The Use of Yoga to Manage Stress and Burnout in Healthcare Workers: A Systematic Review

Effectiveness of a yoga-based intervention on academic burnout syndrome in medical students: A pilot study

BACKGROUND

Approximately 40% of medical students in Mexico experience academic burnout syndrome (ABS), highlighting the lack of institutional strategies to prevent or mitigate this phenomenon, leaving students vulnerable. The aim of this study is to determine the effectiveness of a yoga-based intervention (YBI) in medical students with ABS.

MATERIALS AND METHODS

A quasi-experimental study was designed for medical students whose burnout levels were assessed using the MBI-SS. Subsequently, those students with ABS participated in an YBI for six weeks, with a weekly session of 60 minutes, incorporating postures, body movements, and guided breathing to induce a meditative state and deep relaxation. At the end of the intervention, burnout levels were reassessed. Qualitative variables were analyzed as frequencies and percentages, while quantitative variables were analyzed as means and standard errors of the mean. Paired samples t test was used to compare all dimensions of ABS scores before and after YBI, with P ≤ 0.05 considered statistically significant. All data were analyzed using SPSS software.

RESULTS

The prevalence of ABS was found to be 10.6%. After YBI, 87.5% of students showed changes in scores across all dimensions of ABS, emotional exhaustion decreased from 20.13 ± 0.9 to 12.38 ± 1.9 (P = 0.002), depersonalization decreased from 9.0 ± 0.7 to 5.8 ± 1.0 (P = 0.025), and academic efficacy increased from 16.7 ± 0.9 to 23.8 ± 2.1 (P = 0.019).

CONCLUSIONS

YBI was effective in reducing ABS scores in medical students, consistent with public health goals. Further studies are needed, and consideration should be given to incorporating wellness programs as an integral part of medical education to address mental health issues are recommended.

Yoga, mindfulness and acupuncture impact on burnout: a preliminary meta-analysis

Mindfulness, yoga, and acupuncture are three practices that have received little attention in stress management literature, with scholars suggesting that they can improve physical and mental health, reduce stress and burnout, and boost productivity and job satisfaction. However, while there is growing interest in these practices, many employers remain sceptical about their potential benefits and are hesitant to invest resources in implementing them. This meta-analysis aimed to examine the impact of these practices on burnout and explore potential moderators. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure comprehensive and transparent reporting in the identification of eligible studies. Overall, 21 studies were included (8 on mindfulness, 7 on yoga, and 6 on acupuncture), all involving independent samples, with a total of 1,364 participants. The meta-analytic results showed that all three therapeutic practices have consistent and beneficial effects on reducing burnout. Furthermore, moderation analyses indicated that mindfulness interventions conducted within the work schedule have a significant reduction in burnout, while acupuncture interventions with between 4 or 8 weeks (the more weeks, the better) also reduced burnout. However, no significant moderation effect was observed for yoga interventions. Overall, the findings provide insights into the effectiveness of these complementary practices in reducing burnout and highlight the need for further research in this area.

Knowledge, attitude, and practice towards occupational burnout among doctors and nurses in intensive care unit

Background

Occupational burnout is prevalent among doctors and nurses. This study aimed to investigate the knowledge, attitude, and practice (KAP) of ICU doctors and nurses regarding occupational burnout.

Methods

A cross-sectional study was conducted between December 2023 and June 2024 at the Zhejiang Medical & Health Group Hangzhou Hospital in Zhejiang Province. Demographic information and KAP scores were collected through distributed questionnaires. Occupational burnout was measured by the Maslach Burnout Inventory-General Survey (MBI-GS).

Results

This study included 105 doctors and 165 nurses, with an average age of 32.23 ± 7.38 years. Among all the participants, 6 (2.22%) reported no occupational burnout, 230 (85.19%) experienced moderate occupational burnout, and 34 (12.59%) reported severe occupational burnout. The mean knowledge, attitude, and practice scores were 9.64 ± 4.21 (possible range: 0-18), 29.01 ± 3.15 (possible range: 7-35), and 16.96 ± 4.29 (possible range: 6-30), respectively. Multivariate logistic regression revealed that a higher knowledge score was independently associated with more proactive practice (OR = 1.33, 95% CI: [1.18, 1.50], p < 0.001). Structural equation modeling showed that knowledge positively influenced both (β = 0.33, p < 0.001) and practice (β = 0.37, p < 0.001), while practice negatively impacted the MBI-GS (β = -0.92, p < 0.001).

Conclusion

Most ICU doctors and nurses exhibited moderate occupational burnout, with insufficient knowledge, positive attitude, and moderate practice toward occupational burnout. Implementing strategies to increase knowledge and promote active practical engagement is essential to effectively mitigate occupational burnout among ICU staff.

The psychosomatic impact of Yoga in medical education: a systematic review and meta-analysis

Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve the physical and mental well-being of learners. This study aimed to evaluate the effectiveness of yoga intervention in improving cardiopulmonary parameters such as blood pressure, heart rate, pulmonary function tests and psychosomatic symptoms such as depression, anxiety and stress in medical and dental students. Using the PRISMA protocol, a search from databases such as PubMed, Scopus, and Embase resulted in 304 relevant articles. After screening the title and abstracts, 47 papers were analyzed thoroughly and included in the qualitative analysis. 18 articles with homogenous statistical data on physiology and psychological parameters were included for meta-analysis. In comparison to the control group, the study showed a significant reduction of systolic blood pressure (SBP: 6.82 mmHg, z = -3.06, p = 0.002), diastolic blood pressure (DBP: 2.92 mmHg, z = -2.22, p = 0.03), and heart rate (HR: 2.55 beats/min, z = -2.77, p = 0.006). Additionally, data from 4 studies yielded a significant overall effect of a stress reduction of 0.77 on standardized assessments due to the yoga intervention (z = 5.29, p < 0.0001). Lastly, the results also showed a significant (z = -2.52, p = 0.01) reduction of 1.2 in standardized anxiety tests in intervention group compared to the control. The findings offer promising prospects for medical educators globally, encouraging them to consider reformation and policymaking in medical curricula to enhance academic success and improve the overall quality of life for medical students worldwide.

Compassion Fatigue Rounds (CFR): A Proactive Brief Intervention to Introduce Mental Health Awareness in a Veterinary Clerkship

The mental health and well-being of veterinary students and graduate veterinarians is a critical area of concern. Veterinary students experience high levels of psychological distress, particularly during transitional periods such as clinical training. While mental health interventions typically target pre-clinical years, the unique challenges faced by clinical students are often overlooked, resulting in inadequate support during important periods of professional development. To address this gap, Compassion Fatigue Rounds (CFR) were introduced. CFR is a proactive, integrated intervention within one clinical clerkship program. The rounds address compassion fatigue, burnout, and self-care practices through a small group discussion facilitated by the clinical instructor. An evaluation of CFR was conducted through anonymous online student surveys administered between March and September 2023. Following CFR, students self-reported an increase in knowledge, confidence, and preparedness regarding the mental health challenges in veterinary medicine. Students overwhelmingly reported positive experiences, pointing to the potential effectiveness of CFR in educating, engaging, and supporting clinical students on mental health well-being. This study offers preliminary evidence for integrating mental health education into the clinical year curriculum and serves as a practical guide for clinical instructors.

Effects of dance movement therapy on compassionate flow in nursing students: An experimental study

Purpose

Only a few studies have explored how compassion is taught to nursing students. This study aimed to investigate the differences in compassionate flow among nursing students both before and after an educational intervention.

Materials and methods

This study employed a cluster randomised controlled trial design in medical schools in Taiwan. We enrolled first- and second-year nursing students. The intervention group underwent dance movement therapy, while the control group received yoga training. Compassionate flow was assessed using the Compassionate Engagement and Action Scale and the Fears of Compassion Scale.

Results

A total of 59 participants (31 in the experimental group and 28 in the control group) were included in the final statistical analysis, and an 82 % response rate was recorded. Statistically significant differences were observed in total scores on the Compassionate Engagement and Action Scales, along with compassion for self and compassion from other subscales between the experimental and control groups (p < .05). The η2 effect levels were 0.12, 0.12, and 0.09.

Conclusions

Educational training employing dance movement therapy demonstrated enhancements in self-compassion and compassion for others among first- and second-year nursing students.

Managing Stress and Somatization Symptoms Among Students in Demanding Academic Healthcare Environments

INTRODUCTION

Stress is a common concern among healthcare students, due to the demands of their coursework and the elevated expectations they face. Especially among dentistry and nursing students, the phenomenon, although well-documented, covers psychosocial and physiological dimensions, with somatization symptoms being less explored. These manifestations are crucial to identify discipline-specific stressors and health impacts that can lead to targeted interventions for both disciplines.

AIM

This study investigates stress perceptions, somatization, and coping strategies among 271 nursing and dentistry students at the National and Kapodistrian University of Athens.

METHODOLOGY

An e-questionnaire was open for submissions during February and March 2024.

RESULTS

Females reported higher stress somatization (M = 10.22, SD = 5.23) than males (M = 7.94, SD = 6.14; Cohen's d = 0.412, p < 0.05). The interpretation of stress as "restlessness and psychological pressure" was more prevalent in dentistry students compared to nursing students. Moreover, nursing students who perceived stress as the "inability to manage unexpected or difficult situations, insecurity, panic" were more likely to experience stress somatization symptoms, while for dentistry students, stress somatization was related to "pressure to meet daily obligations/long-term goals". Physical symptoms for all students included chest discomfort, digestive issues, and headaches/nausea. Also, dentistry students reported more teeth clenching or grinding than nursing students. Short-term coping strategies included emotional balance, managing stressors, situation analysis, and breathing techniques. Long-term strategies involved distraction and entertainment, physical exercise, and patience. A higher willingness to seek coaching support correlated with higher stress somatization among dental students. Nursing students favored psychological support, while dentistry students suggested curriculum revision and improved infrastructure.

