Mindfulness-Based Stress Reduction: An Intervention to Enhance the Effectiveness of Nurses' Coping With Work-Related Stress

Embedding Mindfulness-Based Resiliency Curricula Into Surgical Training to Combat Resident Burnout and Improve Wellbeing

Surgery residents are at a higher-than-average risk of burnout syndrome, which is characterized by emotional exhaustion, depersonalization, and a sense of ineffectiveness. This risk of burnout can translate to increased stress and distress in trainees, poor performance, as well as worse patient outcomes. Therefore, developing and implementing burnout reduction strategies that are feasible, acceptable, and effective among surgical residents is paramount. Studies demonstrate that inherent mindfulness is associated with improved resiliency, reduced stress and burnout, as well as improved cognitive and motor skill performance. Fortunately, mindfulness is a skill that can be developed and maintained through targeted mindfulness-based interventions embedded within surgical education curriculum. Here, we present the data supporting the use of mindfulness as an integral part of burnout reduction efforts in surgical trainees as well as highlight evidence-based strategies for implementation in diverse surgical training environments.

Feasibility of a Mindfulness Education Module for Nurses: An Evidence-Based Practice Project

Nurse burnout is a well-defined problem that has been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic and negatively affects nurses' mental health, nursing shortages, patient safety, and quality of care. Evidence shows that mindfulness is an effective strategy for managing stress and decreasing burnout among nurses. This article describes an evidence-based practice project that translated this evidence into practice via a vetted mindfulness educational intervention for nurses on a pulmonary medicine unit and a medical intensive care unit. The goal of this project was to assess the feasibility of this educational intervention, processes, and outcomes with the goal to extend the project hospital-wide. Preintervention levels of nurse burnout were assessed using the validated Copenhagen Burnout Inventory. For both units, personal and work-related burnout were in the moderate range and patient-related burnout was in the mild range. Postintervention surveys completed by participant nurses and the nurse managers of both units supported the feasibility of this education module. Future implementation of annual mindfulness education was supported through both participant and administrative feedback. [J Contin Educ Nurs. 2023;54(11):516-523.].

Academic burnout in psychology and health-allied sciences: the BENDiT-EU program for students and staff in higher education

Studying at university involves demanding academic and clinical training requirements for students from Psychology and other health-allied fields, potentially having severe physical and mental health implications. Existing training programs for addressing burnout have focused thus far on specific areas (e.g., stress management, physical exercise, mindfulness meditation, etc.) with promising outcomes. However, no comprehensive programs have been developed to train students and staff in the early identification of burnout signs and characteristics as well as in self-assessing personal needs and habits (i.e., primary prevention), or in identifying community resources and evidence-based strategies to overcome burnout (i.e., secondary prevention). This paper describes the content development, refinement, and piloting process of the BENDiT-EU program as part of a European collaborative to address academic burnout for health-allied students. Piloting results showed that participants viewed the program positively and provided helpful suggestions for content improvement and training delivery. Future research directions should target experimental investigations of the program's effectiveness and the longitudinal interaction of burnout with other variables (e.g., resilience).

Features of Self-Organization during the Process of Mindfulness-Based Stress Reduction: A Single Case Study

Compared to the extensive evidence of the effectiveness of mindfulness-based interventions, there is only a limited understanding of their mechanisms of change. The three aims of this study are (1) to identify features of self-organization during the process (e.g., pattern transitions), (2) to obtain an impression of the effects of continuous self-assessments and feedback sessions on mindfulness-related stress reduction, and (3) to test the feasibility of high-frequency process monitoring and process feedback. Concerning aim (1), the specific hypothesis is that change will occur as a cascade of discontinuous pattern transitions emerging spontaneously in the sense of not being a reaction to external input. This single case study describes changing patterns of multiple time series that were produced by app-based daily self-assessments during and after an 8-week mindfulness-based stress reduction program. After this MBSR program, the participant (a female nurse) continued the self-assessment and the mindfulness practice for a further 10 months. The results confirm findings on the positive effects of mindfulness programs for healthcare professionals, especially on coping with work-related stress. The analysis of the time series data supports the hypothesis of self-organization as a possible mechanism of change manifesting as a cascade of phase transitions in the dynamics of a biopsychosocial system. At the end of the year, the participant reported a beneficial impact of daily monitoring and systematic feedback on the change process. The results underline the feasibility and usefulness of continuous high-frequency monitoring during and after mindfulness interventions.

Effectiveness of mindfulness-based interventions on burnout and self-compassion among critical care nurses caring for patients with COVID-19: a quasi-experimental study

BACKGROUND

Workloads in intensive care units (ICUs) have increased and extremely challenging ethical dilemmas were generated by the coronavirus disease 2019 (COVID-19) pandemic. ICU nurses experience high-stress levels and burnout worldwide. Egyptian studies on the effectiveness of mindfulness-based intervention (MBI) among ICU nurses are limited, although MBI has been shown to reduce stress and burnout.

METHODS

This quasi-experimental study included 60 nurses working in three hospitals in El-Beheira, Egypt. Participants were randomly allocated to one of the two groups: intervention or control (30 participants per group). The participants in the intervention group (MBI) received 8 MBI sessions, whereas the control group received no intervention. The Maslach Burnout Inventory, the Five-Facet Mindfulness Questionnaire (FFMQ), and the Self-Compassion Scale were used to assess the outcomes. Additionally, demographic and workplace data were collected.

RESULTS

The post-test score of emotional exhaustion after MBI for 8 weeks significantly decreased in the MBI group to 15.47 ± 4.44 compared with the control group with 32.43 ± 8.87 (p < 0.001). The total Self-Compassion Scale significantly increased because of the mindfulness sessions 94.50 ± 3.83 for the MBI group vs. 79.00 ± 4.57 for the control group (p < 0.001). The post-test score of the FFMQ significantly increased to 137.03 ± 5.93, while the control group's score decreased to 114.40 ± 7.44, following the MBI sessions (p < 0.001). As determined by Cohen's d test, the effect size of MBI training is quite large, on the three burnout scale dimensions (emotional exhaustion, depersonalization, and personal achievement), as well as the total score of the mindfulness and self-compassion scales.

CONCLUSION

This study provides preliminary evidence that MBI sessions were effective in reducing emotional exhaustion and depersonalization and increasing levels of mindfulness and self-compassion among critical care nurses.

