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Ciezar Andersen S, Campbell T, White D, King-Shier K. An Intervention to Improve Mental and Physical Health of Undergraduate Nursing Students. Can J Nurs Res 2024:8445621241248308. [PMID: 38706094 DOI: 10.1177/08445621241248308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Nursing students experience poorer mental and physical health relative to students in other health-related disciplines and young adults of similar age outside post-secondary school. Compromised mental and physical health has numerous negative impacts on nursing students and can result in burnout and development of chronic diseases. PURPOSE To determine whether an asynchronous online yoga intervention would improve mental and physical health of students. METHODS An asynchronous online 6-week yoga intervention was carried out between January and December 2021, using a pre/post design. Participants' symptoms of depression, anxiety, stress, and self-compassion were assessed using the Depression, Anxiety, and Stress Scale and Self-Compassion Scale and core endurance was assessed using the Mackenzie Core Endurance Test prior to commencement and at the conclusion of the program. RESULTS Of 114 participants, 68 completed the online program and pre and post measures showed that the mean depression, anxiety, stress, self-compassion and core endurance scores improved significantly (p<0.001) between baseline and study completion. CONCLUSION A six-week virtual yoga program significantly improved mental and physical health of undergraduate nursing students. Targeted modifications to the yoga program might enhance participant retention.
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Affiliation(s)
| | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, Canada
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Yuan Y, Liu X, Yin C, Shi L, Ye X. Cognitive behavioral stress management is an effective intervention to relieve anxiety and depression, improve the quality of life in patients with cervical cancer. Ir J Med Sci 2024; 193:595-604. [PMID: 37656384 DOI: 10.1007/s11845-023-03501-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/10/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Cognitive behavioral stress management (CBSM) modifies individuals' maladaptive cognition and improves their ability in managing stress. The present study was to inquire about the utility of CBSM in mental health and quality of life in patients with cervical cancer. METHODS Totally, 172 postoperative cervical cancer patients were randomly classified into CBSM (N=86) and normal care group (N=86) to receive 8-week CBSM and normal care, correspondingly. Self-rating anxiety/depression scale (SAS/SDS), EuroQol-5 dimensions (EQ-5D), EuroQol-visual analogue scale (EQ-VAS), and quality of life questionnaire-core 30 (QLQ-C30) scores were evaluated at discharge (M0), 1st month (M1), M3, and M6 after discharge. RESULTS SAS scores at M6 (P=0.003), M1 (P=0.042), and M3 (P=0.010), and the proportion of patients with SAS-defined anxiety at M3 (P=0.040) and M6 (P=0.019) were reduced in CBSM group versus normal care group. SDS scores at M3 (P=0.020) and M6 (P=0.016), and the proportion of patients with SDS-defined depression at M6 (P=0.036) was descended in CBSM group versus normal care group. EQ-VAS score at M1 (P=0.044), M3 (P=0.014), and M6 (P=0.002) were increased, while EQ-5D score at M3 (P=0.030) was descended in CBSM group versus normal care group. Meanwhile, QLQ-C30 global health status score at M1 (P=0.046), M3 (P=0.037), and M6 (P=0.007), QLQ-C30 function score at M3 (P=0.033) and M6 (P=0.016) were ascended, but QLQ-C30 symptom score at M3 (P=0.042) was declined in CBSM group versus normal care group. CONCLUSION CBSM is an effective intervention for decreasing anxiety and depression, and improving quality of life in patients with cervical cancer.
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Affiliation(s)
- Yufan Yuan
- Department of Nursing, Shijiazhuang Obstetrics and Gynecology Hospital, Shijiazhuang, 050000, China
| | - Xiaojing Liu
- Department of Nursing, Shijiazhuang Obstetrics and Gynecology Hospital, Shijiazhuang, 050000, China
| | - Cui Yin
- Department of Nursing, Shijiazhuang Obstetrics and Gynecology Hospital, Shijiazhuang, 050000, China
| | - Liyuan Shi
- Department of Gynecology, Shijiazhuang Obstetrics and Gynecology Hospital, No. 206 East Zhongshan Road, Shijiazhuang, 050000, China
| | - Xuekui Ye
- Department of Gynecology, Shijiazhuang Obstetrics and Gynecology Hospital, No. 206 East Zhongshan Road, Shijiazhuang, 050000, China.
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Szoke D, Lancaster C, Hazlett-Stevens H. Relationships Between Burnout, Secondary Traumatic Stress, Mindfulness, and Self-Compassion in Victim Advocates. Violence Against Women 2023; 29:2551-2568. [PMID: 37424450 DOI: 10.1177/10778012231185535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Victim advocates experience burnout and secondary traumatic stress (STS) in response to their exposure to trauma at work. Mindful awareness may serve as a protective factor against these negative outcomes. The current study examined a sample of 133 victim advocates from across the country to better understand and predict STS and burnout. Higher mindful awareness was found to be associated with lower STS and burnout, even when controlling for other best-known predictors. Self-compassion partially mediated these relationships. These findings support further research exploring the effects of mindful awareness training for victim advocates to reduce STS and burnout.
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Affiliation(s)
- Daniel Szoke
- Department of Psychology, University of Nevada Reno, Reno, NV, USA
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Li J, Xue E, He Y. Investigating the Effect of Cognitive-Behavioral, Mindful-Based, Emotional-Based Intervention and Professional Training on Teachers' Job Burnout: A Meta-Analysis. Behav Sci (Basel) 2023; 13:803. [PMID: 37887453 PMCID: PMC10604072 DOI: 10.3390/bs13100803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 10/28/2023] Open
Abstract
Teachers are more likely to experience occupational burnout; intervention for their job burnout has been paid more and more attention by the academic community. However, there is not enough evidence to support the interventions' effect. This study adopts the meta-analysis method and makes a statistical analysis of the interventions' effect on teachers' job burnout based on 29 papers in the literature of randomized controlled experiments. It mainly presents the basic external characteristics of the research literature; besides, based on the results of software CMA.V3, this paper also analysed the overall intervention effect and the separate effect of four types of intervention, namely, cognitive-behavioral interventions (CBI), mindfulness-based interventions (MBI), professional training (PT), and emotional-based intervention (EBI). The results showed that CBI had the best effect, and mindfulness-based intervention had the second-best effect. Professional training also showed a good intervention effect, while the intervention effect of emotional-based intervention remains to be verified. In addition, it was found that only the effect of cognitive-behavioral intervention (CBI) was significant and had a strong effect (g = 0.876, 95% CI-1.06, 2.814, p < 0.05) when considering their effects on emotional exhaustion, while the other three interventions had no significant effect. The discussion section is provided last.
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Affiliation(s)
| | - Eryong Xue
- China Institute of Education Policy, Faculty of Education, Beijing Normal University, Beijing 100875, China; (J.L.)
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Tamminga SJ, Emal LM, Boschman JS, Levasseur A, Thota A, Ruotsalainen JH, Schelvis RM, Nieuwenhuijsen K, van der Molen HF. Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database Syst Rev 2023; 5:CD002892. [PMID: 37169364 PMCID: PMC10175042 DOI: 10.1002/14651858.cd002892.pub6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions. OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms. SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022. SELECTION CRITERIA We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms. DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour); 2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise); 3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above. The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended). MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised. The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants. Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention. A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar. AUTHORS' CONCLUSIONS Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.
