embracing the Buddhist origins of mindfulness techniques might repulse non-Buddhist clients who stand to benefit from the practice. The present study employs a qualitative survey distributed on social media to better understand contemporary mindfulness from the self-identified practitioner's perspective. Using a thematic approach, this research analyzes 127 personal explanations of individual mindfulness usage and practice. These accounts suggest that contemporary mindfulness is not missing an ethical component, that contemporary mindfulness is a tool for spiritual hygiene, and that contemporary mindfulness is generally compatible with non-Buddhist religious traditions.
Article
Background: This study examines the effectiveness of a pilot Mindful Caring workshop in improving self-compassion, mindfulness, and empathy, while reducing stress. Methods: Clinical-year medical students from the National University of Singapore underwent 16 hours of online workshops over 4 days with didactic and experiential teachings on self-compassion and mindfulness. Primary outcomes of self-compassion and mindfulness were measured with the Self-Compassion Scale (SCS) and the Five Facet Mindfulness Questionnaire-15 (FFMQ-15) respectively. Secondary outcomes measured included empathy and stress levels. Qualitative feedback was also sought. Results: Primary outcomes included improvements in self-compassion and mindfulness. Out of 21 participants, 19 (90.5%) completed both pre- and post-intervention questionnaires. Participants experienced significant mean improvements in self-compassion (p<0.05) and mindfulness (p<0.05), while improvements in empathy and stress levels did not reach statistical significance. Conclusions: A short online Mindful Caring workshop could be an avenue to improve self-compassion and mindfulness, which may have a downstream effect on burnout.
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Objectives Hospitals are psychologically demanding workplaces with a need for context-specific stress-preventive leadership interventions. A stress-preventive interprofessional leadership intervention for middle management has been developed. This phase-II study investigates its feasibility and outcomes, including work-related stress, well-being and transformational leadership. Design This is a mixed-methods study with three measure points (T0: baseline, T1: after the last training session, T2: 3-month follow-up). Additionally, focus groups were conducted to assess participants’ change in everyday work. Setting A tertiary hospital in Germany. Participants N=93 leaders of different professions. Intervention An interactive group setting intervention divided in five separate sessions ((1) self-care as a leader, (2) leadership attitudes and behaviour, (3) motives, needs and stressors of employees, (4) strengthen the resource ‘team’, (5) reflection and focus groups). The intervention was conducted between June 2018 and March 2020 in k=5 runs of the intervention. Outcome measures Feasibility and acceptance were measured with a self-developed intervention specific questionnaire. Psychological outcomes were assessed with the following scales: work-related strain with the Irritation Scale, well-being with the WHO-5 Well-being Index and transformational leadership with the Questionnaire of Integrative Leadership. Results After the intervention at T2, over 90% of participants reported that they would recommend the intervention to another coworker (92.1%, n=59) and all participants (n=64) were satisfied with the intervention and rated the intervention as practical relevant for their everyday work. Participants’ self-rated cognitive irritation was reduced, whereas their well-being and transformational leadership behaviour were improved over time. Focus group discussions revealed that participants implemented intervention contents successfully in their everyday work. Conclusions This intervention was feasible and showed first promising intraindividual changes in psychological outcomes. Participants confirmed its practical relevance. As a next step, the intervention will be evaluated as part of a multicentre—randomised controlled trial within the project SEEGEN (SEElische GEsundheit am Arbeitsplatz KrankeNhaus).
