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Mindfulness practice impacts medical students’ compassionate behaviors

Posted 09.19.2016 | by AMRA

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Physician compassion is a key element in good doctor-patient relationships. Nevertheless, nearly 50% of doctors and patients feel that medical care is often insufficiently compassionate. Between 20-70% of physicians suffer from compassion fatigue, a state of emotional exhaustion and diminished empathy brought on by the unceasing demands of patient care. As a consequence, medical educators are interested in finding ways to enhance compassion in medical students who are in training to become future physicians.

Fernando et al. [Mindfulness] tested whether a set of audio-guided mindfulness exercises could increase medical students’ compassionate behaviors, and whether the exercises had differential effects depending on the students’ self-compassion levels.

The researchers recruited 83 medical students (54% female, average age=21) for what they were told was a study of “emotional and clinical decision making.” The students completed a self-report measure of self-compassion, a personality disposition that involves self-kindness, recognition of one’s common humanity, and mindful awareness.

The students were then randomly assigned to listen to 10-minute audio recordings of either experiential mindfulness exercises or a speech on civic service. The mindfulness recording included an explanation of mindfulness and exercises involving mindfulness of the breath and of emotions. The students completed the Toronto Mindfulness Scale (TMS) after hearing the recordings.

Participants were then presented with a series of hypothetical clinical scenarios involving interactions with “difficult” patients. Participants rated how much they liked, wanted to help, and felt caring towards the patients, and their degree of subjective closeness to them. They also decided how much consultation time to allot to each of the patients. After being told the study was finished, the research assistant requested participants to help with an unrelated administrative task. […]

September 19th, 2016|News|

SMART mindfulness program reduces teacher occupational stress up to four months

Posted 08.17.2015 | by AMRA

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The high emotional demands of public school teaching can contribute to impaired teacher morale and professional burnout. Given the stressful nature of the profession, it’s no small wonder that 40-50% of teachers quit teaching within their first five years on the job. Prior research supports the efficacy of mindfulness-based interventions (MBIs) in improving teacher well-being and reducing burnout, but what are the psychological and interpersonal processes underlying their effectiveness?

In a randomized, controlled trial, Taylor et al. [Mindfulness] tested how a MBI affected teachers’ emotional regulation, forgiveness, and compassion, and how changes in these domains contributed to stress reduction.

The researchers randomly assigned a predominantly female cohort of 59 Canadian elementary and secondary school teachers to either a Stress Management and Relaxation Training (SMART) program or a wait-list control. The 9-week SMART program shared components with MBSR (the body scan, sitting, walking, movement and eating meditations) and included specific training in emotional regulation, forgiveness and loving-kindness. Participants completed self-report measures before and after training and at four-month follow-up. Participants were also interviewed after the SMART program about job stress and attitudes towards challenging students and colleagues.

The teachers found the SMART program “quite helpful,” stating they derived a “moderate” to a “great deal” of benefit from it. At the end of training, SMART program teachers showed significant and large (Cohen’s d =.90) declines in occupational stress compared to controls, a difference that remained marginally significant at four month follow-up.

In post-training interviews, SMART participants used significantly fewer negative emotional words than controls when discussing work stressors, and used significantly more positive emotional words than controls when describing challenging students. SMART participants also showed significant and […]

August 17th, 2015|News|

Web-based MBI combats work stress and burnout

Posted: 08.20.2014 | by AMRA

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Occupational stress is not only harmful to employees, but is also costly to employers in terms of increased health-care expenses and decreased employee attendance, morale, and performance. Mindfulness-based interventions (MBIs) may have an important role to play in combatting occupational stress, but MBSR programs are time-intensive and often challenging to implement in the workplace, especially on a scale expansive enough to benefit large corporations.

Aikins et al. [Journal of Occupational and Environmental Medicine] developed an abbreviated MBI modeled after MBSR that was delivered on a web-based virtual classroom platform. The intervention makes use of a live instructor, webinar-and-email technology, and a printed workbook/practice guide to deliver 7, 1 hour-long, virtual classes and support 10.8 hours of home-based practice. The durations of the body scan, meditation, and yoga sessions were shortened to accommodate the hour-long format, there was no daylong retreat, and workplace-relevant material was included in the syllabus.