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Affiliation(s)
- Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lima M Emal
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Julitta S Boschman
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Alice Levasseur
- Faculté des sciences de l'éducation, Université Laval, Québec, Canada
| | | | - Jani H Ruotsalainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Roosmarijn Mc Schelvis
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Henk F van der Molen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Michaelsen MM, Graser J, Onescheit M, Tuma MP, Werdecker L, Pieper D, Esch T. Mindfulness-Based and Mindfulness-Informed Interventions at the Workplace: A Systematic Review and Meta-Regression Analysis of RCTs. Mindfulness (N Y) 2023; 14:1-34. [PMID: 37362186 PMCID: PMC10172073 DOI: 10.1007/s12671-023-02130-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2023] [Indexed: 06/28/2023]
Abstract
Objectives Positive effects of mindfulness-based interventions (MBIs) on occupational health have been demonstrated by several systematic review studies during the last two decades. So far, existing reviews excluded mindfulness-informed interventions (MIIs) that build on informal approaches or mixed techniques aiming at improving mindfulness indirectly. To address this research gap, the present comprehensive meta-analysis synthesizes the results of RCTs of MBIs and MIIs conducted in various workplace settings. Method A systematic literature search was conducted in five electronic databases complemented by manual search. Random-effects models were used to synthesize standardized mean differences (SMDs) for 25 outcomes and seven overarching categories of outcomes, and to detect various temporal effects. Meta-regressions were run to elucidate average SMDs between mindfulness intervention types and intervention and population characteristics, with the goal of detecting sources of heterogeneity and help guide the selection of the most appropriate mindfulness intervention type. Results Based on 91 eligible studies (from 92 publications), including 4927 participants and 4448 controls, the synthesis shows that MBIs and MIIs significantly improve mindfulness (SMD = 0.43; 95%-CI [0.33;0.52]), well-being (SMD = 0.63; 95%-CI [0.34;0.93]), mental health (SMD = 0.67; 95%-CI [0.48;0.86]), stress (SMD = 0.72; 95%-CI [0.54;0.90]), resilience (SMD = 1.06; 95%-CI [-0.22;2.34]), physical health (SMD = 0.45; 95%-CI [0.32;0.59]), and work-related factors (SMD = 0.62; 95%-CI [0.14;1.10]). Sensitivity analyses demonstrate a tendency towards smaller effect sizes due to extreme outliers. Effect sizes are stable in short-term follow-up assessments (1-12 weeks) for most outcomes, but not for long-term follow-up assessments (13-52 weeks). Meta-regressions suggest that observable intervention characteristics (e.g., online delivery) and population characteristics (e.g., age of participants), as well as study quality, do not explain the prevalence of heterogeneity in effect sizes. Conclusions Generally effective, mindfulness interventions are a useful tool to enhance aspects of employee health. However, because of heterogeneity and risk of bias, studies aiming at high-quality data collection and thorough reporting are necessary to draw firm conclusions. Preregistration A protocol of this systematic review was registered with PROSPERO (Registration-No. CRD42020159927). Supplementary Information The online version contains supplementary material available at 10.1007/s12671-023-02130-7.
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Affiliation(s)
- Maren M. Michaelsen
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Johannes Graser
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Miriam Onescheit
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Matthias P. Tuma
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Lena Werdecker
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health System Research, Rüdersdorf, Germany
- Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf, Germany
| | - Tobias Esch
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Brault ME, Laudermith A, Kroll-Desrosiers A. Telemedicine During COVID-19 Response: A Welcome Shift for Younger Female Healthcare Workers. J Gen Intern Med 2023; 38:627-32. [PMID: 36127541 DOI: 10.1007/s11606-022-07785-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 09/06/2022] [Indexed: 10/27/2022]
Abstract
BACKGROUND Healthcare workers, especially female employees, have historically been at an increased risk for occupational stress. During the early stages of the COVID-19 pandemic, many healthcare workers shifted to a telework model of care and started working from home (WFH). It is unclear how WFH impacted female healthcare employees' job satisfaction and stress levels. OBJECTIVE To further understand the impact of WFH on job satisfaction and stress among female healthcare employees. DESIGN An exploratory survey was utilized. Data was evaluated with generalized linear models and logistic regression. Data was collected March to April 2021, between the third and fourth COVID waves in the U.S.A. PARTICIPANTS All employees (approximately 1050) within the Veterans Affairs Central Western Massachusetts (VACWM) Healthcare System were invited to participate. We received 220 responses with most (78.6%) respondents identifying as female. MAIN MEASURES A Work-from-Home Satisfaction Scale and the Professional Quality of Life (ProQOL) Compassion Satisfaction and Burnout Scales. KEY RESULTS A majority of our participants (> 60%) strongly agreed that WFH during COVID-19 increased their work satisfaction and their ability to feel safe and reduced overall stress levels. Female respondents reported that WFH increased their ability to feel safe, reduced overall stress, and did not interfere with work efficiency when compared to male respondents. Overall, reported burnout was low, with only 32.7% of respondents scoring in the moderate category on the PROQOL burnout scale and no respondents scoring in the high burnout category. CONCLUSIONS Employees at this VA medical center who had the ability to work from home during the COVID-19 pandemic, particularly younger women, reported less stress, less burnout, and more satisfaction, while maintaining work efficiency and team cohesion. Providing permission to WFH may decrease the added burden that female healthcare workers often experience as they strive to overcome gender gaps and inequalities in the workplace.
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Reeves TJ, Dyer NL, Borden S, Dusek JA, Khalsa SBS. “Making it okay”: professionals in high-stress environments construct their understanding of the impact of a yoga-based retreat designed to build resilience. Int J Qual Stud Health Well-being 2022; 17:2025640. [PMID: 35156910 PMCID: PMC8925917 DOI: 10.1080/17482631.2022.2025640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purpose While there is growing evidence for resilience building programmes, to date research has not explored how professionals construct understanding of programme impact. RISE (resilience, integration, self-awareness, engagement), a 5-day yoga-based retreat programme, has been linked with positive wellness outcomes. This qualitative inquiry explores participants' reflection and experience 3 months after programme completion. Methods Through a grounded constructivist lens, in-depth semi-structured phone interviews were conducted with 17 adult professionals in high-stress work environments who attended RISE. Initial hand-coding informed codebook development for systematic coding using directed content analysis using sensitizing structuring. Results Two integrated perceptions woven through five themes. Persistent threads of experiential learning and sense of permission provided structure for themes found. Five interrelated themes related to psychological health and workplace dynamics were (1) use of acquired behavioural skills and practices; (2) lived mindfulness; (3) resilience to stress and emotion regulation (4) self-care and self-compassion, and (5) sharing with others. Conclusion Findings provide meaningful interpretation of previously reported programme efficacy by contextualizing perceived benefits within participants' constructed understanding of change. Specifically, environmental, social, and experiential considerations have suggested implications for resilience building programmes. Abbreviations: RISE (resilience, integration, self-awareness, engagement)
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Affiliation(s)
- Tegan J. Reeves
- Global Pediatric Medicine Culture & Communication, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - Natalie L. Dyer
- Global Pediatric Medicine Culture & Communication, Kripalu Center for Yoga & Health, Stockbridge, MA, USA
| | - Sara Borden
- Global Pediatric Medicine Culture & Communication, Kripalu Center for Yoga & Health, Stockbridge, MA, USA
| | - Jeffery A. Dusek
- Global Pediatric Medicine Culture & Communication, Kripalu Center for Yoga & Health, Stockbridge, MA, USA
| | - Sat Bir Singh Khalsa
- Global Pediatric Medicine Culture & Communication, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Pettus M, Netter B, Perlmutter L, Perlmutter JC, Hosler AS. The effects of mantra‐based
A
MI Meditation on burnout, secondary traumatic stress, and compassion satisfaction levels in healthcare providers. Lifestyle Medicine 2022. [DOI: 10.1002/lim2.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mark Pettus
- Department of Medicine University of Massachusetts Chan Medical School Worcester Massachusetts USA
| | - Beth Netter
- Department of Medical Education American Meditation Institute Averill Park New York USA
| | - Leonard Perlmutter
- Department of Medical Education American Meditation Institute Averill Park New York USA
| | | | - Akiko S. Hosler
- Department of Epidemiology and Biostatistics University at Albany Albany New York USA
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Guerra F, Corridore D, Peruzzo M, Dorelli B, Raimondi L, Ndokaj A, Mazur M, Ottolenghi L, Torre GL, Polimeni A. Quality of Life and Stress Management in Healthcare Professionals of a Dental Care Setting at a Teaching Hospital in Rome: Results of a Randomized Controlled Clinical Trial. Int J Environ Res Public Health 2022; 19:13788. [PMID: 36360667 PMCID: PMC9654640 DOI: 10.3390/ijerph192113788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED In the healthcare environment, more and more people experience work-related stress. The Faculty of Medicine and Dentistry of Sapienza University of Rome, having observed the need to take care of healthcare professionals, has set itself the objective of providing useful tools such as additional and necessary personal protective equipment for healthcare professionals. OBJECTIVE To promote health through better management, skills, and the use of strategies and solutions to identify, decompress, and neutralize those responsible for work-related stress mechanisms in order to take care of those who care (CURARE CURANTES). MATERIALS AND METHODS A randomized controlled clinical trial was conducted. The participants were enrolled by three departments of the Department of Dental and Maxillofacial Sciences of Rome; in consideration of emotional involvement of health professionals who work there. A motivational program was offered. RESULTS There were 17 and 16 healthcare professionals in the intervention and control groups, respectively. Levels of the mental composite score (MCS) varied both in the pre-post phase of the intervention group (p = 0.002), and between the intervention group and control group in the post phase (p = 0.006). No significant differences were observed for the physical composite score (PCS). Similarly, there were no significant differences regarding the positivity scale (PS) and the two dimensions of work-related stress (job demand and decision latitude). CONCLUSION This study demonstrates the efficacy of yoga training practiced directly in the workplace and wearing work clothes, entering the work context, not weighing further on the healthcare workload, and being a way to carry out physical activity even in those cases in which professionals do not have the time to do it in their free time.
