Effectiveness of a Mindfulness Education Program in Primary Health Care Professionals: A Pragmatic Controlled Trial (original) (raw)
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Healthcare, 2021
Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a systematic review and meta-analysis to analyze the effects of MBIs to reduce burnout in PHCP. We searched articles in the PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases from inception to September 2021 using MeSH terms: “mindfulness”, “burnout”, and “primary healthcare”. Two reviewers extracted the data and assessed the risk of bias. We used a random-effects meta-analysis to calculate the standardized mean differences (SMD) and mean differences (MD) with 95% confidence intervals (CI) of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) domains of burnout. Of 61 records, ten were included (n = 417). Overall, the studies were rated as...
Global Advances in Health and Medicine, 2013
PURPOSE Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians. METHODS A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months postintervention), participants completed a set of online measures assessing burnout, anxiety, stress, resilience, and compassion. We used a linear mixed-effects model analysis to assess changes in outcome measures. RESULTS Participants had improvements compared with baseline at all 3 follow-up time points. At 9 months postintervention, they had significantly better scores (1) on all Maslach Burnout Inventory burnout subscales-Emotional Exhaustion (P = .009), Depersonalization (P = .005), and Personal Accomplishment (P <.001); (2) on the Depression (P = .001), Anxiety (P = .006), and Stress (P = .002) subscales of the Depression Anxiety Stress Scales-21; and (3) for perceived stress (P = .002) assessed with the Perceived Stress Scale. There were no significant changes on the 14-item Resilience Scale and the Santa Clara Brief Compassion Scale. CONCLUSIONS In this uncontrolled pilot study, participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clinician health and well-being, which may have implications for patient care.
The Annals of Family Medicine, 2013
PURPOSE Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians. METHODS A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months postintervention), participants completed a set of online measures assessing burnout, anxiety, stress, resilience, and compassion. We used a linear mixed-effects model analysis to assess changes in outcome measures. RESULTS Participants had improvements compared with baseline at all 3 follow-up time points. At 9 months postintervention, they had significantly better scores (1) on all Maslach Burnout Inventory burnout subscales-Emotional Exhaustion (P = .009), Depersonalization (P = .005), and Personal Accomplishment (P <.001); (2) on the Depression (P = .001), Anxiety (P = .006), and Stress (P = .002) subscales of the Depression Anxiety Stress Scales-21; and (3) for perceived stress (P = .002) assessed with the Perceived Stress Scale. There were no significant changes on the 14-item Resilience Scale and the Santa Clara Brief Compassion Scale. CONCLUSIONS In this uncontrolled pilot study, participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clinician health and well-being, which may have implications for patient care.
Mindfulness: Assessing the Feasibility of a Pilot Intervention to Reduce Stress and Burnout
Journal of Holistic Nursing, 2018
Purpose: To examine the feasibility of a brief mindfulness intervention and to reduce nurse stress and burnout in an inpatient medical unit. Design: Single-arm, pre/post test study design. Method: Perceived Stress Scale (PSS), Maslach Burnout Inventory (MBI), and pre/post demographic questionnaires given at pre-intervention (baseline) and 6 weeks post-intervention. Intervention effectiveness was compared between the pre-survey ( N = 52) and post-survey ( N = 33). Five choices were offered to inpatient staff: a guided mindfulness CD, soothing sounds machine with a breathing technique instructional, mindfulness prompts, a journal, and water/snacks during six consecutive weekends. Findings: The mean PSS score did not improve and demonstrated a slight increase during the six-weekend intervention. However, mean MBI scores for the subscales of emotional exhaustion and depersonalization did demonstrate improvement as evident by decreased scores. Additionally, the mean MBI score for the sub...
