Effects of a mindfulness-based programme on the health- and work-related quality of life of healthcare professionals

Exploring the use of mindfulness for prevention of burnout in allied health professionals in Singapore

BackgroundBurnout is becoming increasingly prevalent among healthcare professionals where it impacts quality of care and staff turnover, especially in the wake of the COVID-19 pandemic. One promising strategy to reduce burnout is the use of mindfulness-based programs, which may aid allied health professionals (AHPs).ObjectiveTo explore the usefulness of a 10-week mindfulness program on reducing burnout symptoms in AHPs in Singapore, as well as to identify AHPs' attitudes and perceptions towards adopting mindfulness in practice.MethodsIn this mixed methods study, a purposive sample (n = 8) of physiotherapists, occupational therapists, and therapy assistants were recruited. Participants underwent a mindfulness program, comprising 5 face-to-face sessions every other week for 10 weeks. Quantitative data were collected at pre- and post-intervention stages using a survey on participant characteristics and the Maslach Burnout Inventory - Human Services Survey for Medical Personnel to assess burnout symptoms. Qualitative data were collected through semi-structured interviews.ResultsThere was a decrease in emotional exhaustion scores (34.50 to 25.50, p = 0.012) while depersonalization (p = 0.107) and personal accomplishment (p = 0.062) scores showed no significant changes. Qualitative benefits reported include increased introspection, improved emotional regulation and communication, and fostering of supportive workplace culture. Advocacy from superiors and the perceived effectiveness of mindfulness techniques can facilitate the adoption of the mindfulness program.ConclusionA 10-week mindfulness program reduced burnout symptoms, specifically emotional exhaustion, among AHPs. Future studies should explore the application of the program within a larger participant sample to develop an optimal model for feasible and pragmatic adoption within the clinical setting.

Beyond Bouncing Back: Exploring Undergraduate Dental Professional Students' Perceptions of Resilience

INTRODUCTION

The first signs of mental health issues in dentistry manifest as early as undergraduate training, thus it is essential to delve into the concept of resilience to equip those studying and working in dentistry with the resources to cultivate a positive mindset.

MATERIALS AND METHODS

A focus group was conducted with a homogenous purposive sample of eight undergraduate dental profession students from all 3 years of study at the University of Portsmouth Dental Academy (UPDA). The six-phase Braun and Clarke's thematic analysis was adopted to interpret patterns in data.

RESULTS

Four themes of: 'definition of resilience'; 'factors enhancing resilience'; 'factors challenging resilience' and 'developing resilience in dentistry'; and 23 subthemes were identified. Students defined resilience as an ability to bounce back from adversity and perceived it as a dynamic and contextual phenomenon that fluctuated due to an interplay of personal, social and environmental factors.

CONCLUSION

The findings of this study showed undergraduate dental profession students' perceptions of resilience, factors influencing it and strategies to develop it. These findings may inform the curriculum of resilience training programmes targeted towards this population.

Compassion fatigue, compassion satisfaction and mindfulness among healthcare professionals: A meta-analysis of correlational studies and randomized controlled trials

BACKGROUND

Compassion fatigue is a pressing concern for healthcare professionals, impacting their well-being and the quality of service they deliver to service users. Mindfulness has emerged as a potential strategy to mitigate compassion fatigue among healthcare professionals. This meta-analysis aims to investigate the correlation between mindfulness and compassion fatigue/compassion satisfaction and the effect of mindfulness-based interventions (MBI) on compassion fatigue/compassion satisfaction.

METHOD

7568 papers were identified through a systematic search in ProQuest, Web of Science, PsycINFO, Embase, and MEDLINE. 78 correlational studies and 29 randomized controlled trials were screened-in for analysis. Study quality and data were coded for analysis.

RESULTS

Significant moderate negative correlation between mindfulness and compassion fatigue was found. Significant moderate positive correlation was also observed between mindfulness and compassion satisfaction. Older healthcare professionals and professionals working in non-acute settings were found to have stronger correlations between mindfulness and compassion satisfaction. From randomized controlled trial studies of MBI, moderate effect size was found for compassion fatigue, and small effect size was found for compassion satisfaction. Effects were found to be similar across settings.

CONCLUSIONS

This meta-analysis is the first synthesis of the relationship between compassion fatigue and compassion satisfaction with mindfulness, as well as the effectiveness of mindfulness-based interventions on these two variables among healthcare professionals. Future studies could consider investigating mediators of mindfulness-based interventions to understand possible mechanisms.

