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Kannai R, Krontal S, Freud T, Biderman A. Balint groups: an effective tool for improving health professionals' perceived well-being. Isr J Health Policy Res 2024; 13:31. [PMID: 39085974 PMCID: PMC11293207 DOI: 10.1186/s13584-024-00618-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/08/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Physician burnout is a common problem that negatively impacts their well-being and patient care. Balint groups (BGs) deal with doctor-patient relationships. Previous studies that have demonstrated the positive effects of BGs are descriptive and based on small sample sizes. This study aims to evaluate the perceptions of health professionals who participated in BGs, determine the impact of BGs on their personal and professional well-being, and identify the factors related to these positive outcomes. METHODS On January and February 2023 the authors have distributed a questionnaire to 142 healthcare providers in a conference and internet networks. Most respondents were family physicians. RESULTS Participation in BGs is seen to have a positive impact on healthcare professionals' perceived well-being and professional development. Respondents who had participated in the BG reported a reduction in burnout, increased empathy, and enhanced professional identity and relationships with patients and colleagues. The study also highlighted the importance of duration of participation in BG, with attendance longer than 5 years linked to significantly more positive outcomes compared to less than 1 year. In a logistic regression analysis two factors were significantly associated with self-reported well-being: attending BGs for more than five years and perceiving BGs as a means of relieving burnout. CONCLUSIONS The findings suggest that medical organizations should encourage the regular availability of BGs to support physicians' well-being.
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Affiliation(s)
- Ruth Kannai
- Siaal Research Center for Family Medicine and Primary Care, Department of Family Medicine, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, Beer-Sheva, 8410501, Israel.
- Clalit Health Services, Jerusalem district, Jerusalem, Israel.
| | - Shai Krontal
- Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Family Medicine, Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Freud
- Siaal Research Center for Family Medicine and Primary Care, Department of Family Medicine, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, Beer-Sheva, 8410501, Israel
| | - Aya Biderman
- Siaal Research Center for Family Medicine and Primary Care, Department of Family Medicine, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, Beer-Sheva, 8410501, Israel
- Research Unit, Clalit Health Services, South District, Beer-Sheva, Israel
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Teixeira DS, Fortes S, Kestenberg C, Alves K, Campos MR, Neto AO, Ortega F, García-Campayo J, Demarzo M. Improving patient-centered mental health promotion in primary care in vulnerable communities through mindfulness training in Rio de Janeiro, Brazil. Front Med (Lausanne) 2024; 11:1356040. [PMID: 39040898 PMCID: PMC11261806 DOI: 10.3389/fmed.2024.1356040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/07/2024] [Indexed: 07/24/2024] Open
Abstract
Introduction Brazilian Primary Health Care (PHC) is responsible for all-sanitary actions for a community-based population, including health promotion and mental health care. Mindfulness Based Health Promotion (MBHP) is an intervention that can promote self-care and psychosocial support in PHC. Objective To discuss the effects of mindfulness based psychosocial group interventions for health promotion in primary care units in Rio de Janeiro, Brazil. Methods The intervention was based on the MBHP model adapted for SUS. Nine groups were held in Rio de Janeiro. A quali-quanti research was held with two parts: (a) quantitative study, pre and after the 8 weeks intervention, evaluating the effect on mindfulness and self-compassion and their association with levels of anxiety, depression, and quality of life. (b) Qualitative research using Focus Groups with the participants to investigate their experience at the end of the mindfulness groups. Results and discussion Sixty-two participants finished the 9 groups where 86% were women, mostly between 30 and 59 years of age and low income, and around 80% under regular medical care in PHC in SUS. In the studied sample 80% had at least one chronic health condition under treatment, including 42% with anxiety and 35% with depression. The effects included significant improvement in Anxiety and Depression and in Quality of Life, mainly in the psychological but also in the physical and interrelation domains. The qualitative study showed that most patients joined the group on the recommendation of health professionals for managing physical and mental health symptoms. Patients reported being able to use the practices taught in the sessions to manage symptoms such as insomnia and emotionally distressing situations in their daily lives. Including family members in mindfulness practices was a strategy to negotiate not only a space at home to meditate, but also to obtain a different approach to health problems. Participants pointed to mindfulness as a complementary therapeutic option to medication and psychotherapy. Conclusion Mindfulness-Based Intervention have shown to be a feasible, well-accepted and efficacious method of offering psychosocial support and promoting well-being for low-income patients in primary care in LAMIC.
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Affiliation(s)
- Débora Silva Teixeira
- Department of Integral Family and Community Medicine, Medical Sciences College, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandra Fortes
- Medical Sciences College, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celia Kestenberg
- Nursing School, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Kali Alves
- Pedro Ernesto University Hospital – State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Alfredo Oliveira Neto
- Primary Health Care Department, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Francisco Ortega
- Catalan Institution of Research and Advanced Study, Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | | | - Marcelo Demarzo
- Mente Aberta – The Brazilian Center for Mindfulness and Health Promotion – Department of Preventive Medicine, Paulista Medical School – Federal University of São Paulo, São Paulo, Brazil
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Ong NY, Teo FJJ, Ee JZY, Yau CE, Thumboo J, Tan HK, Ng QX. Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis. Gen Psychiatr 2024; 37:e101115. [PMID: 38737894 PMCID: PMC11086195 DOI: 10.1136/gpsych-2023-101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 03/07/2024] [Indexed: 05/14/2024] Open
Abstract
Background Growing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain. Aims To evaluate the evidence for MBIs in improving healthcare workers' psychological well-being. Methods A systematic literature search was conducted on Medline, Embase, Cumulative Index for Nursing and Allied Health Literature, PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords 'healthcare worker', 'doctor', 'nurse', 'allied health', 'mindfulness', 'wellness', 'workshop' and 'program'. Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion. R V.4.0.3 was used for data analysis, with the standardised mean difference as the primary outcome, employing DerSimonian and Laird's random effects model. Grading of Recommendations, Assessment, Development and Evaluation framework was used to evaluate the quality of evidence. Cochrane's Risk of Bias 2 tool was used to assess the risk of bias in the included studies. Results A total of 27 studies with 2506 participants were included, mostly from the USA, involving various healthcare professions. MBIs such as stress reduction programmes, apps, meditation and training showed small to large effects on anxiety, burnout, stress, depression, psychological distress and job strain outcomes of the participants. Positive effects were also seen in self-compassion, empathy, mindfulness and well-being. However, long-term outcomes (1 month or longer postintervention) varied, and the effects were not consistently sustained. Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers. The review also highlights limitations such as intervention heterogeneity, reduced power in specific subgroup analyses and variable study quality. PROSPERO registration number CRD42022353340.
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Affiliation(s)
- Natasha Yixuan Ong
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Finn Jing Jie Teo
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jane Zi Ying Ee
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chun En Yau
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Julian Thumboo
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Health Services Research Unit, Singapore General Hospital, Singapore
- SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Hiang Khoon Tan
- Singhealth Duke-NUS Global Health Institute, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore
| | - Qin Xiang Ng
- Health Services Research Unit, Singapore General Hospital, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Florez A, Villar-Hoz E. Role of motivation and well-being indicators in interventions to improve well-being at work among primary care physicians: a systematic review. BMJ Open 2024; 14:e075799. [PMID: 38503419 PMCID: PMC10952968 DOI: 10.1136/bmjopen-2023-075799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE The well-being of primary care physicians (PCPs) has become an object of concern for governments due to staff shortages and high staff turnover. The objective of this study was to carry out a systematic review of individualised interventions aimed at improving the well-being of PCPs, which allowed us to determine (1) the type of interventions being carried out; (2) the well-being indicators being used and the instruments used to assess them; (3) the theories proposed to support the interventions and the mechanisms of action (MoA) put forward to explain the results obtained and (4) the role that individual motivation plays in the interventions to improve well-being among PCPs. DESIGN Systematic review. ELIGIBILITY CRITERIA Clinical trials on interventions aimed at improving the well-being of PCPs. INFORMATION SOURCES a search of studies published between 2000 and 2022 was carried out in MEDLINE/PubMed, SCOPUS and Web of Science (WOS). RESULTS From the search, 250 articles were retrieved. The two authors each reviewed the articles independently, duplicate articles and those that did not meet the inclusion criteria were discarded. A total of 14 studies that met the criteria were included: 6 randomised clinical trials, 4 controlled clinical trials and 4 unique cohorts, with a before-and-after assessment of the intervention, involving a total of 655 individuals participating in the interventions. A meta-analysis was not possible due to the heterogeneity of the studies. CONCLUSIONS The information evaluated is insufficient to accurately assess which outcomes are the best indicators of PCPs well-being or what role plays in the individual motivation in the results of the interventions. More studies need to be carried out on the subject to determine the MoA of the different interventions on the results and the motivation of the participating PCPs.
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Küppers L, Göbel J, Aretz B, Rieger MA, Weltermann B. Associations between COVID-19 Pandemic-Related Overtime, Perceived Chronic Stress and Burnout Symptoms in German General Practitioners and Practice Personnel-A Prospective Study. Healthcare (Basel) 2024; 12:479. [PMID: 38391854 PMCID: PMC10888352 DOI: 10.3390/healthcare12040479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The mental burdens of general practitioners (GPs) and practice assistants (PrAs) during the COVID-19 pandemic are well investigated. Work-related conditions like overtime are known to contribute to perceived chronic stress and burnout symptoms. However, there is limited evidence regarding the specific mechanisms, which link pandemic-related overtime, chronic stress and burnout symptoms. This study used data from the IMPROVEjob trial to improve psychological well-being in general practice personnel. METHODS This prospective study with 226 German GPs and PrAs used the baseline (pre-pandemic: October 2019 to March 2020) and follow-up data (pandemic: October 2020 to April 2021) of the IMPROVEjob trial. Overtime was self-reported as hours above the regular work time. Perceived chronic stress was assessed using the Trier Inventory for the Assessment of Chronic Stress Screening Scale (TICS-SSCS), while burnout symptoms were evaluated using a short version of the Maslach Burnout Inventory (MBI). A mediation analysis investigated the differences of the three main variables between pre-pandemic and pandemic periods. RESULTS Burnout symptoms increased significantly from baseline to follow-up (p = 0.003). Overtime correlated positively with burnout symptoms (Total Effect: 0.13; 95% CI: 0.03, 0.23). Decomposition of the total effect revealed a significant indirect effect over perceived chronic stress (0.11; 95% CI: 0.06, 0.18) and no significant direct effect (0.02; 95% CI: -0.08, 0.12), indicating a full mediation. CONCLUSION In this large longitudinal study, pandemic-related overtime led to significantly higher levels of burnout symptoms, linked by a pathway through perceived chronic stress. Future prevention strategies need to aim at reducing the likelihood of overtime to ensure the mental well-being of practice personnel.
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Affiliation(s)
- Lucas Küppers
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Julian Göbel
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Benjamin Aretz
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, 72074 Tuebingen, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
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Looper EM, Gleason P, Newnam K, Talbott E, Rouch TM. Feasibility of a Mindfulness Education Module for Nurses: An Evidence-Based Practice Project. J Contin Educ Nurs 2023; 54:516-523. [PMID: 37747143 DOI: 10.3928/00220124-20230918-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Nurse burnout is a well-defined problem that has been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic and negatively affects nurses' mental health, nursing shortages, patient safety, and quality of care. Evidence shows that mindfulness is an effective strategy for managing stress and decreasing burnout among nurses. This article describes an evidence-based practice project that translated this evidence into practice via a vetted mindfulness educational intervention for nurses on a pulmonary medicine unit and a medical intensive care unit. The goal of this project was to assess the feasibility of this educational intervention, processes, and outcomes with the goal to extend the project hospital-wide. Preintervention levels of nurse burnout were assessed using the validated Copenhagen Burnout Inventory. For both units, personal and work-related burnout were in the moderate range and patient-related burnout was in the mild range. Postintervention surveys completed by participant nurses and the nurse managers of both units supported the feasibility of this education module. Future implementation of annual mindfulness education was supported through both participant and administrative feedback. [J Contin Educ Nurs. 2023;54(11):516-523.].