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Objective: To examine the effect of a mindfulness-based program specifically designed for teachers in reducing perceived stress and improving the quality of experienced emotion in female active working teachers. A second outcome evaluated is the associated change in cellular inflammatory activity, measured by peripheral blood levels of cytokines. Method: Eighty-eight female active teachers from public schools from São Paulo Municipality were recruited, and randomly allocated to an eight-week Mindfulness-Based Health Program for Educators (MBHP-Educa) or to Neuroscience for Education Program (Neuro-Educa: active control group). The venue of both programs were several public school facilities, where many of the teachers actually worked. Both groups received activities during eight weeks in a 2 h/week regimen, totalizing 16 h. Sixty-five participants completed the program and pre- and post-interventions measures were taken from the following scales: Interpersonal Multidimensional Reactivity Scale (IRI), Positive-and-Negative Affects Scale (PANAS), Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RISC), and a primary outcome in Ryff's Psychological Well-Being Scale (PBWS). At pre-and post-intervention, blood samples were collected for the measurement of several important inflammatory biomarkers, Tumor Necrosis Factor - α (TNF-α), Interleukin 1β (IL-1β), Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10) and Interleukin 12p70 (IL-12P70) through flow cytometry assay. Intervention effects were analyzed via Generalized mixed models (GLMM). Results: According to the GLMM, MBHP-Educa significantly reduced the scores of perceived stress (p < 0.0001), and negative affect (p < 0.0001) compared to active control group (Neuro-Educa). Conversely, an increase was observed on Psychological Well Being Scale in dimensions of Self-acceptance (p < 0.0001), and Autonomy (p = 0.001), as well as improvements in Resilience (p < 0.0001), and Positive Affect (p < 0.0001). MBHP-Educa also promoted a reduction in the levels of IL-6 (p = 0.003), IL-8 (p = 0.036), and increase in the levels of IL-10 (p < 0.0001) and IL-12p70 (p < 0.044). TNF-α, IL-1β, and IL-10p70 showed results below theoretical limit of detection accepted for CBA kit. Conclusions: Our data suggest that mindfulness-based interventions introduced as a strategy for reducing stress, promoting well-being and improve immune function can be a useful asset in promoting psychological health among teachers in Basic Education.
Article
Background and Objectives Meditation practices have been marketed broadly to ameliorate human suffering. As such, individuals may seek out and use meditation to control or manage unpleasant thoughts and emotions. Emotion and thought control research suggest that meditation used in this way may potentiate unpleasant private experiences and contribute to negative outcomes. We aimed to evaluate the function or purpose guiding meditation and its relations with anxiety, depression, and other indices of well-being. Design and Methods In a cross-sectional design, undergraduate meditators (N = 98) reported intentions guiding their meditation practice (i.e., experiential/emotional control or acceptance/openness) and completed an assessment battery. Results Most participants (58.2%) indicated using meditation to manage, control, or avoid difficult experiences. Participants using meditation with control-based intentions reported greater worry, anxiety, depression, negative affect, and lower mindfulness relative to their acceptance-guided counterparts. After controlling for level of anxiety, viewing anxiety as a problem increased the likelihood of using meditation with control-based intentions. Similar relations were observed between viewing stress as a problem and the likelihood of using meditation for experiential control. Conclusions Findings suggest that (a) how people meditate is significantly related to psychological distress and (b) highlight the importance of evaluating intentions guiding meditative practices, particularly in individuals struggling with unpleasant emotional or psychological experiences.
Article
Mindfulness meditation (MM) has been found to positively affect various aspects related to music performance, yet very few studies have investigated its impact on music performance quality. This study examined whether short-term MM activity would improve vocal skills in regard to pitch intonation, dynamics transmission, and vocal resonation. Experiment and control groups comprising music education students ( N = 55) made pre- and post-intervention recordings of a specially designed solo vocal music excerpt. Intervention consisted of a short-term online MM course covering the main elements exercised in mindfulness practice. Performance evaluation employed novel methods based on both automatic assessment strategies and expert judgments. Statistical analysis failed to indicate a significant effect. However, trends were detected for improvement in dynamics transmission and vocal resonation. Results might attest to MM praxis’ limited influence on music performance quality. The observed trends could, however, evince to the shortcomings of the treatment design. The implications regarding MM’s effect on music performance quality are discussed.