Digital Mindfulness Training for Burnout Reduction in Physicians: Clinician-Driven Approach

BACKGROUND

Physician burnout is widespread in health care systems, with harmful consequences on physicians, patients, and health care organizations. Mindfulness training (MT) has proven effective in reducing burnout; however, its time-consuming requirements often pose challenges for physicians who are already struggling with their busy schedules.

OBJECTIVE

This study aimed to design a short and pragmatic digital MT program with input from clinicians specifically to address burnout and to test its efficacy in physicians.

METHODS

Two separate nonrandomized pilot studies were conducted. In the first study, 27 physicians received the digital MT in a podcast format, while in the second study, 29 physicians and nurse practitioners accessed the same training through a free app-based platform. The main outcome measure was cynicism, one dimension of burnout. The secondary outcome measures were emotional exhaustion (the second dimension of burnout), anxiety, depression, intolerance of uncertainty, empathy (personal distress, perspective taking, and empathic concern subscales), self-compassion, and mindfulness (nonreactivity and nonjudgment subscales). In the second study, worry, sleep disturbances, and difficulties in emotion regulation were also measured. Changes in outcomes were assessed using self-report questionnaires administered before and after the treatment and 1 month later as follow-up.

RESULTS

Both studies showed that MT decreased cynicism (posttreatment: 33% reduction; P≤.04; r≥0.41 and follow-up: 33% reduction; P≤.04; r≥0.45), while improvements in emotional exhaustion were observed solely in the first study (25% reduction, P=.02, r=.50 at posttreatment; 25% reduction, P=.008, r=.62 at follow-up). There were also significant reductions in anxiety (P≤.01, r≥0.49 at posttreatment; P≤.01, r≥0.54 at follow-up), intolerance of uncertainty (P≤.03, r≥.57 at posttreatment; P<.001, r≥0.66 at follow-up), and personal distress (P=.03, r=0.43 at posttreatment; P=.03, r=0.46 at follow-up), while increases in self-compassion (P≤.02, r≥0.50 at posttreatment; P≤.006, r≥0.59 at follow-up) and mindfulness (nonreactivity: P≤.001, r≥0.69 at posttreatment; P≤.004, r≥0.58 at follow-up; nonjudgment: P≤.009, r≥0.50 at posttreatment; P≤.03, r≥0.60 at follow-up). In addition, the second study reported significant decreases in worry (P=.04, r=0.40 at posttreatment; P=.006, r=0.58 at follow-up), sleep disturbances (P=.04, r=0.42 at posttreatment; P=.01, r=0.53 at follow-up), and difficulties in emotion regulation (P=.005, r=0.54 at posttreatment; P<.001, r=0.70 at follow-up). However, no changes were observed over time for depression or perspective taking and empathic concern. Finally, both studies revealed significant positive correlations between burnout and anxiety (cynicism: r≥0.38; P≤.04; emotional exhaustion: r≥0.58; P≤.001).

CONCLUSIONS

To our knowledge, this research is the first where clinicians were involved in designing an intervention targeting burnout. These findings suggest that this digital MT serves as a viable and effective tool for alleviating burnout and anxiety among physicians.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06145425; https://clinicaltrials.gov/study/NCT06145425.

Mindfulness Smartphone Application Implementation to Impact Stress and Burnout in Adult Healthcare Professionals

Many healthcare professionals are experiencing increased stress and burnout, worsened by the COVID-19 pandemic, leading to negative individual and organizational outcomes such as mental illness, maladaptive coping, job dissatisfaction, poor patient care, and higher turnover costs. Mindfulness practice is a promising evidence-based approach to impact stress and burnout. This quality improvement pilot project evaluated the impact of a free mindfulness smartphone application on stress and burnout levels in certified or licensed adult healthcare professionals over 6 weeks. Using a quasi-experimental pre- and post-intervention design, the project assessed the Mindfulness Coach application's (app) impact on stress and burnout using the Perceived Stress Scale and the Mini Z 2.0 survey. The results indicated that using the app significantly reduced perceived stress but did not impact burnout symptoms.

Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis

BACKGROUND

Growing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain.

AIMS

To evaluate the evidence for MBIs in improving healthcare workers' psychological well-being.

METHODS

A systematic literature search was conducted on Medline, Embase, Cumulative Index for Nursing and Allied Health Literature, PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords 'healthcare worker', 'doctor', 'nurse', 'allied health', 'mindfulness', 'wellness', 'workshop' and 'program'. Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion. R V.4.0.3 was used for data analysis, with the standardised mean difference as the primary outcome, employing DerSimonian and Laird's random effects model. Grading of Recommendations, Assessment, Development and Evaluation framework was used to evaluate the quality of evidence. Cochrane's Risk of Bias 2 tool was used to assess the risk of bias in the included studies.

