Using mindfulness to improve quality of life in caregivers of individuals with intellectual disabilities and autism spectrum disorder

Quality of life in caregivers of toddlers with autism features

Understanding factors that contribute to the quality of life (QoL) of primary caregivers of young autistic children can help researchers and clinicians provide high-quality support to caregivers and families. This study examined whether family demographic factors, parenting stress, and caregivers' perceptions of family-centered healthcare experiences uniquely predict caregivers' QoL. Participants were caregivers of toddlers with: features of autism (n = 119), other developmental delays (n = 101), and no developmental concerns (n = 264). We hypothesized that higher levels of perceived family-centered care would moderate (ameliorate) the relation between parenting stress and QoL. Higher levels of perceived family-centered care were associated with higher QoL for all groups but did not moderate the negative relation between parenting stress and QoL. Negative effects of parenting stress on QoL were stronger for caregivers of children with autism features compared to other groups. Future research is needed to determine how to provide additional support to caregivers with lower QoL, particularly caregivers who are experiencing income- or parenting-related stress and lower levels of family-centered care. Caregiver QoL is especially important to support across service settings (e.g., primary care, early intervention) during the birth-to-three period, when the process of accessing autism services can be challenging for caregivers.

The Effectiveness of Mindfulness-Based Interventions in Improving the Mental Health of Parents of Children with Intellectual or Developmental Disabilities: A Systematic Review and Meta-Analysis

This review aims to evaluate the effectiveness of mindfulness-based interventions in improving the mental health of parents of children with intellectual and developmental disabilities (IDDs), specifically focusing on outcomes such as parental stress, anxiety, depression, and parent-child relationships. A systematic search was conducted across multiple databases, including Web of Science, PubMed, Embase, and others, up to December 2024. Two reviewers independently screened studies, extracted data, and assessed bias risk using the Cochrane Risk of Bias tool. Studies involving parents of children with intellectual or developmental disabilities who received mindfulness-based interventions and reported psychological outcomes were included. The meta-analysis was conducted using Review Manager 5.4 software, with a random effects model applied. This systematic review included 15 studies (1124 participants), of which 14 were used for meta-analysis (1078 participants). The results indicate that mindfulness-based interventions reduced the stress levels [SMD = - 0.26, 95% CI (- 0.49, - 0.04)], depressive symptoms [SMD = - 0.37, 95% CI (- 0.66, - 0.08)], distress [SMD = - 0.26, 95% CI (- 0.43, - 0.09)] and anxiety symptoms[SMD = - 0.35, 95% CI (- 0.66, - 0.04)] of parents of children with IDDs, while also improving parent-child relationships [SMD = - 0.32, 95% CI (- 0.05, - 0.58)], although the effects were moderate. Subgroup analyses revealed that interventions lasting 8 weeks or more [SMD =- 0.41, 95% CI (-0.67, -0.14)] and those targeting only the parents [SMD = - 0.26, 95% CI (- 0.44, - 0.08)] showed some positive effects in improving parent-child relationships or parent stress. Mindfulness-based interventions appear to have a positive effect on improving the mental health of parents of children with IDDs. However, the evidence of their effectiveness in enhancing parental mindfulness remains inconclusive. Future studies should consider the key factors influencing intervention implementation and optimize the design of large-scale randomized controlled trials to systematically and comprehensively assess the effectiveness and applicability of mindfulness-based interventions.

Work stress and professional quality of life in disability support workers: The mediating role of psychological flexibility

BACKGROUND

This study aimed to explore perceived work stress and its association with burnout, compassion fatigue, and compassion satisfaction and the mediating effect of psychological flexibility on these relationships.

METHOD

Two hundred and fifty-one disability support workers across Australia reported on work stress, psychological flexibility, burnout, compassion fatigue, and compassion satisfaction through an online anonymous survey.

RESULTS

Perceived work stress was found to have a significant relationship with burnout, compassion fatigue, and compassion satisfaction. Psychological flexibility had a significant mediating effect on all three relationships.

CONCLUSION

These results highlight the role that psychological flexibility has in response to work stress and the development of burnout, compassion fatigue, and compassion satisfaction in disability support workers.

Mindfulness-Based Interventions for People with Autism Spectrum Disorder: A Systematic Literature Review

BACKGROUND/OBJECTIVES

Mindfulness-based interventions (MBIs) have emerged in recent years as a strong candidate for the treatment of a range of difficulties faced by individuals with autism spectrum disorder (ASD), including cognitive, emotional, and social aspects. Therefore, we aimed to conduct a review that systematically examined the efficacy of MBIs for individuals with ASD and their caregivers.