Coping and Caregiving: Leveraging Environmental Design to Moderate Stress Among Healthcare Workers in the Emergency Department Setting

BACKGROUND

Due to exposure to overwhelming work stressors, approximately half of emergency department (ED) physicians and nurses experience burnout, leading to lower productivity, lower quality of care, higher risk of medical errors, higher rates of absenteeism, and eventually turnover. Growing evidence suggests that the physical environment can be leveraged to support healthcare workers' well-being.

OBJECTIVES

This study aimed to identify (1) self-care behaviors that healthcare workers engage in to help them cope with job-related stress, (2) where they engage in those behaviors, (3) attributes of the built environment that may support coping behaviors.

METHODS

A mixed-methods study was conducted in three EDs, using online questionnaires (n = 85) and interviews (n = 20).

RESULTS

Job-related stress was derived from interruptions, workload and inability to take breaks, insufficient workspace, lack of privacy, unpredictability of EDs, and security concerns. Talking with a colleague, getting something to eat or drink, listening to music, and taking a walk were considered destressing activities. The bathroom was considered a place for destressing by the majority of participants, followed by outside areas, physician-only areas, and care team stations. Supportive environmental features included sufficient workspace, maximized privacy, reduced noise and clutter, controlled temperature and lighting, spaces for decompressing, spaces for documentation, close-by breakrooms with enough eating space and massage chairs, chairs with back support, standing desks, food options, and convenient bathrooms.

CONCLUSIONS

Design decisions play an important role in supporting stress reduction among healthcare workers. This study provides several strategies to achieve this aim.

The Moderating Effects of Self-Care on the Relationships between Perceived Stress, Job Burnout and Retention Intention in Clinical Nurses

This study determines the importance of nurses' self-care by identifying its effects as a moderating variable on the relationships between perceived stress, job burnout, and retention intention in clinical nurses. Hence, 174 clinical nurses who worked at two university hospitals and one general hospital located in Seoul, South Korea, participated in this study. As the hospitals required the use of recruitment notices, convenience sampling methods were adopted to recruit volunteers. The data were collected using the perceived stress scale, the burnout assessment tool, the nurse retention index, and the self-care assessment worksheet. Descriptive statistics were used to analyze the general characteristics of participants, and t-test and analysis of variance were conducted for comparisons. Moderated multiple regression was conducted to verify the moderating effects of self-care on the relationships between perceived stress and retention intention and between job burnout and retention intention. The results revealed that the effect of perceived stress on retention intention and the moderating effect of self-care on the relationship between perceived stress and retention intention were not significant, whereas job burnout had a direct effect on retention intention, and self-care had a positive moderating effect on job burnout. Therefore, it is necessary to consider an instructional program on the importance of self-care and conduct campaign activities at the organizational level. Moreover, various support structures should be provided at the organizational level such that nurses can reduce their levels of job burnout.

Effects of psychological intervention on empathy fatigue in nurses: A meta-analysis

Objective

The purpose of this meta-analysis is to systematically assess the effects of psychological intervention on empathy fatigue among nursing staff.

Method

Five electronic databases are searched separately from their establishment to April 8th, 2022. The research team independently performs paper selection, quality assessment, data extraction and analysis for all included studies. PRISMA guidelines are used to report this meta-analysis.

Results

A total of seven randomized controlled trials (RCTs) covering 513 nursing staff are included. The meta-analysis results show that the empathy fatigue score (SMD = -0.22, 95% CI: -0.42~-0.02, P = 0.03) and burnout (SMD = -0.37, 95% CI: -0.56~-0.19, P < 0.001) are lower than the control group. The empathy satisfaction score of the psychological intervention group is higher than that of the control group (SMD = 0.45, 95% CI: 0.27-0.63, P < 0.001). The differences are statistically significant (P < 0.05). Subgroup analysis finds significant heterogeneity in the impact of different departments on psychological intervention at ≥6 weeks (I ² = 71%, P = 0.01) and <6 weeks (I ² = 0%, P = 0.75) (P = 0.05). Different departments also show significant heterogeneity in the effects of psychological intervention: ICU (I ² = 73%, P = 0.02), pediatric (I ² = 53%, P = 0.14) and other departments (I ² = 0%, P = 0.63). The differences are statistically significant (P = 0.0007). Besides, the results show that both mindfulness intervention (SMD = 0.50, 95% CI: 0.24-0.77, P = 0.0002) and other interventions (SMD = 0.41, 95% CI: 0.16-0.65, P = 0.001) are statistically significant difference in the level of empathy satisfaction between the psychological intervention group and the control group.

Conclusion

Psychological intervention has a coordinated improvement effect on empathy fatigue, empathy satisfaction and burnout, and can also improve the quality of life of nursing staff.

Mindfulness as a tool for reducing stress in healthcare professionals: An umbrella review

BACKGROUND: Health care providers (HCPs) and health care students experience a huge amount of stress due to high workloads and pressure to perform and are likely to develop anxiety, depression and burnout. OBJECTIVE: The objective was to carry out an umbrella review of systematic and narrative reviews on the effectiveness of mindfulness-based interventions in reducing stress and improving well-being in HCPs and health care students. METHODS: Systematic and narrative reviews that examined the impact of mindfulness-based interventions on HCPs and healthcare students’ perceived stress were identified through a systematic search of three electronic databases: PubMed, Scopus and Web of Science. RESULTS: Fifteen articles were included in the analysis: eleven systematic and four narrative reviews. Studies’ quality varied from critically low to high. The different interventions showed positive results in reducing stress in both HCPs and students, with mindfulness-based stress reduction (MBSR) course having the major impact. CONCLUSIONS: MBSR techniques and other Mindfulness Based Interventions resulted to be potentially effective in reducing stress. However, despite the vast amount of data collected by the studies and the promising results, several limitations affected the validity of the studies. Therefore, more research that considers the critical aspects of this field is required, in order to provide more reliable results.

The Effects of a Forest Therapy on Work-Related Stress for Employees in the Manufacturing Industry: Randomized Control Study

Background

The effect of a forest therapy in a natural environment noted that the forest therapy induced a state of relaxation among workers, thereby decreasing cortisol levels and work-related stress.

Objective

The primary objective of this study is to determine the effects of the forest therapy for employees in the manufacturing industry on psychological stress responds, stress hormone and heart rate variability (HRV). The secondary objective is to determine the effects of the forest therapy for employees in the manufacturing industry on cytotoxic activity of natural killer (NK) cells, health-related quality of life and mood states compare to urban untreated and remained in urban environment.