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Alzahrani AM, Hakami A, AlHadi A, Al-maflehi N, Aljawadi MH, Alotaibi RM, Alzahrani MM, Alammari SA, Batais MA, Almigbal TH. The effectiveness of mindfulness training in improving medical students' stress, depression, and anxiety. PLoS One 2023; 18:e0293539. [PMID: 37906599 PMCID: PMC10617730 DOI: 10.1371/journal.pone.0293539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/14/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION There is growing interest in Mindfulness-based Stress Reduction (MBSR) program to combat mental distress in medical students. In Saudi Arabia, literature is insufficient about MBSR and its effectiveness. This study aims to measure the effectiveness of MBSR in improving mindful state, stress, anxiety, and depression in medical students. Also, the study explores the association between the attendance rate of MBSR sessions and its effectiveness. Lastly, the study examines gender differences in response to MBSR. METHODS This is a stratified randomized controlled study of 84 medical students from two medical schools in Riyadh, Saudi Arabia. They were recruited voluntarily from November 2018 to April 2021, and allocated to MBSR and waitlist groups using a stratified randomization method based on gender. MBSR group received eight weeks of sessions through audiovisual materials. An online survey utilizing validated questionnaires assessing stress, mindfulness, anxiety, and depression was used to evaluate both groups pre-program (time 0), post-program (time 1), and three months later (time 2). RESULTS Seventy-one participants completed the post-test (time 1). There were no differences between study groups at time 0 and 1. However, in 41 subjects who completed the follow-up test (time 2), the anxiety dropped significantly in MBSR group (mean difference (MD), -3.935; 95% CI, -7.580 to -0.290). Furthermore, attending more MBSR sessions was inversely correlated with depression (r, -0.556; P, 0.002), and anxiety (r, -0.630; P, 0.000). Compared to their baseline, males in MBSR group improved in stress (MD, 3.08; 95% CI, 0.30 to 5.86), anxiety (MD, 4.91; 95% CI, 3.32 to 6.50), and mindfulness (MD, -0.58; 95% CI, -1.01 to -0.15), while females improved in stress (MD, 2.64; 95% CI, 0.02 to 5.26). CONCLUSION Despite the study being interrupted by the stressful COVID-19 outbreak, the findings suggest that MBSR improved psychological outcomes when participants commit to the program.
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Affiliation(s)
- Ahmed M. Alzahrani
- University Family Medicine Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Hakami
- Riyadh Regional Laboratory, Ministry of Health, Riyadh, Saudi Arabia
| | - Ahmad AlHadi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nassr Al-maflehi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed H. Aljawadi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Mohammed A. Batais
- University Family Medicine Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Turky H. Almigbal
- University Family Medicine Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Othman SY, Hassan NI, Mohamed AM. Effectiveness of mindfulness-based interventions on burnout and self-compassion among critical care nurses caring for patients with COVID-19: a quasi-experimental study. BMC Nurs 2023; 22:305. [PMID: 37674145 PMCID: PMC10481566 DOI: 10.1186/s12912-023-01466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Workloads in intensive care units (ICUs) have increased and extremely challenging ethical dilemmas were generated by the coronavirus disease 2019 (COVID-19) pandemic. ICU nurses experience high-stress levels and burnout worldwide. Egyptian studies on the effectiveness of mindfulness-based intervention (MBI) among ICU nurses are limited, although MBI has been shown to reduce stress and burnout. METHODS This quasi-experimental study included 60 nurses working in three hospitals in El-Beheira, Egypt. Participants were randomly allocated to one of the two groups: intervention or control (30 participants per group). The participants in the intervention group (MBI) received 8 MBI sessions, whereas the control group received no intervention. The Maslach Burnout Inventory, the Five-Facet Mindfulness Questionnaire (FFMQ), and the Self-Compassion Scale were used to assess the outcomes. Additionally, demographic and workplace data were collected. RESULTS The post-test score of emotional exhaustion after MBI for 8 weeks significantly decreased in the MBI group to 15.47 ± 4.44 compared with the control group with 32.43 ± 8.87 (p < 0.001). The total Self-Compassion Scale significantly increased because of the mindfulness sessions 94.50 ± 3.83 for the MBI group vs. 79.00 ± 4.57 for the control group (p < 0.001). The post-test score of the FFMQ significantly increased to 137.03 ± 5.93, while the control group's score decreased to 114.40 ± 7.44, following the MBI sessions (p < 0.001). As determined by Cohen's d test, the effect size of MBI training is quite large, on the three burnout scale dimensions (emotional exhaustion, depersonalization, and personal achievement), as well as the total score of the mindfulness and self-compassion scales. CONCLUSION This study provides preliminary evidence that MBI sessions were effective in reducing emotional exhaustion and depersonalization and increasing levels of mindfulness and self-compassion among critical care nurses.
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Affiliation(s)
- Sahar Younes Othman
- Critical Care and Emergency Nursing Department, Faculty of Nursing, Damanhour University, El-Beheira, Egypt
| | - Nagia I. Hassan
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Damanhour University, El-Beheira, Egypt
| | - Alaa Mostafa Mohamed
- Critical Care and Emergency Nursing Department, Faculty of Nursing, Damanhour University, El-Beheira, Egypt
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López-Del-Hoyo Y, Fernández-Martínez S, Pérez-Aranda A, Barceló-Soler A, Bani M, Russo S, Urcola-Pardo F, Strepparava MG, García-Campayo J. Effects of eHealth interventions on stress reduction and mental health promotion in healthcare professionals: A systematic review. J Clin Nurs 2023; 32:5514-5533. [PMID: 36703266 DOI: 10.1111/jocn.16634] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/12/2022] [Accepted: 01/04/2023] [Indexed: 01/28/2023]
Abstract
AIMS To evaluate the effectiveness of eHealth interventions to reduce stress and promote mental health in healthcare professionals, and to compare the efficacy of different types of programs (guided vs. self-guided; 'third-wave' psychotherapies vs. other types). BACKGROUND Healthcare workers present high levels of stress, which constitutes a risk factor for developing mental health problems such as depression and anxiety. eHealth interventions have been designed to reduce these professional's stress considering that the characteristics of this delivery method make it a cost-effective and very appealing alternative because of its fast and easy access. DESIGN A systematic review of quantitative studies. METHODS A comprehensive database search for quantitative studies was conducted in PubMed, EMBASE and Cochrane (until 1 April 2022). The systematic review was conducted in accordance with the PRISMA and SWiM reporting guidelines. The quality of the studies was assessed using the National Heart, Lung and Blood Institute tools. RESULTS The abstracts of 6349 articles were assessed and 60 underwent in-depth review, with 27 fulfilling the inclusion criteria. The interventions were classified according to their format (self-guided vs. guided) and contents ('third-wave' psychotherapies vs. others). Twenty-two interventions emerged, 13 of which produced significant posttreatment reductions in stress levels of health professionals (9 self-guided, 8 'third wave' psychotherapies). Significant effects in improving depressive symptomatology, anxiety, burnout, resilience and mindfulness, amongst others, were also found. CONCLUSION The evidence gathered in this review highlights the heterogeneity of the eHealth interventions that have been studied; self-guided and 'third-wave' psychotherapy programs are the most common, often with promising results, although the methodological shortcomings of most studies hinder the extraction of sound conclusions. PROTOCOL REGISTRATION PROSPERO CRD42022310199. No Patient or Public Contribution.
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Affiliation(s)
- Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Selene Fernández-Martínez
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
| | - Adrián Pérez-Aranda
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Navarra Medical Research Institute (IdiSNA), Pamplona, Spain
| | - Marco Bani
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Fernando Urcola-Pardo
- Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
- Research Group Water and Environmental Health (B43_20R), University Institute of Research in Environmental Science of Aragon, University of Zaragoza, Zaragoza, Spain
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
- Clinical Unit "Psicologia Clinica", Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
- Psychiatry Department, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
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Kitto S. Some Musings About Theorizing Context in a (Post)Pandemic: The Case of Physician Burnout. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:143-144. [PMID: 37584495 DOI: 10.1097/ceh.0000000000000532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- Simon Kitto
- Nanyang Technological University, Lee Kong Chian School of Medicine, Singapore
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Lajante M, Del Prete M, Sasseville B, Rouleau G, Gagnon MP, Pelletier N. Empathy training for service employees: A mixed-methods systematic review. PLoS One 2023; 18:e0289793. [PMID: 37578963 PMCID: PMC10424876 DOI: 10.1371/journal.pone.0289793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
Following the surge for empathy training in service literature and its increasing demand in service industries, this study systematically reviews empirical papers implementing and testing empathy training programs in various service domains. A mixed-methods systematic review was performed to identify and describe empathy training programs and discuss their effectiveness in service quality, service employees' well-being, and service users' satisfaction. Included papers met those eligibility criteria: qualitative, quantitative, or mixed-methods study; one training in empathy is identifiable; described training(s) developed for or tested with service employees dealing with service users. We searched health, business, education, and psychology databases, such as CINAHL, Medline ABI/Inform Global, Business Source Premier, PsycINFO, and ERIC. We used the Mixed-Method Assessment Tool to appraise the quality of included papers. A data-based convergent synthesis design allowed for the analysis of the data. A total of 44 studies published between 2009 to 2022 were included. The narrative presentation of findings was regrouped into these six dimensions of empathy training programs: 1) why, 2) who, 3) what, 4) how, 5) where, and 6) when and how much. Close to 50% of studies did not include a definition of empathy. Four main empathic competencies developed through the training programs were identified: communication, relationship building, emotional resilience, and counseling skills. Face-to-face and group-setting interventions are widespread. Our systematic review shows that the 44 papers identified come only from health services with a predominant population of physicians and nurses. However, we show that the four empathic skills identified could be trained and developed in other sectors, such as business. This is the first mixed-methods, multi-disciplinary systematic review of empathy training programs in service research. The review integrates insights from health services, identifies research limitations and gaps in existing empirical research, and outlines a research agenda for future research and implications for service research.
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Affiliation(s)
- Mathieu Lajante
- The emoLab, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Marzia Del Prete
- Department of Economic Sciences and Statistics, University of Salerno, Fisciano, Salerno, Italy
| | | | - Geneviève Rouleau
- Nursing Department, Université du Québec en Outaouais, Québec, Canada
| | | | - Normand Pelletier
- Business & Economics Librarian, Université Laval, Quebec City, Canada
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Selič-Zupančič P, Klemenc-Ketiš Z, Onuk Tement S. The Impact of Psychological Interventions with Elements of Mindfulness on Burnout and Well-Being in Healthcare Professionals: A Systematic Review. J Multidiscip Healthc 2023; 16:1821-1831. [PMID: 37404957 PMCID: PMC10317529 DOI: 10.2147/jmdh.s398552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/24/2023] [Indexed: 07/06/2023] Open
Abstract
Background Healthcare professionals are highly likely to experience various causes of work-related stress, which often leads to burnout. This became even more obvious during the Covid-19 pandemic. This systematic review aimed to analyze articles where psychological interventions with elements of mindfulness (PIM) were used to support healthcare professionals to foster well-being and reduce burnout levels. Compared to other recently published reviews, it is unique, due to its focus on a wide group of healthcare professionals, a broader selection of psychological interventions, and the evaluation of any sustained effects. Methods Systematic searches were carried out in February 2021 with different combinations of Boolean operators within six electronic databases: PubMed, EBSCOhost, MEDLINE, PsycArticles, Cochrane Library, JSTOR and Cobiss. We included articles that had been published in the last ten years (2011 to 2021) and which reported on original research focused on evaluating the influence of PIM on healthcare professionals. MERSQI was used to assess the quality of the included studies. Results Of 1315 identified studies, 15 were included in this systematic review. Regardless of the specific type, duration and setting (individual vs group) of PIM applied, the results demonstrated a positive impact on well-being and burnout in participating healthcare professionals. The most studied interventions involved MBSR (mindfulness-based stress reduction) and other mindfulness training programmes, in online as well as in-person versions. Conclusion Given the new reality with the presence of the SARS-Cov-2 virus, it is of the utmost importance to offer feasible, effective interventions for burnout reduction to vulnerable groups of healthcare professionals. By focusing on their needs, several key aspects of burnout and mindfulness could be efficiently improved; this review demonstrates that short, online interventions could be as effective as longer, in-person ones.