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Affiliation(s)
- Fabrizio Guerra
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Denise Corridore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Margherita Peruzzo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Barbara Dorelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Artnora Ndokaj
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Marta Mazur
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Livia Ottolenghi
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
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Unick JL, Dunsiger SI, Bock BC, Sherman SA, Braun TD, Wing RR. A preliminary investigation of yoga as an intervention approach for improving long-term weight loss: A randomized trial. PLoS One 2022; 17:e0263405. [PMID: 35120162 DOI: 10.1371/journal.pone.0263405] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/10/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Yoga targets psychological processes which may be important for long-term weight loss (WL). This study is the first to examine the feasibility, acceptability, and preliminary efficacy of yoga within a weight management program following WL treatment. METHODS 60 women with overweight or obesity (34.3±3.9 kg/m2, 48.1±10.1 years) were randomized to receive a 12-week yoga intervention (2x/week; YOGA) or a structurally equivalent control (cooking/nutrition classes; CON), following a 3-month behavioral WL program. Feasibility (attendance, adherence, retention) and acceptability (program satisfaction ratings) were assessed. Treatment groups were compared on weight change, mindfulness, distress tolerance, stress, affect, and self-compassion at 6 months. Initial WL (3-mo WL) was evaluated as a potential moderator. RESULTS Attendance, retention, and program satisfaction ratings of yoga were high. Treatment groups did not differ on WL or psychological constructs (with exception of one mindfulness subscale) at 6 months. However, among those with high initial WL (≥5%), YOGA lost significantly more weight (-9.0kg vs. -6.7kg) at 6 months and resulted in greater distress tolerance, mindfulness, and self-compassion and lower negative affect, compared to CON. CONCLUSIONS Study findings provide preliminary support for yoga as a potential strategy for improving long-term WL among those losing ≥5% in standard behavioral treatment.
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Abstract
BACKGROUND Teachers have had to deal with many of the negative aspects of COVID-19 over the past year. The demands associated with the sudden requirement to teach remotely, and later having to manage hybrid (both in person and online) learning may be having adverse effects on the mental and physical health of teachers. OBJECTIVE To determine whether COVID-19 continued to impact teacher stress, burnout, and well-being a year into the pandemic. METHODS An online survey was sent out to 5300 teachers in public and private schools, and 703 completed the survey. RESULTS Stress and burnout continue to be high for teachers, with 72% of teachers feeling very or extremely stressed, and 57% feel very or extremely burned out. Many teachers struggled to have a satisfactory work-family balance (37% never or almost never; 20% only has sometimes). CONCLUSION School systems must start to deal with the mental and physical health of teachers before a large number of them leave the profession.
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Affiliation(s)
- Susan E Kotowski
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Kermit G Davis
- Department of Environmental and Public Health Science, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Clare L Barratt
- Department of Psychology, College of Arts and Science, Bowling Green State University, Bowling Green, OH, USA
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Upadhyay V, Saoji AA, Verma A, Saxena V. Development and validation of 20-min yoga module for reducing burnout among healthcare worker(s). Complement Ther Clin Pract 2022; 46:101543. [DOI: 10.1016/j.ctcp.2022.101543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 01/10/2022] [Accepted: 01/27/2022] [Indexed: 11/03/2022]
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Braun TD, Riley KE, Kunicki ZJ, Finkelstein-Fox L, Conboy LA, Park CL, Schifano E, Abrantes AM, Lazar SW. Internalized weight stigma and intuitive eating among stressed adults during a mindful yoga intervention: associations with changes in mindfulness and self-compassion. Health Psychol Behav Med 2021; 9:933-950. [PMID: 34868736 PMCID: PMC8635578 DOI: 10.1080/21642850.2021.1992282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose Internalized weight stigma (IWS) is common in the United States of America across body weight categories, and is implicated in the development of distress and unhealthy eating behaviors (e.g. overeating, disordered eating) that can foster poor cardiometabolic health. While emerging intervention research shows early promise in reducing IWS, long-term efficacy is unclear and novel strategies remain needed. This analysis examined whether participation in a mindful yoga intervention was associated with reduced IWS and increased intuitive eating, an adaptive eating behavior, and whether these changes correlated with each other or with changes in mindfulness and self-compassion. Methods Participants were stressed adults with low fruit and vegetable intake (N = 78, 64.1% White, M. Body Mass Index 25.59 ± 4.45) enrolled in a parent clinical trial of a 12-week mindful yoga intervention. Validated self-report measures of IWS, intuitive eating, mindfulness, and self-compassion were administered at pre-treatment, mid-treatment (8 weeks), post-treatment (12 weeks), and 4-month follow-up (24 weeks). Results Linear mixed modeling revealed significant improvements in IWS and intuitive eating across the four timepoints (p < .001). Reduced IWS correlated with increased intuitive eating pre- to post-treatment (p = .01). Improved self-compassion and mindfulness correlated with intuitive eating (both p = . 04), but not IWS (p = .74 and p = .56, respectively). Conclusion This study offers preliminary support for the hypothesis that mindful yoga may promote intuitive eating and reduce IWS among stressed adults with poor diet, and suggests that changes in these factors may co-occur over time. Further investigation with controlled designs is necessary to better understand the temporality and causality of these relationships.Trial registration: ClinicalTrials.gov identifier: NCT02098018.
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Affiliation(s)
- Tosca D Braun
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine, Brown University, Providence, RI, USA.,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Kristen E Riley
- Department of Clinical Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ, USA
| | - Zachary J Kunicki
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Lucy Finkelstein-Fox
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, USA
| | - Lisa A Conboy
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Crystal L Park
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, USA
| | | | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine, Brown University, Providence, RI, USA.,Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychology, Harvard Medical School, Boston, MA, USA
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Braun TD, Schifano ED, Finkelstein-Fox L, Park CL, Conboy LA, Deshpande R, Riley KE, Lazar SW. Yoga participation associated with changes in dietary patterns and stress: A pilot study in stressed adults with poor diet. Complement Ther Clin Pract 2021; 45:101472. [PMID: 34530181 PMCID: PMC8898640 DOI: 10.1016/j.ctcp.2021.101472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/18/2021] [Accepted: 08/03/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Stress contributes to dietary patterns that impede health. Yoga is an integrative stress management approach associated with improved dietary patterns in burgeoning research. Yet, no research has examined change in dietary patterns, body mass index (BMI), and stress during a yoga intervention among stressed adults with poor diet. MATERIALS AND METHODS Objectively-measured BMI and a battery of self-report questionnaires were collected at four time points during and following a 12-week yoga intervention (N = 78, 71% women, mean BMI = 25.69 kg/m2±4.59) - pre-treatment (T1), mid-treatment (6 weeks; T2), post-treatment (12 weeks; T3), and at 3-month follow-up (24 weeks; T4). RESULTS T1 to T3 fruit and vegetable intake, BMI, and stress significantly declined in the overall sample. Reduction in vegetable intake was no longer significant after accounting for reductions in caloric intake, and reduction in caloric intake remained significant after accounting for reductions in stress. CONCLUSION Findings may be interpreted as yoga either encouraging or adversely impacting healthy dietary patterns (i.e., minimizing likelihood of future weight gain vs. decreasing vegetable intake and overall caloric intake among individuals who may not need to lose weight, respectively). Continued research is warranted, utilizing causal designs.