Methods

Forty-two employees were recruited from a single workplace located in Incheon city, Republic of Korea. Participants were allocated to either an experimental group (n= 21), wherein they participated in the forest therapy and or a control group (n= 21), wherein they were given no treatment. Participants were assigned to these groups on a randomized, open-label basis. Pre and post-test measures of natural killer (NK) cell activity, salivary cortisol, heart rate variability (HRV), health-related quality of life, stress response, and mood states were taken for both groups.

Results

The results showed that participants who took part in the forest therapy showed greater physiological improvement when compared to those in the control group, as indicated by a significant increase in some HRV measures. The forest therapy also contributed to a significantly greater decrease in work-related stress symptoms and a significantly greater improvement in health-related quality of life and mood states compared to participants in the control group.

Conclusions

These results may suggest that the forest therapy could be an effective means of relaxation technique, reducing stress and leads to an increase in positive mood for employees in the manufacturing industry.

Four Weeks of a Neuro-Meditation Program Improves Sleep Quality and Reduces Hypertension in Nursing Staff During the COVID-19 Pandemic: A Parallel Randomized Controlled Trial

The purpose of this study was to examine the effectiveness of a neuro-meditation program to support nurses during the COVID-19 pandemic. Forty-five (10 men and 35 women) nurses were classified into three groups based on their systolic blood pressure: normotensive (G-nor; n = 16, 43.8 ± 11.0 year), hypertensive (G-hyp; n = 13, 45.2 ± 10.7 year) and control (G-con; n = 16, 44.9 ± 10.6 year). Using a parallel, randomly controlled design across a 4-week period, 10 × 30-min sessions using the Rebalance© Impulse were completed. Sleep was assessed by wrist actigraphy and subjective sleep questionnaires; perceived sleep quality, Ford Insomnia Response to Stress Test questionnaire and the Spiegel Sleep Quality questionnaire (SSQ). Blood pressure, resting heart rate, mean heart rate (HRmean), heart rate variability index (RMSSD), cortisol, and alpha-amylase were also measured. Statistical analysis was completed using factorial ANOVA. Sleep improved in the G-hyp group; SSQ (p < 0.01); perceived sleep quality (p < 0.01); sleep efficiency and fragmentation index (p < 0.05). In the G-nor group, sleep was improved to a lesser extent; perceived sleep quality (p < 0.01). A significant time-group interaction was reported in resting heart rate (p < 0.01), systolic blood pressure (p < 0.01), and diastolic blood pressure (p < 0.05) with these measures being significantly reduced in the G-hyp group. RMSSD increased in the G-nor group (p < 0.01). This initial evidence suggests that neuro-meditation reduces excessive sympathetic activity, promoting enhanced sleep quality and autonomic control during periods of increased work-related stress.

Clinical Trial Registration

The study was conducted at Bioesterel, Sophia-Antipolis, France as a clinical trial: Neuro-meditation improves sleep quality, https://www.drks.de/ui_data_web/DrksUI.html?locale=en, DRKS00025731.

Emergency Department Nurses' Experiences of a Mindfulness Training Intervention: A Phenomenological Exploration

Purpose: The purpose of this study was to explore emergency care nurses' experiences of an intervention to increase compassion and empathy and reduce stress through individual mindfulness training delivered via workshops and a smartphone application. We also explored how the nurses felt about the practical and technical aspects of the intervention. Design: Qualitative interview study. Method: Individual interviews were conducted with eight of the 56 participants in the intervention study and used phenomenological analysis to illuminate how they made sense of their lived experiences of mindfulness training. Findings: Three themes illuminated the nurses' experiences: becoming aware, changing through mindfulness, and gaining the tools for mindfulness through workshops and the mobile application. The first two themes expressed personal experiences, whereas the third expressed experiences of the practical and technical aspects of the intervention. Most nurses found the mobile application easy to use and effective. Conclusions: Emergency care nurses can feel that the awareness and changes that come with mindfulness training benefit them, their colleagues, and the patients for whom they care. The findings also provide insights into the challenges of practicing mindfulness in a busy emergency care setting and into the practical aspects of using a smartphone application to train mindfulness.

The effectiveness of adapted group mindfulness-based stress management program on perceived stress and emotion regulation in midwives: a randomized clinical trial

Background

Midwives' stress can have negative consequences on their emotional state, burnout, and poor quality of midwifery care. This study aimed to determine the effectiveness of an adapted mindfulness-based stress management program on perceived stress and the emotional regulation of midwives.

Methods

The study was a parallel randomized clinical trial on the midwives working in general hospitals of Zanjan, Iran. In this study, 121 midwives registered to participate based on the census sampling method were screened using a cut point of ≥ 28 in the Perceived Stress Scale (PSS). From the initial sample, 42 subjects had inclusion criteria assigned to two groups of control (n = 21) and intervention (n = 21) using online random allocation. The intervention group received an 8-week adapted mindfulness-based stress management program. This program emanates from the Kabat-Zinn's MBSR program, which has been adjusted according to the Iranian culture. The ANCOVA and repeated measure analysis of variance test were used to compare groups over time.

Results

The results showed that the group intervention effectively affected perceived stress (P = 0.001) and difficulty in emotion regulation during the post-intervention period (P = 0.001). Moreover, the interventions were effective in emotion regulation (P = 0.003), but it was not effective on perceived stress (P = 0.125) at the 3-month follow-up.

Conclusions

This adapted mindfulness-based program successfully reduced stress and increased emotion regulation strategies in midwives; however, the long-term outcomes of this treatment program need further consideration.

Evaluation of Guided Respiration Mindfulness Therapy (GRMT) for Reducing Stress in Nurses

Guided respiration mindfulness therapy (GRMT) is a clinical model of breathwork that has shown promise as a treatment for depression, anxiety, and stress. This study examined the effectiveness of GRMT as a holistically oriented intervention for reducing psychological distress in nurses. Sixty-two nurses were assigned to either five sessions of GRMT or 5 sessions of a mindfulness-based intervention (MBI) comparison condition which were conducted over 5 weeks. A no-treatment control was also included. Session-by-session change in depression, anxiety, and stress, along with change in mindfulness and self-compassion were assessed. Multilevel analysis showed GRMT resulted in statistically significant reductions in overall psychological distress, anxiety, and stress levels, as well as significant increases in mindfulness and self-compassion with large to very large effect sizes. On all measures, GRMT performed better than the comparison MBI intervention which showed no significant effect on stress levels. Results suggest that GRMT can provide nurses with an effective group intervention for reducing stress, and increasing mindfulness and self-compassion which are foundational elements of self-care for the holistic nurse.