DISCUSSION/CONCLUSIONS

Females exhibited higher stress somatization levels, with themes of insecurity and physical symptoms. Nursing students reported higher somatization linked to insecurity, while dental students associated stress with daily obligations and goals. The study highlights the need for improved support systems, flexible academic procedures, and better communication to address stress in healthcare academia.

Effect of tele-yoga on burnout, mental health and immune markers of health care workers on COVID-19 duty: An open-label parallel group pilot randomized controlled trial

BACKGROUND

The COVID-19 pandemic overburdened the healthcare system and affected the mental health of healthcare workers. Yoga has proven to improve mental health correlates, within diverse population groups, including healthcare workers. Considering the pandemic-imposed restrictions, this trial was designed to study the feasibility and effect of tele-yoga intervention on burnout, sleep quality, depression, anxiety, stress, mindfulness, and immune markers of healthcare workers on COVID-19 duty.

METHODS

This randomized controlled trial was conducted in a tertiary care hospital. Tele-yoga intervention was delivered five days a week for 8 weeks. Stanford Professional Fulfilment Index (SPFI), Pittsburg Sleep Quality Index (PSQI), Depression Anxiety and Stress Scale (DASS-21), Mindfulness Attention Awareness Scale (MAAS) were used to assess the burnout, sleep quality, depression, anxiety, stress and mindfulness. Blood samples were assessed for TNF-α, IL-6 and serum cortisol levels.

RESULTS

A total of 147 healthcare workers were screened to achieve a sample size of 90 (45 each in tele-yoga intervention and control group). Of the 45 subjects in the intervention group, 35 attended at least 50 % of sessions over 8 weeks, at the rate of 3.35 sessions per week. Nearly 37.14 % of subjects among 35 were able to attend more than 70 % of the tele-yoga sessions. At the endline, 35 in the intervention and 37 in the control group completed the outcome questionnaires. On both per protocol (PPA) and intention to treat analyses (ITT) the burnout index, PSQI, anxiety and stress scores and IL-6 and serum cortisol level were significantly lower among the tele-yoga group compared to control group participants (p<0.05) at the endline. The effect size was medium (r=0.3-0.5) favoring intervention group for most of the parameters.

CONCLUSIONS

Tele-yoga is a feasible and accessible intervention for improving burnout, sleep quality, and reducing anxiety, stress, IL-6, and serum cortisol among healthcare workers in tertiary care hospitals during the COVID-19 pandemic. Being a single-center pilot study in India and with other methodological limitations, the generalizability of the study findings is restricted.

Yoga as an intervention for stress: a meta-analysis

The escalating stress epidemic in modern society has raised concerns about its impact on physical and mental health, prompting the need for effective interventions. Yoga, a multifaceted mind-body practice, has gained recognition for its potential in mitigating perceived stress. Our meta-analysis aimed to estimate yoga's impact on lowering perceived stress as measured by the Perceived Stress Scale. We identified 36 studies meeting inclusion criteria and found a statistically significant moderate effect of yoga on reducing perceived stress (g = 0.48, 95% CI = 0.29-0.66). Our analysis uncovered substantial heterogeneity (Q = 117.33, p < .001), with 74.90% of the variation in effect sizes attributed to study characteristics. In planned moderator analyses, we hypothesised that yoga with breathwork, relaxation, high stress symptoms, greater number of hours practiced, and studies conducted in India would yield larger effects. Stress severity was shown to be statistically significant. However, the remaining hypotheses were not supported. Additionally, we examined five exploratory moderator variables, which did not yield significant results. Further research is needed to elucidate the source of heterogeneity across studies and reveal recommendations for specific populations.

Yoga as Potential Therapy for Burnout: Health Technology Assessment Report on Efficacy, Safety, Economic, Social, Ethical, Legal and Organizational Aspects

PURPOSE OF REVIEW: This health technology assessment aimed to systematically assess the efficacy and safety of yoga as therapy for burnout. Economic, ethical, legal, social and organizational aspects were considered as well. RECENT FINDINGS: Yoga as a therapy has been shown to have positive effects on a range of symptoms, including stress, anxiety and depression. Regarding work-related stress and burnout, the effects of yoga have mainly been examined in a preventative context. Meta-analyses revealed no effects on burnout severity comparing yoga with passive controls in general. Compared with passive controls, yoga had a positive effect on subjective stress. Compared to active control, yoga had an effect on the burnout subscale depersonalization on individual study level. Yoga may have positive effects on burnout, but the results are mixed. Common definitions and standardized diagnostic tools are necessary to improve research and further assess yoga as therapy for burnout. TRIAL REGISTRATION: The HTA is registered with PROSPERO, CRD42022299405, on 6th February 2022.

Effect of cyclic meditation on anxiety and sleep quality in sailors on merchant ships-A quasi-experimental study

Background

Sailors undergo anxiety and sleep disturbances due to prolonged journeys and the nature of their work on ships. Earlier studies indicate Cyclic Meditation (CM) being beneficial for managing anxiety and improving sleep quality. Thus, the current study was designed to investigate the effect of CM on anxiety and sleep quality among sailors.

Materials and methods

Fifty sailors were assigned to experimental (n = 25) and control (n = 25) groups. The experimental group received 45 min of CM, 7 days a week for 3 weeks. Control group continued with their routine activities and were offered CM practice the following 3 weeks. Hamilton Anxiety Scale for anxiety (HAM-A) and the Pittsburg Sleep Quality Index (PSQI) for sleep along with blood pressure and pulse rate were taken at baseline and by the end of 3 weeks. Data were analyzed using Repeated Measures Analysis of Variance (RM ANOVA) for within and between group effects.

Results

Significant differences were found between the groups following 3 weeks for all the variables. Experimental group demonstrated reduced anxiety (p < 0.001) and improved sleep (p < 0.001) along with improvements in blood pressure and pulse rate. The control group did not show any significant changes following 3 weeks.

Conclusion

CM could be incorporated as a routine for sailors to manage their anxiety and improve sleep quality during the period on board ships.

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.

Hemodynamic and Stress Response After Sound Intervention with Different Headphone Systems: A Double-Blind Randomized Study in Healthy Volunteers Working in the Health Care Sector

Objectives: Two headphone systems using different sound systems were compared to investigate the effects of a sound intervention on cardiovascular parameters, indicators of stress, and subjective feelings. Methods: One hundred volunteers who work in the health care sector reporting elevated workplace-related stress were enrolled and randomized to a 12-min sound intervention (classical music) with either conventional headphones ("MEZE 99 Classic") or with the same-but internally modified-headphone (called "Lautsaenger"). Cardiovascular parameters were measured with the VascAssist2.0, both before and after sound interventions. In addition, participants were asked to complete questionnaires on burnout risk and emotions/stress. Results: The study population consisted mainly of female participants (n = 83), with the majority being students (42%). Median age was 32.5 years (range 21-71). In terms of cardiovascular parameters, a significant reduction in aortic pulse wave velocity, as measure of arterial stiffness, and heart rate was observed within both treatment arms. Both systolic blood pressure and arterial flow resistance were reduced by sound intervention, while these effects were only documented with Lautsaenger. Treatment groups were comparable in terms of subjective feedback by participants: a significant increase in emotional wellbeing was achieved with both headphone systems. Conclusions: A single short-term sound intervention seems to be able to achieve objective cardiovascular improvements in healthy volunteers reporting subjective symptoms of workplace-related stress, using two different headphone systems. Moreover, significant emotional improvement was reported within both arms. Trial Registration: ISRCTN registry 70947363, date of registration August 13, 2021.

Examining the impact of a restorative breath-based intervention "Sudarshan Kriya Yoga" at work: a field experiment

Background

Human capital plays a crucial role in the success of an organization and further contributes to the broader goals of growth and development of society. In this regard, it is essential to ensure the well-being of employees at the workplace. Given the positive impact of yoga on psycho-physiological aspects of health, this study aims to examine the impact of a breath-based yogic intervention, Sudarshan Kriya Yoga (SKY), on stress, anxiety, thriving, general health, emotional well-being, social well-being, and psychological well-being among employees of a leading manufacturing firm in India.

Methods

Undertaking a randomized-control experiment design (n = 64), we examined the impact of SKY on stress, anxiety, thriving, general health, and emotional, social, and psychological well-being. Two certified instructors conducted the SKY intervention in a retreat format over 3 days.

Results

The analysis demonstrated positive outcomes across various aspects of participants' well-being, i.e., it significantly reduced their stress and anxiety and increased the levels of thriving, general health, and emotional, social, and psychological well-being. These findings are valuable for understanding the potential benefits of the SKY intervention.

Discussion

The findings provide support for considering SKY as a potential well-being intervention for employers at the workplace and society at large. Further exploration, implementation, and research in diverse contexts will be crucial to fully understand the long-term impact and scalability of the SKY intervention in promoting holistic well-being.

Changes in harm reduction service providers professional quality of life during dual public health emergencies in Canada

BACKGROUND

Harm reduction (HR) is a critical response to the pronounced toxicity deaths being experienced in Canada. HR providers report many benefits of their jobs, but also encounter chronic stress from structural inequities and exposure to trauma and death. This research study sought to quantify the emotional toll the toxicity emergency placed on HR providers (Cycle One; 2019). Study objectives were later expanded to determine the impact of the ongoing toxicity as well as the pandemic's impact on well-being (Cycle Two; 2021).

METHODS

Standardized measures of job satisfaction, burnout, secondary traumatic stress, and vulnerability to grief were used in an online national survey. Open-ended questions addressed resources and supports. HR partners across Canada validated the findings and contributed to alternative interpretations and implications.