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Affiliation(s)
- Tosca D Braun
- Department of Psychological Sciences, University of Connecticut, USA; Department of Psychiatry and Human Behavior, The Alpert Medical School of Brown University, Providence, RI, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.
| | | | | | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, USA.
| | - Lisa A Conboy
- Beth Israel Deaconess Medical Center, Harvard Medical School, USA; New England School of Acupuncture, Massachusetts College of Pharmacy and Health Sciences, USA.
| | - Rina Deshpande
- Department of Psychiatry, Massachusetts General Hospital, USA.
| | - Kristen E Riley
- Department of Clinical Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, USA.
| | - Sara W Lazar
- Department of Psychiatry, Massachusetts General Hospital, USA; Department of Psychology, Harvard Medical School, USA.
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Valiente Millán ML, Méndez Iglesias SM, Morales Serrano JM, Arroyo de la Rosa A. Cansados de estar cansados. El impacto de la pandemia en el colectivo de Medicina Familiar: valoración y propuestas de mejora. Rev Clín Med Fam 2021. [DOI: 10.55783/rcmf.140312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- M.ª Luisa Valiente Millán
- Especialista en Medicina Familiar y Comunitaria. Servicio de Urgencias Hospital Sierrallana. Servicio Cántabro de Salud. Torrelavega. Cantabria (España). Coordinadora del Grupo de Trabajo de Salud Basada en las Emociones de la semFYC
| | - Stella Maris Méndez Iglesias
- Especialista en Medicina Familiar y Comunitaria. Área Sanitaria Pontevedra y Salnés. Servicio Gallego de Salud (SERGAS). Miembro del Grupo de Trabajo de Salud Basada en las Emociones de la semFYC
| | - José Manuel Morales Serrano
- Especialista en Medicina Familiar y Comunitaria. Gerencia de Atención Primaria de Gran Canaria. Servicio Canario de Salud. Miembro del Grupo de Trabajo de Salud Basada en las Emociones de la semFYC
| | - Ana Arroyo de la Rosa
- Especialista en Medicina Familiar y Comunitaria. Servicio Extremeño de Salud (SES). Mérida. Badajoz (España). Vicepresidenta 3.ª de la Junta Directiva de la semFYC
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Couturier J, Ma Z, Rahman L, Webb C. A mixed methods exploratory evaluation of burnout in frontline staff implementing dialectical behavior therapy on a pediatric eating disorders unit. J Eat Disord 2021; 9:98. [PMID: 34389055 PMCID: PMC8360815 DOI: 10.1186/s40337-021-00453-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Eating disorders are life-threatening illnesses that commonly affect adolescents. The treatment of individuals with eating disorders can involve slow treatment progression and addressing comorbidities which can contribute to staff burnout. Dialectical behavior therapy (DBT) has emerged as a viable treatment option and has reduced staff burnout in several other settings. Our aim was to describe frontline staff burnout using mixed methodology on a DBT-trained combined inpatient/day hospital unit for pediatric eating disorders. METHOD Frontline staff were trained to provide DBT skills for adolescents with eating disorders. Twelve months following the training and implementation, they completed the Copenhagen Burnout Inventory (CBI) and a qualitative interview. Directed and summative content analyses were used. RESULTS Eleven frontline staff including nurses, child life specialists and child and youth workers participated. The CBI revealed that only one staff member experienced high personal burnout, while another experienced high client-related burnout. Qualitative data indicated that all frontline staff felt DBT had the potential to reduce burnout. CONCLUSION Qualitative data indicate that staff believe that DBT may hold promise in reducing burnout for pediatric frontline staff who treat children and adolescents with eating disorders. Further study is needed. Understanding burnout is particularly important for nursing staff in inpatient and day hospital settings for eating disorders, as nursing staff generally have the most frequent patient contact; thought to be a risk factor for burnout. The reduction of burnout can prevent detrimental effects on job performance, personal well-being, and patient outcomes. Our exploratory study shows that frontline staff believe that DBT may have the potential to reduce burnout in staff treating children and adolescents with eating disorders in a combined inpatient/day hospital setting. Further study is needed in this area.
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Affiliation(s)
- Jennifer Couturier
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. .,McMaster Children's Hospital - Hamilton Health Sciences, 1200 Main Street W, Hamilton, ON, L8N 3Z5, Canada.
| | - Zechen Ma
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Liah Rahman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Cheryl Webb
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Braun TD, Uebelacker LA, Ward M, Holzhauer CG, McCallister K, Abrantes A. "We really need this": Trauma-informed yoga for Veteran women with a history of military sexual trauma. Complement Ther Med 2021; 59:102729. [PMID: 33965560 DOI: 10.1016/j.ctim.2021.102729] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/27/2021] [Accepted: 04/30/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Up to 70% of women service members in the United States report military sexual trauma (MST); many develop post-traumatic stress disorder (PTSD) and co-occurring disorders. Trauma-informed yoga (TIY) is suggested to improve psychiatric symptoms and shown feasible and acceptable in emerging research, yet no work has evaluated TIY in MST survivors. The current quality improvement project aimed to examine TIY's feasibility, acceptability, and perceived effects in the context of MST. DESIGN Collective case series (N = 7). SETTING New England Vet Center. INTERVENTIONS Extant TIY program (Mindful Yoga Therapy) adapted for Veteran women with MST in concurrent psychotherapy. MAIN OUTCOME MEASURES Attrition and attendance; qualitative exit interview; validated self-report measure of negative affect pre/post each yoga class, and symptom severity assessments and surveys before (T1; Time 1) and after the yoga program (T2; Time 2). RESULTS Feasibility was demonstrated and women reported TIY was acceptable. In qualitative interviews, women reported improved symptom severity, diet, exercise, alcohol use, sleep, and pain; reduced medication use; and themes related to stress reduction, mindfulness, and self-compassion. Regarding quantitative change, results suggest acute reductions in negative affect following yoga sessions across participants, as well as improved affect dysregulation, shame, and mindfulness T1 to T2. CONCLUSIONS TIY is both feasible and acceptable to Veteran women MST survivors in one specific Vet Center, with perceived behavioral health benefits. Results suggest TIY may target psychosocial mechanisms implicated in health behavior change (stress reduction, mindfulness, affect regulation, shame). Formal research should be conducted to confirm these QI project results.
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Affiliation(s)
- Tosca D Braun
- VA Central Western Massachusetts, 421 N. Main St., Leeds, MA, 01053, United States; West Springfield, MA Vet Center, 95 Ashley Ave., West Springfield, MA, 01089-1352, United States; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, United States(1); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, 700 Butler Drive, Providence, RI, 02906, United States.
| | - Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, 700 Butler Drive, Providence, RI, 02906, United States; Psychosocial Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, United States.
| | - Mariana Ward
- Memorial Sloan Kettering, Sloan Kettering Institute, 1275 York Ave., New York, NY, 10065, United States.
| | - Cathryn Glanton Holzhauer
- VA Central Western Massachusetts, 421 N. Main St., Leeds, MA, 01053, United States; Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave., North Worcester, MA, 01655, United States.
| | - Kelly McCallister
- West Springfield, MA Vet Center, 95 Ashley Ave., West Springfield, MA, 01089-1352, United States.
| | - Ana Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, 700 Butler Drive, Providence, RI, 02906, United States; Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, United States.