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Background: Mindfulness-based interventions (MBIs) are known for their beneficial effects on positive and negative psychological factors. When applied in an occupational context, MBIs might help workers to cope with stress, increase their professional outcomes and wellbeing. Objective: In this two-groups pre-post experimental design we tested the effect of our MBI, called Integral Meditation (IM), among the employers of an Italian service company by measuring positive and negative aspects of psychological wellbeing related to mindfulness and workplace functioning through eight self-report questionnaires (CORE-OM, FFMQ, WEMWBS, MAIA, PSS, PANAS, STAI-X1, SCS). Method: Forty-two voluntary non-clinical employers of the company, randomly assigned to the experimental or the control group, were analyzed. The experimental group underwent our IM program, which consists of 12 weekly meditation classes given after the afternoon shift, while the control group did not receive any intervention. Data was analyzed via linear mixed models. Results: Statistically significant results were obtained for FFMQ observing subscale (β= 0.49, p = 0.014), WEMWBS (β= 5.31, p = 0.02), PSS (β= -3.31, p = 0.03), the whole scale of SCS (β= 0.47, p = 0.01) and self-judgment (β= 0.68, p = 0.003) and isolation (β= -0.66, p = 0.01) SCS subscales. Statistically significant results were also found in four out of eight subscales of MAIA: emotional awareness (β= 1.26, p < 0.001), self-regulation (β= 1.28, p < 0.001), body listening (β= 1.08, p < 0.001) and trusting (β= 1.1, p < 0.001). Conclusion: Our intervention has demonstrated to bring beneficial effects in a mindfulness subdomain, in perceived stress, self-compassion, interoception and psychological wellbeing. Based on our results, we conclude that our intervention was effective in increasing the positive aspects of wellbeing and in reducing stress.
Article
Burnout rates among physicians are rapidly rising. Leaders in the movement to address burnout have made the case that health care workplaces need to foster a culture of well-being, including trusting coworker interactions, collaborative and transparent leadership, work-life balance, flexibility, opportunities for meaningful work and for professional development, and effective 2-way communication. The rationale for focusing on organizational change to prevent burnout has pointed to persistent symptoms of burnout even when individual healthy lifestyle interventions are adopted. However, a case can be made that the lifestyle interventions were not implemented at the level of intensity recommended by the lifestyle medicine evidence-base to secure the desired improvement in physical and mental health when facing significant personal and environmental stressors. The lifestyle medicine community has the ethical mandate to advocate for intensive healthy lifestyle approaches to burnout prevention, in conjunction with organizational supports. By combining comprehensive and intensive lifestyle changes with organizational cultures of well-being, we can more effectively turn the tide of physician burnout.
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The literature is replete with evidence that the stress inherent in health care negatively impacts health care professionals, leading to increased depression, decreased job satisfaction, and psychological distress. In an attempt to address this, the current study examined the effects of a short-term stress management program, mindfulness-based stress reduction (MBSR), on health care professionals. Results from this prospective randomized controlled pilot study suggest that an 8-week MBSR intervention may be effective for reducing stress and increasing quality of life and self-compassion in health care professionals. Implications for future research and practice are discussed.
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Faculty in counseling training programs often give voice to the importance of self-care for students during the training period and into practice after training is completed. However, few programs specifically address this issue in their curricula. To address this perceived need, a course was developed to provide students with (a) personal growth opportunities through self-care practices and (b) professional growth through mindfulness practices in counseling that can help prevent burnout. A focus group assessed course impact on students who reported significant changes in their personal lives, stress levels, and clinical training.