METHODS

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our literature search was conducted within the MEDLINE database. We included in the review only longitudinal or intervention studies focusing mainly on mindfulness principles, while we excluded mixed intervention studies. We only included studies that explicitly utilized quantitative methodologies for evaluating the outcomes of the interventions, including mental health indices (e.g., stress, anxiety, depression) and assessments of cognitive and social skills (e.g., attention, prosociality). We conducted also a risk of bias assessment through the method of the Cochrane risk of bias tool for intervention studies ROBINS-I.

RESULTS

Thirty-seven studies were included in the review, and we grouped the studies by the targets of the interventions, i.e., adults (n = 12), children and adolescents (n = 9), caregivers and medical staff (n = 13), and combined intervention for both children/adolescents and their parents/caregivers (n = 5). The reviewed papers seem to support the feasibility and utility of mindfulness interventions for persons with ASD and their caregivers, but any recommendations based on this body of evidence should be made with caution due to the overall low quality of the studies conducted so far.

CONCLUSIONS

The review reveals a positive outcome, including the alleviation of psychological distress, reduced behavioral problems, and enhanced cognitive and social skills in individuals with ASD. Despite such promising results, the review notes a limitation in the scarcity of MBIs for young patients, emphasizing caution in universally endorsing the existing literature. Moreover, the results underline the urgency of the exploration of tailored interventions for different ASD subgroups, considering varying levels of autism, and expanding support to teachers in educational settings.

The Effects of Mindfulness-Based Breathing on Strain, Burden, and Burnout in Family Caregivers of Palliative Care Patients: Randomized Controlled Study

The aim of this study was to assess the effects of online mindfulness-based breathing therapy combined with music on the levels of perceived strain, caregiver burden and burnout in caregivers of palliative care patients. This was a prospective, single-blind, randomized-controlled study. A total of 100 caregivers were randomly assigned to the intervention group (n = 50) and the control group (n = 50). Participants in the intervention group agreed to 3 sessions of mindfulness-based breathing therapy per week. Participants in the control group agreed to sit in a comfortable position in a quiet environment for 30 minutes for 3 consecutive days. We found statistical differences in groups in strain (P < .001), burden (P = .015) and burnout (P = .039) when comparing intervention and control groups. Mindfulness-based breathing therapy combined with music is a non-pharmacological approach that may reduce perceived strain, caregiver burden and burnout in caregivers.

The effect of mindfulness-based compassionate living training for informal caregivers of palliative inpatients on burnout and caregiving burden: a randomized controlled trial

This study was conducted to determine the effect of Mindfulness-Based Compassionate Living (MBCL) training given to the informal caregivers of palliative patients on burnout and caregiving burden. A single-blind, randomized, controlled, experimental study was conducted with 54 caregivers of patients admitted to a hospital palliative care unit. The participants were randomly allocated to the experimental group (n = 26) and control group (n = 28). The experimental group received MBCL training twice a week for 4 weeks. Data were collected before and after the intervention using the Maslach Burnout Inventory, Caregiver Burden Scale and Self-Compassion Scale-Short Form. The data were analyzed using kurtosis and skewness coefficients, number, percentage, mean, standard deviation, chi-square test, independent samples t test, Wilcoxon signed ranks test and Mann-Whitney U test in SPSS version 22.0. The informal caregivers in the experimental group demonstrated a significant decrease in emotional exhaustion and depersonalization scores and an increase in personal accomplishment and self-compassion scores in posttest assessments after the MBCL intervention (P < 0.05). All of these parameters differed significantly between the experimental and control groups after the intervention (P < 0.05). MBCL training seems to be effective in reducing emotional exhaustion and depersonalization and increasing personal accomplishment and self-compassion among informal caregivers of palliative inpatients. The results of this study can be generalized to the caretakers of patients receiving palliative care in university hospitals.

Conceptualization, use, and outcomes associated with compassion in the care of youth with childhood-onset disabilities: a scoping review

Introduction

To examine the scope of existing literature on the conceptualization, use, and outcomes associated with compassion in the care of youth with childhood-onset disabilities.

Methods

A protocol was developed based on the Joanna Briggs Institute (JBI) scoping review method. MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and EBSCOhost CINAHL, were searched.

Results

Eight studies were selected for inclusion; four used quantitative methodology, and four used qualitative methods. Compassion was not defined a priori or a posteriori in any of the included studies. The concept of self-compassion was explicitly defined only for parents of youth with childhood-onset disabilities in three studies a priori. The most reported outcome measure was self-compassion in parents of youth with childhood-onset disabilities. Self-compassion among parents was associated with greater quality of life and resiliency and lower stress, depression, shame and guilt.