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Reilly SE, Soulliard ZA, McCuddy WT, Mahoney JJ 3rd. Frequency and perceived effectiveness of mental health providers' coping strategies during COVID-19. Curr Psychol 2021;:1-10. [PMID: 33867779 DOI: 10.1007/s12144-021-01683-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 01/22/2023]
Abstract
There has been an emphasis on understanding the detrimental effects of coronavirus disease (COVID-19) on individuals’ wellbeing. Healthcare workers, including mental health providers, may experience increased emotional and behavioral health concerns to a greater degree than the general public. The objective of the present study was to examine the frequency and the perceived effectiveness of various coping strategies implemented by mental health practitioners during the COVID-19 pandemic, as well as differences across career stages (i.e., trainees versus licensed practitioners [LPs]). Survey data were collected from mental health practitioners (N = 888) assessing the strategies they used to manage COVID-19-associated anxiety/distress and the perceived effectiveness of these strategies. Bonferroni-adjusted chi-square tests and t-tests were conducted to assess differences by career stage. Overall, respondents used various coping strategies, most commonly behavioral strategies such as distraction/engaging in an enjoyable activity (88.63%), spending time with loved ones (77.82%), and exercise (72.64%). Over one-quarter reported using alcohol to cope (28.27%). Respondents generally perceived their coping strategies as somewhat to very effective; no strategies were generally perceived as ineffective. Compared to LPs, trainees were significantly more likely to manage COVID-19-related anxiety/distress using supervision (p < .001) and substances other than alcohol or tobacco (p < .001). There were no significant differences in how effective trainees and LPs perceived each strategy. U.S. mental health practitioners’ use of predominantly behavioral coping strategies, which were generally perceived as effective, during the first months of COVID-19 offers implications for interventions as the pandemic progresses.
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Ciezar-Andersen SD, Hayden KA, King-Shier KM. A systematic review of yoga interventions for helping health professionals and students. Complement Ther Med 2021; 58:102704. [PMID: 33652090 DOI: 10.1016/j.ctim.2021.102704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/25/2021] [Accepted: 02/24/2021] [Indexed: 10/24/2022] Open
Abstract
Helping Health Professionals (HHP) and HHP students are among the highest risk occupational groups for compromised mental and physical health. There is a paucity of information regarding preventive interventions for mental and physical health in this group of healthcare providers. OBJECTIVE The objective of this review was to examine the effectiveness of yoga interventions for the prevention and reduction of mental and physical disorders among HHPs and HHP students. DESIGN An exhaustive systematic search was conducted in May 2020. Databases searched in the OVID interface included: MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Embase, and PsycINFO. EbscoHost databases searched included: CINAHL Plus with Full Text, SPORTDiscus with Full Text, Alt HealthWatch, Education Research Complete, SocINDEX with Full Text, ERIC, and Academic Search Complete. Scopus was also searched. RESULTS The search yielded 4,973 records, and after removal of duplicates 3197 records remained. Using inclusion and exclusion criteria, titles and abstracts were screened and full text articles (n = 82) were retrieved and screened. Twenty-five studies were identified for inclusion in this review. Most frequently reported findings of yoga interventions in this population included a reduction in stress, anxiety, depression, and musculoskeletal pain. CONCLUSION It is our conclusion that mental and physical benefits can be obtained through implementation of yoga interventions for HHPs and HHP students across a variety of settings and backgrounds. However, researchers would benefit from following recommended guidelines for the design and reporting of yoga interventions to improve study quality and rigour.
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Affiliation(s)
| | - K Alix Hayden
- Taylor Family Digital Library, University of Calgary, Calgary, AB, Canada
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Zhang M, Murphy B, Cabanilla A, Yidi C. Physical relaxation for occupational stress in healthcare workers: A systematic review and network meta-analysis of randomized controlled trials. J Occup Health 2021; 63:e12243. [PMID: 34235817 PMCID: PMC8263904 DOI: 10.1002/1348-9585.12243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/10/2021] [Accepted: 06/08/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Work related stress is a major occupational health problem that is associated with adverse effects on physical and mental health. Healthcare workers are particularly vulnerable in the era of COVID-19. Physical methods of stress relief such as yoga and massage therapy may reduce occupational stress. The objective of this systematic review and network meta-analysis is to determine the effects of yoga, massage therapy, progressive muscle relaxation, and stretching on alleviating stress and improving physical and mental health in healthcare workers. METHODS Databases were searched for randomized controlled trials on the use of physical relaxation methods for occupational stress in healthcare workers with any duration of follow-up. Meta-analysis was performed for standard mean differences in stress measures from baseline between subjects undergoing relaxation vs non-intervention controls. Network meta-analysis was conducted to determine the best relaxation method. RESULTS Fifteen trials representing 688 healthcare workers were identified. Random-effects meta-analysis shows that physical relaxation methods overall reduced measures of occupational stress at the longest duration of follow-up vs baseline compared to non-intervention controls (SMD -0.53; 95% CI [-0.74 to -0.33]; p < .00001). On network meta-analysis, only yoga alone (SMD -0.71; 95% CI [-1.01 to -0.41]) and massage therapy alone (SMD -0.43; 95% CI [-0.72 to -0.14]) were more effective than control, with yoga identified as the best method (p-score = .89). CONCLUSION Physical relaxation may help reduce occupational stress in healthcare workers. Yoga is particularly effective and offers the convenience of online delivery. Employers should consider implementing these methods into workplace wellness programs.
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Affiliation(s)
- Michael Zhang
- Administration DivisionSouthern Nevada Health DistrictLas VegasNVUSA
| | - Brittany Murphy
- Department of Exercise ScienceFlorida Atlantic UniversityBoca RatonFLUSA
| | | | - Christina Yidi
- Department of Veterans AffairsOrlando VA Healthcare SystemOrlandoFLUSA
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Dyer NL, Borden S, Dusek JA, Khalsa SBS. A 3-Day residential yoga-based program improves education professionals' psychological and occupational health in a single arm trial. Explore (NY) 2020; 17:513-520. [PMID: 32919893 DOI: 10.1016/j.explore.2020.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/24/2020] [Accepted: 08/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study examined changes in psychological and occupational health in urban education professionals after attending a brief yoga-based program. METHODS Education professionals from the New York City Department of Education (NYC DOE) who were attending a residential 3-day yoga-based program at Kripalu Center for Yoga & Health were recruited to participate in the study. Measures of psychological and occupational health and health-related behaviors were completed before (baseline), after (post), and two months after the program (follow-up). Paired samples t-tests were used to compare scores between time points. RESULTS At post, participants (N = 74) showed improvements in stress, resilience, affect, mindfulness, empowerment, self-compassion, satisfaction with life, work engagement, burnout, exercise, and vegetable intake (all p values < 0.05) compared to baseline. At the follow-up (N = 33), showed improvements in resilience, affect, mindfulness, empowerment, self-compassion, work engagement, and burnout (all p values < 0.05) compared to baseline. There were significant correlations between the degree of home practice of the skills and techniques learned in the program and improvements in multiple measures of psychological and occupational health at follow-up (all p values < 0.05). CONCLUSIONS These findings suggest that the yoga-based program improves psychological and occupational health and healthy behaviors in education professionals immediately following the program and up to two-months following the program, however, more data with larger sample sizes are needed to confirm sustained benefits over the longer term.