Leader Psychological Need Satisfaction Trickles Down: The Role of Leader-Member Exchange

This article addresses the impact of leader psychological need satisfaction on employees. We draw on the self-determination theory (SDT) and leader-member exchange (LMX) theory to investigate if and how leader psychological need satisfaction trickles down to employee psychological need satisfaction. Adopting a multi-actor, multilevel design, results from 1036 leader-employee dyads indicate that employee-rated LMX mediates the trickle-down effect of leader psychological need satisfaction. Additional analyses of leader psychological needs show that leader competence is the main psychological need that underlying this relationship. We also found an unexpected negative association between leader autonomy need satisfaction and employee competence need satisfaction. Overall, this study shows the importance of both (1) leaders' psychological need satisfaction and (2) employee perceptions of the relationship quality for employee psychological need satisfaction.

Current occupational well-being status and protective and risk factors of male nurses in Chengdu, China: A cross-sectional study

Aims

This study explores the current occupational well‐being status of male nurses in Chengdu, China, and identifies the concomitant protective and risk factors.

Design

This study has a cross‐sectional survey design.

Methods

From 13 July to 21 July 2019, a cross‐sectional survey involving 209 male nurses in 7 tertiary hospitals in Chengdu, China, was conducted using a general information questionnaire, the Mindfulness Attention Awareness Scale, the Acceptance and Action Questionnaire‐II, the Professional Identity Scale and the Nurses' Occupational Well‐being Scale.

Results

The score of male nurses' occupational well‐being was 78.7 ± 14.2. The higher the mindfulness and professional identity (p = .002, p < .001, respectively), the higher the occupational well‐being of male nurses. The lower the experiential avoidance, the higher the occupational well‐being (p = .001). The highest occupational well‐being was found among male nurses who had less than 5‐years' working experience.

Conclusions

The results suggest that male nurses' occupational well‐being was at a moderate level. Mindfulness and professional identity were the protective factors of male nurses' occupational well‐being, and experiential avoidance was the risk factor. Nursing managers should ascertain male nurses' current occupational well‐being and the influencing factors and formulate effective improvement strategies. Male nurse courses on enhancing mindfulness and professional identity and reducing experiential avoidance should be explored, with a focus on helping nurses improve their professional well‐being and, in turn, prospectively reducing the turnover rate.

Effects of mindfulness-based stress reduction on psychological distress in health workers: A three-arm parallel randomized controlled trial

Mindfulness-based Stress Reduction (MBSR) has shown good efficacy for improving wellbeing in employees experiencing occupational stress. However, comparisons with other interventions, longer-term follow-up, and data from varying sociocultural contexts are lacking. This three-arm, parallel randomised controlled trial (RCT) examined the effects of MBSR on psychological distress in non-physician health workers in direct contact with patients. 105 participants were randomly allocated to either: (1) MBSR (N = 35), (2) Stress Management Course (SMC; N = 34) or (3) wait-list (N = 36). Participants and those assessing outcomes were blinded to group assignment. Participants completed questionnaires pre- and post-intervention and four months after the intervention. Psychological distress was measured using the General Health Questionnaire (GHQ-12) and Outcome Questionnaire (OQ-45). Secondary outcomes included perceived stress, job satisfaction, mindfulness skills and changes in salivary cortisol. 77 participants completed measures post-intervention and 52 at 4-month follow-up. MBSR showed a post-intervention effect in reducing GHQ-12 (ß = -0.80 [SE = 1.58] p < 0.01) and OQ-45 (ß = -0.72, [SE = 5.87] p < 0.05) psychological distress, compared to SMC and in reducing GHQ-12 (ß = -1.30 [SE = 1.38] p < 0.001) and OQ-45 (ß = -0.71, [SE = 5.58] p < 0.01) psychological distress compared to wait-list condition. In our secondary outcome, only MBSR was associated with a decrease in the cortisol awaking response by 23% (p < 0.05). At follow-up, only effects of MBSR on the psychological distress 'social role' subscale (ß = -0.76 [SE = 1.31] p < 0.05) remained significant, compared to SMC. In conclusion, MBSR appears useful in reducing short-term psychological distress in healthcare workers, but these effects were not maintained at follow-up. Trial registration: ISRCTN12039804.

Effectiveness of mindfulness-based interventions on psychotherapy processes: A systematic review

In the field of psychotherapy, scientific research has highlighted the importance of empathy and therapeutic alliance in regard to the effectiveness and better results of psychological treatments. In recent years, mindfulness-based interventions (MBIs) have shown to be effective at increasing empathy and therapeutic alliance and how this could affect the patients' symptomatology. In this study, we conducted a systematic review of the effectiveness of MBIs applied to psychotherapists to improve their empathy, the therapeutic alliance and the patients' symptomatology. Sixteen studies evaluating the impact of an MBI on some of these variables were identified, of which six included measures evaluated by the patients whose ahe MBI. The risk of bias of the included studies was analysed following the methodological standards. We found very different designs and methodologies in the studies included in this review, with few of them including a control group. The results show a limited increase in empathy, measured by the psychotherapist, after an MBI. However, the results in therapeutic alliance are not conclusive, as well as the improvements in the perception of patients about their symptomatology. It is concluded that MBIs can have a beneficial effect on the psychotherapeutic practice, through the development of psychotherapists' empathy. Future research would require new studies with a higher methodological quality, and in which the effects of MBIs on empathy, therapeutic alliance and patients' symptomatology and the relationships between them are analyzed.

Reducing Stress and Burnout in Military Healthcare Professionals Through Mind-Body Medicine: A Pilot Program

INTRODUCTION

A 6-week mindfulness training course, the Mind-Body Medicine (MBM) pilot program for staff, was implemented at a large military treatment facility to examine the preliminary efficacy of the program in reducing stress and burnout in military healthcare professionals.

MATERIALS AND METHODS

A retrospective analysis was conducted of data collected from a single-arm prospective MBM pilot program. The program was designed to help staff members increase their awareness of burnout and its consequences and to learn how to utilize mindfulness-based self-care practices as a means for reducing stress and preventing burnout at work. Participants attended a 2-hour MBM group each week for a total duration of 6 weeks. Assessments of stress, resilience, anxiety, somatic symptoms, functional impairment, sleep quality, quality of life, and burnout were administered at baseline (T1), upon completion of the 6-week program (T2), and at least 3 months after program completion (T3). Multilevel modeling was used as the primary statistical model to assess changes in outcomes. Fifty-nine staff members completed assessments at T1, 31 (52.5%) at T2, and 17 (28.8%) at T3.