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Affiliation(s)
- Polona Selič-Zupančič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Psychology, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Ljubljana, Slovenia
| | - Zalika Klemenc-Ketiš
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Ljubljana, Slovenia
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Sara Onuk Tement
- Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia
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Hughey L, Flynn TW, Dunaway J, Moore J, Sabbahi A, Fritsch A, Koszalinski A, Reynolds B. Mindfulness, exercise, diet, and sleep - A necessary and urgently needed skill set of the musculoskeletal practitioner. Musculoskeletal Care 2023; 21:198-201. [PMID: 35989616 DOI: 10.1002/msc.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | - Jeff Moore
- South College, Knoxville, Tennessee, USA
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Sucich JT, Lehrer J, Breitbart V, Julliard KN. Mindfulness training for community-based psychotherapists: a feasibility study. Pilot Feasibility Stud 2022; 8:250. [PMID: 36494854 PMCID: PMC9733050 DOI: 10.1186/s40814-022-01205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 11/09/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND While mindfulness training's feasibility has been assessed in many health care settings, the feasibility of teaching mindfulness to psychotherapists of various orientations for both self- and patient-care has not been explored. The objectives of this feasibility assessment were to determine the degree to which clinic psychotherapists were willing to complete a skills-based mindfulness training program; evaluate the acceptability of integrating mindfulness interventions into an urban community mental health clinic; examine the training's influence on both personal mindfulness practice and integration into patient care; and explore the impact of a support group following the training. METHODS Data on six aspects of feasibility were gathered through quantitative surveys, semi-structured qualitative interviews, and group observation and feedback, analyzed using grounded theory. RESULTS Sixteen therapists and one administrator attended at least one session of this voluntary program and responded to the associated surveys. At 1-year post-training, 7 participants had attended one or more group support sessions, and 4 more than 50% of sessions. The following factors were identified as contributing to the training's success: significant interest on the part of clinic staff to receive the training; diversity of the teaching staff, buy-in from clinic administration, provision of meditation scripts, role-play exercises, the variety of practices taught, and case presentations. Therapists indicated that the training helped them create a personal mindfulness practice, and several proceeded to integrate mindfulness into client sessions. A bi-weekly support group organized after the training encompassed group practice, discussion, case presentations, and information about trauma-sensitive mindfulness. Clinicians identified the following challenges to integrating mindfulness into sessions: lack of scripts in client languages other than English, the unacceptability of mindfulness to some clients' religious beliefs, the lack of appropriateness for clients facing ongoing psychosocial crises, the lack of interest on the part of some clients, and the time constraints posed by brief therapy sessions. CONCLUSIONS These findings indicate that such training may be feasible in community mental health settings given support from leadership and the presence of qualified facilitators within the organization. Adaptations to the training based on participant feedback can inform a larger scale trial that compares our protocol with another intervention in the treatment of a psychological disorder or condition identified by the participants as having responded favorably to the program.
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Affiliation(s)
- James T. Sucich
- grid.137628.90000 0004 1936 8753Family Health Centers at NYU Langone, 514 49th Street, Brooklyn, NY 11220 USA
| | - Jeremy Lehrer
- grid.21729.3f0000000419368729Columbia University, New York City, USA
| | - Vicki Breitbart
- grid.137628.90000 0004 1936 8753Silver School of Social Work, New York University, New York City, USA
| | - Kell N. Julliard
- grid.137628.90000 0004 1936 8753Family Health Centers at NYU Langone, 514 49th Street, Brooklyn, NY 11220 USA
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López-Del-Hoyo Y, Fernández-Martínez S, Pérez-Aranda A, Barceló-Soler A, Guzman-Parra J, Varela-Moreno E, Campos D, Monreal-Bartolomé A, Beltrán-Ruiz M, Moreno-Küstner B, Mayoral-Cleries F, García-Campayo J. Effectiveness and implementation of an online intervention (MINDxYOU) for reducing stress and promote mental health among healthcare workers in Spain: a study protocol for a stepped-wedge cluster randomized trial. BMC Nurs 2022; 21:308. [PMID: 36357881 PMCID: PMC9647243 DOI: 10.1186/s12912-022-01089-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The World Health Organization has formally recognized that healthcare professionals are at risk of developing mental health problems; finding ways to reduce their stress is mandatory to improve both their quality of life and, indirectly, their job performance. In recent years, particularly since the COVID-19 pandemic outbreak, there has been a proliferation of online interventions with promising results. The purpose of the present study is twofold: to test the effectiveness of an online, self-guided intervention, MINDxYOU, to reduce the stress levels of healthcare workers; and to conduct an implementation study of this intervention. Additionally, an economic evaluation of the intervention will be conducted. METHODS The current study has a hybrid effectiveness-implementation type 2 design. A stepped wedge cluster randomized trial design will be used, with a cohort of 180 healthcare workers recruited in two Spanish provinces (Malaga and Zaragoza). The recruitment stage will commence in October 2022. Frontline health workers who provide direct care to people in a hospital, primary care center, or nursing home setting in both regions will participate. The effectiveness of the intervention will be studied, with perceived stress as the main outcome (Perceived Stress Scale), while other psychopathological symptoms and process variables (e.g., mindfulness, compassion, resilience, and psychological flexibility) will be also assessed as secondary outcomes. The implementation study will include analysis of feasibility, acceptability, adoption, appropriateness, fidelity, penetration, and sustainability. The incremental costs and benefits, in terms of quality-adjusted life years, will be examined by means of cost-utility and cost-effectiveness analyses. DISCUSSION MINDxYOU is designed to reduce healthcare workers' stress levels through the practice of mindfulness, acceptance, and compassion, with a special focus on how to apply these skills to healthy habits and considering the particular stressors that these professionals face on a daily basis. The present study will show how implementation studies are useful for establishing the framework in which to address barriers to and promote facilitators for acceptability, appropriateness, adoption, feasibility, fidelity, penetration, and sustainability of online interventions. The ultimate goal is to reduce the research-to-practice gap. TRIAL REGISTRATION This study was registered in ClinicalTrials.gov on 29/06/2022; registration number: NCT05436717.
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Affiliation(s)
- Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Departamento de Psicología Y Sociología, Facultad de Ciencias Humanas Y de La Educación, Universidad de Zaragoza, Saragossa/Huesca, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Saragossa, Spain
| | - Selene Fernández-Martínez
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
| | - Adrián Pérez-Aranda
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain.
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola Del Vallès, Spain.
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain.
- Navarra Medical Research Institute (IdiSNA), Pamplona, Spain.
| | - Jose Guzman-Parra
- Mental Health Clinical Management Unit, Regional University Hospital of Malaga, Málaga, Spain
- Malaga Biomedical Research Institute (IBIMA), Málaga, Spain
| | - Esperanza Varela-Moreno
- Mental Health Clinical Management Unit, Regional University Hospital of Malaga, Málaga, Spain
- Malaga Biomedical Research Institute (IBIMA), Málaga, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Malaga, Málaga, Spain
| | - Daniel Campos
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Departamento de Psicología Y Sociología, Facultad de Ciencias Humanas Y de La Educación, Universidad de Zaragoza, Saragossa/Huesca, Spain
| | - Alicia Monreal-Bartolomé
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Saragossa, Spain
| | - María Beltrán-Ruiz
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Saragossa, Spain
| | - Berta Moreno-Küstner
- Malaga Biomedical Research Institute (IBIMA), Málaga, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Malaga, Málaga, Spain
- MARISTAN Network, Málaga, Spain
| | - Fermín Mayoral-Cleries
- Mental Health Clinical Management Unit, Regional University Hospital of Malaga, Málaga, Spain
- Malaga Biomedical Research Institute (IBIMA), Málaga, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Saragossa, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Saragossa, Spain
- Department of Psychiatry, Faculty of Medicine, University of Zaragoza, Saragossa, Spain
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Hu Z, Wen Y, Wang Y, Lin Y, Shi J, Yu Z, Lin Y, Wang Y. Effectiveness of mindfulness-based interventions on empathy: A meta-analysis. Front Psychol 2022; 13:992575. [PMID: 36337535 PMCID: PMC9632989 DOI: 10.3389/fpsyg.2022.992575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/29/2022] [Indexed: 10/13/2023] Open
Abstract
Empathy is essential for human survival and social interaction. Although mindfulness-based interventions (MBIs) have been used to improve empathy in healthy populations, its therapeutic efficacy remains unknown. This study aims to investigate the therapeutic effects of MBIs on empathy in a healthy population and the potential factors affecting the efficacy of MBIs. The literature search focused on PubMed, Embase, Web of Science, Cochrane Library, and CNKI from inception to September 2022. Randomized controlled trials and quasi-experimental studies reporting the effects of using MBIs on empathy in healthy populations were included. A total of 13 studies were included in this review. Results of the meta-analysis showed that MBIs improved empathy (SMD, 0.372, 95% CI, 0.164-0.579, p = 0.001) in the healthy population compared with that in the control group. Moreover, results of the subgroup analysis showed that intervention dose (over 24 h vs. under 24 h), format (online vs. offline), and types (different types) were important factors affecting treatment outcomes. This comprehensive review suggests that MBIs are effective treatment for empathy in healthy population. Future research should markedly focus on large-sample, rigorously designed experiments to explore the long-term effects of MBIs on empathy and to elucidate the underlying mechanisms of MBIs. This study provides a reference for the daily application of MBIs.
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Affiliation(s)
- Zhengyu Hu
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yurong Wen
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yafei Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yangyang Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Shi
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zihan Yu
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
| | - Youtian Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Yuling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Malik H, Annabi CA. The impact of mindfulness practice on physician burnout: A scoping review. Front Psychol 2022; 13:956651. [PMID: 36204751 PMCID: PMC9530040 DOI: 10.3389/fpsyg.2022.956651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022] Open
Abstract
Background Physician burnout is a growing phenomenon in current health systems worldwide. With the emergence of COVID-19, burnout in healthcare is progressively becoming a serious concern. Increasing emotional exhaustion, depersonalization, and reduced personal accomplishment threaten the effective delivery of healthcare. Compassion fatigue and moral injury are a considerable risk to the doctor-patient relationship. These issues can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in physicians. Methodology A scoping review was conducted to investigate the effects of mindfulness practice on physician burnout. High-ranking journals were targeted to analyze high-quality studies and synthesize common themes in the literature. Studies conducted on current practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Gray literature and studies conducted only on allied health personnel were excluded from this review. Results 31 studies were included in this scoping review. Mindfulness practice decreased emotional exhaustion and depersonalization while improving mood, responses to stress, and vigor. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to physician mindfulness practice. Conclusion Mindfulness was widely reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate physician leader will play a crucial role in addressing current practice gaps, prioritizing staff mental health, and providing a supportive platform for innovation.
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Affiliation(s)
- Hani Malik
- Department of Family Medicine, Royal College of Surgeons in Ireland, Medical University of Bahrain, Manama, Bahrain
- *Correspondence: Hani Malik,
| | - Carrie Amani Annabi
- Graduate School of Healthcare Management, Royal College of Surgeons in Ireland-Dubai, Dubai, United Arab Emirates
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Bégin C, Berthod J, Martinez LZ, Truchon M. Use of Mobile Apps and Online Programs of Mindfulness and Self-Compassion Training in Workers: A Scoping Review. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 7:477-515. [PMID: 36091081 PMCID: PMC9444703 DOI: 10.1007/s41347-022-00267-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022]
Abstract
Mindfulness and self-compassion interventions are two strategies helpful in preventing and reducing burnout and work stress. However, professionals with overburdened schedules can experience obstacles in learning and practicing these interventions, originally taught with lengthy programs. The use of digital technologies could make these interventions more accessible to workers, as studied in a recent, growing body of evidence. The evidence available is diverse in terms of interventions, designs, outcomes, and populations. This calls for a review that can take into consideration this diversity while still rigorously synthesize it. Scoping reviews are designed to examine emerging evidence and summarize the evidence on a specific topic of interest. The present scoping review aims to assess the current state of the literature on the use of online programs and mobile applications of self-compassion, mindfulness, and meditation (digital mindfulness-based interventions; dMBIs) by workers. More specifically, information on the type of intervention, population, advantages, and disadvantages, measured outcomes, and advice for future research are gathered. MEDLINE (PubMed; Ovid), PsychInfo (Ovid), and Web of Science (Clarivate) were searched to identify all relevant articles. The screening process resulted in 56 articles being included in this scoping review. Inclusion criteria were (1) participants are workers; (2) the intervention is individual, digital, and mindfulness/self-compassion/meditation-based; and (3) articles were available in French or English language at the time of the review. Interventions used were mostly mindfulness-based, equally categorized under web-based and app-based interventions. Most interventions included information on mindfulness, meditation or self-compassion, meditation exercises, other types of exercises, instructions on how to use, and reminders. dMBIs are often studied in the healthcare population and predominantly in female samples. Although dMBIs present advantages (low cost, accessibility, practicality, feasibility), obstacles can arise in their implementation (low engagement and motivation, concerns about confidentiality). Included articles measured outcomes related to work, mindfulness or self-compassion, and other psychological variables (stress/anxiety, depression, resilience, wellbeing). Articles provided important directions to further research on dMBIs regarding methodological aspects, modality and intervention, and individual and organizational questions. dMBIs are becoming more popular and interventions are diverse. Although not without limitations, this scoping provided a synthesis on different aspects of the use of dMBIs within workers and highlighted pertinent future research directions.