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Affiliation(s)
| | - Sara Borden
- Kripalu Center for Yoga & Health, Stockbridge MA, USA
| | | | - Sat Bir S Khalsa
- Brigham and Women's Hospital, Harvard Medical School, Boston MA, USA
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Conversano C, Ciacchini R, Orrù G, Di Giuseppe M, Gemignani A, Poli A. Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review. Front Psychol 2020; 11:1683. [PMID: 32849021 PMCID: PMC7412718 DOI: 10.3389/fpsyg.2020.01683] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022] Open
Abstract
Health care professionals (HCPs) are a population at risk for high levels of burnout and compassion fatigue. The aim of the present systematic review was to give an overview on recent literature about mindfulness and compassion characteristics of HCPs, while exploring the effectiveness of techniques, involving the two aspects, such as MBSR or mindfulness intervention and compassion fatigue-related programs. A search of databases, including PubMed and PsycINFO, was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the methodological quality for this systematic review was appraised using AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews-2). The number of articles that met the inclusion criteria was 58 (4 RCTs, 24 studies with pre-post measurements, 12 cross-sectional studies, 11 cohort studies and 7 qualitative studies). MBSR intervention was effective at improving, and maintaining, mindfulness and self-compassion levels and to improve burnout, depression, anxiety, stress. The most frequently employed interventional strategies were mindfulness-related trainings that were effective at improving mindfulness and self-compassion, but not compassion fatigue, levels. Compassion-related interventions have been shown to improve self-compassion, mindfulness and interpersonal conflict levels. Mindfulness was effective at improving negative affect and compassion fatigue, while compassion satisfaction may be related to cultivation of positive affect. This systematic review summarized the evidence regarding mindfulness- and compassion-related qualities of HCPs as well as potential effects of MBSR, mindfulness-related and compassion-related interventions on professionals' psychological variables like mindfulness, self-compassion and quality of life. Combining structured mindfulness and compassion cultivation trainings may enhance the effects of interventions, limit the variability of intervention protocols and improve data comparability of future research.
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Abstract
BACKGROUND Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence). AUTHORS' CONCLUSIONS For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.
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Affiliation(s)
| | | | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Dyer NL, Borden S, Dusek JA, Khalsa SBS. A Pragmatic Controlled Trial of a Brief Yoga and Mindfulness-Based Program for Psychological and Occupational Health in Education Professionals. Complement Ther Med 2020; 52:102470. [PMID: 32951720 DOI: 10.1016/j.ctim.2020.102470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To examine changes in psychological and occupational wellbeing in education professionals that attended a brief yoga and mindfulness-based program. DESIGN Pragmatic controlled trial comparing education professionals that attended a yoga mindfulness-based program (n = 9) to a waitlist control group (n = 22). SETTING The 3-day program was delivered at the Kripalu Center for Yoga & Health in Massachusetts. INTERVENTION The 3-day yoga mindfulness program included 5 hours per day of yoga, mindfulness exercises, formal meditation, didactic, and experiential activities. MAIN OUTCOME MEASURES Measures of psychological and occupational wellbeing were completed before (baseline), immediately after (post-program), and two months after the program (follow-up). RESULTS Relative to controls (n = 21), the RISE group (n = 9) showed significant improvements in positive affect (p = .033), negative affect (p = .044), mindfulness (p = .001), empowerment (p = .022), self-compassion (p = .001), and work engagement from baseline to post-program. From baseline to follow-up, the RISE group showed significant improvements in stress (p = .008), negative affect (p = .013), mindfulness (p = .001), empowerment (p = .007), and self-compassion (p = .001) compared to the control group. CONCLUSIONS The yoga mindfulness program was associated with improvements in educators' psychological and occupational wellbeing immediately following and 2-months following the program. Future research with a larger sample size is needed to confirm these results.
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Affiliation(s)
- Natalie L Dyer
- Kripalu Center for Yoga & Health, 57 Interlaken Rd, Stockbridge, MA, 01262, USA.
| | - Sara Borden
- Kripalu Center for Yoga & Health, 57 Interlaken Rd, Stockbridge, MA, 01262, USA
| | - Jeffery A Dusek
- Kripalu Center for Yoga & Health, 57 Interlaken Rd, Stockbridge, MA, 01262, USA
| | - Sat Bir S Khalsa
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA
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La Torre G, Raffone A, Peruzzo M, Calabrese L, Cocchiara RA, D’Egidio V, Leggieri PF, Dorelli B, Zaffina S, Mannocci A. Yoga and Mindfulness as a Tool for Influencing Affectivity, Anxiety, Mental Health, and Stress among Healthcare Workers: Results of a Single-Arm Clinical Trial. J Clin Med 2020; 9:E1037. [PMID: 32272758 PMCID: PMC7230658 DOI: 10.3390/jcm9041037] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022] Open
Abstract
Mindfulness-based interventions have emerged as unique approaches for addressing a range of clinical and subclinical difficulties such as stress, chronic pain, anxiety, or recurrent depression. Moreover, there is strong evidence about the positive effects of yoga practice on stress management and prevention of burnout among healthcare workers. The aim of this study was to conduct a single-arm clinical trial to assess the effectiveness of an intervention based on mindfulness-based stress reduction and yoga in improving healthcare workers' quality of life. Healthcare workers of two hospitals in Rome were enrolled in a 4-week yoga and mindfulness course. Four questionnaires were administered at different times (Short Form-12 (SF-12), State-Trait Anxiety Inventory (STAI) Y1 and Y2, and Positive and Negative Affect Schedule (PANAS)) to evaluate the efficacy of the intervention. Forty participants took part to the study (83.3 %). The Mental Composite Score-12, that is part of the quality of life assessment, passed from a median of 43.5 preintervention to 48.1 postintervention (p = 0.041), and the negative affect passed from a score of 16 in the preintervention to 10 in the postintervention (p < 0.001). Both the forms of the STAI questionnaires showed a decrease after the intervention. Yoga and mindfulness administered together seem to be effective to reduce stress and anxiety in healthcare workers, providing them with more consciousness and ability to manage work stressful demands.
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Affiliation(s)
- Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (R.A.C.); (V.D.); (P.F.L.); (B.D.); (A.M.); (Y.C.G.)
| | - Antonino Raffone
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (L.C.)
| | - Margherita Peruzzo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (R.A.C.); (V.D.); (P.F.L.); (B.D.); (A.M.); (Y.C.G.)
| | - Lucia Calabrese
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (L.C.)
| | - Rosario Andrea Cocchiara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (R.A.C.); (V.D.); (P.F.L.); (B.D.); (A.M.); (Y.C.G.)
| | - Valeria D’Egidio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (R.A.C.); (V.D.); (P.F.L.); (B.D.); (A.M.); (Y.C.G.)
| | - Pasquale Fabio Leggieri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (R.A.C.); (V.D.); (P.F.L.); (B.D.); (A.M.); (Y.C.G.)
| | - Barbara Dorelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (R.A.C.); (V.D.); (P.F.L.); (B.D.); (A.M.); (Y.C.G.)
| | - Salvatore Zaffina
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (R.A.C.); (V.D.); (P.F.L.); (B.D.); (A.M.); (Y.C.G.)
| | - YOMIN Collaborative Group
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (M.P.); (R.A.C.); (V.D.); (P.F.L.); (B.D.); (A.M.); (Y.C.G.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (A.R.); (L.C.)
- Occupational Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
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Rizkalla N, Segal SP. Trauma during humanitarian work: the effects on intimacy, wellbeing and PTSD-symptoms. Eur J Psychotraumatol 2019; 10:1679065. [PMID: 31692832 PMCID: PMC6818129 DOI: 10.1080/20008198.2019.1679065] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/30/2019] [Accepted: 09/06/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Organizations assisting refugees are over burdened with the Syrian humanitarian catastrophe and encounter diverse difficulties facing the consequences of this massive displacement. Aid-workers experience the horrors of war through their efforts to alleviate suffering of Syrian refugees. Objective: This study of Syrian refugee aid-workers in Jordan examined work-stressors identified as secondary traumatic stress (STS), number of refugees assisted, worker feelings towards the organization, and their associations to PTSD-symptoms, wellbeing and intimacy. It also examined whether self-differentiation, physical health, and physical pain were associated with these variables. Method: Syrian refugee aid-workers (N = 317) in Jordan's NGOs were surveyed. Univariate statistics and structural equation modeling (SEM) were utilized to test study hypotheses. Results: Increased STS was associated with lower self-differentiation, decreased physical health and increased physical pain, as well as elevated PTSD-symptoms and decreased intimacy. Decreased connection to the NGO was associated with lower self-differentiation, decreased physical health, increased physical pain, and with decreased intimacy and wellbeing. Lower self-differentiation was associated with increased PTSD-symptoms, decreased wellbeing and intimacy. Elevated physical pain was associated with increased PTSD-symptoms, and decreased wellbeing. Diverse mediation effects of physical health, physical pain and self-differentiation were found among the study's variables. Conclusions: Aid-workers who assist refugees were at risk of physical and mental sequelae as well as suffering from degraded self-differentiation, intimacy and wellbeing. Organizations need to develop prevention policies and tailor interventions to better support their aid-workers while operating in such stressful fieldwork.