RESULTS

651 respondents in Cycle One and 1,360 in Cycle Two reported moderately high levels of job satisfaction; they reported finding great meaning in their work. Yet, mean levels of burnout and secondary traumatic stress were moderate, with the latter significantly increasing in Cycle Two. Reported vulnerability to grief was moderate but increased significantly during COVID. When available, supports lacked the quality necessary to respond to the complexities of HR workers' experiences, or an insufficient number of sessions were covered through benefits. Respondents shared that their professional quality of life was affected more by policy failures and gaps in the healthcare system than it was by the demands of their jobs.

CONCLUSION

Both the benefits and the strain of providing harm reduction services cannot be underestimated. For HR providers, these impacts are compounded by the drug toxicity emergency, making the service gaps experienced by them all the more critical to address. Implications highlight the need for integration of HR into the healthcare system, sustainable and reliable funding, sufficient counselling supports, and equitable staffing models. Support for this essential workforce is critical to ensuring the well-being of themselves, the individuals they serve, and the health of the broader healthcare system.

Addressing Health Care Workers' Mental Health: A Systematic Review of Evidence-Based Interventions and Current Resources

Background. Mental health is declining in health care workers. Objectives. To provide a comprehensive assessment of intervention literature focused on the support and treatment of mental health within the health care workforce. Search Methods. We searched online databases (e.g., Medline, PsycINFO). Selection Criteria. We selected manuscripts published before March 2022 that evaluated the target population (e.g., nurses), mental health outcomes (e.g., burnout, depression), and intervention category (e.g., mindfulness). Data Collection and Analysis. Of 5158 publications screened, 118 interventions were included. We extracted relevant statistics and information. Main Results. Twenty (17%) earned study quality ratings indicating design, analysis, and implementation strengths. Randomized controlled trials were used by 52 studies (44%). Thirty-eight percent were conducted in the United States (n = 45). Ninety (76%) reported significant changes, and 46 (39%) reported measurable effect sizes. Multiple interventions significantly reduced stress (n = 29; 24%), anxiety (n = 20; 17%), emotional exhaustion or compassion fatigue (n = 16; 14%), burnout (n = 15; 13%), and depression (n = 15; 13%). Authors' Conclusions. Targeted, well-designed mental health interventions can improve outcomes among health care workers. Public Health Implications. Targeted health care‒focused interventions to address workers' mental health could improve outcomes within this important and vulnerable workforce. (Am J Public Health. 2024;114(S2):S213-S226. https://doi.org/10.2105/AJPH.2023.307556).

Impact of Yoga on anxiety, stress and sleep quality among health care professionals during a public health crisis

BACKGROUND

Health care professionals (HCPs) working on the frontlines of health care emergencies/pandemics often experience elevated anxiety, stress and reduced quality of sleep. Yoga is a mind-body practice that has been proven to effective in improving physical and mental health.

OBJECTIVE

To evaluate the effectiveness of integrated Yoga intervention on mental health measures and sleep quality among HCPs working during the COVID-19 pandemic.

METHODS

This quasi-experimental study was conducted on 110 HCPs, including Doctors and nursing staff, with an age range of 20 to 65 years who were recruited through a convenience sampling method and assigned to a Yoga group (n = 55) or a control group (n = 55). The Yoga group received a weekly one-hour Yoga session followed by a 30-minute self-practice three times a week at home for one month. The control group followed routine activity. Heart rate (HR), Blood Pressure, stress measures (Perceived Stress and visual analogue Scale for Stress), COVID-related anxiety, Sleep Quality, Quality of life and Preservative Thinking were assessed before and after the intervention.

RESULTS

A significant decrease in stress measures, COVID-19-related anxiety and fear, and perseverative thinking was noticed in the Yoga group. Sleep quality and quality of life also improved significantly. The control group showed no significant change. At one month, the Yoga group showed significantly greater improvement in stress measures, COVID-19-related anxiety and fear, perseverative thinking, sleep quality and quality of life compared to the control group.

CONCLUSION

Yoga practice during the public health crisis would help reduce anxiety and stress and improve sleep among HCPs. Further randomized controlled trials are warranted.

Āsana for Back, Hips and Legs to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yóga Protocol

Dental professionals are exposed to significant unavoidable physical stress, and theoretical ergonomic recommendations for a sitting workplace are inapplicable in many dental activities. Work-related musculoskeletal disorders (WMSDs) represent a serious health problem among dental professionals (prevalence: 64-93%), showing involvement of 34-60% for the low back and 15-25% for the hips. Muscle stress; prolonged sitting; forward bending and twisting of the torso and head; unbalanced working postures with asymmetrical weight on the hips and uneven shoulders; and others are inevitable for dental professionals. Therefore, the approach for the prevention and treatment of WMSDs must be therapeutic and compensatory. This project was conceived to provide a Yoga protocol for dental professionals to prevent or treat WMSDs from a preventive medicine perspective, and it would represent a Yoga-based guideline for the self-cure and prevention of musculoskeletal problems.

METHODS

Specific Yoga positions (āsana, such as Virāsana, Virabhadrāsana, Garudāsana, Utkatāsana, Trikonāsana, Anuvittāsana, Chakrāsana, Uttanāsana, Pashimottanāsana) have been selected, elaborated on and adapted to be practiced in a dental office using a dental stool or the dental office walls or a dental unit chair. The protocol is specifically devised for dental professionals (dentists, dental hygienists and dental assistants) and targeted for the low back, hips and legs (including knees and ankles). The protocol includes Visranta Karaka Sthiti (supported positions) in sitting (Upavistha Sthiti) and standing (Utthistha Sthiti) positions, twisting/torsions (Parivrtta), flexions/forward bend positions (Pashima) and extensions/arching (Purva) for musculo-articular system decompression and mobilization.

RESULTS

Over 60 Yogāsana-specifically ideated for back detensioning and mobilization, lumbar lordosis restoration, trunk side elongation, hip release and leg stretches and decontraction-are shown and described. The paper provides a meticulous description for each position, including the detailed movement, recommendations and mistakes to avoid, and the breathing pattern (breath control) in all the breath-driven movements (āsana in vinyāsa). An exhaustive analysis of posture-related disorders affecting the lower body among dental professionals is reported, including low-back pain, hip pain and disorders, piriformis syndrome and quadratus femoris dysfunction (gluteal pain), iliopsoas syndrome, multifidus disorders, femoroacetabular and ischiofemoral impingement, spinopelvic mobility, lumbopelvic rhythm, impairment syndromes, lower crossed syndrome, leg pain, knee pain and ankle disorders.

CONCLUSIONS

A detailed guideline of āsana for low-back decompression, hip joint destress, piriformis and gluteal muscle release, lumbar lordosis recovery and a spinopelvic mobility increase has been elaborated on. The designed Yogāsana protocol represents a powerful tool for dental professionals to provide relief to retracted stiff muscles and unbalanced musculoskeletal structures in the lower body.

Chain mediations of perceived social support and emotional regulation efficacy between role stress and compassion fatigue: insights from the COVID-19 pandemic

Background

Nurses at the frontline faced high risks of the COVID-19 infection, undertook heavy workloads of patient care, and experienced tremendous stress that often led to compassion fatigue.

Aim

This study was to explore the role of positive psychosocial resources (i.e., perceived social support and emotional regulation efficacy) in the relationship between role stress and compassion fatigue.

Methods

A cross-sectional design was conducted in Hubei Province, China between May and September 2021. The Role Stress Questionnaire, the Perceived Social Support Scale, the Emotional Regulation Efficacy Scale, and the Professional Quality of Life Scale were used to measure key variables of interest. Nurse socio-demographic data were also collected. Structural equation modeling was used to explore the relationships, including potential mediating effect, among role stress, perceived social support, emotional regulation efficacy, and compassion fatigue.

Results

A total of 542 nurses participated in this investigation, and 500 were eventually enrolled in the analysis. The incidence of compassion fatigue among nurses was 94.2%, including 65.8% of nurses reporting at least moderate compassion fatigue. Univariate analysis showed that educational level, marital status, hospital rank, sleep time were the factors affecting compassion fatigue of the nurses. The structural equation modeling revealed that: Role stress had a direct positive effect on compassion fatigue; Perceived social support and emotional regulation efficacy partially mediated the link between role stress and compassion fatigue respectively; And there was a chain mediating role of perceived social support and emotional regulation efficacy between role stress and compassion fatigue.

Conclusion

The incidence of compassion fatigue was high during the COVID-19 pandemic among bedside nurses in China. Improving social support and enhancing the efficacy of emotion regulation may help alleviate compassion fatigue directly and/or via buffering the impact of role stress.

Efficacy of mHealth aided 12-week meditation and breath intervention on change in burnout and professional quality of life among health care providers of a tertiary care hospital in north India: a randomized waitlist-controlled trial

Introduction

Burnout is "Chronic workplace stress that has not been successfully managed." Professional quality of life (PQL) includes work related experiences of compassion satisfaction and compassion fatigue. Healthcare providers (HCPs) are highly susceptible to burnout and compassion fatigue due to their demanding work, which lowers PQL. Burnout leads to poor care, medical errors, and patient safety across healthcare disciplines. Yoga has been shown to improve resilience, reduce stress, and increase self-compassion and psycho-physiological coherence. This study compared HCPs in a mHealth-aided 12-week yoga-based meditation and breath intervention to waitlist controls for HCP burnout and PQL at a north Indian tertiary care hospital.

Methods

This was randomized waitlist-controlled trial. Total 98 HCPs (62 males and 36 females) with an average age of 28.26 ± 3.547 years were enrolled consecutively from March 2021 to November 2022. Randomization was done with opaque sealed envelopes numbered in a computer-generated sequence. The experimental group (n = 49) received 12 online weekly yoga sessions and performed daily home practice (6 days a week). The waitlisted control group (n = 49) continued their daily routine. Maslach's burnout inventory (MBI), professional quality of life (PQL) and anthropometric measurements were assessed at baseline and after 12 weeks.