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Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Objective: This paper, composed by an interest group of clinicians and researchers based in Melbourne, presents some background to the practice of mindfulness-based therapies as relevant to the general professional reader. We address the empirical evidence for these therapies, the principles through which they might operate, some practical questions facing those wishing to commence practice in this area or to refer patients into mindfulness-based therapies, and some considerations relevant to the conduct and interpretation of research into the therapeutic application of mindfulness. Method: Databases ( e. g. PsycINFO, MEDLINE) were searched for literature on the impact of mindfulness interventions, and the psychological and biological mechanisms that underpin the effects of mindfulness practice. This paper also draws upon the clinical experience of the author group. Results: Mindfulness practice and principles have their origins in many contemplative and philosophical traditions but individuals can effectively adopt the training and practice of mindfulness in the absence of such traditions or vocabulary. A recent surge of interest regarding mindfulness in therapeutic techniques can be attributed to the publication of some well-designed empirical evaluations of mindfulness-based cognitive therapy. Arising from this as well as a broader history of clinical integration of mindfulness and Western psychotherapies, a growing number of clinicians have interest and enthusiasm to learn the techniques of mindfulness and to integrate them into their therapeutic work. This review highlights the importance of accurate professional awareness and understanding of mindfulness and its therapeutic applications. Conclusions: The theoretical and empirical literatures on therapeutic applications of mindfulness are in states of significant growth and development. This group suggests, based on this review, that the combination of some well-developed conceptual models for the therapeutic action of mindfulness and a developing empirical base, justifies a degree of optimism that mindfulness-based approaches will become helpful strategies to offer in the care of patients with a wide range of mental and physical health problems.
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There is an absence of comprehensive, systematically gathered data concerning psychologists' beliefs about and compliance with ethical principles. Furthermore, we know little about which resources are valued as effective in guiding appropriate behavior. Survey data were collected from 456 APA Division 29 members regarding the degree to which they engaged in each of 83 behaviors and the degree to which they considered each behavior to be ethical. These data were categorized and examined in terms of five principles derived from the Hippocratic oath (avoiding harm, competence, avoiding exploitation, respect, and confidentiality) as well as two additional principles (informed consent; social equity and justice). Twelve of the behaviors were very difficult for participants to evaluate on the basis of ethics. Seven of the 83 behaviors were practiced by over 90% of the participants; 16 by fewer than 10%. Colleagues, the APA Ethical Principles, and internship training were rated as the most helpful resources in guiding behavior; state and federal laws, published research, and local ethics committees were rated least helpful.
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The inability to cope successfully with the enormous stress of medical education may lead to a cascade of consequences at both a personal and professional level. The present study examined the short-term effects of an 8-week meditation-based stress reduction intervention on premedical and medical students using a well-controlled statistical design. Findings indicate that participation in the intervention can effectively (1) reduce self-reported state and trait anxiety, (2) reduce reports of overall psychological distress including depression, (3) increase scores on overall empathy levels, and (4) increase scores on a measure of spiritual experiences assessed at termination of intervention. These results (5) replicated in the wait-list control group, (6) held across different experiments, and (7) were observed during the exam period. Future research should address potential long-term effects of mindfulness training for medical and premedical students.
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Mindful practitioners attend in a nonjudgmental way to their own physical and mental processes during ordinary, everyday tasks. This critical self-reflection enables physicians to listen attentively to patients' distress, recognize their own errors, refine their technical skills, make evidence-based decisions, and clarify their values so that they can act with compassion, technical competence, presence, and insight. Mindfulness informs all types of professionally relevant knowledge, including propositional facts, personal experiences, processes, and know-how, each of which may be tacit or explicit. Explicit knowledge is readily taught, accessible to awareness, quantifiable and easily translated into evidence-based guidelines. Tacit knowledge is usually learned during observation and practice, includes prior experiences, theories-in-action, and deeply held values, and is usually applied more inductively. Mindful practitioners use a variety of means to enhance their ability to engage in moment-to-moment self-monitoring, bring to consciousness their tacit personal knowledge and deeply held values, use peripheral vision and subsidiary awareness to become aware of new information and perspectives, and adopt curiosity in both ordinary and novel situations. In contrast, mindlessness may account for some deviations from professionalism and errors in judgment and technique. Although mindfulness cannot be taught explicitly, it can be modeled by mentors and cultivated in learners. As a link between relationship-centered care and evidence-based medicine, mindfulness should be considered a characteristic of good clinical practice.