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Affiliation(s)
- Niveen Rizkalla
- Mack Center on Mental Health & Social Conflict, School of Social Welfare, University of California Berkeley, Berkeley, CA, USA
| | - Steven P. Segal
- School of Social Welfare, University of California, Berkeley, CA, USA
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Rauvola RS, Vega DM, Lavigne KN. Compassion Fatigue, Secondary Traumatic Stress, and Vicarious Traumatization: a Qualitative Review and Research Agenda. ACTA ACUST UNITED AC 2019; 3:297-336. [DOI: 10.1007/s41542-019-00045-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Affiliation(s)
- Nathaniel Embse
- College of EducationUniversity of South FloridaTampa Florida
| | - Shannon V. Ryan
- College of EducationTemple UniversityPhiladelphia Pennsylvania
| | - Tera Gibbs
- College of EducationTemple UniversityPhiladelphia Pennsylvania
| | - Ariel Mankin
- College of EducationTemple UniversityPhiladelphia Pennsylvania
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Trent NL, Borden S, Miraglia M, Pasalis E, Dusek JA, Khalsa SBS. Improvements in Psychological and Occupational Well-being Following a Brief Yoga-Based Program for Education Professionals. Glob Adv Health Med 2019; 8:2164956119856856. [PMID: 31218118 PMCID: PMC6563397 DOI: 10.1177/2164956119856856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/09/2019] [Accepted: 05/21/2019] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The purpose of this study was to examine changes in psychological and occupational well-being in education professionals who attended a yoga-based program. METHODS Education professionals who attended a 3-day yoga-based RISE (resilience, integration, self-awareness, engagement) program were recruited to participate. RISE was administered at the Kripalu Center for Yoga & Health. Measures of psychological and occupational well-being, and health-related behaviors were completed before (baseline), after (post), and 2 months after RISE (follow-up). Forty-four participants completed baseline and post and were included in the analysis. Of those, 33 participants also completed the follow-up. Paired samples t tests were used to compare scores between time points. RESULTS Compared to baseline, at post, participants showed improvements in perceived stress, mindfulness, empowerment, positive affect, negative affect, self-compassion, total work engagement, vigor, sleep quality (all P values < .001), resilience, satisfaction with life, as well as exhaustion and professional efficacy which are dimensions of burnout (all P values < .01). At the follow-up, significant improvements were maintained for mindfulness, empowerment, self-compassion, sleep quality (all P values < .001), resilience, vigor, and exhaustion (all P values < .01) and positive affect, satisfaction with life, and work engagement (all P values < .05). CONCLUSIONS These findings suggest that the yoga-based RISE program improves psychological and occupational well-being in education professionals. In addition, participants reported that attending RISE was feasible, they could continue using RISE practices long-term, shared them with work colleagues, and reported that RISE positively impacted both their daily lives and workplace environment. With these promising results, additional controlled research is warranted.
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Affiliation(s)
- Natalie L Trent
- Department of Research, Kripalu Center for Yoga & Health, Stockbridge, Massachusetts
| | - Sara Borden
- Department of Research, Kripalu Center for Yoga & Health, Stockbridge, Massachusetts
| | - Mindy Miraglia
- Department of Research, Kripalu Center for Yoga & Health, Stockbridge, Massachusetts
| | - Edi Pasalis
- Department of Research, Kripalu Center for Yoga & Health, Stockbridge, Massachusetts
| | - Jeffery A Dusek
- Department of Research, Kripalu Center for Yoga & Health, Stockbridge, Massachusetts
| | - Sat Bir S Khalsa
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Trent NL, Borden S, Miraglia M, Pasalis E, Dusek JA, Khalsa SBS. Improvements in Psychological and Occupational Well-Being in a Pragmatic Controlled Trial of a Yoga-Based Program for Professionals. J Altern Complement Med 2019; 25:593-605. [DOI: 10.1089/acm.2018.0526] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
| | - Sara Borden
- Kripalu Center for Yoga & Health, Stockbridge, MA
| | | | - Edi Pasalis
- Kripalu Center for Yoga & Health, Stockbridge, MA
| | | | - Sat Bir Singh Khalsa
- Department of Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Cocchiara RA, Peruzzo M, Mannocci A, Ottolenghi L, Villari P, Polimeni A, Guerra F, La Torre G. The Use of Yoga to Manage Stress and Burnout in Healthcare Workers: A Systematic Review. J Clin Med 2019; 8:E284. [PMID: 30813641 PMCID: PMC6462946 DOI: 10.3390/jcm8030284] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/18/2019] [Accepted: 02/22/2019] [Indexed: 12/17/2022] Open
Abstract
The purpose of this systematic review is to analyze and summarize the current knowledge regarding the use of yoga to manage and prevent stress and burnout in healthcare workers. In February 2017, a literature search was conducted using the databases Medline (PubMed) and Scopus. Studies that addressed this topic were included. Eleven articles met the inclusion criteria. Seven studies were clinical trials that analyzed yoga interventions and evaluated effectiveness by gauging stress levels, sleep quality and quality of life. A study on Chinese nurses showed statistical improvement in stress levels following a six-month yoga program (χ2 = 16.449; p < 0.001). A population of medical students showed improvement in self-regulation values after an 11-week yoga program (from 3.49 to 3.58; p = 0.04) and in self-compassion values (from 2.88 to 3.25; p = 0.04). Four of the included articles were observational studies: They described the factors that cause stress in the work environment and highlighted that healthcare workers believe it is possible to benefit from improved physical, emotional and mental health related to yoga activity. According to the literature, yoga appears to be effective in the management of stress in healthcare workers, but it is necessary to implement methodologically relevant studies to attribute significance to such evidence.
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Affiliation(s)
| | - Margherita Peruzzo
- Department of Oral and Maxillofacial Sciences, Sapienza University, 00161 Rome, Italy.
| | - Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy.
| | - Livia Ottolenghi
- Department of Oral and Maxillofacial Sciences, Sapienza University, 00161 Rome, Italy.
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy.
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University, 00161 Rome, Italy.
| | - Fabrizio Guerra
- Department of Oral and Maxillofacial Sciences, Sapienza University, 00161 Rome, Italy.
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy.