Results

After 12 weeks, the MBI outcomes of emotional exhaustion, depersonalization, and personal accomplishment showed a highly significant difference between the two groups (p < 0.001). PQL outcomes of compassion satisfaction, burnout, and secondary trauma also differed significantly (p < 0.001). Within group analysis showed that MBI and PQL outcomes improved significantly (p < 0.001) for the experimental group after 12 weeks.

Conclusion

The current study contributes to the existing evidence on the effectiveness of Yoga in managing stress and developing resilience among doctors, nurses, and other medical professionals. Integrating yoga into healthcare settings is crucial for addressing the detrimental impact of burnout on decision-making and promoting positive patient outcomes. mHealth technologies have the potential to enhance the user-friendliness of yoga-based interventions by personalizing the practice space and time. Yoga-based interventions and mHealth technologies can effectively address physician burnout, in a simple and implementable manner.

Impact of 10-Min Daily Yoga Exercises on Physical and Mental Discomfort of Home-Office Workers During COVID-19

OBJECTIVE

Evaluate the effects of 10 min/day of yoga for 1 month on musculoskeletal discomfort and mood disturbance of home-office workers.

BACKGROUND

The COVID-19 pandemic forced many people to switch to teleworking. The abrupt change from an office setting to an improvised home-office may negatively affect the musculoskeletal and emotional health of workers. By providing mental and physical exercises, yoga may be effective in reducing adverse effects.

METHOD

Fifty-four participants (42 women, 12 men) followed a 1-month yoga program, while 40 participants (26 women, 14 men) continued with their common work routine. The Cornell Musculoskeletal Discomfort Questionnaire was used to evaluate severity, interference with work and frequency of pain, and to obtain a total discomfort score for 25 body areas. Mood disturbance was evaluated with the Profile of Mood States questionnaire. Both groups completed both questionnaires, before and after the experimentation period.

RESULTS

After 1 month, for the yoga group only, significant reductions were observed in the discomfort of eyes, head, neck, upper and lower back, right wrist, and hips/buttocks, as well as reductions in discomfort severity, frequency and interference for the neck, upper and lower back. Total mood disturbance was also significantly reduced for the yoga group only. No favorable changes occurred for the control group.

CONCLUSION

The yoga intervention program appears to reduce musculoskeletal discomfort and mood disturbance of home-office workers.

APPLICATION

Sedentary workers may benefit from 10 min/day of yoga during the workday to attenuate potential physical and emotional discomfort during the current pandemic and beyond.

Stress, Burnout, and General Mental Health among Healthcare Workers in Poland during the Long-Lasting COVID-19 Pandemic

Medical professions are characterized by a great responsibility for human health and life; they are also vulnerable to burnout. The outbreak of the COVID-19 pandemic has brought new challenges and threats. This study aimed to assess the mental health of healthcare workers after a year and a half of working in COVID-19 pandemic conditions. The Perceived Stress Scale (PSS-10), the Link Burnout Questionnaire (LBQ), and the General Health Questionnaire (GHQ-28) were utilized in this cross-sectional investigation. A total of 335 healthcare employees from Polish hospitals (median age 44 years) filled out online questionnaires between the 16 August 2021 and the 30 March 2022. Most of the sample was female (86%). In this study, 40.0% of the surveyed healthcare workers reported a high stress intensity. Burnout was reported by 9.6% of the workers, and the most frequently experienced symptom was psychophysical exhaustion. Almost half of the healthcare workers surveyed (49.6%) reported health disorders at both the mental and physiological levels. Interestingly, working in a COVID-19 ward did not significantly differentiate healthcare workers in any of the evaluated variables: PSS-10 (gr. A F = 1.21; gr. B F = 0.71; p > 0.05), LBQ (gr. A F = 1.89, F = 0.94, F = 1.08, F = 2.57; gr. B F = 0.32, F = 1.14, F = 0.77, F = 0.36; p > 0.05), and GHQ-28 (gr. A F = 0.85, F = 0.52, F = 0.57, F = 0.31; gr. B F = 0.31, F = 0.06, F = 0.06, F = 0.54; p > 0.05). Furthermore, there were no statistically significant differences between the compared occupational groups of healthcare workers: PSS-10 (F = 1.08; p > 0.05) and GHQ-28 (F = 1.78; F = 0.85; F = 0.62; F = 0.54; p > 0.05). The mental health of healthcare workers is alarming, and psychophysical conditions can affect the quality of work and relations with patients. Psychological care in workplaces and workshops that build resources for dealing with difficult situations are necessary.

A student-driven mindfulness curriculum for first-year osteopathic medical students: a pilot study

CONTEXT

Medical education is stressful and can adversely affect the health and well-being of students. Although mindfulness-based interventions (MBIs) have been successfully utilized in other settings, little is known about the use of student-led interventions in undergraduate medical education.

OBJECTIVES

The objectives of this study are to assess student satisfaction with four student-selected and student-led mindfulness activities incorporated into mandatory small-group sessions, the immediate impact of these activities on student stress levels, and student use of these activities outside the mindfulness sessions.

METHODS

First-year osteopathic medical students voluntarily participated in weekly student-selected and student-led mindfulness activities once a week for 8 consecutive weeks during regularly scheduled class time. Activities included yoga postures, the 4-7-8 breathing technique, progressive muscle relaxation (PMR), and values affirmation. Each activity was completed twice during the 8 weeks. After each session, students could anonymously complete an electronic survey assessing participation, change in stress level, satisfaction with the activity, and mindfulness activities practiced outside the session. Survey questions included dichotomous, Likert-like, and multiple-choice responses. A chi-square test was utilized to analyze student responses from each week about the decrease in stress level, and satisfaction with the mindfulness activity, and student use of the activities outside the classroom. Wilcoxon rank sum tests were utilized to determine associations between outcomes, and a logistic regression model was utilized to determine relationships between the change in stress levels and other outcomes.

RESULTS

Of the 154 first-year medical students initially enrolled in the 2021-2022 academic year, 14 (9.1 %) to 94 (61.0 %) actively participated in the weekly mindfulness activities. Students indicated that the 4-7-8 breathing technique was the activity most practiced outside the mindfulness sessions (32.3 %, 43/133 total responses) across all weeks. The mindfulness activity with the highest percentage of reported decrease in stress level was the yoga postures in week 5 (94.8 %, 36/38), and both weeks of the yoga activities had the highest reported student satisfaction (95.7 %, 90/94 for week 1; 92.1 %, 35/38 for week 5). For students who answered the change in stress level question, the stress level decrease was related to participation in the weekly activity for weeks 1 through 7 (all p<0.03). For students who participated in mindfulness sessions, the odds of reporting a reduction in the stress level were 16.6 times (95 % CI, 6.8-47.2; p<0.001) that of students who did not participate. For those satisfied with the activities, the odds of reporting a reduction in stress level were 6.7 (95 % CI, 3.3-13.9; p<0.001).

CONCLUSIONS

Results suggested that the student-selected and student-led mindfulness activities may successfully reduce medical student stress in students who actively participate. However, additional research is needed to determine how to optimize mindfulness curricula implementation.

Effect of Structured Yoga Program on Stress and Well-being Among Frontline Healthcare Workers During COVID-19 Pandemic

CONTEXT

Frontline healthcare workers are at risk of developing psychological distress during a pandemic. Yoga, a form of mind-body medicine can reduce body stress and increases well-being.

AIMS

To assess the effect of yoga on the stress and well-being of healthcare workers during the COVID-19 pandemic.

SETTINGS AND DESIGN

This single-arm pre-post study was conducted among frontline health workers (support staff, paramedics, and medics) posted at a secondary care hospital in a North Indian district.

METHODS AND MATERIALS

Basic demographic details, blood pressure, anthropometric variables like height, weight, and biochemical variables like glycosylated hemoglobin (Hb1Ac), fasting and post-prandial blood sugar, lipid profile, serum cortisol, and C-reactive protein were measured. Stress levels were assessed using the depression anxiety and stress scale (DASS)-21 while well-being was assessed using the World Health Organization (WHO)-5 well-being scale. Twelve weeks of supervised yoga session was provided for 1 hour per session, 3 times per week.

STATISTICAL ANALYSIS

The mean value was compared from baseline to post-intervention with paired t-test/Wilcoxon signed rank test.

RESULT

A total of 89 participants were enrolled, 53 (59.5%) being male. Two-thirds of the participants were aged 20-39 years. During follow-up, 80 participants completed 12 weeks of yoga sessions. Post-intervention DASS-21 score decreased and WHO-5 increased significantly. The glycosylated hemoglobin (HbA1c) level and cholesterol-HDL ratio decreased significantly. Other variables didn't change significantly. No adverse effects were reported by the participants.

CONCLUSION

Supervised structured yoga sessions helped decrease stress, depression, and anxiety and improved well-being. Therefore, it can be a feasible strategy to manage workplace-related stress and phycological morbidities.

Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review

There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19.

OBJECTIVES

To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals.

DESIGN

Systematic literature review.

DATA SOURCES

Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May-October 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included.

DATA EXTRACTION AND SYNTHESIS

Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesised and presented in both quantitative and narrative formats. Meta-analysis was not possible due to variations in study designs and outcomes.

RESULTS

A total of 1663 articles were screened for eligibility, with 33 meeting inclusion criterium. Thirty studies used individually focused interventions, while three were organisationally focused. Thirty-one studies used secondary level interventions (managed stress in individuals) and two were primary level (eliminated stress causes). Mindfulness-based practices were adopted in 20 studies; the remainder used meditation, yoga and acupuncture. Other interventions promoted a positive mindset (gratitude journaling, choirs, coaching) while organisational interventions centred on workload reduction, job crafting and peer networks. Effective outcomes were reported in 29 studies, with significant improvements in well-being, work engagement, quality of life and resilience, and reductions in burnout, perceived stress, anxiety and depression.

