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Kwok G, Senger A, Sharma A, Mandato I, Devine KA. Understanding the multilevel factors influencing the implementation of digital health interventions for supportive care in Adolescents and Young Adult (AYA) cancer survivorship: determinants of adopting mindfulness-based mobile applications. Implement Sci Commun 2024; 5:76. [PMID: 39020422 PMCID: PMC11253365 DOI: 10.1186/s43058-024-00612-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 07/08/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Adolescents and Young Adult (AYA) cancer survivors are at risk for psychological distress due to their unique developmental and medical needs. Healthcare providers can leverage the convenience and appeal of technology to provide supportive care for this vulnerable population. Using evidence-based mindfulness-based mobile interventions as a case example, the goal of this study was to identify key patient-, provider-, and organization-level barriers and facilitators to supportive care and implementing digital health interventions in AYA survivorship care. METHODS Twenty semi-structured interviews were conducted with stakeholders including AYA survivors (n = 10; between 18-29 years old) and clinical providers and administrators (n = 10). Interviews were transcribed and deductively mapped using the Consolidated Framework for Implementation Research (CFIR) and Theoretical Domains Framework (TDF) complementary frameworks. RESULTS Results indicated that factors like cost and patients' needs and resources were prevalent among both survivors and providers. There were key differences between providers and AYA survivors. Providers' adoption and promotion of digital health interventions were influenced most strongly by contextual factors, including available resources (Inner Setting), culture (Outer Setting), and networks and communications (Outer Setting). On the other hand, survivors emphasized individual and intervention-related factors; they reported that social influence and knowledge influenced their adoption and use of digital health interventions, including meditation apps. CONCLUSIONS These results identified barriers and facilitators to the adoption of supportive care digital health interventions from multiple stakeholders. Results can be used to guide the development of implementation strategies to improve the uptake of digital health interventions in survivorship care, ultimately improving the psychosocial well-being of AYA cancer survivors.
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Affiliation(s)
- Gary Kwok
- Cancer Prevention Precision Control Institute, Center for Discovery & Innovation, at Hackensack Meridian Health, Nutley, NJ, 07110, USA.
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA.
| | - Angela Senger
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA
| | - Archana Sharma
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA
| | - Ivelisse Mandato
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA
| | - Katie A Devine
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA
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Paterson C, Leduc C, Maxwell M, Aust B, Strachan H, O'Connor A, Tsantila F, Cresswell-Smith J, Purebl G, Winter L, Fanaj N, Doukani A, Hogg B, Corcoran P, D'Alessandro L, Mathieu S, Hegerl U, Arensman E, Greiner BA. Barriers and facilitators to implementing workplace interventions to promote mental health: qualitative evidence synthesis. Syst Rev 2024; 13:152. [PMID: 38849924 PMCID: PMC11157821 DOI: 10.1186/s13643-024-02569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/17/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Despite growing interest in workplace mental health interventions, evidence of their effectiveness is mixed. Implementation science offers a valuable lens to investigate the factors influencing successful implementation. However, evidence synthesis is lacking, especially for small-to-medium-sized enterprises (SMEs) and for specific work sectors. The objectives of this review are to establish the scope of research with explicit analysis of implementation aspects of workplace mental health interventions and to identify barriers and facilitators to implementation in general and within SMEs and selected sectors. METHODS A systematic scoping review and meta-synthesis of mixed methods process evaluation research from 11 databases, with the evaluation of methodological quality (MMAT) and confidence in findings (CERQual), was conducted. We selected information-rich studies and synthesised them using domains within the Nielsen and Randall implementation framework: context, intervention activities, implementation; and mental models. RESULTS We included 43 studies published between 2009 and 2022, of which 22 were rated as information-rich to be analysed for barriers and facilitators. Most studies were conducted in healthcare. Facilitators reflecting 'high confidence' included: relevant and tailored content, continuous and pro-active leadership buy-in and support, internal or external change agents/champions, assistance from managers and peers, resources, and senior-level experience and awareness of mental health issues. Healthcare sector-specific facilitators included: easy accessibility with time provided, fostering relationships, clear communication, and perceptions of the intervention. Stigma and confidentiality issues were reported as barriers overall. Due to the small number of studies within SMEs reported findings did not reach 'high confidence'. A lack of studies in construction and Information and Communication Technology meant separate analyses were not possible. CONCLUSIONS There is dependable evidence of key factors for the implementation of workplace mental health interventions which should be used to improve implementation. However, there is a lack of studies in SMEs and in a larger variety of sectors. SYSTEMATIC REVIEW REGISTRATION Research Registry ( reviewregistry897 ).