EXPLORE, 2019
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JAMA Network Open
IMPORTANCE Stress among health care professionals is well documented. The use of mindfulnessbased interventions to reduce stress has shown promising results; however, the time commitment of typical programs can be a barrier to successful implementation in health care settings. OBJECTIVE To determine the efficacy and feasibility of a brief mindfulness-based program to reduce stress during work hours among health care professionals. DESIGN, SETTING, AND PARTICIPANTS This intent-to-treat randomized clinical trial was conducted among full-time health care professionals at the Clinical Center at the National Institutes of Health in Bethesda, Maryland, between September 2017 and May 2018. Participants were randomized to receive mindfulness-based self-care (MBSC) training or life-as-usual control. Data were analyzed from June 2018 to January 2020. INTERVENTIONS The MBSC intervention included 5 weekly, 1.5-hour in-class mindfulness practice sessions. MAIN OUTCOMES AND MEASURES Stress level was the primary outcome, assessed with the Perceived Stress Scale 10-Item version. Secondary outcomes included anxiety, burnout, positive and negative affect, mindfulness (trait and state), and self-care. Assessments were taken at baseline and at the end of the intervention (week 5) in the intervention and control groups, and at follow-up (week 13) in the intervention group to test for a maintenance effect. A postprogram evaluation was also obtained. RESULTS Of 82 randomized participants, 78 who completed the study at week 5 were included in the modified intent-to-treat analysis (median [interquartile range] age, 32 [23-48] years; 65 [83%] women), including 43 participants in the MBSC group and 35 participants in the control group. At the end of the intervention, compared with the control group, the MBSC group had reduced levels of stress (mean [SD] score, 17.29 [5.84] vs 18.54 [6.30]; P = .02) and anxiety (mean [SD] score, 2.58 [1.52] vs 4.23 [1.73]; P < .001), and improved positive affect (mean [SD] score, 35.69 [7.12] vs 31.42 [7.27]; P < .001), state mindfulness (mean [SD] score, 3.74 [1.18] vs 2.78 [1.16]; P < .001), and mindful self-care (mean [SD] score, 7.29 [2.44] vs 5.54 [2.77]; P < .001). Burnout, negative affect, and trait mindfulness levels did not differ between groups. Changes within the MBSC group through follow-up included sustained reductions in stress (change,-6.14; 95% CI,-7.84 to-4.44; P < .001), anxiety (change,-1.46; 95% CI,-1.97 to-0.94; P < .001), trait mindfulness (change, 0.63; 95% CI, 0.36 to 0.90; P < .001), and state mindfulness (change, 1.89; 95% CI, 1.39 to 2.39; P < .001).
Complementary Therapies in Clinical Practice, 2009
Demands faced by health care professionals include heavy caseloads, limited control over the work environment, long hours, as well as organizational structures and systems in transition. Such conditions have been directly linked to increased stress and symptoms of burnout, which in turn, have adverse consequences for clinicians and the quality of care that is provided to patients. Consequently, there exists an impetus for the development of curriculum aimed at fostering wellness and the necessary self-care skills for clinicians. This review will examine the potential benefits of mindfulness-based stress reduction (MBSR) programs aimed at enhancing well-being and coping with stress in this population. Empirical evidence indicates that participation in MBSR yields benefits for clinicians in the domains of physical and mental health. Conceptual and methodological limitations of the existing studies and suggestions for future research are discussed.
European Journal of Mental Health
This pre-post, single-centered study evaluates the effects of a compassion-oriented mindfulnessbased intervention on health professionals' quality of life. The intervention was conducted in an Italian general hospital in the province of Milan. Between 2014 and 2015, thirty-four health professionals operating in the territorial psychiatric services followed an 18-week Compassion-Oriented Mindfulness-based Program. The program involved the practice of mindfulness meditation combined with a psycho-educational training. This pilot study analysed the impact of the intervention on mood, quality of life, and burnout-related characteristics. Outcome measures included the State-Trait Anxiety Inventory, the Beck Depression Inventory, the Maslach Burnout Inventory, the Five Facets of Mindfulness Questionnaire, and the Professional Quality of Life Scale. After the intervention, participants showed significantly decreased levels of depression, state anxiety, and emotional exhaustion. We found that an overall beneficial effect of the Compassion-Oriented Mindfulness-based Program existed in preventing burnout symptomatology. Non-evaluative and mindful attention was shown to improve stress resilience and coping strategies while simultaneously reducing worry and rumination. These results suggest that a compassion-oriented mindfulness program could prevent the development of anxiety and depression traits.
OBM Integrative and Complementary Medicine, 2021
Mindfulness-Based Stress Reduction (MBSR) is an evidence-based health education program for medical patients with a variety of chronic conditions. MBSR also benefits health care providers themselves, decreasing work-related stress and preventing burnout. The objectives of this study were to describe an abbreviated MBSR curriculum developed for health care providers and to present initial program evaluation data assessing acceptability and outcomes. This program was implemented outside the research context with an open trial design. Mindfulness training sessions were held in a conference room at the administrative offices of a large, non-profit community health care system. Five clinic providers, three male and two female, included four primary care physicians and one social worker. All five participants participated in and completed the training. A six-session abbreviated MBSR protocol was developed. Participants attended weekly two-hour group sessions scheduled at the end of the wo...