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Yin M, Li W, Yang Q, Yue Y, Fang X, Yang Z, Wang X, Liu Q, Kong F, Ji C, Lv X, Wang H, Yuan N, Li Z, Zhang C, Li K, Yang Y, Du X. The Mediating Role of Coping Style in the Relationship Between Sleep Quality and Burnout: A Cross-Sectional Study Among Psychiatric Nurses. Front Psychiatry 2022; 13:926040. [PMID: 35815050 PMCID: PMC9260227 DOI: 10.3389/fpsyt.2022.926040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 11/15/2022] Open
Abstract
Background Although sleep quality is clearly associated with job burnout as shown in the existing research, the mechanism underpinning such relationship remains undefined. This work, thus, aimed to assess the current situation of sleep quality and burnout in Chinese psychiatric nurses, and to analyze the relationships between sleep quality, burnout and coping style, in order to provide possible targets to enhance mental health and wellbeing among psychiatric nurses. Method This cross-sectional study was carried out in seven rehabilitation centers located in four different regions of China. The Pittsburgh Sleep Quality Index, the Epworth Sleeping Scale, the Maslach Burnout Inventory General Survey, and the Coping Style Questionnaire were distributed to 853 nurses in various mental hospitals, with a total of 664 participants being recruited in the final research. Results The results of this current study showed a high prevalence of sleep disorders and burnout in Chinese psychiatric nurses. Moreover, emotional exhaustion (r = 0.456), cynicism (r = 0.323) and negative coping style (r = 0.191) in nurses were all positively correlated with total Pittsburgh Sleep Quality Index (PSQI) score, while professional efficacy (r = -0.079) and positive coping style (r = -0.140) were negatively correlated with total PSQI score. More interestingly, of all negative coping strategies, we found that self-blame had the most significant effect (β = 0.156). Conclusions The above results showed that coping style mediates the association of poor sleep quality with job burnout in Chinese psychiatric nurses. This study claimed that there is an urgent need to development the coping skills to sustain a healthy work life for nurses.
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Affiliation(s)
- Ming Yin
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Weiqin Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Qun Yang
- Nanchong Psychosomatic Hospital, Nanchong, China
| | - Yan Yue
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | - Xiaojia Fang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhong Yang
- The Third People's Hospital of Changshu, Suzhou, China
| | - Xinda Wang
- Taicang Third People's Hospital, Suzhou, China
| | - Qin Liu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Fanzhen Kong
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Caifang Ji
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiaoli Lv
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Hao Wang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Nian Yuan
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Caiyi Zhang
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Kan Li
- Jiangxi Mental Hospital, Nanchang, China
| | - Yang Yang
- Mental Hospital of Yunnan Province, Kunming, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
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Blevins D, Henry BF, Sung M, Edelman EJ, Black AC, Dawes M, Molfenter T, Hagle H, Drexler K, Cates-Wessel K, Levin FR. Well-Being of Health Care Professionals Treating Opioid Use Disorder During the COVID-19 Pandemic: Results From a National Survey. Psychiatr Serv 2022; 73:374-380. [PMID: 34369804 PMCID: PMC8825878 DOI: 10.1176/appi.ps.202100080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has dramatically affected health care delivery, effects that are juxtaposed with health care professional (HCP) burnout and mental distress. The Opioid Use Disorder Provider COVID-19 Survey was conducted to better understand the impact of COVID-19 on clinical practice and HCP well-being. METHODS The cross-sectional survey was e-mailed to listservs with approximately 157,000 subscribers of diverse professions between July 14 and August 15, 2020. Two dependent variables evaluated HCP functioning and work-life balance. Independent variables assessed organizational practices and HCP experiences. Covariates included participant demographic characteristics, addiction board certification, and practice setting. Multilevel multivariate logistic regression models were used. RESULTS Among 812 survey respondents, most were men, White, and physicians, with 46% located in urban settings. Function-impairing anxiety was reported by 17%, and 28% reported more difficulty with work-life balance. Difficulty with functioning was positively associated with having staff who were sick with COVID-19 and feeling close to patients, and was negatively associated with being male and having no staff changes. Difficulty with work-life balance was positively associated with addiction board certification; working in multiple settings; having layoffs, furloughs, or reduced hours; staff illness with COVID-19; and group well-being check-ins. It was negatively associated with male gender, older age, and no staff changes. CONCLUSIONS Demographic, provider, and organizational-practice variables were associated with reporting negative measures of well-being during the COVID-19 pandemic. These results should inform HCPs and their organizations on factors that may lead to burnout, with particular focus on gender and age-related concerns and the role of well-being check-ins.
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Affiliation(s)
- Derek Blevins
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Brandy F Henry
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Minhee Sung
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - E Jennifer Edelman
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Anne C Black
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Michael Dawes
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Todd Molfenter
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Holly Hagle
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Karen Drexler
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Kathryn Cates-Wessel
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
| | - Frances R Levin
- Department of Psychiatry, Columbia University Irving Medical Center, New York City (Blevins, Levin).,New York State Psychiatric Institute, New York City (Blevins, Levin).,Columbia University School of Social Work, New York City (Henry).,Department of Educational Psychology, Counseling and Special Education, College of Education, Pennsylvania State University, University Park (Henry).,U.S. Department of Veterans Affairs (VA) Health Services Research and Development, West Haven, Connecticut (Sung).,VA Connecticut Healthcare System, West Haven (Sung, Black).,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Edelman, Black).,Department of Psychiatry, Boston University School of Medicine, Boston (Dawes).,Boston Medical Center, Boston (Dawes).,Center for Health Enhancement System Studies, University of Wisconsin, Madison (Molfenter).,Addiction Technology Transfer Center Network, Kansas City, Missouri (Hagle).,School of Nursing and Health Studies, University of Missouri, Kansas City (Hagle).,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Drexler).,American Academy of Addiction Psychiatry, East Providence, Rhode Island (Cates-Wessel)
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21
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Caragol JA, Johnson AR, Kwan BM. A gratitude intervention to improve clinician stress and professional satisfaction: A pilot and feasibility trial. Int J Psychiatry Med 2022; 57:103-116. [PMID: 33472468 DOI: 10.1177/0091217420982112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Resilience training combined with medical system changes have the potential to reduce clinician burnout. We sought to estimate effects and assess feasibility of a brief gratitude intervention for primary care clinicians. METHODS This was a pre-test/post-test single group intervention design with longitudinal follow-up. Volunteer participants were from either a primary care community engagement conference or worked at one of two clinical sites in a Western mid-size city. Eligible clinicians held an MD/DO or NP/PA degree and currently worked at least 0.50 FTE in a primary care clinical practice and were willing and able to participate in the initial group session and complete weekly journaling. The gratitude intervention consisted of an in-person 90-minute group psychoeducation and skills-building workshop, followed by an 8-week daily gratitude journal exercise. The primary outcomes were related to resilience, including coping self-efficacy, clinician autonomy, and self-care behaviors. The secondary outcomes were the feasibility and acceptability of the intervention, as well as career satisfaction, and types and frequency of things for which clinicians were grateful in their daily work. RESULTS The intervention was brief, feasible, and of interest to clinicians. Statistically significant improvements were seen in most outcome measures at both 4 and 8 weeks follow-up, with the exception of gratitude, which also increased, but not significantly so. Gratitude categories mentioned most frequently were support platforms at work (47%) and sense of competence (42%). CONCLUSIONS The intervention had positive effects on resilience and is a promising brief intervention for clinicians experiencing stress. Larger experimental designs are needed.
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Affiliation(s)
- Jennifer A Caragol
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Alexandra R Johnson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Bethany M Kwan
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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22
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Serrão C, Martins V, Ribeiro C, Maia P, Pinho R, Teixeira A, Castro L, Duarte I. Professional Quality of Life Among Physicians and Nurses Working in Portuguese Hospitals During the Third Wave of the COVID-19 Pandemic. Front Psychol 2022; 13:814109. [PMID: 35178016 PMCID: PMC8845595 DOI: 10.3389/fpsyg.2022.814109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/03/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In the last 2 weeks of January 2021, Portugal was the worst country in the world in incidence of infections and deaths due to COVID-19. As a result, the pressure on the healthcare system increased exponentially, exceeding its capacities and leaving hospitals in near collapse. This scenario caused multiple constraints, particularly for hospital medical staff. Previous studies conducted at different moments during the pandemic reported that COVID-19 has had significant negative impacts on healthcare workers' psychological health, including stress, anxiety, depression, burnout, post-traumatic stress symptoms, and sleep disturbances. However, there are many uncertainties regarding the professional quality of life of hospital nurses and physicians. To address gaps in previous research on secondary traumatic stress, we focused on healthcare workers working in hospitals affected by a major traumatic event: the third wave of COVID-19. OBJECTIVES The aim of the present study was to identify the contribution of personal and work-related contextual variables (gender, age, parental status, occupation, years of experience, working with patients affected by COVID-19) on professional quality of life of healthcare workers. METHODS Cross-sectional study with a web-based questionnaire given to physicians and nurses working in a hospital setting. A total of 853 healthcare professionals (276 physicians and 586 nurses; median age 37 years old) participated in the survey assessing professional quality of life compassion satisfaction, secondary traumatic stress, and burnout. Factors of professional quality of life were assessed using regression analysis. RESULTS Most of the participants showed moderate (80%; n = 684) or high (18%; n = 155) levels of compassion satisfaction, whereas the majority of them experienced moderate levels of burnout (72%; n = 613) and secondary traumatic stress (69%; n = 592). The analyzed variables demonstrated no differences between professionals who were directly or not involved in the care of COVID-19 patients. Parental status was found to be a significant factor in compassion satisfaction. Female gender was significantly associated with more susceptibility to secondary traumatization. Factors that may potentially contribute to burnout include years of professional experience and the number of work hours per week. CONCLUSION The COVID-19 pandemic has created a new challenge for the healthcare system. Burnout and secondary traumatic stress can lead to medical errors and impact standards of patient care, particularly compromising compassionate care. It is therefore recommended that hospitals develop psychoeducational initiatives to support professionals in dealing with barriers to compassion.
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Affiliation(s)
- Carla Serrão
- School of Education, Polytechnic of Porto, Porto, Portugal
- Center for Research and Innovation in Education (inED), Porto, Portugal
| | - Vera Martins
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carla Ribeiro
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Paulo Maia
- Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto e CHUPorto, Porto, Portugal
| | - Rita Pinho
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Teixeira
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- ADiT-LAB, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
| | - Luísa Castro
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- School of Health, Polytechnic of Porto, Porto, Portugal
| | - Ivone Duarte
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
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23
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Bazargan-Hejazi S, Shirazi A, Wang A, Shlobin NA, Karunungan K, Shulman J, Marzio R, Ebrahim G, Shay W, Slavin S. Contribution of a positive psychology-based conceptual framework in reducing physician burnout and improving well-being: a systematic review. BMC MEDICAL EDUCATION 2021; 21:593. [PMID: 34823509 PMCID: PMC8620251 DOI: 10.1186/s12909-021-03021-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The PERMA Model, as a positive psychology conceptual framework, has increased our understanding of the role of Positive emotion, Engagement, Relationships, Meaning, and Achievements in enhancing human potentials, performance and wellbeing. We aimed to assess the utility of PERMA as a multidimensional model of positive psychology in reducing physician burnout and improving their well-being. METHODS Eligible studies include peer-reviewed English language studies of randomized control trials and non-randomized design. Attending physicians, residents, and fellows of any specialty in the primary, secondary, or intensive care setting comprised the study population. Eligible studies also involved positive psychology interventions designed to enhance physician well-being or reduce physician burnout. Using free text and the medical subject headings we searched CINAHL, Ovid PsychINFO, MEDLINE, and Google Scholar (GS) electronic bibliographic databases from 2000 until March 2020. We use keywords for a combination of three general or block of terms (Health Personnel OR Health Professionals OR Physician OR Internship and Residency OR Medical Staff Or Fellow) AND (Burnout) AND (Positive Psychology OR PERMA OR Wellbeing Intervention OR Well-being Model OR Wellbeing Theory). RESULTS Our search retrieved 1886 results (1804 through CINAHL, Ovid PsychINFO, MEDLINE, and 82 through GS) before duplicates were removed and 1723 after duplicates were removed. The final review included 21 studies. Studies represented eight countries, with the majority conducted in Spain (n = 3), followed by the US (n = 8), and Australia (n = 3). Except for one study that used a bio-psychosocial approach to guide the intervention, none of the other interventions in this review were based on a conceptual model, including PERMA. However, retrospectively, ten studies used strategies that resonate with the PERMA components. CONCLUSION Consideration of the utility of PERMA as a multidimensional model of positive psychology to guide interventions to reduce burnout and enhance well-being among physicians is missing in the literature. Nevertheless, the majority of the studies reported some level of positive outcome regarding reducing burnout or improving well-being by using a physician or a system-directed intervention. Albeit, we found more favorable outcomes in the system-directed intervention. Future studies are needed to evaluate if PERMA as a framework can be used to guide system-directed interventions in reducing physician burnout and improving their well-being.