CONCLUSION

The review found that interventions benefitted healthcare workers by increasing well-being, engagement and resilience, and reducing burnout. It is noted that the outcomes of numerous studies were impacted by design limitations that is, no control/waitlist control, and/or no post intervention follow-up. Suggestions are made for future research.

The Relationship between COVID-19 Exposure Risk and Burnout in Prehospital Emergency Medical Technicians

Introduction

Exposure to coronavirus disease 2019 (COVID-19) has caused many physical and psychological effects on front-line healthcare workers (HCWs). This study aimed to assess the relationship between the exposure risk to COVID-19 disease and burnout in prehospital emergency medical technicians (EMTs).

Methods

In this correlational study, 335 prehospital EMTs were selected by random sampling method from the 49 stations of emergency medical services in the northwest of Iran. Data were collected using a questionnaire developed by the world health organization for the risk assessment and management of exposure of health care workers to COVID-19. Moreover, Pines burnout measure was used for the assessment of participants' burnout. Data were analyzed using SPSS version 13.

Results

Results showed that 30.7 % of prehospital EMTs had a high burnout score against COVID-19 disease. The prehospital EMTs who had a high occupational exposure risk experienced a high risk of burnout (P=0.03). The results of the linear regression analysis showed that prehospital EMTs who had a low exposure risk of COVID-19 had a low burnout score (β=-9.30; P<0.001), and those who had less than 10 years of work experience showed less burnout (β=-10.54; P<0.001).

Conclusion

According to the results, the exposure risk to COVID-19 increases the prehospital EMT's burnout. As a result, reducing the exposure risk to COVID-19 by providing adequate access to personal protective equipment (PPE), development of training and following standards and protocols can be effective in controlling burnout in HCWs.

Perceived benefit of yoga among adults who have practiced yoga for a long time: a qualitative study

BACKGROUND

Previous quantitative studies have shown many of the perceived benefits of yoga practice on the mind and body. Although there are many quantitative studies in the international literature on yoga, the number of qualitative studies showing the experience of yoga practice is insufficient. An accurate demonstration of yoga participents experiences, opinions, and judgments on this subject requires a qualitative, rather than a quantitative approach.

PURPOSE

This study was to explore the benefit perceived by adults who have practiced yoga for a long time.

DESIGN AND METHOD

This qualitative study is based on a hermeneutic-phenomenological approach. The research sample consisted of 18 adults who volunteered to participate in the research and regularly joined yoga practice. The study data were collected through individual and focus group interviews with the participants who practise yoga and analyzed by content analysis method.

RESULTS

We created five themes. Themes coded by researchers: meaning of the concept of yoga (theme 1), physical, mental, and social state before starting yoga (theme 2), reasons for practising yoga (theme 3), the participants' experiences related to their physical and mental health and social relationships (theme 4), and difficulties of doing yoga (theme 5). In addition, individuals in the study reported their perceptions of the concept of "yoga" through the creation of metaphors that completed the following sentence "yoga is like ……". These metaphors were used to give insight into the participants deep feelings about yoga.

CONCLUSIONS

Both in their individual and focus group interviews, almost all of the participants described that doing yoga has positive benefits on the mind and body. The positive experiences of the participants in the study included decrease in pain and flexibility, increase in sleep quality, development of positive personality traits, increase in self-esteem, and coping with anxiety and stress more effectively. Because the study was qualitative and long-term, it was able to evaluate the beliefs, attitudes and behaviors of individuals in a realistic, systematic, and detailed manner.

Yoga for Preventive Health: A Holistic Approach

Yoga has been prevalent for over 5000 years; it originated in India and has become an essential lifestyle ingredient for achieving optimal health. The goal of this article in lifestyle modification is to increase awareness about the benefits of yoga and how its practice can reduce the overall risk of chronic diseases. Yoga has been proven to be therapeutic for enhancing immunity and support management of chronic diseases such as cardiovascular, respiratory, endocrine disorders, obesity, cancer, and metabolic syndrome. Yoga techniques called asanas, such as pranayama for breathing regulation and dhyana for meditation, boost innate immune response, interrupt inflammation, and thereby prevent the manifestation of chronic diseases. Yoga also provides symptomatic relief for chronic arthritis by increasing joint flexibility and microcirculation. Yoga and meditation regulate neurotransmitters, neuropeptides, hormones, and cytokines that mediate interactions between the central nervous system and the immune system. These techniques reduce the psychological and physiological effects of chronic stress. Serotonin, oxytocin, and melatonin released directly due to practicing yoga have been shown to better manage anxiety and fear, especially during the pandemic. We believe the current trends of chronic disease management will become more effective with the implementation of lifestyle changes using yoga.

Restorative yoga therapy for third-year medical students in pediatrics rotation: Working to improve medical student well-being

BACKGROUND

Stress experienced by medical students is a well-documented and widespread phenomenon that may have physical and psychological effects on their well-being. One solution is to provide students with the tools to recognize and cope with stress. The aim of this study was to incorporate restorative yoga training-a well-recognized tool for stress reduction-in the third-year medical student pediatrics clerkship and assess the intervention's impact on students' well-being.

MATERIALS AND METHOD

Restorative yoga, as a prospective intervention, was offered to third-year medical students at Texas Tech University Health Sciences Center during their pediatrics rotation. The study was between March and August 2020. Each yoga session lasted 45-minutes, once a week for six weeks. Participants completed anonymous questionnaires before and after the intervention via the Warwick-Edinburgh Mental Well-being Scale (WEMWBS).

RESULT

Over the six-month study period, 25 (71%) of 35 medical students, having been given the option, chose to participate. The WEMWBS contains 14 statements on well-being, and all but one from the list showed a positive increase in average rating from pre intervention to post intervention. The statements "I've been feeling more relaxed" and "I've been thinking clearly" showed the greatest average increase. Following Chi-squared testing, two statements were found to be significantly different (P < 0.05) before intervention and after intervention: "I've been feeling more relaxed" and "I've been feeling good about myself."

CONCLUSION

Students' well-being is paramount to medical schools. Restorative yoga offers hopeful outcomes for effective mitigation of the stresses of medical education and may be recommended for wider use.

Āsana for Neck, Shoulders, and Wrists to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yóga Protocol

Extensive literature reports an increase in physical disorders (pain, pathologies, dysfunctions) and mental malaise/uneasiness (stress, burnout) affecting dental professionals in relation to fast and pressing rhythms of work, long working hours, increasingly demanding patients, ever-evolving technologies, etc. This project has been conceived to bring the science of yoga around the world to dental professionals as a preventive (occupational) medicine and to provide knowledge and means for self-care. Yoga is a concentrative self-discipline of the mind, senses, and physical body, that requires regular daily exercise (or meditation), attention, intention, and disciplined action. M&M: The study aimed to design a Yoga protocol specifically devised for dental professionals (dentists, dental hygienists, and dental assistants) including positions (āsana) to be practiced/used in the dental office. The protocol is targeted for the upper body, namely neck, upper back, chest, shoulder girdle, and wrists, being areas greatly affected by work-related musculoskeletal disorders. This paper represents a yoga-based guideline for the self-cure of musculoskeletal disorders among dental professionals. Results: The protocol includes both sitting (Upavistha position) and standing (Utthana or Sama position) āsana, with twisting (Parivrtta), side bending (Parsva), flexion and forward bending (Pashima), and extension and arching (Purva) āsana to mobilize and decompress, and to provide nourishment and oxygen to the musculo-articular system. The paper delivers different concepts and theories developed and deepened by the authors and introduces and spreads yoga as a medical science among dental professionals for the prevention and treatment of work-related musculoskeletal disorders. We articulate notions ranging from stretching out using the vinyāsa method (breath-driven movement) and inward-focused attention to contemplative/concentrative science, interoceptive attention, self-awareness, the mind-body connection, and receptive attitude. The theory of "muscles are bone ties" is coined and delivered with regard to tensegrity musculoskeletal fascial structures connecting, pulling together, and nearing the bone segments where they are anchored. The paper describes over 60 āsana envisaged to be performed on dental stools or using the walls of a dental office or a dental unit chair. A detailed guideline on the work-related disorders that can find relief with the protocol is provided, including the description of breath control for the practice of āsana in vinyāsa. The foundations of the technique reside in the IyengarYoga method and ParināmaYoga method. Conclusions: This paper represents a guideline for self-cure in the prevention or treatment of musculoskeletal disorders affecting dental professionals. Yoga is a powerful concentrative self-discipline able to provide physical and mental well-being, representing great help and support in daily life and business for dental professionals. Yógāsana restores retracted and stiff muscles, giving relief to the strained and tired limbs of dental professionals. Yoga is not intended for flexible or physically performing persons but for people who decide to take care of themselves. The practice of specific āsana represents a powerful tool for the prevention or treatment of MSDs related to poor posture, forward head, chronic neck tension (and related headache), depressed chest, compressive disorders on wrists and shoulders as carpal tunnel, impingement syndromes, outlet syndrome, subacromial pain syndrome and spinal disc pathologies. Yoga, as an integrative science in medicine and public health, represents a powerful tool for the prevention and treatment of occupational musculoskeletal disorders and an extraordinary path for the self-care of dental professionals, sitting job workers, and healthcare providers suffering from occupational biomechanical stresses and awkward postures.