RESULTS

A total of 27 studies with 2506 participants were included, mostly from the USA, involving various healthcare professions. MBIs such as stress reduction programmes, apps, meditation and training showed small to large effects on anxiety, burnout, stress, depression, psychological distress and job strain outcomes of the participants. Positive effects were also seen in self-compassion, empathy, mindfulness and well-being. However, long-term outcomes (1 month or longer postintervention) varied, and the effects were not consistently sustained.

CONCLUSIONS

MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers. The review also highlights limitations such as intervention heterogeneity, reduced power in specific subgroup analyses and variable study quality.

PROSPERO REGISTRATION NUMBER

CRD42022353340.

Development, validation and implementation of the medical affairs pharmaceutical physician work-related quality of life instrument

BACKGROUND

Medical affairs pharmaceutical physicians (MAPPs) are at risk for low work-related quality of life (WRQoL). The aim of this study was to develop, validate and implement the first WRQoL instrument for this population.

METHODS

A prospective observational cohort clinical study, the Medical Affairs Pharmaceutical Physician Work-related Quality of Life (MAPPWrQoL) Instrument Development and Patient Registry (MAPPWrQoLReg), was registered in November 2021 (NCT05123846). Thirteen MAPPs and 12 non-MAPPs participated in development and validation between December 2021 and January 2022. Development used the Jandhyala method for observing proportional group awareness and consensus. Discriminant validity analysis used the WRQoL Scale as a reference standard and assessed whether the instrument could differentiate between the groups. Twelve MAPPs and 12 non-MAPPs self-reported their WRQoL in the registry each month from February 2022. Recruitment and data collection are ongoing; 6-month data between February 2022 and August 2022 are reported here.

RESULTS

Two participants were excluded from the registry. Chi-squared analysis showed a significant difference between the MAPPWRQoL instrument and WRQoL Scale (p = 1.029e-08) with acceptable sensitivity (89.19%) and specificity (75.00%). There were significant between-group differences for total scores at each follow-up (p = .003; n = 6 questions). Chi-squared analysis showed a significant difference between MAPPs' and non-MAPPs' ability to answer MAPPWRQoL instrument items (p = .002629), with acceptable sensitivity (91.9%) and near-acceptable specificity (66.7%). MAPPs' WRQoL did not change significantly over 6 months.

CONCLUSION

Discriminant validity of the 39-item MAPPWRQoL instrument was confirmed. The Jandhyala method successfully developed and validated a specific WRQoL instrument and may be applied to similar populations, such as junior doctors and UK general practitioners.

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.].

Effectiveness of Workplace Interventions to Improve Health and Well-Being of Health and Social Service Workers: A Narrative Review of Randomised Controlled Trials

Health and social service workers face high levels of workload and job stressors, which can affect their health and well-being. Therefore, it is important to evaluate the effectiveness of workplace interventions that aim to improve their mental and physical health outcomes. This review summarizes the findings of randomized controlled trials (RCTs) that examined the impact of different types of workplace interventions on various health indicators among health and social service workers. The review searched the PubMed database from its inception to December 2022 and included RCTs that reported on the effectiveness of organizational-level interventions and qualitative studies that explored barriers and facilitators to participation in such interventions. A total of 108 RCTs were included in the review, covering job burnout (N = 56 RCTs), happiness or job satisfaction (N = 35), sickness absence (N = 18), psychosocial work stressors (N = 14), well-being (N = 13), work ability (N = 12), job performance or work engagement (N = 12), perceived general health (N = 9), and occupational injuries (N = 3). The review found that several workplace interventions were effective in improving work ability, well-being, perceived general health, work performance, and job satisfaction and in reducing psychosocial stressors, burnout, and sickness absence among healthcare workers. However, the effects were generally modest and short-lived. Some of the common barriers to participation in workplace interventions among healthcare workers were inadequate staff, high workload, time pressures, work constraints, lack of manager support, scheduling health programs outside work hours, and lack of motivation. This review suggests that workplace interventions have small short-term positive effects on health and well-being of healthcare workers. Workplace interventions should be implemented as routine programs with free work hours to encourage participation or integrate intervention activities into daily work routines.

Individual-level interventions for reducing occupational stress in healthcare workers

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.

The impact of mindfulness practice on physician burnout: A scoping review

Background

Physician burnout is a growing phenomenon in current health systems worldwide. With the emergence of COVID-19, burnout in healthcare is progressively becoming a serious concern. Increasing emotional exhaustion, depersonalization, and reduced personal accomplishment threaten the effective delivery of healthcare. Compassion fatigue and moral injury are a considerable risk to the doctor-patient relationship. These issues can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in physicians.