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Physicians are not immune to psychosocial problems but may face unique impediments to attending to them. Self-care among physicians is not a topic generally included as a part of professional training, nor is it a topic that readily receives consideration in professional practice. The stresses of professional practice can exact a great toll, however, and self-neglect can lead to tragic consequences. In some areas, particularly suicide rates, physicians have increased vulnerability, and in other areas problems may be unrecognized (depression, substance abuse, marital problems, and other stress-related concerns). Female physicians show some particular areas of risk. In this paper, we raise questions about how and why physicians may be particularly vulnerable, review the available literature about the extent and nature of such problems in physicians, discuss possible factors related to the development of these problems in physicians, and suggest a variety of solutions to improve physician self-care.
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The goals of this work were to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in cancer outpatients immediately after and 6 months after program completion. A convenience sample of eligible cancer patients were enrolled after they had given informed consent. All patients completed the Profile of Mood States (POMS) and Symptoms of Stress Inventory (SOSI) both before and after the intervention and 6 months later. The intervention consisted of a mindfulness meditation group lasting 1.5 h each week for 7 weeks, plus daily home meditation practice. A total of 89 patients, average age 51, provided pre-intervention data. Eighty patients provided post-intervention data, and 54 completed the 6-month follow-up The participants were heterogeneous with respect to type and stage of cancer. Patients' scores decreased significantly from before to after the intervention on the POMS and SOSI total scores and most subscales, indicating less mood disturbance and fewer symptoms of stress, and these improvements were maintained at the 6-month follow-up. More advanced stages of cancer were associated with less initial mood disturbance, while more home practice and higher initial POMS scores predicted improvements on the POMS between the pre- and post-intervention scores. Female gender and more education were associated with higher initial SOSI scores, and improvements on the SOSI were predicted by more education and greater initial mood disturbance. This program was effective in decreasing mood disturbance and stress symptoms for up to 6 months in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and educational background, and with disparate ages.
Article
The heads of 107 programs in professional psychology certified by the American Psychological Association participated in a questionnaire study designed to learn their views about well-functioning in professional psychologists and what they had done and would like to do, programmatically, to maintain and enhance it. Their responses were compared with those of 339 licensed psychologists in a prior study. Although the 2 groups both assigned high ratings to self-awareness, a balanced lifestyle, relationship with spouse or partner, and personal values, overall the program heads put more emphasis on the didactic-supervisory items, whereas the practitioners emphasized the personal-existential items. Modifications of psychology programs to place well-functioning of students on par with other major purposes are described in detail.
Article
Mental health, once defined in terms of absence of illness, has gradually become understood in a more holistic way, which also includes the positive qualities that help people flourish. This evolving definition of mental health has led to an exploration of other traditions and practices, including meditation, which for thousands of years have been devoted to developing an expanded vision of human potential. One result was the introduction of the practice of meditation into Western scientific study. However, the principal original intentions of meditation, to uncover the positive and to catalyze our internal potential for healing and development, have been largely ignored by the scientific community. Yet, a small number of researchers and theorists have explored and continue to explore the positive effects of meditation. The chapter focuses on this pioneering work.
Article
This article defines the construct of self-compassion and describes the development of the Self-Compassion Scale. Self-compassion entails being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical; perceiving one's experiences as part of the larger human experience rather than seeing them as isolating; and holding painful thoughts and feelings in mindful awareness rather than over-identifying with them. Evidence for the validity and reliability of the scale is presented in a series of studies. Results indicate that self-compassion is significantly correlated with positive mental health outcomes such as less depression and anxiety and greater life satisfaction. Evidence is also provided for the discriminant validity of the scale, including with regard to self-esteem measures.