Dismantling the Component-Specific Effects of Yogic Breathing: Feasibility of a Fully Remote Three-Arm RCT with Virtual Laboratory Visits and Wearable Physiology

Despite the growing research base examining the benefits and physiological mechanisms of slow-paced breathing (SPB), mindfulness (M), and their combination (as yogic breathing, SPB + M), no studies have directly compared these in a "dismantling" framework. To address this gap, we conducted a fully remote three-armed feasibility study with wearable devices and video-based laboratory visits. Eighteen healthy participants (age 18-30 years, 12 female) were randomized to one of three 8-week interventions: slow-paced breathing (SPB, N = 5), mindfulness (M, N = 6), or yogic breathing (SPB + M, N = 7). The participants began a 24-h heart rate recording with a chest-worn device prior to the first virtual laboratory visit, consisting of a 60-min intervention-specific training with guided practice and experimental stress induction using a Stroop test. The participants were then instructed to repeat their assigned intervention practice daily with a guided audio, while concurrently recording their heart rate data and completing a detailed practice log. The feasibility was determined using the rates of overall study completion (100%), daily practice adherence (73%), and the rate of fully analyzable data from virtual laboratory visits (92%). These results demonstrate feasibility for conducting larger trial studies with a similar fully remote framework, enhancing the ecological validity and sample size that could be possible with such research designs.

Internal Corporate Social Responsibility and Employee Burnout: An Employee Management Perspective from the Healthcare Sector

Purpose

The issue of burnout has been identified as one of the most pressing challenges in organizational management, impacting the ability of an organization to succeed as well as employee productivity. In the healthcare industry, burnout is particularly prevalent. Burnout has received increasing attention from scholars, and different models have also been proposed to address this issue. However, burnout is on the rise in healthcare, especially in developing countries, indicating the need for more research on how to mitigate burnout. Research indicates that internal corporate social responsibility (ICSR) has a significant impact on employee behavior. However, little attention has been paid to exploring how ICSR might effectively reduce healthcare burnout. This study aims to investigate how ICSR and employee burnout are related in the healthcare sector of a developing country. In addition, we tested how subjective well-being and resilience mediate and moderate the effect of ICSR on employee burnout.

Methods

Data were collected from 402 healthcare employees working in different hospitals in Pakistan. In our study, we used a self-administered questionnaire as a data collection instrument. We have adapted the items in this survey from reliable and already published sources. Data collection was carried out in three waves.

Results

Hypotheses were evaluated using structural equation modeling (SEM). Software such as IBM-SPSS and AMOS were used for this purpose. ICSR significantly reduces healthcare employees' burnout, according to the results of the structural analysis. The relationship between ICSR and burnout was also found to be mediated by subjective well-being, and resilience moderated the relationship between ICSR and subjective well-being.

Findings

In light of our findings, hospitals can take some important steps to resolve the problem of burnout. The study specifically stresses the importance of ICSR as a contextual organizational resource for preventing burnout among healthcare employees.

Predictors of perceived stress and quality of life amongst dental master and doctoral students

OBJECTIVES

This study aimed to identify predictors of perceived stress and quality of life (QoL) amongst dental master and doctoral students.

MATERIALS AND METHODS

This is a cross-sectional study with Brazilian students as participants (n = 707). The following instruments were administered: Perceived stress scale (PSS), the WHOQOL-BREF and a socio-demographic questionnaire. A linear regression model was estimated.

RESULTS

The results showed that female was associated with higher scores of PSS and lower scores of QoL. A negative correlation was observed between PSS and all four domains of QoL. Multivariate analysis revealed that the set of selected variables partially explained the variability of PSS score (28%) and the four QoL domains: physical (52%), psychological (62%), social relationships (25%) and environment (37%). The variable number of children, hours of sleep, concurrent work and study, leisure time and physical activity practice were associated with positive changes on QoL, whilst PSS and medication intake with negative. Lower PSS score was associated with the variables age, hours of sleep, leisure time and physical activity.

CONCLUSIONS

Our findings suggest that perceived stress and medication intake due to study are important predictors of lower QoL in dental master and doctoral students, especially in the psychological domain. More hours of sleep, leisure time and physical activity improved both QoL and perceived stress scores and might be feasible coping strategies for these outcomes in this population.

Yoga for COVID-19: An ancient practice for a new condition - A literature review

A substantial proportion of people with acute COVID-19 develop post-COVID-19 condition (previously known as long-COVID) characterized by symptoms that persist for months after the initial infection, including neuropsychological sequelae. Post-COVID-19 condition frequency varies greatly according to different studies, with values ranging from 4 to 80% of the COVID-19 patients. Yoga is a psycho-somatic approach that increases physical, mental, emotional and spiritual strength, and connection. Yoga practice enhances innate immunity and mental health, so it can be used as complementary therapy in the COVID-19 treatment, namely the post-COVID-19 condition. In this article, we conducted a literature review on yoga and COVID-19, finding that an intervention comprising asana, pranayama, and meditation may be a strategy of choice for these patients' recovery. However, further studies are needed to show its effectiveness in this, still unknown, context.

Feeling Informed and Safe Are Important Factors in the Psychosomatic Health of Frontline Workers in the Health Sector during the COVID-19 Pandemic in Austria

The global spread of the coronavirus disease (COVID-19) has created new challenges for the entire healthcare system, and those who work directly with the patients or even on the front lines with COVID-19 patients have been particularly stressed. Only a few studies are currently available investigating psychosomatic symptoms among healthcare workers, particularly frontline workers, over the entire pandemic period (2020-2022). There is also a lack of knowledge about strategies to prevent stress during and after a health crisis.

METHODS

An online survey was conducted at three times (April 2020, winter 2020/2021, and winter 2021/2022) during the COVID-19 pandemic in Austria. The sample included 160 healthcare workers at screening time 1, 1.361 healthcare workers at screening time 2, and 1.134 healthcare workers at screening time 3. The survey included COVID-19 work-related fears, satisfaction with the frontline work, and standardized inventories to assess psychosomatic symptoms, such as the Patient Health Questionnaire (PHQ-D).

RESULTS

Psychosomatic symptoms were more common among women compared to men, and among frontline workers compared to non-frontline workers, especially during the course of the pandemic at t2 and t3. Self-reported scores of COVID-19 work-related fears were significantly associated with psychosomatic symptoms. Furthermore, in frontline workers, there was a significant association between the feeling of being safe and well-informed and psychosomatic symptoms.

CONCLUSION

COVID-19 work-related fears and psychosomatic symptoms have been prevalent among healthcare workers throughout the pandemic. Feeling safe and informed appears to be essential to prevent psychosomatic symptoms, leading to a recommendation for employers in the healthcare sector to focus on communication and information. As frontline workers are especially prone to psychosomatic symptoms, more stress prevention programs for them will be essential to maintain productivity and reduce sick days and fluctuations in the healthcare system.

Journey Mapping Healthcare Worker Experience With Heart Rhythm Meditation

BACKGROUND

Levels of stress and burnout continue to rise amongst healthcare workers. In addition to systemic and institution-level changes to healthcare practice environments, well-being interventions, resources, and support to assist healthcare providers are necessary. Meditation practices like Heart Rhythm Meditation (HRM) may provide benefits to healthcare workers, but healthcare worker experiences with HRM are not well understood.

OBJECTIVE

To explore healthcare worker experiences with HRM using a journey mapping approach.

METHODS

An exploratory cross-sectional online survey was administered between May and July of 2020 to a purposeful sample of 25 healthcare workers currently practicing HRM. Surveys consisted of 5 open-ended and 36 multiple-choice items mapped to five journey mapping domains: Discover, Search, Assess, Decide, Assist. Descriptive statistics for survey items were generated in addition to a visual representation of a Persona and associated journey map for HRM. Content analysis was performed on open-ended responses using a general inductive approach to code responses and identify representative quotes.

RESULTS

Twenty surveys were completed for a response rate of 80%. The majority of respondents identified as women (n = 14). From the journey mapping output, the overall emotional experience score was an 8.2/10, suggesting respondents had positive experiences with HRM. Open-ended comments suggest that HRM provides important benefits to the personal and professional lives of healthcare workers. A small number of participants reported challenges like feeling difficult emotions during HRM practice.

CONCLUSION

Mapping the healthcare worker journey with HRM identified generally positive experiences with personal and professional benefits. While experiences were largely positive, HRM elicited difficult emotions from some individuals, suggesting that appropriate resources and support are required when considering HRM and other meditation forms.

Nurses' emotional exhaustion: Prevalence, psychosocial risk factors and association to sick leave depending on care setting-A quantitative secondary analysis

AIMS

To explore differences in the prevalence, psychosocial risk factors and the connection to annual sick leave of nurses' emotional exhaustion depending on the care setting.

DESIGN

Quantitative study.

METHODS

We conducted a secondary data analysis of a cross-sectional, representative survey with German nurses (BIBB/BAuA-Employment Survey 2018). We analysed data from three groups of nurses (hospital care HC: n = 333, nursing homes NH: n = 143, home health care HHC: n = 109). We calculated prevalence estimates for all psychosocial risk factors and emotional exhaustion and utilized Χ² -tests to explore differences relating to the care setting. We calculated risk estimates using logistic regression analyses.

RESULTS

Forty-four per cent of all nurses reported symptoms of emotional exhaustion. Care settings did not affect prevalence estimates (HC: 45.3%, NH: 37.8%, HHC: 50.5%). Weekend work was a risk factor for exhaustion. Being at the limit of efficiency was the only work-related psychosocial risk factor being independent of the care setting. Emotional demands were a significant risk factor for nurses working in HC and NH, and low team cooperation was a risk factor for nurses working in NH. Nurses' emotional exhaustion is associated with more sick leave days.

CONCLUSIONS

The high prevalence of nurses' emotional exhaustion is independent of the care setting. This threatens nurses' health and negatively affects the organization and society due to the relation to sick leave. Weekend work and quantitative demands relate to exhaustion independently of the care context. Emotional demands and low team cooperation show context-specific correlations.