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Affiliation(s)
- Charlotte Paterson
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | - Caleb Leduc
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK.
| | - Birgit Aust
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, 2100, Denmark
| | - Heather Strachan
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | | | - Fotini Tsantila
- LUCAS, Centre for Care Research and Consultancy, KU Leuven, Louvain, 3000, Belgium
| | - Johanna Cresswell-Smith
- Finnish Institute for Health and Welfare (THL) Equality Unit-Mental Health Team, Helsinki, Finland
| | - Gyorgy Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Lars Winter
- Phrenos Center of Expertise for Severe Mental Illnesses, Utrecht, the Netherlands
| | - Naim Fanaj
- Mental Health Center Prizren, Prizren, Kosovo
- Almae Mater Europaea Campus College Rezonanca, Prishtina, Kosovo
| | - Asmae Doukani
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bridget Hogg
- Centre Fòrum Research Unit, Institute of Mental Health, Hospital del Mar Barcelona, Barcelona, SpainHospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Paul Corcoran
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Luigia D'Alessandro
- International Association for Suicide Prevention (IASP), 5221 Wisconsin Avenue NW, Washington, DC, 20015, USA
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Brisbane, Australia
- School of Applied Psychology, Griffith University, Mt. Gravatt Campus, Brisbane, QLD, 4122, Australia
| | - Ulrich Hegerl
- European Alliance Against Depression E.V., Leipzig, 04109, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt Am Main, 60528, Germany
| | - Ella Arensman
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Birgit A Greiner
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
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McNicholas F, Adamis D, Minihan E, Doody N, Gavin B. Occupational stress in clinical and non-clinical staff in Child and Adolescent Mental Health Services (CAMHS): a cross-sectional study. Ir J Psychol Med 2024; 41:54-60. [PMID: 35403597 DOI: 10.1017/ipm.2022.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Previous literature has highlighted high rates of burnout among doctors and nurses in healthcare settings. Non-clinical and support staff such as administrative, housekeeping and managerial staff are also exposed to the stressors of a health care setting, but fewer studies report on their experiences. Therefore, the aim of this research is to examine occupational stress in all staff working in Child and Adolescent Mental Health Services (CAMHS) in Ireland and identify risk and protective factors. METHOD Fifty-nine clinical and non-clinical staff (44% response rate) were surveyed. Participants completed the Copenhagen Burnout Inventory (CBI) and the Effort Reward Imbalance scale, as well as survey-specific questions. RESULTS Both clinical and non-clinical staff were found to experience moderate or high rates of work-related, personal and patient-related burnout (57.6%, 52.2% and 50.8%, respectively). Univariate general linear modelling showed an association between total CBI scores and effort reward index (B = 64 306, t = 3.430, p = 0.001); overcommitment (B = 1.963, t = 3.061, p = 0.003); and an unwillingness to work in CAMHS (B = 28.429, t = 3.247, p = 0.002). CONCLUSION Pre-pandemic levels of stress were high among clinical and non-clinical staff surveyed. Given the anticipated increased demand on CAMHS post COVID-19, urgent action is needed to protect all staff from intolerable levels of occupational stress and burnout.
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Affiliation(s)
- F McNicholas
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Lucena Clinic, Child and Adolescent Mental Health Service, St John of God, Dublin, Ireland
- Department of Pediatric Liaison Psychiatry, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - D Adamis
- Department of Psychiatry, Sligo Mental Health Services, Sligo, Ireland
| | - E Minihan
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Lucena Clinic, Child and Adolescent Mental Health Service, St John of God, Dublin, Ireland
| | - N Doody
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Lucena Clinic, Child and Adolescent Mental Health Service, St John of God, Dublin, Ireland
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - B Gavin
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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Barber J, Resnick SG. Can Measurement-Based Care Reduce Burnout in Mental Health Clinicians? ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01349-3. [PMID: 38379054 DOI: 10.1007/s10488-024-01349-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/22/2024]
Abstract
Burnout is a syndrome characterized by mental and emotional fatigue or exhaustion, depersonalization, and a lessened sense of personal accomplishment and efficacy. Burnout leads to negative consequences for mental health clinicians and for mental health care organizations. Measurement-based care (MBC) is a clinical process in which clinicians and clients use patient-generated data, also called treatment feedback, to collaboratively monitor mental health care and to inform goal-setting and treatment planning. We propose that MBC may improve the experience of care for both clients and clinicians, and ultimately protect against each of the three components of burnout. When combined with other organizational changes, adoption of MBC may support organizational level efforts to reduce burnout in mental health services.