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Affiliation(s)
- Shahrzad Bazargan-Hejazi
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA.
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
| | - Anaheed Shirazi
- Department of Psychiatry, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Andrew Wang
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Nathan A Shlobin
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Krystal Karunungan
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Joshua Shulman
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
| | - Robert Marzio
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
| | - Gul Ebrahim
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
| | - William Shay
- College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA
| | - Stuart Slavin
- Accreditation Council for Graduate Medical Education, Chicago, USA
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24
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Salvado M, Marques DL, Pires IM, Silva NM. Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9101342. [PMID: 34683022 PMCID: PMC8544467 DOI: 10.3390/healthcare9101342] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 01/23/2023] Open
Abstract
Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a systematic review and meta-analysis to analyze the effects of MBIs to reduce burnout in PHCP. We searched articles in the PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases from inception to September 2021 using MeSH terms: "mindfulness", "burnout", and "primary healthcare". Two reviewers extracted the data and assessed the risk of bias. We used a random-effects meta-analysis to calculate the standardized mean differences (SMD) and mean differences (MD) with 95% confidence intervals (CI) of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) domains of burnout. Of 61 records, ten were included (n = 417). Overall, the studies were rated as having a high risk of bias and limited quality evidence. MBIs significantly reduced EE (SMD = -0.54, 95%CI: -0.72 to -0.36; MD = -5.89, 95%CI: -7.72 to -4.05), DP (SMD = -0.34, 95%CI: -0.52 to -0.17; MD = -1.96, 95%CI: -2.96 to -0.95), and significantly increased PA (SMD = 0.34, 95%CI: 0.17 to 0.52; MD = 2.05, 95%CI: 1.04 to 3.06). Although further high-quality research is needed, our findings support the implementation of MBIs for reducing burnout in PHCP.
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Affiliation(s)
- Mafalda Salvado
- Centro de Saúde Dr. Gorjão Henriques, Unidade de Saúde Familiar Cidade do Lis, 2410-272 Leiria, Portugal;
- Correspondence:
| | - Diogo Luís Marques
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
| | - Ivan Miguel Pires
- Instituto de Telecomunicações, Universidade da Beira Interior, 6200-001 Covilhã, Portugal;
- Escola de Ciências e Tecnologias, University of Trás-os-Montes e Alto Douro, Quinta de Prados, 5001-801 Vila Real, Portugal
| | - Nádia Mendes Silva
- Centro de Saúde Dr. Gorjão Henriques, Unidade de Saúde Familiar Cidade do Lis, 2410-272 Leiria, Portugal;
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25
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Degen L, Linden K, Seifried-Dübon T, Werners B, Grot M, Rind E, Pieper C, Eilerts AL, Schroeder V, Kasten S, Schmidt M, Goebel J, Rieger MA, Weltermann BM. Job Satisfaction and Chronic Stress of General Practitioners and Their Teams: Baseline Data of a Cluster-Randomised Trial (IMPROVE job). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189458. [PMID: 34574383 PMCID: PMC8466539 DOI: 10.3390/ijerph18189458] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022]
Abstract
Background: A high prevalence of poor job satisfaction and high chronic stress is documented for general practitioners (GPs) and non-physician practice staff from various countries. The reasons are multifactorial and include deficits in leadership, communication and workflows. This publicly funded study evaluates the effectiveness of the newly developed participatory, interdisciplinary, and multimodal IMPROVEjob intervention on improving job satisfaction among GPs and practice personnel. Here, we report the baseline characteristics of the participating GPs and practice assistants, focusing on job satisfaction and perceived chronic stress. Methods: The IMPROVEjob study was performed as a cluster-randomised, controlled trial (cRCT) with German GP practices in the North Rhine Region. The IMPROVEjob intervention comprised two leadership workshops (one for practice leaders only; a second for leaders and practice assistants), a toolbox with supplemental printed and online material, and a nine-month implementation phase supported by IMPROVEjob facilitators. The intervention addressed issues of leadership, communication, and work processes. During study nurse visits, participants completed questionnaires at baseline and after nine months follow up. The primary outcome was the change in job satisfaction as measured by the respective scale of the validated German version of the Copenhagen Psychosocial Questionnaire (German COPSOQ, version 2018). Perceived chronic stress was measured using the Trier Inventory of Chronic Stress (TICS- SSCS). Results: Recruitment of 60 practices was successful: 21 were solo, 39 were group practices. At baseline, n = 84 practice owners, n = 28 employed physicians and n = 254 practice assistants were included. The mean age of all participants was 44.4 (SD = 12.8). At baseline, the job satisfaction score in the total sample was 74.19 of 100 (±14.45) and the perceived chronic stress score was 19.04 of 48 (±8.78). Practice assistants had a significantly lower job satisfaction than practice owners (p < 0.05) and employed physicians (p < 0.05). In the regression analysis, perceived chronic stress was negatively associated with job satisfaction (b= −0.606, SE b = 0.082, p < 0.001, ICC = 0.10). Discussion: The degree of job satisfaction was similar to those in other medical professionals published in studies, while perceived chronic stress was markedly higher compared to the general German population. These findings confirm the need for interventions to improve psychological wellbeing in GP practice personnel.
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Affiliation(s)
- Lukas Degen
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (K.L.); (S.K.); (M.S.); (J.G.); (B.M.W.)
- Correspondence: ; Tel.: +49-(0)-228-287-11156
| | - Karen Linden
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (K.L.); (S.K.); (M.S.); (J.G.); (B.M.W.)
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstraße 5, 72076 Tuebingen, Germany;
| | - Brigitte Werners
- Institute of Management, Operations Research, Ruhr University Bochum, Universitätsstr. 150, 44801 Bochum, Germany; (B.W.); (M.G.)
| | - Matthias Grot
- Institute of Management, Operations Research, Ruhr University Bochum, Universitätsstr. 150, 44801 Bochum, Germany; (B.W.); (M.G.)
| | - Esther Rind
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstr. 27, 72074 Tuebingen, Germany; (E.R.); (M.A.R.)
| | - Claudia Pieper
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany; (C.P.); (A.-L.E.)
| | - Anna-Lisa Eilerts
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany; (C.P.); (A.-L.E.)
| | - Verena Schroeder
- Center for Clinical Trials, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany;
| | - Stefanie Kasten
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (K.L.); (S.K.); (M.S.); (J.G.); (B.M.W.)
| | - Manuela Schmidt
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (K.L.); (S.K.); (M.S.); (J.G.); (B.M.W.)
| | - Julian Goebel
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (K.L.); (S.K.); (M.S.); (J.G.); (B.M.W.)
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstr. 27, 72074 Tuebingen, Germany; (E.R.); (M.A.R.)
| | - Birgitta M. Weltermann
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; (K.L.); (S.K.); (M.S.); (J.G.); (B.M.W.)
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Abstract
OBJECTIVE The aim of this study was to examine the short-term and sustained effect on well-being, burnout, and mindful awareness of an abbreviated mindfulness practice course designed for nurses and other healthcare professionals. BACKGROUND Most mindfulness programs are impractical for frontline healthcare providers because of the intensive, off-site initial training and prolonged practice commitment. A psychiatric nurse educator developed a brief training program tailored for healthcare providers. METHODS Two institutional review board-approved studies examined the abbreviated mindfulness practice course for healthcare providers: the first, a single-group pretest-posttest design with 25 nursing employees in an academic medical center, and the second, a randomized controlled trial with 83 healthcare professionals. RESULTS Significant improvement in mindful awareness and at least 1 indicator of burnout were demonstrated. Improvements in quality of life were noted with nurses. CONCLUSIONS Findings support the short-term and sustained impact of this brief mindfulness curriculum on mindful awareness, quality of life, and aspects of burnout for healthcare professionals.
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Naehrig D, Schokman A, Hughes JK, Epstein R, Hickie IB, Glozier N. Effect of interventions for the well-being, satisfaction and flourishing of general practitioners-a systematic review. BMJ Open 2021; 11:e046599. [PMID: 34408036 PMCID: PMC8375719 DOI: 10.1136/bmjopen-2020-046599] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Clinician well-being has been recognised as an important pillar of healthcare. However, research mainly addresses mitigating the negative aspects of stress or burnout, rather than enabling positive aspects. With the added strain of a pandemic, identifying how best to maintain and support the well-being, satisfaction and flourishing of general practitioners (GPs) is now more important than ever. DESIGN Systematic review. DATA SOURCES We searched MEDLINE, PsycINFO, Embase, CINAHL and Scopus from 2000 to 2020. STUDY SELECTION Intervention studies with more than 50% GPs in the sample evaluating self-reported well-being, satisfaction and related positive outcomes were included. The Cochrane Risk of Bias 2 tool was applied. RESULTS We retrieved 14 792 records, 94 studies underwent full-text review. We included 19 studies in total. Six randomised controlled trials, three non-randomised, controlled trials, eight non-controlled studies of individual or organisational interventions with a total of 1141 participants. There were two quasi-experimental articles evaluating health system policy change. Quantitative and qualitative positive outcomes were extracted and analysed. Individual mindfulness interventions were the most common (k=9) with medium to large within-group (0.37-1.05) and between-group (0.5-1.5) effect sizes for mindfulness outcomes, and small-to-medium effect sizes for other positive outcomes including resilience, compassion and empathy. Studies assessing other intervention foci or other positive outcomes (including well-being, satisfaction) were of limited size and quality. CONCLUSIONS There is remarkably little evidence on how to improve GPs well-being beyond using mindfulness interventions, particularly for interventions addressing organisational or system factors. This was further undermined by inconsistent reporting, and overall high risk of bias. We need to conduct research in this space with the same rigour with which we approach clinical intervention studies in patients. PROSPERO REGISTRATION NUMBER CRD42020164699. FUNDING SOURCE Dr Diana Naehrig is funded through the Raymond Seidler PhD scholarship.
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Affiliation(s)
- Diana Naehrig
- The Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Aaron Schokman
- The Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | | | - Ronald Epstein
- Family Medicine Research Programs, University of Rochester School of Medicine, Rochester, New York, USA
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Nick Glozier
- The Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Pérula-de Torres LÁ, Verdes-Montenegro-Atalaya JC, Melús-Palazón E, García-de Vinuesa L, Valverde FJ, Rodríguez LA, Lietor-Villajos N, Bartolomé-Moreno C, Moreno-Martos H, García-Campayo J, González-Santos J, Rodríguez-Fernández P, León-del-Barco B, Soto-Cámara R, González-Bernal JJ. Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4340. [PMID: 33923868 PMCID: PMC8073262 DOI: 10.3390/ijerph18084340] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022]
Abstract
Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.
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Affiliation(s)
- Luis Ángel Pérula-de Torres
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (Imibic), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | | | - Elena Melús-Palazón
- Family and Community Medicine Teaching Department of Zaragoza Sector 1, 5018 Zaragoza, Spain; (E.M.-P.); (C.B.-M.)
| | - Leonor García-de Vinuesa
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, 14001 Córdoba, Spain;
| | | | - Luis Alberto Rodríguez
- Family and Community Medicine Teaching Department of Ponferrada, Ponferrada, 24400 León, Spain;
| | - Norberto Lietor-Villajos
- Family and Community Medicine Teaching Department of Jaen, 23007 Jaen, Spain; (F.J.V.); (N.L.-V.)
| | - Cruz Bartolomé-Moreno
- Family and Community Medicine Teaching Department of Zaragoza Sector 1, 5018 Zaragoza, Spain; (E.M.-P.); (C.B.-M.)
| | - Herminia Moreno-Martos
- Multi-Professional Teaching Unit for Family and Community Care of Almería, 04009 Almería, Spain;
| | | | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (P.R.-F.); (J.J.G.-B.)
| | | | - Benito León-del-Barco
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, 10071 Caceres, Spain;
| | - Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (P.R.-F.); (J.J.G.-B.)