RESULTS

Participants showed improvements on scores of perceived stress, resilience, anxiety, somatic symptoms, quality of life, and burnout variables from T1 to T2 and from T1 to T3 (P < .05). Additionally, they reported improvements in their knowledge, understanding, and utilization of MBM concepts and practices from T1 to T2 and from T1 to T3 (P < .05).

CONCLUSIONS

Results from this pilot suggest that the MBM program has the potential to reduce occupational stress and burnout and improve well-being in military healthcare professionals.

Effectiveness of a Mindfulness and Self-Compassion Standard Training Program versus an Abbreviated Training Program on Stress in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain

Stress is one of the most common problems among healthcare professionals, as they are exposed to potentially stressful and emotionally challenging situations in the workplace. Mindfulness-based stress reduction (MBSR) training programs have been shown to decrease stress. The objective of this study was to compare the effectiveness of an abbreviated 4-weeks MBSR training program in relation to a standard 8-weeks one on the stress levels. A controlled and randomized clinical trial was designed, in which 112 tutors and resident intern specialists in Family and Community Medicine and Nursing of six Spanish National Health System teaching units (TUs) participated. Participants included in the experimental groups (EGs) received a MBRS training program (standard or abbreviated), while control group (CG) participants did not receive any intervention. The stress levels were assessed by the Perceived Stress Questionnaire (PSQ) in three different moments during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant reduction in stress (F_(2,91) = 5.165; p = 0.008; η² = 0.102) in the post-test visit, attributable to the implementation of the standard training program, but without the maintenance of its effects over time. No significant impact of the abbreviated training program on stress levels was observed in the intergroup comparison. A standard 8-weeks MBSR training program aimed at tutors and resident intern specialists in Family and Community Medicine and Nursing produces significant improvements in stress levels compared with the abbreviated intervention and no intervention. New studies about abbreviated training programs are needed to provide effective treatments which improve well-being of these professionals.

Mindfulness Is Associated With Lower Stress and Higher Work Engagement in a Large Sample of MOOC Participants

Objective: This study aimed to understand the associations between mindfulness, perceived stress, and work engagement in a very large sample of English-speaking adults, from 130 different countries. It also aimed to assess participants' self-reported changes following a 6-week mindfulness massive open online course (MOOC). Methods: Participants in the 6-week MOOC were invited to complete pre-post online surveys. Cross-sectional associations were assessed using univariate linear models, followed by structural equation models to test mediation pathways in baseline data (N = 16,697). Self-reported changes in mindfulness, stress and engagement following training were assessed using paired t-tests (n = 2,105). Results: Each standard deviation unit increase in mindfulness was associated with a 0.52 standard deviation unit decrease in perceived stress, and with 0.06 standard deviation unit increment in work engagement. 73% of the influence of mindfulness on engagement was direct. Following the mindfulness MOOC, participants reported higher mindfulness (d = 1.16), reduced perceived stress (d = 1.00) and a small improvement in work engagement (d = 0.29). Conclusions: Mindfulness was associated with lower perceived stress and higher work engagement in both cross-sectional and longitudinal analyses. These findings support mindfulness as a potentially protective and modifiable personal resource. The MOOC format offers a low cost, highly accessible means for extending the reach and potential benefits of mindfulness training to large numbers of people.

Gender Gap in Mindfulness Assessment Among Italian Nurses: A Pilot Descriptive Study

"Purpose: The present study aimed to explore gender differences in the mindfulness tendency, specifically in the awareness and attention dimensions and also in the observing, describing, acting with awareness and accepting without judgement in Italian nurses. Methods: In June 2020 an on-line questionnaire was administered to nurses in order to analyze any differences both in the Mindfulness Attention Awareness Scale (MAAS) and the Kentucky Inventory of Mindfulness Skills (KIMS) according to gender variable. Findings: 200 questionnaires were collected. Findings showed significant higher MAAS total score in males than females (p=.004). Additionally, by considering the four sub dimensions in the Mindfulness tendency, females reported significant higher levels in some items of “Observe” (p=.004) and “Act with awareness” (p=.001) than males, while males reported significant higher scores in the “Accept without judgement” than females (p<.001). Conclusions: The present study was a pilot research on exploring gender differences in mindfulness in Italian nurses in order to hope that it will be only the beginning of empirical research on this topic and to better address future mindfulness training courses addressed to nurses by emphasizing certain aspects of mindfulness for females compared to males and vice versa."

Impact of a Mindfulness-Based, Workplace Group Yoga Intervention on Burnout, Self-Care, and Compassion in Health Care Professionals: A Pilot Study

OBJECTIVE

To investigate whether a workplace, group mindfulness-based yoga intervention could help manage burnout and improve wellbeing among health care professionals.

METHODS

A total of 43 health care professionals participated in 8-week supervised workplace, group mindfulness-based yoga activities. The authors used a single-sample, pre-post design. At two points in time (baseline and postintervention), participants completed a set of online measures assessing burnout, depression, anxiety, stress, resilience, and compassion. The authors used linear mixed model analysis to assess changes in outcome measures.

RESULTS

Participants had improvements after the 8-week intervention. At postintervention, they had significantly better scores on personal accomplishment, depression, anxiety, stress, perceived resilience, and compassion. Participants had a positive perception of the yoga intervention.

CONCLUSION

Group mindfulness-based yoga program may be convenient and low-cost approach to support health and wellbeing among health care professionals.

An Exploratory Study of a 3-Minute Mindfulness Intervention on Compassion Fatigue in Nurses

This study shows that breathing mindfully for 3 minutes over a period of 4 weeks, positively affects compassion fatigue in nurses. A nonrandomized, pre/postintervention study was conducted using a 3-minute attentional breathing intervention. Thirty-two nurses participated over 4 weeks. The intervention demonstrated statistically significant reductions in compassion fatigue measures.

Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain

Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.

Mindfulness-based programmes to reduce stress and enhance well-being at work: a realist review

OBJECTIVES

To understand how and why workplace mindfulness-based programmes (MBPs) work or do not work.

DESIGN

A realist review.