Article
A study of US physicians showed that physicians in 1997 were less satisfied in every aspect of their professional life than those asked similar questions in 1986. They were dissatisfied with the time they have with individual patients and their lack of incentives for high-quality care.1 Similarly, a 1998 study revealed that two thirds of Canadian physicians have a workload they consider too heavy, and more than half stated their family and personal lives have suffered because they chose medicine as a profession.2 Dissatisfaction has been documented in several diverse physician groups, including primary care,3 surgery,4 infectious disease specialists,5 and anesthesiologists.6 The leaders of medical school departments are exposed to similar pressures.7 These recent articles highlight the growing discontent of physicians with the increasing complexities of the practice of medicine. Burnout, a term that has moved from colloquial speech into the social and psychological vernacular, describes this phenomenon.
Article
It is not uncommon to hear about a family’s experience with a family counselor who is impaired in some fashion such as being burned out, experiencing stress, or dealing with his or her own personal issues. However, it is unethical to continue to practice or to knowingly allow a family counselor to continue when the impairment ultimately negatively affects the clients. An issue that is at the core is accepting students into the counselor education program and allowing them to continue in the program despite personal characteristics or mental health issues that prevent them from developing professionally and personally. This article addresses this issue, examines legal implications and cases, and provides recommendations for counselor educators.
Article
This research considers the role of communicative responsiveness, empathic concern, and emotional contagion as precursors to burnout among human service workers. Theory and research drawn from the areas of stress and burnout, empathy, and patient‐doctor communication are used to formulate a causal model of the burnout process. The model is tested with data from employees at a large psychiatric hospital. The results indicate that empathic concern leads to communicative responsiveness but that emotional contagion decreases responsiveness. Communicative responsiveness, in turn, leads to the prediction of three dimensions of burnout and occupational commitment. The implications of the model for theory and practice are discussed.
Article
This paper presents research that examines the negative and stressful aspects of learning counselling and methods for harm reduction. Using an in-depth semi-structured interviewing approach, six people who recently graduated from a UK university counselling programme have commented on their negative experiences of learning counselling and what helped or would have helped to reduce the harmful effects. This research has produced information which indicates that counselling trainees experience significant disruptions in their relationships with their family and friends; that a sizeable number of trainees report feelings of depression and or stress; and that counselling trainers have not addressed these issues effectively. The study concludes with a suggestion that an extra training component could be built into existing training frameworks that focus on the process of 'becoming a counsellor'.
Article
Objective: To determine the results of a stress-reduction, cognitive behavioral treatment [SR-CBT] program in fibromyalgia. Methods: Seventy-nine patients with fibromyalgia completed a 10 week meditation based SR-CBT program that met once weekly for 2 hours per session. Controls consisted of 42 fibromyalgia patients, 18 of whom had been placed on a waiting list for the treatment program and 24 randomly selected patients who had not expressed an interest in enrolling in the program. Medications and other treatments were not altered during the 10 week study. Fibromyalgia symptoms were evaluated at the beginning and at the end of the study in patients and controls by self-administered visual analog scales [VAS] for global well-being, pain, sleep, fatigue, and tiredness upon awakening. Functional status was evaluated by the Fibromyalgia Impact Questionnaire [FIQ], and psychological status by the SCL-90-R. Participants and controls were comparable at study entry. Results: Fibromyalgia symptoms improved in 67% of the participants in the SR-CBT program compared to 40% of the controls [P =. 006]. The mean VAS, adjusted for baseline, was decreased 16% in the participants compared to controls [P = 0.01]. The mean FIQ score in the participants decreased 11% compared to the control group baseline [P = 0.05]. Most impressively, the global severity index of the SCL-90-R improved by 32% [P = 0.0001]. Conclusion: A SR-CBT program is a useful adjunct in the treatment of patients with fibromyalgia.