Eighty-nine Dow Chemical Company employees were randomly assigned to either the MBI or a wait-list control. Only 66 participants completed the study, due in part to the 6 MBI and 10 wait-list control subjects who never attended a class after being initially assigned to their groups. MBI participants significantly improved their mindfulness (as measured by the Five-Facet Mindfulness Questionnaire), resilience, and physical, emotional, and cognitive vigor, and decreased their perceived stress compared with wait-list controls.

Treatment gains were maintained or continued to improve at six-month follow-up, with the exception of a small, non-significant rise in perceived stress. MBI participants reported significant decreases in high-stress days, burnout, and fast-food consumption, as well as increases in fruit and vegetable consumption.

Eighty-seven percent of the participants rated the program as […]

August 11th, 2014|News|

MBSR Reduces Burnout in Primary Care Providers

Posted from archive: 10.07.2013 | by AMRA

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Previous studies have shown that health care providers can be taught to be mindful, but busy clinicians often don’t have the time to attend lengthy programs. Fortney et al. [Annals of Family Medicine] tested the efficacy of an abbreviated form of MBSR in alleviating/ preventing symptoms of clinician burnout. The program offered 14 hours of mindfulness instruction over a three-day weekend, followed by two 2-hour post-training sessions. Exercises emphasized mindfulness while sitting, walking, listening and speaking, mindfulness in interaction with patients, and compassion for self and others. Participants were encouraged to practice 10 to 20 minutes per day at home.

Thirty primary care providers (physicians, nurse practitioners and physician assistants) participated in the program. They were assessed at baseline, immediately after the intervention, and at 8-week and 9-month follow-up on measures of burnout, depression, anxiety, stress, resilience, and compassion. While 63 of the participants had some prior meditation experience at some point in their life, only 7 were actively practicing meditation at the start of the study.

After the intervention, the clinicians reported significant decreases in emotional exhaustion, depersonalization, anxiety, and stress, and significant increases in a sense of personal accomplishment. All of these differences were significant at nine-month follow-up. No changes in clinician resilience or compassion were found, but the clinicians’ high scores on the brief five-item compassion scale at baseline left little room for improvement. These preliminary results suggest that abbreviated MBSR holds promise as a time, efficient means of improving clinician well-being, and, as a consequence, the quality of patient care.

Reference:

Fortney, L., Luchterhand, C., Zakletskaia, L., Zgierska, A., & Rakel, D. (2013). Abbreviated mindfulness intervention for job satisfaction, quality […]

January 21st, 2014|News|

Mindfulness Relieves Burnout in Grade School Teachers

Posted from archive: 06.25.2013 | by AMRA

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Roeser et al. [Journal of Education Psychology] tested an 8-week mindfulness training, based on MBSR but designed specifically for grade school teachers, that focused group discussions and homework assignments on teaching-related concerns. Teachers (N=113) from Canada and the U.S. were randomly assigned to either mindfulness training or a wait-list control.

Teachers in the mindfulness condition showed higher levels of self-reported mindfulness (as measured by the FFMQ) and occupational self-compassion, and lower levels of self-reported occupational stress and burnout, anxiety, and depression than did controls both at program’s end and at 3-month follow-up. The effect sizes were large, ranging from 0.57 to 1.56. Changes in stress, burnout, depression, and anxiety were all mediated by changes in mindfulness and occupational self-compassion.

The Canadian teachers also completed an objective measure of working memory (the ability to hold multiple items of information in mind simultaneously) using a task requiring the recall of strings of digits while checking math problems for accuracy.

Teachers in the mindfulness group showed significantly better working memory capacity after training than did controls, but the effects on working memory were small, ranging from 0.15 to 0.33. Measures of cortisol, blood pressure, and heart rate were also obtained from the Canadian teachers, but yielded no significant changes over time. Most teachers (87%) completed the program, and 98 would recommend it to their peers. Average ratings on a 5-point scale of perceived benefit were high, both for professional (4.10) and personal (4.58) benefit.

Reference:

Roeser, R. W., Schonert-Reichl, K. A., Jha, A., Cullen, M., Wallace, L., Wilensky, R., . . . Harrison, J. (2013). Mindfulness training and reductions in teacher stress and burnout: Results from two randomized, waitlist-control […]

January 3rd, 2014|News|