ELIGIBILITY CRITERIA FOR SELECTION

We considered any studies (experimental quasi-experimental, observational, qualitative and mixed-methods studies) of workplace MBPs as long as they provided data to explain our programme theories. All MBP formats and delivery modes were included.

ANALYSIS

Consistent with realist review methodology, we systematically screened and analysed data to explain how and why workplace MBPs work or do not work. These explanations were consolidated into a programme theory augmented by theories from organisational literature, such as conservation of resources theory.

RESULTS

Findings from 75 primary studies suggest that workplace MBPs enable participants (including healthcare professionals) to deal more skillfully with stressful events and improve their well-being. The mechanisms involved can be grouped around awareness/self-regulation, acceptance/compassion, feeling permitted to take care of self, sense of growth and promise of goal attainment. In order for professionals to invest in an MBP and benefit from it, it is important that they feel safe to engage with self-care at work and share emotional difficulties among peers. It is also important that employees are able to link the programme and its activities to existing goals and practices. Concerns of being non-productive, of not getting work done or of being exposed in front of colleagues can result in strategic use of brief mindfulness exercises, non-adherence or drop-out.

CONCLUSIONS

Simply offering an MBP to (healthcare) professionals in order to reduce stress and enhance well-being does not suffice. A supportive environment must exist in order for the programme's benefits to be reaped.

PROSPERO REGISTRATION NUMBER

CRD42018086280.

The Health of Health Care Professionals

Health care professionals represent a population at high risk for poor health. Although this may be counterintuitive given their expertise in health, the high stress and long hours of many medical work environments present challenges for health care professionals to engage in healthy lifestyle behaviors. This is extremely problematic for the health and well-being of both health care professionals and the patients they treat. Medical settings are encouraged to implement interventions that intervene at both the enviornmental and personal level to help faciliate behavior change among health care providers.

The Use of Mindfulness-Based Interventions to Mitigate Stress and Burnout in Nurses

Research indicates that mindfulness-based interventions can positively change how individuals perceive stress and burnout. Part of the responsibility of mitigating stress and burnout among nurses should be placed upon the organization; thus, nursing professional development practitioners are in a unique position to engage nurses in mindfulness-based practices. Therefore, a quality improvement project aimed to decrease perceived stress and/or burnout among nurses on three pilot units was implemented utilizing evidence-based mindfulness interventions.

Effect of four weeks of integrated yoga intervention on perceived stress and sleep quality among female nursing professionals working at a tertiary care hospital: A pilot study

BACKGROUND

Studies have reported that significant nursing professionals experience tremendous stress which often affects their sleep quality leading to poor well-being. Yoga being a mind body intervention reported to improve sleep quality and reduce stress.

AIM

The present pilot study was designed to assess the effect of yoga on perceived stress and sleep quality of the female nursing professionals working at tertiary care hospital.

MATERIALS AND METHODS

Thirty-three apparently healthy nursing staffs in the age range of 30-60 years (mean age 40.60 ± 10.26) were recruited as participants of the study, from a tertiary care hospital in Delhi. Participants were administered perceived stress scale (PSS) and Pittsburgh sleep quality index (PSQI) before and after the yoga intervention. Participants received 4 week of yoga intervention for 45 min/day for 5 days a week.

RESULTS

There was a significant reduction on the postscores of PSS (t = 5.86, P < 0.0001, paired t-test) and PSQI (z = -4.38, P < 0.0001, Wilcoxon signed-ranks test) in comparison to prescores. After the yoga intervention, perceived stress reduced by 27.01% and the sleep quality improved by 38.68%.

CONCLUSION

The finding of the study suggests effectiveness of yoga in reduction of the perceived stress and improvement of the quality of sleep of the nursing professional. However, the present findings need to be confirmed with further studies with larger sample size and robust research design.

Effect of Structured Yoga Program on Stress and Professional Quality of Life Among Nursing Staff in a Tertiary Care Hospital of Delhi-A Small Scale Phase-II Trial

BACKGROUND

Nursing staff suffer from various level of stress and burnout. We aimed to assess the effect of 12 weeks of structured yoga on stress and the professional quality of life among nursing staff.

DESIGN AND METHOD

An open-label, phase-II randomized clinical trial was undertaken considering a sample size of convenience was done. In service nursing staff were randomized (1:1) to intervention group and wait-list control group. Primary outcome was perceived stress which was measured by Perceived Stress Scale (PSS). Secondary measures were professional quality measured by Professional Quality of Life (ProQOL) scale, blood pressure, serum cortisol, and high-sensitive C-reactive protein. Both the per-protocol and intention to treat analysis was done.

RESULTS

Total 113 participants were allocated to intervention group (n = 58, mean = 35 years, SD = 7.9 years) and wait-list control group (n = 55, mean = 32.5 years, SD = 6.8 years). After 12 weeks, 19 participants of intervention group and 32 participants of wait-list control group were included in the per-protocol analysis. Follow-up mean PSS score was 15.4 (95% CI 12.6-18.2, SD 5.8) in intervention group, 20.7 (95% CI 19.7-21.7, SD 2.8) in wait-list control group (p-value < 0.0001). The other parameters didn't differ between the groups and from baseline to end line too.

CONCLUSIONS AND RELEVANCE

The finding showed supervised structured yoga may be efficacious to reduce stress. Studies with larger sample size are needed to confirm the findings.

TRIAL REGISTRATION

It was approved by the Institute Ethics Committee (Reference no: IECPG-543/20.12.2017, RT-57/31.01.2018) and was registered prospectively in the Clinical Trial Registry of India prospectively (No. CTRI/2018/02/012206).

The Role of Yoga in Treating Stress-Related Symptoms in Dental Hygiene Students

Context:

Research has provided evidence for yoga's effectiveness in the prevention and treatment of pain and stress, both of which have been implicated as significant negative moderators of student performance and experience.

Aims:

This study investigated the feasibility and preliminary impact of a 10-week yoga intervention with dental hygiene students to reduce perceptions of stress and stress-related symptoms.

Settings and Design:

Students self-selected into a yoga treatment versus control condition. They completed stress and pain measures at four time points during and after the intervention or control period of 10-weeks.

Methods:

Participants were students enrolled in a dental hygiene program. All 77 participants completed a 10-week study, self-selecting into an intervention or control group. They completed three self-report questionnaires assessing pain and stress, administered at baseline, mid-point, postintervention, and two follow-ups. The 10-week yoga intervention consisted of 10 90-min yoga sessions that provided check-ins, breathing exercises, sequences of postures, relaxation exercises, and closing meditations.