Article
Both dialectical behavior therapy (DBT) and mindfulness-based cognitive therapy (MBCT) include training in mindfulness skills and address the synthesis of acceptance and change. DBT is a comprehensive treatment for borderline personality disorder (BPD). MBCT was developed for prevention of relapse in individuals with a history of depressive episodes. Both have considerable empirical support for their efficacy. Many individuals with BPD also suffer from depressive episodes, which can interfere with motivation to participate in DBT. In such cases, it may be helpful to integrate strategies designed to prevent recurrence of depressive episodes. This case study describes integration of MBCT into ongoing DBT in the treatment of an individual with BPD and a history of depressive episodes. Findings suggest that MBCT can be successfully integrated into ongoing DBT in cases in which prevention of depressive episodes is an important goal. Findings also suggest that mindfulness skills may be very helpful in enhancing the efficacy of traditional cognitive-behavioral treatment approaches.
Article
Interest in mindfulness and its enhancement has burgeoned in recent years. In this article, we discuss in detail the nature of mindfulness and its relation to other, established theories of attention and awareness in day-to-day life. We then examine theory and evidence for the role of mindfulness in curtailing negative functioning and enhancing positive outcomes in several important life domains, including mental health, physical health, behavioral regulation, and interpersonal relationships. The processes through which mindfulness is theorized to have its beneficial effects are then discussed, along with proposed directions for theoretical development and empirical research.
Article
Mental health, similar to physical health, has been defined in terms of illness. In the 1960's, interest shifted toward exploring positive mental health. One result was the introduction of the Eastern practice of meditation into Western scientific study. One of the main goals of meditation, to uncover the positive and to catalyze our internal potential for healing and development, has been largely ignored. We focus on the positive aspects of meditation in this chapter. The aim of positive psychology is to catalyze change in psychology from a preoccupation only with repairing the worst things in life to also building the best qualities in life. The field of positive psychology at the subjective level is about positive subjective experience: well-being and satisfaction (past); flow, joy, the sensual pleasures, and happiness (present); and constructive cognitions about the future--optimism, hope, and faith. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Experienced professional psychologists identified factors that contributed to their ability to function well in Study 1, through interviews with 6 well-functioning psychologists, and in Study 2, through questionnaire responses from 339 randomly selected licensed psychologists. Collectively they highlighted self-awareness and monitoring; support from peers, spouses, friends, mentors, therapists, and supervisors; values; and a balanced life, including vacations and other stress-reducers. Discussion focuses on stress-management enhancers to maintain well-functioning, especially at times of deep and pervasive change, like the present and the foreseeable future. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The heads of 107 programs in professional psychology certified by the American Psychological Association participated in a questionnaire study designed to learn their views about well-functioning in professional psychologists and what they had done and would like to do, programmatically, to maintain and enhance it. Their responses were compared with those of 339 licensed psychologists in a prior study. Although the 2 groups both assigned high ratings to self-awareness, a balanced lifestyle, relationship with spouse or partner, and personal values, overall the program heads put more emphasis on the didactic-supervisory items, whereas the practitioners emphasized the personal-existential items. Modifications of psychology programs to place well-functioning of students on par with other major purposes are described in detail. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
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.
Article
There has been substantial interest in mindfulness as an approach to reduce cognitive vulnerability to stress and emotional distress in recent years. However, thus far mindfulness has not been defined operationally. This paper describes the results of recent meetings held to establish a consensus on mindfulness and to develop conjointly a testable operational definition. We propose a two-component model of mindfulness and specify each component in terms of specific behaviors, experiential manifestations, and implicated psychological processes. We then address issues regarding temporal stability and situational specificity and speculate on the conceptual and operational distinctiveness of mindfulness. We conclude this paper by discussing implications for instrument development and briefly describing our own approach to measurement.