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De Simone S, Vargas M, Servillo G. Organizational strategies to reduce physician burnout: a systematic review and meta-analysis. Aging Clin Exp Res 2021; 33:883-894. [PMID: 31598914 DOI: 10.1007/s40520-019-01368-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 09/21/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The growing "process" of burnout impair performance and quality of professional services, with consequences for physicians, healthcare care organization, and patient's outcomes. AIMS We aim to evaluate which strategy of intervention, individual or organization directed, is more effective to reduce physician burnout and to provide management suggestions in terms of actual organizational strategies and intensity leading to reductions in physician burnout. METHODS The meta analysis was conducted according to the PRISMA guidelines. We included physicians of any specialty in the primary, secondary, or intensive care setting, including residents and fellows. Eligible interventions were any intervention designed to relieve stress and/or improve the performance of physicians and reported burnout outcomes, including physician-directed interventions and organization-directed interventions. The electronic search strategy applied standard filters for identification of the different studies. Databases searched were the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (from inception to September 2018), and EMBASE (from beginning to September 2018). Meta analysis was performed with mixed random effect using DerSimonian and Laird method. The standardized mean difference (SMD) and 95% CI for each outcome were separately calculated for each trial pooling data when needed, according to an intention-to-treat principle. RESULTS Pooled interventions were associated with small significant reductions in burnout (SMD = - 0.289; 95% CI, - 0.419 to - 0.159; I2 = 29%) (Fig. 2). Organization-directed interventions were associated with a medium reduction in burnout score (SMD = - 0.446; 95% CI, - 0.619 to - 0.274; I2 = 8%) while physician-directed interventions were associated with a moderate reduction in burnout score (SMD = - 0.178; 95% CI, - 0.322 to - 0.035; I2 = 11%). DISCUSSION This systematic review and meta-analysis showed that (1) organization-directed interventions were associated with moderate reduction in burnout score, (2) physician-directed interventions were associated with small reduction in burnout score, (3) organization-directed interventions reduced more the depersonalization than physician-directed interventions, (4) organization-directed interventions were related to a more improvement of the personal accomplishment than physician-directed interventions. CONCLUSIONS This meta analysis found that physicians could gain important benefits from interventions to reduce burnout, especially from organizational strategies, by viewing burnout rooted in issues related to the working environment and organizational culture.
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Affiliation(s)
- Stefania De Simone
- Institute for Research on Innovation and Services for Development, National Research Council of Italy, Via San Felice, Naples, Italy.
| | - Maria Vargas
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini, Naples, Italy
| | - Giuseppe Servillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini, Naples, Italy
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Ardenghi S, Rampoldi G, Pepe A, Bani M, Salvarani V, Strepparava MG. An Exploratory Cross-Sectional Study on the Relationship between Dispositional Mindfulness and Empathy in Undergraduate Medical Students. TEACHING AND LEARNING IN MEDICINE 2021; 33:154-163. [PMID: 32870715 DOI: 10.1080/10401334.2020.1813582] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There is a growing interest in identifying the psychological variables that promote and sustain empathy in medical students during their studies. Dispositional mindfulness has been shown to be empirically associated with socio-demographic characteristics and empathy among the general population. This research aimed to assess dispositional mindfulness in a sample of undergraduate medical students and to investigate its association with gender, age, and empathy. Hypotheses: It is hypothesized that male medical students would show, on average, higher dispositional mindfulness than their female counterparts, and that older students would exhibit higher dispositional mindfulness than younger ones. Dispositional mindfulness was also expected to be positively associated with the ability to feel compassion for others and to adopt their perspective, and negatively associated with the personal distress in tense interpersonal settings. Method: An exploratory cross-sectional study was conducted. Data were gathered from a large sample (N = 933) of Italian non-meditating second- and fifth-year medical students. Dispositional mindfulness and empathy were assessed using the Five-Facet Mindfulness Questionnaire and the Interpersonal Reactivity Index, respectively. Gender and age differences in dispositional mindfulness scores were calculated by analyses of variance, whereas hierarchical multiple regression models were used to assess the association between dispositional mindfulness and empathy scores. RESULTS Female medical students were more able to Act with Awareness than males, whereas males had higher levels than females of Describing and Nonreactivity to their feelings. When compared to their older counterparts, younger students scored higher on Observing and lower on Nonreactivity facets. Dispositional mindfulness facets correlated differently with both emotional and cognitive empathy dimensions, beyond the effects of gender and age. Medical students who displayed higher dispositional mindfulness appeared to be less emotionally distressed in tense interpersonal settings and more able to take others' cognitive perspective. Conclusions: The findings support the notion that dispositional mindfulness is related to empathy and may have implications for the design of mindfulness-based training for use in the medical educational setting. Tailored interventions that cultivate specific dispositional mindfulness facets may be implemented along the medical curriculum to prevent the emotional distress in tense interpersonal settings and to sustain the cognitive capability to take others' viewpoints among medical students.
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Affiliation(s)
- Stefano Ardenghi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza and Brianza, Italy
| | - Giulia Rampoldi
- Department of Human Sciences for Education, University of Milano-Bicocca, Milano, Milan, Italy
| | - Alessandro Pepe
- Department of Human Sciences for Education, University of Milano-Bicocca, Milano, Milan, Italy
| | - Marco Bani
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza and Brianza, Italy
| | - Valerio Salvarani
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza and Brianza, Italy
| | - Maria Grazia Strepparava
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza and Brianza, Italy
- Clinical Psychology Unit, San Gerardo Hospital, ASST-Monza, Monza, Monza and Brianza, Italy
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Miller JJ, Reddin Cassar J. Self-care among healthcare social workers: The impact of COVID-19. SOCIAL WORK IN HEALTH CARE 2021; 60:30-48. [PMID: 33550956 DOI: 10.1080/00981389.2021.1885560] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/25/2020] [Accepted: 01/31/2021] [Indexed: 06/12/2023]
Abstract
For social work practitioners in healthcare settings, self-care can be an integral tool to assuaging stressors associated with COVID-19. However, research that examines the impact of public health crises, such as COVID-19, is nominal, at best. This exploratory study investigated the impact of COVID-19 on the self-care practices of self-identified healthcare social workers (N = 2,460) in one southeastern state. Primary data were collected via an electronic survey and assessed via a retrospective pre/post design. Analyses compared practices before and after COVID-19 was declared a pandemic. Overall, data suggest that participants experienced significant pre/post decreases in self-care practices across multiple domains. As well, findings indicate that participants who identified as married, financially stable, and working non-remotely, and in good physical/mental health engaged in significantly more self-care practices than other participants, at post. This study underscores the need to foster supportive professional cultures that include developing self-care practice skills, particularly during large-scale crisis, such as COVID-19.
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Affiliation(s)
- J Jay Miller
- Self-Care Lab, College of Social Work, University of Kentucky, Lexington, USA
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Leu GR, Links AR, Tunkel DE, Walsh JM, Ryan MA, DiCarlo H, Jelin EB, Beach MC, Boss EF. Understanding Bias in Surgery: Perceived Cultural Similarity Between Surgeons and Patient Families. Otolaryngol Head Neck Surg 2021; 165:282-289. [PMID: 33430701 DOI: 10.1177/0194599820982639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We describe surgeon and parent perceptions of similarity toward each other and evaluate differences in the perceptions of similarity by race. STUDY DESIGN Observational cohort analysis. SETTING Three outpatient sites. METHODS Following consultations for children undergoing evaluation for 1 of 3 surgical procedures (tonsillectomy, hernia repair, circumcision), surgeons and parents rated their perception of cultural similarity toward each other on a 6-point Likert scale. Surgeon evaluation of 9 parent characteristics was measured with 7-point Likert scales. Regression analyses were performed to identify predictors of greater surgeon-perceived similarity and to assess associations of perceived similarity with evaluation of parent characteristics. RESULTS Most parents were women (n = 38, 84%), whereas surgeons were primarily men (n = 7, 54%). Of 45 parents, 23 (51%) were non-White, whereas only 4 of 13 clinicians (31%) were non-White. Mean perceived similarity score was 21.7 for parents (range, 10-24) and 18.2 for surgeons (range, 10-24). There was no difference in parent-perceived similarity based on race (White vs non-White parents, mean [SD] = 22.3 [3.4] vs 21.1 [3.0]; P = .26). Surgeons perceived greater similarity with White parents (odds ratio = 4.78; 95% CI, 1.02-22.54; P = .04) and parents with higher income (odds ratio = 11.84; 95% CI, 1.32-106.04; P = .03). Greater perceived similarity by the surgeons was associated with more positive assessments of parent personality characteristics. CONCLUSION Surgeons perceived similarity more commonly with White parents, while parents' perception of similarity to surgeons was uniform regardless of parent race. Elucidating biases of surgeons may help to tailor interventions promoting culturally competent, equitable communication and decision making for elective surgery.
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Affiliation(s)
- Grace R Leu
- School of Medicine, Tufts University, Boston, Massachusetts, USA
| | - Anne R Links
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - David E Tunkel
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jonathan M Walsh
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Marisa A Ryan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Heather DiCarlo
- Department of Pediatric Urology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Eric B Jelin
- Department of Pediatric Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mary Catherine Beach
- Department of Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily F Boss
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Wolpaw JT, Adair KC. Shoe Covers but Not Burnout? Making Burnout Reduction a Criteria for Centers for Medicare and Medicaid Services Funding Would Protect Patients. J Patient Saf 2021; 17:68-70. [PMID: 32217936 DOI: 10.1097/pts.0000000000000681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT In the United States, hospitals must meet eligibility criteria to receive federal funding. Regulatory bodies, such as the Joint Commission, are approved by the government to give, or withhold, accreditation to hospitals. This accreditation is a requisite to continue receiving funding. Hospitals are frequently cited for items such as inadequate wearing of boot covers or covering of facial hair in the operating rooms. There are very little, if any, data to support an improvement in patient safety when these items are complied with. There is, however, a large amount of data showing the negative consequences for patient safety when providers are burned out. We therefore propose that regulatory agencies such as the Joint Commission require that hospital systems measure burnout and reduce concerning levels of burnout in their employees to continue receiving certification. We briefly review evidence-based methods that hospital systems might consider to accomplish this goal.
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Affiliation(s)
- Jed T Wolpaw
- From the Johns Hopkins Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland
| | - Kathryn C Adair
- The Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC
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Galante J, Friedrich C, Dawson AF, Modrego-Alarcón M, Gebbing P, Delgado-Suárez I, Gupta R, Dean L, Dalgleish T, White IR, Jones PB. Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials. PLoS Med 2021; 18:e1003481. [PMID: 33428616 PMCID: PMC7799763 DOI: 10.1371/journal.pmed.1003481] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is an urgent need for mental health promotion in nonclinical settings. Mindfulness-based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions. METHODS AND FINDINGS Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in-person, expert-defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk-of-Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well-being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta-regression and sensitivity analyses were prespecified. Pairwise random-effects multivariate meta-analyses and prediction intervals (PIs) were calculated. A total of 11,605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = -0.56; 95% confidence interval (CI) -0.80 to -0.33; p-value < 0.001; 95% PI -1.19 to 0.06), depression (14 trials; SMD = -0.53; 95% CI -0.72 to -0.34; p-value < 0.001; 95% PI -1.14 to 0.07), distress (27 trials; SMD = -0.45; 95% CI -0.58 to -0.31; p-value < 0.001; 95% PI -1.04 to 0.14), and well-being (9 trials; SMD = 0.33; 95% CI 0.11 to 0.54; p-value = 0.003; 95% PI -0.29 to 0.94). Compared with nonspecific active control conditions, in most but not all scenarios MBPs improved average depression (6 trials; SMD = -0.46; 95% CI -0.81 to -0.10; p-value = 0.012, 95% PI -1.57 to 0.66), with no statistically significant evidence for improving anxiety or distress and no reliable data on well-being. Compared with specific active control conditions, there is no statistically significant evidence of MBPs' superiority. Only effects on distress remained when higher-risk trials were excluded. USA-based trials reported smaller effects. MBPs targeted at higher-risk populations had larger effects than universal MBPs. The main limitation of this review is that confidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is moderate to very low, mainly due to inconsistency and high risk of bias in many trials. CONCLUSIONS Compared with taking no action, MBPs of the included studies promote mental health in nonclinical settings, but given the heterogeneity between studies, the findings do not support generalisation of MBP effects across every setting. MBPs may have specific effects on some common mental health symptoms. Other preventative interventions may be equally effective. Implementation of MBPs in nonclinical settings should be partnered with thorough research to confirm findings and learn which settings are most likely to benefit.