Methodology

A scoping review was conducted to investigate the effects of mindfulness practice on physician burnout. High-ranking journals were targeted to analyze high-quality studies and synthesize common themes in the literature. Studies conducted on current practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Gray literature and studies conducted only on allied health personnel were excluded from this review.

Results

31 studies were included in this scoping review. Mindfulness practice decreased emotional exhaustion and depersonalization while improving mood, responses to stress, and vigor. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to physician mindfulness practice.

Conclusion

Mindfulness was widely reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate physician leader will play a crucial role in addressing current practice gaps, prioritizing staff mental health, and providing a supportive platform for innovation.

Post-Traumatic Growth in Professionals Caring for People with Intellectual Disabilities during COVID-19: A Psychological Intervention

BACKGROUND

Health professionals present a greater vulnerability to the effects of COVID-19 on their mental health, especially those who work with vulnerable groups such as those who suffer from intellectual disability (ID). The objective of the present research was to develop and verify the effectiveness of a psychological intervention for professionals in the field of ID to improve their mental health during this health crisis.

METHODS

A total of 32 professionals participated. The variables measured were: post-traumatic growth, mental health, burnout, coping strategies, resilience, life satisfaction, optimism, and cognitive and affective empathy.

RESULTS

The results revealed statistically significant differences in the post-traumatic growth variable. In the rest of the variables (mental health, burnout, coping strategies, resilience, vital satisfaction, optimism, and empathy), no significant differences between groups were found.

CONCLUSIONS

An increase in the levels of post-traumatic growth was observed in the intervention group after a brief online psychological intervention. However, given the small sample size, these results should be taken with caution. Institutions should foster and promote interventions aimed at reducing the high emotional impact produced by COVID-19 in professionals that care for people diagnosed with ID.

Creating joy in the workplace

Creating a joyful workplace is not the same as dealing with issues of stress, fatigue, burn-out, and resilience. It requires a proactive approach to augment feelings of worth, appreciation, and well-being in the members of the team. The sense that one is pursuing worthwhile, valuable activities requires a wholesale commitment to the mission, vision and values of the organization. These tenets are often created through an organic consensus of collegial workmates and then put to action by a leadership team. Reassessing the goals and virtues of the organization at appropriate intervals leads to ongoing loyalty and commitment to the team and a positive attitude. Well-being is addressed through the creation of a bright and cheerful physical and psychosocial workplace that offers programs that encourage mindfulness, humor, playfulness, and fitful lifestyle choices. The sense that one's work is appreciated and valued stems from an attitude of gratitude on behalf of all levels of the organization including management and peers where such encouragement flourishes. Those expressions of appreciation may be in the form of celebrations in the workplace and/or compensation and benefits that appropriately value the contributions of the employee. The organization's executive team should be dedicated to crafting an environment that leads to delighted, healthy employees.

Sustained resiliency building and burnout reduction for healthcare professionals via organizational sponsored mindfulness programming

PURPOSE

To measure healthcare professional (HCP) result sustainability following implementation of an organizationally sponsored Mindfulness Based Intervention (MBI), Mindfulness in Motion (MIM), in areas of burnout, perceived stress, resilience, and work engagement.

METHODS

A follow-up survey was sent via email to healthcare professionals (n = 220) who previously participated in the 8-week MIM intervention. Survey assessed burnout, perceived stress, resilience, work engagement, and included open-ended questions pertaining to barriers, facilitators, and sustained impact of practicing mindfulness after program end.

RESULTS

Analysis included 66 healthcare professionals with sustainability time frames ranging from 3 to 28 months from initial program finish. Average time since intervention end was 12.2 months. Based on 12.2 months sustained results post MIM, there were significant differences from pre-MIM to sustainability follow-up in burnout (*p = 0.0047), perceived stress (*p = 0.00001), and resilience (*p = 0.0004). Work engagement benefits were non-significant from pre-test to follow-up (p = 0.4008). There were no significant differences in results when comparing the length of time since participant was enrolled in the initial study. Additionally, analysis of the qualitative data revealed multiple subthemes relating to facilitators of sustained mindfulness, barriers to practicing mindfulness, and lasting impacts of the MIM intervention.

CONCLUSIONS

For Healthcare Professionals, the organizationally sponsored mindfulness intervention outcomes were sustained beyond the 8-weeks of the initial MIM intervention for all but one outcome variable. Post 8-week intervention end, participants were given the option of receiving weekly "Mindful Moment" emails and attending monthly mindfulness booster sessions. Organizational support may be a pivotal factor in sustaining positive results achieved via mindfulness programming.