Statistical Analysis Used:

Independent samples t-tests were used to compare perceived stress levels of participants in the control versus treatment groups. Paired t-test was used to assess differences in stress-related symptom levels across time.

Results:

Results suggested that a yoga intervention is feasible for this group and that active yoga practice can lower perceived stress across multiple domains and across time.

Conclusions:

A specially adapted and designed 10-week yoga protocol appears to be an accessible option for dental hygiene programs that seek to support their students in improving overall wellbeing.

Effects of Mindfulness-Based Stress Reduction Training on Healthcare Professionals' Mental Health: Results from a Pilot Study Testing Its Predictive Validity in a Specialized Hospital Setting

This pilot study aimed to evaluate the feasibility and acceptability of a Mindfulness-Based Stress Reduction (MBSR) training and to examine positive and negative symptom-focused mental health variables. The mental health variables were used to test the predictive validity of the training among healthcare professionals. Thirty healthcare professionals participated in this non-randomized pre-post intervention pilot study. The questionnaire on mental health was filled in twice. Baseline and post-intervention differences were tested with paired samples t-tests and Wilcoxon signed-rank tests. The participants’ evaluation of the training was assessed with a five-item questionnaire. The recruitment and retention were successful, and participants’ evaluation of the training itself was positive but the influence on daily life was rated only moderately positive. In comparison with baseline at post-intervention participants showed significant improvements in general mindfulness, the burnout dimension personal accomplishment, quality of sleep, positive emotions, and self-efficacy. A significant decrease was found in the burnout dimension emotional exhaustion, stress level, negative emotions at work, and worrying. No significant changes were found for the burnout dimension mental distance, and work engagement. The measures showed ample within-person differences and low, medium, or high effect sizes. The current trial approach of the MBSR training seems feasible and acceptable. Our results suggest that mindfulness, burnout, stress level, quality of sleep, positive emotions at work, negative emotions at work, self-efficacy, and worrying are meaningful mental health variables for inclusion in a larger-scale Randomized Controlled Trial on the effects of MBSR.

An online mindfulness intervention to enhance compassion in nursing practice: A feasibility and acceptability study with nursing students

Background

Compassion is an important component of nursing care, but public enquiries into care failures have noted that it is not always evident. Mindfulness interventions have the potential to support compassion. However, the feasibility of delivering a mindfulness intervention at scale to nursing students has not been established.

Objectives

To develop and test the feasibility and acceptability of a tailored mindfulness based online intervention to foster compassion in nursing students within clinical practice.

Design

A randomised feasibility study with a waiting list control.

Setting

A UK nursing faculty within a large university.

Participants

Post-graduate, post-registration and pre-registration nursing students (N = 77).

Methods

An online five module mindfulness based intervention (Mindful Nursing Online) was developed and tailored to support compassion in clinical nursing. The feasibility study comprised 77 participants randomised in a 2:1 ratio into an immediate access group (intervention, n = 50) or a delayed access group (waiting list control, n = 27). Data on feasibility through completion, attrition and practice rates, were collected through follow-up questionnaires at post-intervention, and 14 and 20 weeks after baseline. Acceptability data was collected through semi-structured interviews with 12 participants.

Results

Non-completion rates were high with all five modules completed by only 28% (n = 14) of participants, and three modules completed by only 46% (n = 23). The most commonly cited reason for non-completion was lack of time. However, the interview data suggested those who completed the intervention were using mindfulness techniques in practice. They described feeling less stressed on the ward, having an increased focus on patients and a greater appreciation of the importance of self-care. Evaluative feedback therefore showed that the intervention was perceived to be effective at promoting mindfulness skills and was relevant to nursing work.

Conclusion

Minimising attrition and enhancing engagement with the intervention should be the key objectives of a future study. Feedback from participants who completed the intervention indicates that a brief mindfulness intervention delivered online may support the delivery of compassionate nursing care.

The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review

Objectives

Burnout and occupational stress are frequently experienced by healthcare professionals (HCPs). Mindfulness-based stress reduction (MBSR) has been found to improve the psychological health outcomes of HCPs. To date, systematic reviews and meta-analyses have primarily focused upon empirical investigations into the reduction of stress amongst HCPs using MBSR and are limited to empirical studies published before December 2019. This systematic review aimed to update the current evidence base and broaden our understanding of the effectiveness of MBSR on improving the psychological functioning of HCPs.

Methods

Three electronic databases (Medline, Psych Info and Web of Science) were searched without time frame restrictions. Quantitative studies included randomised controlled trials, clinical controlled trials, pre-post designs and studies with up to a 12-month follow-up period. All studies included in the review employed a MBSR programme, standardised measures of psychological functioning and qualified HCPs as participants.

Results

Using PRISMA guidelines thirty studies were included in the review. The reviewed literature suggested that MBSR was effective in reducing HCPs experiences of anxiety, depression and stress. MBSR was also found to be effective in increasing HCP levels of mindfulness and self-compassion. However, MBSR did not appear as effective in reducing burnout or improving resilience amongst HCPs. Abbreviated MBSR programmes were found to be as effective as the traditional 8-week MBSR programmes.

Conclusions

MBSR is an effective intervention which can help improve the psychological functioning of HCPs. Recommendations include improving the overall quality of the studies by employing more robust controlled designs with randomisation, increased sample sizes with heterogeneous samples, and making active comparisons between interventions used.

Healthcare professionals' experiences of using mindfulness training in a cardiology department - a qualitative study

OBJECTIVE AND AIM

Person-centred communication and healthcare professionals' ability to be attentively present in their encounter with patients are essential aspects of patients' experiences of well-being, ability to cope with illness-related challenges and feelings of being recognised. However, the ability to be attentive in relational encounters can be challenging for healthcare staff for many reasons, such as time constraints and a high work pace. Research suggests that mindfulness training could increase staff attentiveness and compassion, but only few qualitative studies have explored the subject. The aim of the current study was to explore doctors' and nurses' individual experiences of how attending an 8-week Mindfulness-Based Stress Reduction course (MBSR) influenced their clinical practice and encounters with colleagues and patients in a cardiology department.

METHOD

Qualitative interviews were held with six doctors and nurses who had completed the 8-week MBSR course. Interpretative phenomenological analysis was applied to explore and understand the meaning of the participants' accounts.