Discussion

There is limited evidence on the conceptualization, use, and outcomes associated with compassion among youth with childhood-onset disabilities. Self-compassion may be an effective internal coping process among parents of youth with childhood-onset disabilities. Further research is required to understand the meaning of compassion to youth with childhood-onset disabilities, their parents and caregivers.

Systematic review registration

https://doi.org/10.17605/OSF.IO/2GRB4.

A model of hope as a protective measure to lower burnout and secondary traumatic stress among employees working in developmental and intellectual disabilities services

BACKGROUND

Burnout and secondary traumatic stress (STS) are problems for the workforce supporting people with developmental disabilities. This study investigated hope as a potential protective resource for burnout and STS among the developmental disability services workforce.

METHOD

One hundred and fifty-two non-supervisor caseworkers from a state agency, developmental disabilities division were recruited to participate in an anonymous web-based survey.

RESULTS

The analyses showed that hope was negatively associated with the three dimensions of STS (intrusion, avoidance, and arousal) and burnout. Controlling for tenure in the workforce and STS, the results of the hierarchical regression analyses showed that hope accounted for a significant incremental variance to burnout.

CONCLUSION

These findings provide support for emerging literature showing hope as a protective resource to workforce burnout.

The Perspective of Administrators of Intellectual Disability Organizations on the COVID-19 Pandemic

OBJECTIVE

To learn about the challenges, policies, and needed resources to serve people with intellectual disability and protect staff during the COVID-19 pandemic. From the perspective of intellectual disability service providers.

METHODS

We conducted in-depth qualitative interviews with 16 intellectual disability organization administrators throughout Illinois, USA from November 2020 through February 2021. We coded and analyzed the data using thematic analysis.

RESULTS

Three major themes emerged: (1) COVID-19 caused considerable challenges to people with intellectual disability and staff and service providers, (2) intellectual disability organizations reinvented service provisions in response to COVID-19 challenges, and (3) the interrelatedness of intellectual disability organizations, public policies, and community entities became evident.

CONCLUSIONS

Exhibiting responsiveness to needs and developing innovative solutions were strategies championed by intellectual disability organizations during the pandemic. Fostering collaboration with community entities may assist these organizations in navigating pandemic challenges and developing resilient infrastructure for future environmental threats.

Mindfulness and compassion training for health professionals: A qualitative study

Background

Compassion is a key component of quality care. Encouraging Health Care Professionals (HCPs) to develop a patient-centered care relationship through mindfulness and compassion training may be beneficial for both patients and HCPs.

Method

We assessed the impact of a compassion-centered mindfulness program [i.e., the Mindfulness Based (MB) CARE program] on healthcare practice conducting 10 phone interviews with HCPs who experienced the program.

Results

The training had an overall positive impact on the HCPs ability to feel compassion toward their patients and themselves, helped them develop kindness toward themselves and their patients, and enhanced their attention to their patient's needs and theirs. Participants were better able to accept the difficult work experiences or those their patients experienced, with more perceived equanimity and less reactivity.

Conclusion

Professional mindfulness and compassion training programs could be operational levers for institutions aiming at fostering more compassionate HCPs-patients relationships.

Burnout, Depression, and Anxiety Levels among Healthcare Workers Serving Children with Autism Spectrum Disorder

Burnout in healthcare workers (HCWs) is defined as a state of emotional, physical, and mental exhaustion that results from unmanaged, excessive, and long-term workplace stressors. This study aims to assess the prevalence of burnout and the levels of anxiety and depression among HCWs who primarily work with children who have autism spectrum disorder (ASD). A quantitative cross-sectional survey was conducted utilizing the Arabic version of the Maslach Burnout Inventory (MBI), Areas of Worklife Survey (AWS), Patient Health Questionnaire for Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire for Depression (PHQ-9). Among the 381 participants working in autism centers, the majority were young Saudi females (326) working full-time as specialists in the private sector with less than five years of experience. The HCWs' overall mean scores on the three Maslach Burnout Inventory (MBI) subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were 62%, 23.7%, and 76.5%, respectively. A total of 51.4% of HCWs reported moderate to high anxiety levels on GAD-7, and 47.8% showed moderate to very high levels of depression on PHQ-9. The mean perceived EE converged significantly but negatively on their overall mean perceived satisfaction with AWS (p-value < 0.001), demonstrating that greater emotional fatigue predicts less satisfaction with their work. The PA scores correlated significantly and positively with their overall mean satisfaction with their AWS score (p-value < 0.001). Considering sociodemographic variables, HCWs aged between 20-29 years have significantly lower mean PA scores than HCWs aged thirty and older (p = 0.007). Also, male HCWs perceived significantly higher work-related DP than females. More research is required to determine the nature of variables that contribute to burnout, depression, and anxiety in HCWs helping children with ASD.