Article
Baer's review (2003; this issue) suggests that mindf ulness-based interventions are clinically efficacious, but that better designed studies are now needed to substantiate the field and place it on a firm foundation for future growth. Her review, coupled with other lines of evidence, suggests that interest in incorporating mindfulness into clinical interventions in medicine and psychology is growing. It is thus important that professionals coming to this field understand some of the unique factors associated with the delivery of mindfulness-based interventions and the potential conceptual and practical pitfalls of not recognizing the features of this broadly unfamiliar landscape. This commentary highlights and contextualizes (1) what exactly mindfulness is, (2) where it came from, (3) how it came to be introduced into medicine and health care, (4) issues of cross-cultural sensitivity and understanding in the study of meditative practices stemming from other cultures and in applications of them in novel settings, (5) why it is important for people who are teaching mind-fulness to practice themselves, (6) results from 3 recent studies from the Center for Mindfulness in Medicine, Health Care, and Society not reviewed by Baer but which raise a number of key questions about clinical applicability, study design, and mechanism of action, and (7) current opportunities for professional training and development in mindfulness and its clinical applications.
Article
Risk management is viewed as a systematic process based on multiprofessional and multi-agency decision-making. A learning pack was developed as part of a team-based learning project aiming to encourage and develop collaborative working practice. This brought different professionals and agencies working in mental health together to learn. There is little doubt that mental health practice is a source of stress for practitioners. Apart from the stress associated with managing ‘risky’ situations, risk management is also a relatively new concept. This can increase stress around ability to cope, both on an individual practitioner level and in teams. This article reports the impact that the learning pack had on team members’ stress, specifically work-related stress. A range of scales were used to measure change in stress and results demonstrated reduced work-related pressure in a number of areas following the learning. The implications for team learning in relation to clinical risk management are discussed in light of the findings.
Article
The practice of mindfulness is increasingly being integrated into contemporary clinical psychology. Based in Buddhist philosophy and subsequently integrated into Western health care in the contexts of psychotherapy and stress management, mindfulness meditation is evolving as a systematic clinical intervention. This article describes stress-reduction applications of mindfulness meditation predominantly in medical settings, as originally conceived and developed by Kabat-Zinn and colleagues. It describes process factors associated with the time-limited, group-based formal favored by this model, and presents in tabular form results of both early and more recent outcome studies.
Article
Objective: This paper, composed by an interest group of clinicians and researchers based in Melbourne, presents some background to the practice of mindfulness-based therapies as relevant to the general professional reader. We address the empirical evidence for these therapies, the principles through which they might operate, some practical questions facing those wishing to commence practice in this area or to refer patients into mindfulness-based therapies, and some considerations relevant to the conduct and interpretation of research into the therapeutic application of mindfulness. Method: Databases (e.g. PsycINFO, MEDLINE) were searched for literature on the impact of mindfulness interventions, and the psychological and biological mechanisms that underpin the effects of mindfulness practice. This paper also draws upon the clinical experience of the author group. Results: Mindfulness practice and principles have their origins in many contemplative and philosophical traditions but individuals can effectively adopt the training and practice of mindfulness in the absence of such traditions or vocabulary. A recent surge of interest regarding mindfulness in therapeutic techniques can be attributed to the publication of some well-designed empirical evaluations of mindfulness-based cognitive therapy. Arising from this as well as a broader history of clinical integration of mindfulness and Western psychotherapies, a growing number of clinicians have interest and enthusiasm to learn the techniques of mindfulness and to integrate them into their therapeutic work. This review highlights the importance of accurate professional awareness and understanding of mindfulness and its therapeutic applications. Conclusions: The theoretical and empirical literatures on therapeutic applications of mindfulness are in states of significant growth and development. This group suggests, based on this review, that the combination of some well-developed conceptual models for the therapeutic action of mindfulness and a developing empirical base, justifies a degree of optimism that mindfulness-based approaches will become helpful strategies to offer in the care of patients with a wide range of mental and physical health problems.