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Affiliation(s)
- Julieta Galante
- University of Cambridge, Cambridge, United Kingdom
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, United Kingdom
| | | | | | - Marta Modrego-Alarcón
- University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | | | - Irene Delgado-Suárez
- University of Zaragoza, Zaragoza, Spain
- Institute of Medical Research Aragón, Zaragoza, Spain
| | | | - Lydia Dean
- University of Cambridge, Cambridge, United Kingdom
| | - Tim Dalgleish
- University of Cambridge, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Ian R White
- University College London, London, United Kingdom
| | - Peter B Jones
- University of Cambridge, Cambridge, United Kingdom
- National Institute for Health Research Applied Research Collaboration East of England, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
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Perry MA, Creavey K, Arthur E, Chance Humer J, Lundgren PJ, Rivera I. Cultivating emotional intelligence in child welfare professionals: A systematic scoping review. CHILD ABUSE & NEGLECT 2020; 110:104438. [PMID: 32164944 DOI: 10.1016/j.chiabu.2020.104438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 12/27/2019] [Accepted: 02/26/2020] [Indexed: 06/10/2023]
Abstract
Emotional intelligence (EI) refers to the ability to recognize and appropriately respond to emotions in oneself and others; these competencies include, but are not limited to, empathy, emotion regulation, reflective ability, self-awareness, and psychological flexibility. Such abilities are crucial to meaningful and effective child welfare work. Further, they are part of resilience and healthy coping mechanisms, which are important for those working in child welfare if compassion fatigue and burnout are to be combated. However, little is known about how to cultivate these competencies in child welfare professionals. The present study had two goals: 1) To conduct a systematic scoping review of the literature on interventions purporting to develop and/or enhance EI-related competencies in this population, whether those interventions be at the caseworker, supervisor, or organizational level; 2) To consider future directions for the teaching and enhancement of EI competencies for child welfare professionals. A total of 18 studies met inclusion criteria, with the majority focused on developing mindfulness and/or empathy skills. However, no studies focused on child welfare professionals, and instead focused on social work students or professionals, with a few including other helping professionals. Additionally, none were focused on a supervisory or organizational level. Future directions for research are discussed, including the use of experiential or simulation-based training in order to elicit emotions within a safe and supportive learning context, the use of reflective supervision to help develop self-reflection and emotion regulation skills, and system-wide interventions that enhance the development of emotional intelligence competencies in public child welfare organizations.
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Affiliation(s)
- Marlo A Perry
- University of Pittsburgh, School of Social Work, United States.
| | | | - Erin Arthur
- University of Pittsburgh, School of Social Work, United States
| | | | - P J Lundgren
- University of Pittsburgh, School of Social Work, United States
| | - Isabella Rivera
- University of Pittsburgh, School of Social Work, United States
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Melnyk BM, Kelly SA, Stephens J, Dhakal K, McGovern C, Tucker S, Hoying J, McRae K, Ault S, Spurlock E, Bird SB. Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review. Am J Health Promot 2020; 34:929-941. [PMID: 32338522 PMCID: PMC8982669 DOI: 10.1177/0890117120920451] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVE This systematic review focused on randomized controlled trials (RCTs) with physicians and nurses that tested interventions designed to improve their mental health, well-being, physical health, and lifestyle behaviors. DATA SOURCE A systematic search of electronic databases from 2008 to May 2018 included PubMed, CINAHL, PsycINFO, SPORTDiscus, and the Cochrane Library. STUDY INCLUSION AND EXCLUSION CRITERIA Inclusion criteria included an RCT design, samples of physicians and/or nurses, and publication year 2008 or later with outcomes targeting mental health, well-being/resiliency, healthy lifestyle behaviors, and/or physical health. Exclusion criteria included studies with a focus on burnout without measures of mood, resiliency, mindfulness, or stress; primary focus on an area other than health promotion; and non-English papers. DATA EXTRACTION Quantitative and qualitative data were extracted from each study by 2 independent researchers using a standardized template created in Covidence. DATA SYNTHESIS Although meta-analytic pooling across all studies was desired, a wide array of outcome measures made quantitative pooling unsuitable. Therefore, effect sizes were calculated and a mini meta-analysis was completed. RESULTS Twenty-nine studies (N = 2708 participants) met the inclusion criteria. Results indicated that mindfulness and cognitive-behavioral therapy-based interventions are effective in reducing stress, anxiety, and depression. Brief interventions that incorporate deep breathing and gratitude may be beneficial. Visual triggers, pedometers, and health coaching with texting increased physical activity. CONCLUSION Healthcare systems must promote the health and well-being of physicians and nurses with evidence-based interventions to improve population health and enhance the quality and safety of the care that is delivered.
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Affiliation(s)
| | | | - Janna Stephens
- The Ohio State University College of Nursing, Columbus, OH, USA
| | - Kerry Dhakal
- The Ohio State University Office of Health Sciences, Columbus, OH, USA
| | - Colleen McGovern
- The Ohio State University College of Nursing, Columbus, OH, USA
- University of North Carolina Chapel Hill College of Nursing, Chapel Hill, NC, USA
| | - Sharon Tucker
- The Ohio State University College of Nursing, Columbus, OH, USA
| | | | - Kenya McRae
- Illinois Department of Health, Chicago IL, USA
| | - Samantha Ault
- The Ohio State University College of Nursing, Columbus, OH, USA
| | | | - Steven B. Bird
- University of Massachusetts Medical School, Worcester, MA, USA
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Lamothe M, Rondeau É, Duval M, McDuff P, Pastore YD, Sultan S. Changes in hair cortisol and self-reported stress measures following mindfulness-based stress reduction (MBSR): A proof-of-concept study in pediatric hematology-oncology professionals. Complement Ther Clin Pract 2020; 41:101249. [DOI: 10.1016/j.ctcp.2020.101249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/24/2020] [Accepted: 10/04/2020] [Indexed: 12/15/2022]
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Kriakous SA, Elliott KA, Lamers C, Owen R. The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review. Mindfulness (N Y) 2020; 12:1-28. [PMID: 32989406 PMCID: PMC7511255 DOI: 10.1007/s12671-020-01500-9] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2020] [Indexed: 12/14/2022]
Abstract
Objectives Burnout and occupational stress are frequently experienced by healthcare professionals (HCPs). Mindfulness-based stress reduction (MBSR) has been found to improve the psychological health outcomes of HCPs. To date, systematic reviews and meta-analyses have primarily focused upon empirical investigations into the reduction of stress amongst HCPs using MBSR and are limited to empirical studies published before December 2019. This systematic review aimed to update the current evidence base and broaden our understanding of the effectiveness of MBSR on improving the psychological functioning of HCPs. Methods Three electronic databases (Medline, Psych Info and Web of Science) were searched without time frame restrictions. Quantitative studies included randomised controlled trials, clinical controlled trials, pre-post designs and studies with up to a 12-month follow-up period. All studies included in the review employed a MBSR programme, standardised measures of psychological functioning and qualified HCPs as participants. Results Using PRISMA guidelines thirty studies were included in the review. The reviewed literature suggested that MBSR was effective in reducing HCPs experiences of anxiety, depression and stress. MBSR was also found to be effective in increasing HCP levels of mindfulness and self-compassion. However, MBSR did not appear as effective in reducing burnout or improving resilience amongst HCPs. Abbreviated MBSR programmes were found to be as effective as the traditional 8-week MBSR programmes. Conclusions MBSR is an effective intervention which can help improve the psychological functioning of HCPs. Recommendations include improving the overall quality of the studies by employing more robust controlled designs with randomisation, increased sample sizes with heterogeneous samples, and making active comparisons between interventions used.
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Affiliation(s)
| | - Katie Ann Elliott
- Forensic Clinical Psychology Department, North Wales Forensic Psychiatric Service, Ty Llywelyn Medium Secure Unit, Ysbyty Bryn y Neuadd, Llanfairfechan, LL33 0HH Conwy, UK
| | - Carolien Lamers
- North Wales Clinical Psychology Programme, Bangor University, LL57 2DG Bangor, UK
| | - Robin Owen
- Early Interventions in Psychosis, Hergest Unit, Ysbyty Gwynedd, Gwynedd, LL57 2PW Bangor, UK
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Self-compassion mediates the association between conflict about ability to practice end-of-life care and burnout in emergency nurses. Int Emerg Nurs 2020; 53:100917. [PMID: 32950764 DOI: 10.1016/j.ienj.2020.100917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 08/19/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION End-of-life care (EOLC) is necessary for patients who are not expected to live long. Nurses have positive attitudes toward EOLC, but they encounter difficulties in practice. That situation creates conflict, which can affect burnout. It is essential to manage nurses' conflict about their ability to practice EOLC by enhancing their individual strengths. Focusing on the role of self-compassion may help to prevent burnout related to the conflict about ability to practice EOLC. OBJECTIVE The study aim was to assess the mediating effect of self-compassion on the association between conflict about ability to practice EOLC and burnout. METHODS A correlational study was conducted with emergency department nurses who practiced EOLC. Self-report measures of conflict about ability to practice EOLC, burnout, and self-compassion were obtained. RESULTS Negative aspects of self-compassion mediated the relationship among conflict, emotional exhaustion, and depersonalization (burnout). Self-compassion did not mediate the association between conflict and reduced personal accomplishment (burnout). CONCLUSIONS Negative aspects of self-compassion mediated the relationship between conflict and burnout (excluding reduced personal accomplishment). To prevent burnout, it is necessary to screen for nurses with low self-compassion and to provide opportunities to change their cognitive recognition and disclose their conflicts.
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Cascales-Pérez ML, Ferrer-Cascales R, Fernández-Alcántara M, Cabañero-Martínez MJ. Effects of a mindfulness-based programme on the health- and work-related quality of life of healthcare professionals. Scand J Caring Sci 2020; 35:881-891. [PMID: 32865258 DOI: 10.1111/scs.12905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/02/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES The objective of mindfulness-based stress reduction (MBSR) programmes is to promote awareness of the present moment without judging, evaluating or reacting to the different thoughts or emotions that may arise. Development of these abilities appears especially important for healthcare professionals. The objective of this study was to evaluate the effectiveness and medium- and long-term effects of a MBSR programme for primary care (PC) health professionals on their health-related quality of life and quality of work life. DESIGN Randomised clinical trial using an intervention and control group with follow-up of the experimental group. SETTING Primary Care centres in the Alicante Public Health Service (Spain). PARTICIPANTS Participants were PC health professionals (N = 58) divided between an intervention group receiving the 8-week MBSR programme and a control group receiving a theoretical training session alone. METHOD Both groups were evaluated at baseline and at 8 weeks, and the intervention group was additionally evaluated at 3-, 6-, 9- and 12-month postprogramme. RESULTS In comparison to the control group, the intervention group obtained higher scores postintervention for mindfulness, health-related quality of life, mood and compassion satisfaction and a lower score for burnout. Improvements in mindfulness, mood and burnout syndrome persisted at 12 months after the programme. CONCLUSIONS In conclusion, MBSR is an effective intervention to enhance the health-related quality of life and quality of work life of Primary Care Health professionals.
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Affiliation(s)
- María Luisa Cascales-Pérez
- Doctoral Programme in Health Sciences, Faculty of Health Sciences, University of Alicante, Alicante, Spain
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Kashat L, Carter B, Mosha M, Kavanagh KR. Mindfulness Education for Otolaryngology Residents: A Pilot Study. OTO Open 2020; 4:2473974X20945277. [PMID: 32844140 PMCID: PMC7416142 DOI: 10.1177/2473974x20945277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/01/2020] [Indexed: 12/30/2022] Open
Abstract
This pilot project was designed to (1) implement a mindfulness-based wellness curriculum
for otolaryngology residents, (2) determine the impact of a mindfulness-based curriculum
on resident mood, and (3) examine the use of mindfulness among otolaryngology residents.
Otolaryngology residents participated in a 6-week course guided by the Headspace
mindfulness mobile application. Resident use of mindfulness was measured by the validated
Mindful Attention Awareness Scale (MAAS). Changes in mood before and after each session
were assessed using the validated Positive and Negative Affect Schedule (PNAS). Residents
reported a statistically significant decrease in postsession negative affect scores
(P < .001). A moderate positive correlation was noted between
mindfulness scores and presession positive mood (Pearson r = 0.597,
P < .001). This pilot study supports the feasibility and impact of
including mindfulness training as part of a resident wellness curriculum.