FINDINGS

The MBSR course appeared to have changed the healthcare professionals' thoughts and actions, especially regarding their ability to stay focused on the task at hand, to prioritise and to stay calm in an unpredictable and busy work environment. This was facilitated by using concrete techniques learned during the course, such as breathing and taking small breaks to clear their heads and help them be attentive in relation to themselves, colleagues and patients. Furthermore, they described an increased acceptance of their own limitations, better understanding of their colleagues and greater awareness of the unique patient.

CONCLUSION

These findings suggest that changing healthcare professionals' actions, mindset, awareness and understanding of others may result in a more compassionate work environment and more person-centred care.

Effect of Anxiety on Empathy: An Observational Study Among Nurses

Empathy, defined as an emotional ability to put oneself in the place of others, read their state of mind, and think how they are feeling, is an essential pillar of nursing care. On the other hand, anxiety is a frequent emotion that can be generated in stressful work environments, like nurses developing their activity. The aim of the present study is to explore the value of empathy and anxiety personal traits in staff nurses. The sample was comprised of 197 staff nurses from tertiary level hospitals from Madrid, Spain, where 79.2% were women and 20.8% were men in the present study. The instrument used for analysis was the Spanish adaptation of the 16PF5 questionnaire. The results showed the following measurements to warmth (5.58), lively (5.25), socially bold (5.6), privacy (5.82), open to change (5.62), self-reliance (6.12), and anxiety (6.38). Furthermore, anxiety affects positively to warmth (t: 2.66; p > 0.0001) and lively (t = 2.36; p < 0.05), but in a negative way to social bold (t = −3.17; p < 0.001) or open to change (t = −5.81; p < 0.0001). However, it was not seen to have any effect over privacy (t = 1.96; p = 0.052) and self-reliance (t = 1.19; p = 0.234). Finally, it is recommended that healthcare professionals reinforce their personal competencies to strengthen their skills to manage anxiety and improve their empathy competencies.

Mindfulness-Based Student Training Leads to a Reduction in Physiological Evaluated Stress

Background and Objective

In today’s fast-paced modern lifestyle, chronic stress has become a serious issue with potential consequences for our physical and mental health. The concept of mindfulness and its derived Mindfulness-Based Stress Reduction (MBSR) program is considered to be an effective stress management technique for patients as well as for healthy persons. The effects of MBSR interventions on their participants have been subject of previous research, especially with regard to psychological or social science approaches using self-reports and questionnaires. In contrast, medical investigations in this field have been less frequent and often somehow limited, for example, addressing only absolute (discrete) mean values for heart rate or blood pressure.

Methods

In this study, we have evaluated a Mindfulness Based Student Training program (MBST) by applying methods of biosignal analysis to examine its impact on the training participants’ autonomic regulation. This intervention program included classical MBSR elements but was adapted to suit the normal daily needs of university students. We obtained the electrocardiogram, finger-pulse plethysmography, and respiration activity from students participating in either the intervention group (IGR, 38 subjects) or a passive control group (CON, 35 subjects) prior to and after 8 weeks of MBST intervention.

Results

When comparing various indices from heart rate variability, pulse wave variability, and respiration in linear and nonlinear domains, significant changes in the autonomic regulation were observed for the IGR group after 8 weeks of MBST.

Conclusion

The results indicate a reduced stress level exclusively for the intervention participants, and therefore, we assume a health benefit from the MBST program.

Yoga and Mindfulness as a Tool for Influencing Affectivity, Anxiety, Mental Health, and Stress among Healthcare Workers: Results of a Single-Arm Clinical Trial

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.

The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis

AIM

To analyse the effect of mindfulness training on levels of burnout among nurses.

BACKGROUND

Burnout syndrome is a common occupational hazard for nursing staff. Mindfulness training has been proposed as a valid intervention for burnout.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

The CINAHL, LILACS, Medline, ProQuest, PsycINFO, Scielo and Scopus databases were consulted, using the search equation 'Nurs * AND burnout AND mindfulness'. There was no restriction on the year of publication.

REVIEW METHODS

Papers were selected for analysis in accordance with the PRISMA guidelines. The meta-analysis was carried out using Review Manager 5.3 software.

RESULTS

The sample was of 17 articles including 632 nurses. Mindfulness training reduces levels of burnout, producing lower scores for emotional exhaustion and depersonalization and higher for personal accomplishment. The differences in the means were 1.32 (95% CI: -9.41-6.78), 1.91 (95% CI: -4.50-0.68) and 2.12 (95% CI: -9.91-14.14), respectively, between the intervention and control groups.

CONCLUSION

Mindfulness training reduces the emotional burden and hence levels of burnout, among nurses. However, further randomized clinical trials are required.

Spirituality and Prayer on Teacher Stress and Burnout in an Italian Cohort: A Pilot, Before-After Controlled Study

INTRODUCTION

Teaching is a stressful profession that exposes workers to the risk of burnout. Techniques involving higher mental functions, such as transcendental meditation and prayer, have been used in stress and burnout prevention programs. In this study, we report the results of an experience conducted in a group of teachers of a religious institute, in which prayer was used as a technique to prevent burnout.

METHODS

Fifty teachers and support staff employed at a Catholic school of a Congregation of nuns volunteered for this study. They were randomized into two groups: prayer treatment (n = 25) or control group (n = 25). The treatment protocol was based on the combination of individual Christian prayer and a focus group of prayer-reflection. The participants received two 30 min training sessions a week over 2 months. Job satisfaction, well-being, and burnout symptoms (emotional exhaustion and depersonalization sub-scales) were measured at baseline and at follow-up (4 months) with the Italian versions of the Maslach Burnout Inventory validated for teaching and education sector, the General Health Questionnaire, and the Warr, Cook, and Wall's Job Satisfaction Scale.

RESULTS

At follow-up, a significant improvement of all outcome measures was observed. Emotional exhaustion (16.80-4.92, p < 0.001), depersonalization (3.72-0.60, p < 0.001) levels, and psychological impairment (10.08-2.04, p < 0.001) were significantly decreased, and job satisfaction (45.96-77.00, p < 0.001) was increased. The effect sizes (Glass' Δ) of the therapeutic interventions ranged from 0.53 (satisfaction level) to 2.87 (psychological health), suggesting moderate to large effects.

DISCUSSION

Prayer could be effective, no less than meditation and other spiritual or mind-body techniques, in contrasting the negative effects of occupational stress and preventing burnout among teachers and possibly other human service professionals.