IMPACT

Organizational interventions that limit quantitative demands are needed to prevent exhaustion among nurses. In HC and NH, measures are needed to improve coping with emotional demands and to strengthen team cooperation. Policymakers and nursing managers should take action to address nurses' emotional exhaustion.

NO PATIENT OR PUBLIC CONTRIBUTION

Due to the study design.

From Corporate Social Responsibility to Employee Well-Being: Navigating the Pathway to Sustainable Healthcare

Purpose

Despite extensive research on the impact of corporate social responsibility (CSR) on employee outcomes, only limited research has been conducted to investigate the impact of CSR on healthcare employees' burnout (BUO). Additionally, the underlying mechanism by which CSR may reduce BUO has not been fully understood. In order to fill these gaps, we explored the relationship between CSR and BUO, as well as the possible mediating effects of subjective wellbeing (SW) and compassion (CM). Also, employee admiration (AM) was examined as a moderating factor.

Methods

The study utilized a questionnaire to collect data, which was distributed using the paper-pencil method. A total of 335 healthcare employees, including nurses, doctors, paramedics, and general administration, participated in the study. Specifically, we focused on the healthcare segment of Pakistan. A survey was conducted to assess participants' perceptions of CSR practices, BUO, AM, SW, and CM within their organizations. The questionnaire consisted of several standardized scales validated in previous research.

Results

We investigated the relationship between CSR and BUO using the AMOS software. BUO was negatively associated with CSR, suggesting that organizations with strong CSR practices may be able to reduce employee burnout. Moreover, the relationship between CSR and BUO was mediated by both subjective wellbeing (SW) and compassion (CM), revealing how CSR may impact employee burnout. Furthermore, we found that employee admiration (AM) buffered the relationship between CSR and BUO.

Findings

BUO is a growing concern among healthcare professionals and has the potential to negatively impact the quality of patient care, staff morale, and, ultimately, the success of healthcare organizations. BUO in healthcare settings can be effectively addressed by implementing CSR strategies. Effective CSR strategies should be implemented in a meaningful way to employees and provide them with opportunities to engage in activities that align with their values and interests.

Effect of yoga on cardiovascular functions and psychological aspects of people on public service-related work: an exploratory study

OBJECTIVES

Yoga is increasingly being introduced in workplace settings to improve health and well-being. However, there is a lack of studies reporting the effect of yoga in people on public service-related work, who are at high risk for various health-related problems. Thus, the objective of this study was to find the effect of yoga on cardiovascular functions and psychological (stress, anxiety, and depression) aspects of people on public service-related work.

METHODS

A single-group pre-test and post-test experimental study design was adopted. Eighty-two participants aged 41.52 ± 7.44 years who are working in the Tamil Nadu Public Service Commission were undergone 1-h of yoga (under the supervision of a yoga & naturopathy doctor) a day, 5-days a week for a period of 1-month at their office. Cardiovascular functions such as systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were measured using an automatic BP monitor. Psychological variables such as stress, anxiety, and depression were measured using Depression Anxiety and Stress Scales (DASS) before and after the intervention.

RESULTS

Results of this study showed a significant reduction in body mass index, SBP, DBP, PR, mean arterial pressure, rate pressure product, and double product. Though results showed insignificant (just missed the statistical significance [p=0.056]) reduction in anxiety, it showed clinical improvement (i.e. the mean anxiety score has reduced from moderate category to mild category). However, there is neither statistically significant nor clinical difference in stress and depression. None of the participants reported any untoward events during the study period.

CONCLUSIONS

Results suggest that yoga might improve the cardiovascular functions and anxiety of people in public service-related work. However, no such significant improvement was noted in their stress and depression levels. However, a randomized controlled trial is required to warrant the results of this study.

Psychometric Properties of the New Working Parent Burnout Scale

INTRODUCTION

Parental burnout is an underrecognized condition with adverse consequences for parents and children. The objective of this study was to determine the psychometric properties of a new scale, the Working Parent Burnout Scale, and a concurrent one-item assessment.

METHOD

A cross-sectional survey was conducted. The sample included parents (N = 1,285) living with children < 18 years. Content, face, construct, and predictive validity and reliability were established.

RESULTS

Cronbach α was 0.90 with the elimination of item four on the scale. All factor loadings were > 0.40. The one-factor model was supported by confirmatory factor analysis. The Pearson r correlation was 0.59 for the total score on the original 10-item burnout scale (item 4 excluded) and the one-item assessment.

DISCUSSION

These are the first known scales to measure working parent burnout. By better identifying parental burnout, preventive and interventional approaches can be initiated to enhance parent and child outcomes.

Quality of Life and Stress Management in Healthcare Professionals of a Dental Care Setting at a Teaching Hospital in Rome: Results of a Randomized Controlled Clinical Trial

In the healthcare environment, more and more people experience work-related stress. The Faculty of Medicine and Dentistry of Sapienza University of Rome, having observed the need to take care of healthcare professionals, has set itself the objective of providing useful tools such as additional and necessary personal protective equipment for healthcare professionals.

OBJECTIVE

To promote health through better management, skills, and the use of strategies and solutions to identify, decompress, and neutralize those responsible for work-related stress mechanisms in order to take care of those who care (CURARE CURANTES).

MATERIALS AND METHODS

A randomized controlled clinical trial was conducted. The participants were enrolled by three departments of the Department of Dental and Maxillofacial Sciences of Rome; in consideration of emotional involvement of health professionals who work there. A motivational program was offered.

RESULTS

There were 17 and 16 healthcare professionals in the intervention and control groups, respectively. Levels of the mental composite score (MCS) varied both in the pre-post phase of the intervention group (p = 0.002), and between the intervention group and control group in the post phase (p = 0.006). No significant differences were observed for the physical composite score (PCS). Similarly, there were no significant differences regarding the positivity scale (PS) and the two dimensions of work-related stress (job demand and decision latitude).

CONCLUSION

This study demonstrates the efficacy of yoga training practiced directly in the workplace and wearing work clothes, entering the work context, not weighing further on the healthcare workload, and being a way to carry out physical activity even in those cases in which professionals do not have the time to do it in their free time.

Preparing for the “black swan”: Reducing employee burnout in the hospitality sector through ethical leadership

Hospitality is at a crossroads. While the growth and developmental indicators in this sector show economic potential, the rising employee burnout rate is a serious challenge to hospitality management. Literature suggests that an ethical leader can reduce employee burnout significantly. Although hospitality employees face a higher risk of burnout than other service segments, shockingly, past leadership studies did not focus on how ethical leaders in a hospitality organization may reduce the risk of burnout. Therefore, we conducted this research to explore ethical leadership-burnout relationships in the hospitality sector with the mediating effects of subjective wellbeing and employee resilience. A questionnaire was provided to employees in different hotel organizations (n = 346). Structural equation modeling was employed for hypothesis testing. The statistical evidence supported the theoretical assumptions that ethical leadership negatively predicts employee burnout, and subjective wellbeing and resilience mediate this relationship. The outcomes of this study suggest different theoretical and social implications. For example, the findings indicate the effectiveness of ethical leadership in reducing employee burnout in the hospitality sector. Several other implications have been discussed in detail.

Effect of Practicing Meditation, Pranayama, and Yoga on the Mental Health of Female Undergraduate Medical Students: An Interventional Study

Background

Medical education is a rigorous formal education with a vast syllabus. Burnout and stresses are common among medical students and more prominent in females. Female medical students suffer from a higher level of stress than male medical students. For the improvement of physical and mental health, meditation, pranayama, and yoga are some of the ancient techniques. Meditation is a technique of focusing the mind on a target like an object, activity, or any thought. Pranayama is an ancient yogic practice focusing on the breath. Yoga is a combination of physical, mental, and spiritual dimensions that has the potential to improve mental and physical health.

Objective

This study aimed to find the effect of meditation, pranayama, and yoga on the improvement of mental health among female undergraduate medical students.

Materials and methods

This was an interventional study. A total of 105 females with a median age of 19 years (first quartile - third quartile: 18-20) first-year undergraduate medical students were recruited for this study. They were randomly allocated to control, meditation, pranayama, and yoga groups. The control group did not practice any form of meditation, pranayama, or yoga. The rest of the group practiced a designated program for their group, six days a week for 12 weeks. The anxiety, depression, anger, and sense of well-being were assessed by a validated self-administered questionnaire developed by the Defence Institute of Physiology and Allied Sciences, New Delhi before starting the study, at six weeks, and at 12 weeks after the intervention. Inter-group levels of anxiety, depression, anger, and well-being were compared by the Kruskal-Wallis test with Dunn’s posthoc test. Intra-group parameters at baseline, at six weeks, and at 12 weeks after the intervention was tested by Friedman’s test.

Result

The age (years) (p = 0.07), height (cm) (p = 0.98), and weight (kg) (p = 0.26) of participants among groups were similar. Anxiety, depression, and anger significantly decreased after six weeks in all three intervention groups. A further decrement was seen after 12 weeks of meditation, pranayama, and yoga. The maximum effect was seen in the yoga group. A sense of well-being was improved after practicing all types of interventions. However, meditation was found to increase a sense of well-being to the highest level compared to pranayama and yoga.

Conclusion

Introduction and sustainment of meditation, pranayama, and yoga programs for first-year female undergraduate medical students may help reduce anxiety, depression, and anger and promote a sense of well-being. Although a six-week program helps to improve mental health, a 12-week program helps in further improvement. A yoga program is more effective for improving the mental health of the students in comparison with pranayama and meditation.