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Affiliation(s)
- Lawrence Kashat
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | | | - Maua Mosha
- Connecticut Children's, Hartford, Connecticut, USA
| | - Katherine R Kavanagh
- University of Connecticut School of Medicine, Farmington, Connecticut, USA.,Connecticut Children's, Hartford, Connecticut, USA
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Weltermann BM, Kersting C, Pieper C, Seifried-Dübon T, Dreher A, Linden K, Rind E, Ose C, Jöckel KH, Junne F, Werners B, Schroeder V, Bois JM, Siegel A, Thielmann A, Rieger MA, Kasten S. IMPROVEjob - Participatory intervention to improve job satisfaction of general practice teams: a model for structural and behavioural prevention in small and medium-sized enterprises - a study protocol of a cluster-randomised controlled trial. Trials 2020; 21:532. [PMID: 32546256 PMCID: PMC7298849 DOI: 10.1186/s13063-020-04427-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/16/2020] [Indexed: 11/11/2022] Open
Abstract
Background Perceived high chronic stress is twice as prevalent among German general practitioners (GPs) and non-physician medical staff compared to the general population. The reasons are multi-factorial and include patient, practice, healthcare system and societal factors, such as multi-morbidity, the diversity of populations and innovations in medical care. Also, practice-related factors, like stressful patient-staff interactions, poor process management of waiting times and lack of leadership, play a role. This publicly funded study evaluates the effectiveness of the newly developed participatory, interdisciplinary, and multimodal IMPROVEjob intervention on improving job satisfaction among general practice personnel. The intervention aims at structural stress prevention with regard to working conditions and behavioural stress prevention for leaders and other practice personnel. Methods In this cluster-randomised controlled trial, a total of 56 general practices will be assigned to either (1) participation in the IMPROVEjob intervention or (2) the waiting-list control group. The IMPROVEjob intervention consists of the following elements: three workshops, a toolbox with supplemental material and an implementation period with regular contact to so-called IMPROVEjob facilitators. The first workshop, addressing leadership issues, is designed for physicians with leadership responsibilities only. The two subsequent workshops target all GP and non-physician personnel; they address issues of communication (with patients and within the team), self-care and team-care and practice organisation. During the 9-month implementation period, practices will be contacted by IMPROVEjob facilitators to enhance motivation. Additionally, the practices will have access to the toolbox materials online. All participants will complete questionnaires at baseline and follow up. The primary outcome is the change in job satisfaction as measured by the respective scale of the validated German version of the Copenhagen Psychosocial Questionnaire (COPSOQ, version 2018). Secondary outcomes obtained by questionnaires and - qualitatively - by facilitators comprise psychosocial working conditions including leadership aspects, expectations and experiences of the workshops, team and individual efforts and organisational changes. Discussion It is hypothesised that participation in the IMPROVEjob intervention will improve job satisfaction and thus constitute a structural and behavioural prevention strategy for the promotion of psychological wellbeing of personnel in general practices and prospectively in other small and medium sized enterprises. Trial registration German Clinical Trials Register: DRKS00012677. Registered on 16 October 2019. Retrospectively, https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID = DRKS00012677.
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Affiliation(s)
- Birgitta M Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. .,Institute for General Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45122, Essen, Germany.
| | - Christine Kersting
- Institute for General Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45122, Essen, Germany
| | - Claudia Pieper
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstraße 5, 72076, Tuebingen, Germany
| | - Annegret Dreher
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Karen Linden
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Esther Rind
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstr 27, 72074, Tuebingen, Germany
| | - Claudia Ose
- Center for Clinical Trials, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany.,Center for Clinical Trials, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstraße 5, 72076, Tuebingen, Germany
| | - Brigitte Werners
- Institute for Operations Research, Ruhr University Bochum, Universitätsstr 150, 44801, Bochum, Germany
| | - Verena Schroeder
- Center for Clinical Trials, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Jean-Marie Bois
- Center for Clinical Trials, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Achim Siegel
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstr 27, 72074, Tuebingen, Germany
| | - Anika Thielmann
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstr 27, 72074, Tuebingen, Germany
| | - Stefanie Kasten
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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Maximiano-Barreto MA, Fabrício DDM, Luchesi BM, Chagas MHN. Factors associated with levels of empathy among students and professionals in the health field: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:207-215. [DOI: 10.1590/2237-6089-2019-0035] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 11/22/2019] [Indexed: 12/15/2022]
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Hagemann TM, Reed BN, Bradley BA, Clements JN, Cohen LJ, Coon SA, Derington CG, DiScala SL, El‐Ibiary S, Lee KC, May A, Oh S, Phillips JA, Rogers KM. Burnout among clinical pharmacists: Causes, interventions, and a call to action. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2020. [DOI: 10.1002/jac5.1256] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | - Brent N. Reed
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | | | - Scott A. Coon
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | | | - Kelly C. Lee
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Alisyn May
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Song Oh
- American College of Clinical Pharmacy Lenexa Kansas USA
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Ruiz-Fernández MD, Ortíz-Amo R, Ortega-Galán ÁM, Ibáñez-Masero O, Rodríguez-Salvador MDM, Ramos-Pichardo JD. Mindfulness therapies on health professionals. Int J Ment Health Nurs 2020; 29:127-140. [PMID: 31498549 DOI: 10.1111/inm.12652] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 07/30/2019] [Accepted: 08/06/2019] [Indexed: 01/08/2023]
Abstract
Health professionals are exposed to situations of emotional vulnerability by being in continuous contact with patients and their suffering, which can cause conditions such as compassion fatigue. To address this issue, therapies such as mindfulness are being used to reduce stress and promote self-compassion. The objective of this research was to carry out a systematic review and meta-analysis to analyse the types of mindfulness interventions that are being used for healthcare professionals and their effectiveness in reducing stress and improving self-compassion and mindfulness. Following the PRISMA guideline, a systematic review of original studies was carried out in the following databases: Medline, Scopus, Cinhal, PsycINFO, Lilacs, and Science Direct, without a limited time frame. Controlled experimental mindfulness interventions on health professionals were selected, in which the following outcome variables were measured: stress, self-compassion, and mindfulness. A meta-analysis was performed with a random effects model. In cases of very high heterogeneity, the data were analysed by subgroup. Mindfulness-Based Stress Reduction Therapy (MBSR) was the most often used in the studies. There is diversity in the implementation of MBSR, and a common finding is a reduction of stress and increased mindfulness in health professionals. However, studies that analyse self-compassion are scarce. The effect of these therapies varies depending on how long the individual has been practising meditation. In conclusion, more studies are needed to describe the clinical usefulness of these programmes, to jointly analyse these three variables (stress, self-compassion, and mindfulness), and to measure compassion fatigue as an outcome variable.
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Affiliation(s)
| | - Rocío Ortíz-Amo
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
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Parsons M, Bailitz J, Chung AS, Mannix A, Battaglioli N, Clinton M, Gottlieb M. Evidence-Based Interventions that Promote Resident Wellness from the Council of Emergency Residency Directors. West J Emerg Med 2020; 21:412-422. [PMID: 32191199 PMCID: PMC7081870 DOI: 10.5811/westjem.2019.11.42961] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 11/19/2019] [Indexed: 12/15/2022] Open
Abstract
Initiatives for addressing resident wellness are a recent requirement of the Accreditation Council for Graduate Medical Education in response to high rates of resident burnout nationally. We review the literature on wellness and burnout in residency education with a focus on assessment, individual-level interventions, and systemic or organizational interventions.
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Affiliation(s)
- Melissa Parsons
- University of Florida College of Medicine, Department of Emergency Medicine, Jacksonville, Florida
| | - John Bailitz
- Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois
| | - Arlene S Chung
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Alexandra Mannix
- University of Florida College of Medicine, Department of Emergency Medicine, Jacksonville, Florida
| | - Nicole Battaglioli
- Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York
| | - Michelle Clinton
- Carilion Clinic, Department of Emergency Medicine, Roanoke, Virginia
| | - Michael Gottlieb
- Rush Medical Center, Department of Emergency Medicine, Chicago, Illinois
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Kersemaekers WM, Vreeling K, Verweij H, van der Drift M, Cillessen L, van Dierendonck D, Speckens AEM. Effectiveness and feasibility of a mindful leadership course for medical specialists: a pilot study. BMC MEDICAL EDUCATION 2020; 20:34. [PMID: 32019524 PMCID: PMC7001198 DOI: 10.1186/s12909-020-1948-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 01/24/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Medical specialists experience high levels of stress. This has an impact on their well-being, but also on quality of their leadership. In the current mixed method study, the feasibility and effectiveness of a course Mindful Leadership on burnout, well-being and leadership skills of medical specialists were evaluated. METHODS This is a non-randomized controlled pre-post evaluation using self-report questionnaires administered at 3 months before (control period), start and end of the training (intervention period). Burn-out symptoms, well-being and leadership skills were assessed with self-report questionnaires. Semi-structured interviews were used to qualitatively evaluate barriers and facilitators for completion of the course. RESULTS From September 2014 to June 2016, 52 medical specialists participated in the study. Of these, 48 (92%) completed the course. Compared to the control period, the intervention period resulted in greater reductions of depersonalization (mean difference = - 1.2, p = 0.06), worry (mean difference = - 4.3, p = 0.04) and negative work-home interference (mean difference = - 0.2, p = 0.03), and greater improvements of mindfulness (mean difference = 0.5, p = 0.04), life satisfaction (mean difference = 0.4, p = 0.01) and self-reported ethical leadership (mean difference = 0.1, p = 0.02). Effect sizes were generally small to medium (0.3 to 0.6) and large for life satisfaction (0.8). Appreciation of course elements was a major facilitator and the difficulty of finding time a major barrier for participating. CONCLUSIONS A 'Mindful Leadership' course was feasible and not only effective in reducing burnout symptoms and improving well-being, but also appeared to have potential for improving leadership skills. Mindful leadership courses could be a valuable part of ongoing professional development programs for medical specialists.
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Affiliation(s)
- Wendy M. Kersemaekers
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Kiki Vreeling
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Hanne Verweij
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Miep van der Drift
- Department of Respiratory Medicine, Radboudumc, Nijmegen, The Netherlands
| | - Linda Cillessen
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Dirk van Dierendonck
- Department of Organisation and Personnel Management, Rotterdam School of Management, Erasmus University, Rotterdam, The Netherlands
| | - Anne E. M. Speckens
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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Hofert SM, Tackett S, Gould N, Sibinga E. Mindfulness instruction for community-hospital physicians for burnout and patient care: A pilot study. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2019. [DOI: 10.1177/2516043519897830] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sheila M Hofert
- Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Sean Tackett
- Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Core Faculty Biostatistics, Epidemiology and Data Management (BEAD) Core, Baltimore, MD, USA
| | - Neda Gould
- Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Erica Sibinga
- Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
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Hicks M, Hanes D. Naturopathic medical student empathy and burnout: A preliminary study. ADVANCES IN INTEGRATIVE MEDICINE 2019; 6:151-158. [PMID: 39239459 PMCID: PMC11376202 DOI: 10.1016/j.aimed.2018.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Many studies have demonstrated empathy decline in medical students over the course of training. Burnout negatively affects academic or professional performance and has been negatively correlated with empathy. Neither empathy nor burnout has been previously studied in naturopathic medical students. Objective The aims of this cross-sectional study were to (1) compare empathy at different levels of training, (2) describe the prevalence of burnout, and (3) identify correlations between empathy and burnout, in naturopathic medical students. Methods This cross-sectional study used the Interpersonal Reactivity Index and Maslach Burnout Inventory to measure empathy and burnout, respectively, in an online survey of current naturopathic medical students at one institution. Results 1) There was no significant difference in empathy between any cohorts or between those in internship versus those not in internship. 2) Among burnout outcomes, 42% of participants met criteria for emotional exhaustion, 19% for depersonalization, and 64% for low sense of personal accomplishment. 3) Cognitive empathy was positively correlated with affective empathy and a higher sense of personal accomplishment and negatively correlated with emotional exhaustion and depersonalization. Conclusions While a longitudinal study would provide more definitive evidence, this study suggests that empathy in naturopathic medical students is relatively stable over the course of training. It also demonstrates that burnout is prevalent in this population and has an inverse relationship with empathy. Interventions to prevent burnout and increase empathy are discussed.
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Affiliation(s)
- Matthew Hicks
- National University of Natural Medicine, Portland, Oregon, United States
| | - Douglas Hanes
- National University of Natural Medicine, Portland, Oregon, United States
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