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Wolfenden L, Goldman S, Stacey FG, Grady A, Kingsland M, Williams CM, Wiggers J, Milat A, Rissel C, Bauman A, Farrell MM, Légaré F, Ben Charif A, Zomahoun HTV, Hodder RK, Jones J, Booth D, Parmenter B, Regan T, Yoong SL. Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity. Cochrane Database Syst Rev 2018; 11:CD012439. [PMID: 30480770 PMCID: PMC6362433 DOI: 10.1002/14651858.cd012439.pub2] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Given the substantial period of time adults spend in their workplaces each day, these provide an opportune setting for interventions addressing modifiable behavioural risk factors for chronic disease. Previous reviews of trials of workplace-based interventions suggest they can be effective in modifying a range of risk factors including diet, physical activity, obesity, risky alcohol use and tobacco use. However, such interventions are often poorly implemented in workplaces, limiting their impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to improve their effects on health outcomes. OBJECTIVES To assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use.Secondary objectives were to assess the impact of such strategies on employee health behaviours, including dietary intake, physical activity, weight status, and alcohol and tobacco use; evaluate their cost-effectiveness; and identify any unintended adverse effects of implementation strategies on workplaces or workplace staff. SEARCH METHODS We searched the following electronic databases on 31 August 2017: CENTRAL; MEDLINE; MEDLINE In Process; the Campbell Library; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. We also handsearched all publications between August 2012 and September 2017 in two speciality journals: Implementation Science and Journal of Translational Behavioral Medicine. We conducted searches up to September 2017 in Dissertations and Theses, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Registry. We screened the reference lists of included trials and contacted authors to identify other potentially relevant trials. We also consulted experts in the field to identify other relevant research. SELECTION CRITERIA Implementation strategies were defined as strategies specifically employed to improve the implementation of health interventions into routine practice within specific settings. We included any trial with a parallel control group (randomised or non-randomised) and conducted at any scale that compared strategies to support implementation of workplace policies or practices targeting diet, physical activity, obesity, risky alcohol use or tobacco use versus no intervention (i.e. wait-list, usual practice or minimal support control) or another implementation strategy. Implementation strategies could include those identified by the Effective Practice and Organisation of Care (EPOC) taxonomy such as quality improvement initiatives and education and training, as well as other strategies. Implementation interventions could target policies or practices directly instituted in the workplace environment, as well as workplace-instituted efforts encouraging the use of external health promotion services (e.g. gym membership subsidies). DATA COLLECTION AND ANALYSIS Review authors working in pairs independently performed citation screening, data extraction and 'Risk of bias' assessment, resolving disagreements via consensus or a third reviewer. We narratively synthesised findings for all included trials by first describing trial characteristics, participants, interventions and outcomes. We then described the effect size of the outcome measure for policy or practice implementation. We performed meta-analysis of implementation outcomes for trials of comparable design and outcome. MAIN RESULTS We included six trials, four of which took place in the USA. Four trials employed randomised controlled trial (RCT) designs. Trials were conducted in workplaces from the manufacturing, industrial and services-based sectors. The sample sizes of workplaces ranged from 12 to 114. Workplace policies and practices targeted included: healthy catering policies; point-of-purchase nutrition labelling; environmental supports for healthy eating and physical activity; tobacco control policies; weight management programmes; and adherence to guidelines for staff health promotion. All implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes. Four trials compared an implementation strategy intervention with a no intervention control, one trial compared different implementation interventions, and one three-arm trial compared two implementation strategies with each other and a control. Four trials reported a single implementation outcome, whilst the other two reported multiple outcomes. Investigators assessed outcomes using surveys, audits and environmental observations. We judged most trials to be at high risk of performance and detection bias and at unclear risk of reporting and attrition bias.Of the five trials comparing implementation strategies with a no intervention control, pooled analysis was possible for three RCTs reporting continuous score-based measures of implementation outcomes. The meta-analysis found no difference in standardised effects (standardised mean difference (SMD) -0.01, 95% CI -0.32 to 0.30; 164 participants; 3 studies; low certainty evidence), suggesting no benefit of implementation support in improving policy or practice implementation, relative to control. Findings for other continuous or dichotomous implementation outcomes reported across these five trials were mixed. For the two non-randomised trials examining comparative effectiveness, both reported improvements in implementation, favouring the more intensive implementation group (very low certainty evidence). Three trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence). One trial reported an increase in absolute workplace costs for health promotion in the implementation group (low certainty evidence). None of the included trials assessed adverse consequences. Limitations of the review included the small number of trials identified and the lack of consistent terminology applied in the implementation science field, which may have resulted in us overlooking potentially relevant trials in the search. AUTHORS' CONCLUSIONS Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting.
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Affiliation(s)
- Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Sharni Goldman
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanNSWAustralia2287
| | - Alice Grady
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Christopher M Williams
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - John Wiggers
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Andrew Milat
- NSW Ministry of HealthCentre for Epidemiology and EvidenceNorth SydneyNSWAustralia2060
- The University of SydneySchool of Public HealthSydneyAustralia
| | - Chris Rissel
- Sydney South West Local Health DistrictOffice of Preventive HealthLiverpoolNSWAustralia2170
| | - Adrian Bauman
- The University of SydneySchool of Public HealthSydneyAustralia
- Sax InstituteThe Australian Prevention Partnership CentreSydneyAustralia
| | - Margaret M Farrell
- US National Cancer InstituteDivision of Cancer Control and Population Sciences/Implementation Sciences Team9609 Medical Center DriveBethesdaMarylandUSA20892
| | - France Légaré
- Université LavalCentre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)2525, Chemin de la CanardièreQuebecQuébecCanadaG1J 0A4
| | - Ali Ben Charif
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)Université Laval2525, Chemin de la CanardièreQuebecQuebecCanadaG1J 0A4
| | - Hervé Tchala Vignon Zomahoun
- Centre de recherche sur les soins et les services de première ligne ‐ Université LavalHealth and Social Services Systems, Knowledge Translation and Implementation Component of the SPOR‐SUPPORT Unit of Québec2525, Chemin de la CanardièreQuebecQCCanadaG1J 0A4
| | - Rebecca K Hodder
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Jannah Jones
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Debbie Booth
- University of NewcastleAuchmuty LibraryUniversity DriveCallaghanNSWAustralia2308
| | - Benjamin Parmenter
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Tim Regan
- University of NewcastleThe School of PsychologyCallaghanAustralia
| | - Sze Lin Yoong
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
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Clemow LP, Pickering TG, Davidson KW, Schwartz JE, Williams VP, Shaffer JA, Williams RB, Gerin W. Stress management in the workplace for employees with hypertension: a randomized controlled trial. Transl Behav Med 2018; 8:761-770. [PMID: 30202927 PMCID: PMC6128963 DOI: 10.1093/tbm/iby018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
While behavioral interventions can improve blood pressure (BP) in individuals with hypertension, getting such services to people who could benefit remains difficult. Workplace programs have potential as dissemination vehicles. The objective is to evaluate the effectiveness of a standardized stress management program delivered in groups at the workplace for reducing BP compared with enhanced usual care. This randomized controlled trial studied 92 urban medical center employees with hypertension randomized into two groups. The intervention was a 10-week group workshop on cognitive-behavioral coping skills. Enhanced usual care included self-help materials for BP reduction and physician referral. Intervention group participants' systolic BP (SBP) decreased 7.5 mm Hg over controls between baseline and follow-up, from 149.1 (95% CI: 146.0-152.1) to 140.0 (95% CI: 134.7-145.2), p < .001. The differential change between intervention and enhanced usual care groups (Group × Time interaction) was 7.5 mm Hg (t = -2.05; p = .04). Diastolic BP reductions were not significantly different. Scores on measures of emotional exhaustion and depressive rumination showed significant improvements and correlated with reductions in SBP. There was no significant change in the usual care group. A standardized worksite group intervention produced clinically meaningful reductions in SBP in participants with hypertension.
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Affiliation(s)
- Lynn P Clemow
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
- Department of Family and Community Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Thomas G Pickering
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | - Karina W Davidson
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | - Joseph E Schwartz
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | | | - Jonathan A Shaffer
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | - Redford B Williams
- Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC, USA
| | - William Gerin
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
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Trent NL, Miraglia M, Dusek JA, Pasalis E, Khalsa SBS. Improvements in Psychological Health Following a Residential Yoga-Based Program for Frontline Professionals. J Occup Environ Med 2018; 60:357-67. [DOI: 10.1097/jom.0000000000001216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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36
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Domingues RB. Modern postural yoga as a mental health promoting tool: A systematic review. Complement Ther Clin Pract 2018; 31:248-255. [PMID: 29705463 DOI: 10.1016/j.ctcp.2018.03.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 03/07/2018] [Indexed: 12/22/2022]
Abstract
Yoga has been gaining popularity as a complementary therapy for mental health conditions, but research on the efficacy of yoga is still in its beginnings. The aim of this systematic review is to investigate the effects of modern postural yoga (strong focus on physical postures) on positive mental health (PMH) indicators in clinical and nonclinical populations. The most common PMH indicators were mindfulness, affect, resilience and well-being, followed by satisfaction with life, self-compassion, empathy and others. Diverse results were found across the 14 studies analysed, including significant positive effects of yoga practice on outcome variables, to no significant effects, both in relation to baseline levels and in relation to control groups. Nonetheless, most studies observed ameliorations in PMH indicators due to yoga practice. Given that yoga interventions pose serious methodological concerns, more research and better experimental designs are needed to properly assess the effects of yoga on PMH indicators.
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Affiliation(s)
- Rita B Domingues
- Centre for Marine and Environmental Research (CIMA), University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal; Research Centre for Spatial and Organizational Dynamics (CIEO), University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal.
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