Effectiveness of Aromatherapy Yoga in Stress Reduction and Sleep Quality Improvement among Chinese Female College Students: A Quasi-Experimental Study

College students, particularly female students, often suffer from severe stress and poor sleep. Aromatherapy yoga has become a popular exercise in recent years and may help reduce stress and improve sleep quality, although empirical evidence is limited. We investigated the effectiveness of aromatherapy yoga intervention in reducing stress and improving sleep quality among Chinese female college students. A total of 89 participants—44 in the experimental group (aromatherapy yoga) and 45 in the control group (yoga)—with an average age of 19.88 ± 1.13 years, were enrolled in this quasi-experimental study. Interventions were performed in the respective groups once a week for 12 weeks, for 90 min each time. The Wilcoxon signed-rank test and Mann–Whitney U test (including effect size) were used to test the differences in stress reduction and sleep quality before and after the intervention. From the findings of the current research, both therapies did not help female students’ stress levels or sleep hygiene significantly. However, aromatherapy yoga has the potential to improve sleep disturbances experienced by female college students. Additionally, there was no difference in the amount of stress or the quality of sleep between the aromatherapy yoga groups and the regular yoga groups before and after therapy.

Workplace Stress in Portuguese Oncology Nurses Delivering Palliative Care: A Pilot Study

Oncology nurses often face complex end-of-life issues, underlining their need for specific training in palliative care. In this context, nurses experience several emotional and psychological dilemmas, which are often difficult to manage and result in high levels of workplace stress. This study aimed to determine the levels and work-related factors of workplace stress among oncology nurses. A descriptive baseline study was performed as part of a large four-phase study based on quantitative data collected from Portuguese oncology nurses. Of the 32 participating nurses, most were women, and the mean age was 42.69 ± 10.04 years. Overall, nurses revealed moderate levels of stress. Younger nurses with less professional experience had difficulties dealing with issues related to death and dying. This pilot study supported the development of a program of six Stress Management Training Workshops (SMTW) to reduce stress and increase adaptative strategies. Assessing workplace stress among oncology nurses should be the focus of intervention by managers and institutional leaders.

When uncertainty becomes the norm: The Chris Hani Baragwanath Academic Hospital’s Speech Therapy and Audiology Department’s response to the COVID-19 pandemic

Background

In March 2020 the World Health Organization declared the coronavirus disease 2019 (COVID-19) a pandemic. Management of this pandemic had significant implications for clinical departments across the world. Healthcare systems were urgently required to reorganise and redesign patient care as well as repurpose staff.

Objectives

We will share the lived experience of our response as speech therapy and audiology (STA) clinicians to the COVID-19 pandemic.

Method

This study adopted an autoethnographic approach within Bronfenbrenner’s bioecological model to describe STA clinicians’ response to the COVID-19 pandemic.

Results

Adaptations to practice were made to continue service provision whilst adhering to COVID-19 regulations. We assisted in other areas to meet the immediate needs of the hospital. Service delivery strategies consisted of a review of clinical and quality assurance protocols. We developed a telehealth service package which included a hybrid approach, within a context of digital poverty. We created resources to ensure continuity of care. Collaboration within our systems facilitated innovative solutions. Mental health and well-being of staff members were key to the response developed.

Conclusion

South African healthcare systems’ inequalities were highlighted by the pandemic. The response showed that the needs of vulnerable populations were not accounted for when developing this public health response. Lessons learnt included the importance of adaptability, becoming comfortable with uncertainty and maintaining open and transparent communication. Consultation and collaboration within various levels of our healthcare system were critical in responding to the needs of patients. Commitment to compassionate leadership and staff well-being were crucial.

Investigating the Psychological Impact of COVID-19 on Healthcare Professionals: Implications and Recommendations

Public health crises that increase the demand for healthcare professionals (HCPs) often result in increased mental distress in HCPs. The current study investigated the specific mental health ramifications of the COVID-19 pandemic on HCPs and perceived support from their places of work. Data was collected from US-based HCPs (N = 325) working as physicians (21.8%), nurses (26.8%), mental health professionals (MHPs; 30.5%), and allied healthcare professionals (AHPs; 20.9%) from April 2020 to April 2021 amidst the COVID-19 pandemic, using an online self-report survey. Descriptive and correlational statistical analyses assessed worry, stressors, psychological functioning, and perceived support. A majority of participants expressed worry about the pandemic broadly (93%), and approximately half (50.5%) indicated that their degree of worry was moderate to extreme. Respondents worried most about the risk of infection for family and relatives. HCPs reported not having been able to enjoy daily activities (66.9%), losing sleep (43.1%), and feeling constantly under strain (66.9%), compared to usual. Most HCPs indicated a strong desire for clear communication regarding the pandemic and psychological support from their workplaces. This paper provides recommendations to support HCP mental health by both ameliorating distress caused by the COVID-19 pandemic as well as protecting the health and wellness of HCPs more generally. HCPs and institutions that employ them should seek out or provide access to mental health resources and services, engage with or provide opportunities and activities to actively address mental health, and improve communication regarding COVID-19 or other topics HCPs demonstrate interest in.

Burnout syndrome among healthcare workers during COVID-19 Pandemic in Accra, Ghana

BACKGROUND

The emergence of the corona virus disease 2019 (COVID-19) has increased the workload of health workers particularly those in sub-Saharan Africa predisposing them to extra job-related stress and its associated job-related burnout. Burnout reduces the number, distribution and productivity of health workers. This study sought to determine personal and job-related characteristics of health workers in Accra, Ghana that influenced their experience of burnout during the COVID-19 pandemic.

METHOD

A cross-sectional study was conducted among 1,264 health workers recruited from three public hospitals in Accra, Ghana between March to November, 2020. The participants were recruited using a proportionate stratified sampling technique and completed a pre-tested questionnaire that collected information on socio-demographic and job-related factors. Also, the questionnaire assessed participants' level of resilience and job-related burnout. Pearson's chi-square test was used to determine the association between burnout and the socio-demographic as well as job-related factors. However, for variables with observations less than six, a Fisher's exact test, was used to determine the associations. After the binary analysis, multivariate logistic regressions were used to determine the strength of association between the socio-demographic as well as job-related factors and burnout. Data analyses were conducted at a significant level (alpha 0.05) and power of 95% confidence with the aid of Stata 15.0.

RESULTS

The prevalence of burnout among the participants was 20.57% with non-clinicians displaying higher burnout compared to clinicians (26.74&% v 15.64%, p< 0.001). Health workers with 1-5 years working experience were 26.81 more likely to experience burnout (AOR = 26.81, CI = 6.37-112.9). Night shifts defined as shifts between 8:00pm to 8:00am was associated with the 1.86 odds of experiencing burnout (OR = 1.86; 95% CI: 1.33-2.61; p<0.001). Also, participants of the primary level facility were 3.91 times more likely (AOR = 3.91, 95% CI = 2.39-6.41) to experience burnout on the job. Similarly, participants with additional jobs were 1.14 times more likely (AOR = 1.14, 95% CI = 0.75-1.74) to experience burnout. In addition, participants harboring intentions of leaving their current jobs were 4.61 times more likely (AOR = 4.61, 95% CI = 2.73-7.78) to experience burnout. Furthermore, participants with perceived high workload were 2.38 times more likely (AOR = 2.38, 95% CI = 1.40-4.05) to experience burnt-out on the job.

CONCLUSION

There is high prevalence of burnout among health workers in Accra particularly during the onslaught of the COVID-19 pandemic. Working on night shifts and at the primary level of healthcare is significantly associated with increased odds of experiencing burnout.We recommend shift rotation for staff and adequate resource provision for primary level hospitals. The high burnout in this study could be influenced by other factors such as the grief caused by multiple losses and also the limited supportive resources for health workers.

"Room to Reflect": A Pilot Workplace Resiliency Intervention for Nurses

Rising workload demands for nurses necessitate the implementation of easily accessible and innovative clinician well-being resources on health care units. This pre/post pilot study sought to measure the impact of a mobile workplace intervention, “Room to Reflect” on staff nurse and nurse manager resilience. A mobile toolbox with a sound machine, Virtual Reality headset, and associated Quick Response code audio/video offerings, and a paper Pocket Guide of mindful restoration practices were provided to 7 health care units for a 3 month period. Pre/post questionnaires assessed perceived resilience using the Connor-Davidson Resilience scale, and intervention feasibility (ease of use), accessibility (spaces used), and effectiveness (restoration). Data analysis consisted of descriptive statistics, paired and independent samples t-tests, and Wilcoxon Signed Rank tests. From the pre (n = 97) to post (n = 57) intervention period, there was a significant difference in resilience for Clinician 3 staff nurses. A mean increase in resilience was noted among nurse managers following participation in the intervention, z = −2.03, p < 0.05. The Pocket Guide was the easiest offering to use, while VR offerings were accessed the most through Quick Response code. Space and time were the most common barriers to Room to Reflect use. Staff nurses felt supported by managers to use the program, and managers perceived that the program improved nurse job satisfaction.

Systematic Review of Mind–Body Modalities to Manage the Mental Health of Healthcare Workers during the COVID-19 Era

Healthcare workers (HCWs) have suffered physical and psychological threats since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. Mind-body modalities (MBMs) can reduce the long-term adverse health effects associated with COVID-specific chronic stress. This systematic review aims to investigate the role of MBMs in managing the mental health of HCWs during the COVID-19 pandemic. A comprehensive search was conducted using 6 electronic databases, resulting in 18 clinical studies from 2019 to September 2021. Meta-analysis showed that MBMs significantly improved the perceived stress of HCWs (standardized mean difference, −0.37; 95% confidence intervals, −0.53 to −0.21). In addition, some MBMs had significant positive effects on psychological trauma, burnout, insomnia, anxiety, depression, self-compassion, mindfulness, quality of life, resilience, and well-being, but not psychological trauma and self-efficacy of HCWs. This review provides data supporting the potential of some MBMs to improve the mental health of HCWs during COVID-19. However, owing to poor methodological quality and heterogeneity of interventions and outcomes of the included studies, further high-quality clinical trials are needed on this topic in the future.