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Affiliation(s)
- Jessica Barber
- Office of Mental Health and Suicide Prevention, US Department of Veterans Affairs, West Haven, CT, USA.
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT, 06511, USA.
| | - Sandra G Resnick
- Office of Mental Health and Suicide Prevention, US Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT, 06511, USA
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Knudsen RK, Ammentorp J, Storkholm MH, Skovbjerg S, Tousig CG, Timmermann C. The influence of mindfulness-based stress reduction on the work life of healthcare professionals - A qualitative study. Complement Ther Clin Pract 2023; 53:101805. [PMID: 37837781 DOI: 10.1016/j.ctcp.2023.101805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/14/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND and purpose: Quantitative studies show that mindfulness-based interventions can reduce stress and burnout in healthcare professionals. Few qualitative studies have explored healthcare professionals' experiences with mindfulness training. The aim of the study was to explore healthcare professionals' experiences of how attending a course in Mindfulness-Based Stress Reduction influenced their work life, including their relationship with patients and colleagues. METHODS Fifty-six healthcare professionals attended a Mindfulness-Based Stress Reduction course between January and June 2022. Participant observation followed by six semi-structured focus group interviews and 15 individual interviews were conducted. Data were collected in a cardiology department and in an obstetrics and gynaecology department. Thematic data analysis was performed. Reporting followed COREQ guidelines. RESULTS Six themes were identified: 1) Allowing a pause and focusing on one thing at a time, 2) Awareness of the freedom to choose, 3) The need for self-compassion, as a prerequisite for taking care of others, 4) The value of presence and calmness in patient encounters, 5) Awareness of how stressful behavior affects oneself and others, 6) The value of practicing mindfulness with colleagues. CONCLUSION This study suggests that offering Mindfulness-Based Stress Reduction to healthcare professionals can start a positive process of change from a tendency to neglect personal needs to becoming more compassionate towards oneself and others. Mindfulness training may thus prevent burnout and lead to a more compassionate workplace culture that also manifests in better patient care. However, a collective understanding and knowledge of mindfulness in the work setting may be necessary to sustain these changes.
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Affiliation(s)
- Randi Karkov Knudsen
- Department of Gynecology and Obstetrics, Horsens Regional Hospital, Sundvej 30C, 8700, Horsens, Denmark; Department of Cardiology, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark; Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000, Odense C, Denmark.
| | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000, Odense C, Denmark.
| | - Marie Højriis Storkholm
- Department of Gynecology and Obstetrics, Horsens Regional Hospital, Sundvej 30C, 8700, Horsens, Denmark; Department of Clinical Medicine, Aarhus University Hosipital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Sine Skovbjerg
- Danish Center for Mindfulness, Aarhus University, Hack Kampmanns Plads 1-3, 8000, Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University Hosipital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Charlotte Gad Tousig
- Department of Cardiology, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.
| | - Connie Timmermann
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000, Odense C, Denmark.
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Braun SE, Mladen S, Crawford M, Edwards S, Kinser P. A constructivist grounded theory exploration of Mindfulness for Healthcare Professional students. Complement Ther Clin Pract 2023; 50:101689. [PMID: 36375326 DOI: 10.1016/j.ctcp.2022.101689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/07/2022] [Accepted: 11/04/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE To better understand the effects of an intervention, Mindfulness for Healthcare Professional (MIHP), and how it may improve healthcare professional student (HCP) functioning, a constructivist grounded theory exploration was conducted. MATERIALS AND METHODS Ten participants with the lowest or highest changes on quantitative measures of burnout and perceived stress at the end of MIHP were interviewed at a long-term follow-up. A theoretical framework was developed from the resultant themes to describe the mechanisms by which MIHP had effects on work-relevant functioning. RESULTS Three overarching themes emerged as mechanisms of change both from their presence in those participants reporting an improvement in stress and their missingness from those participants who reported no change: developing a mindfulness practice, integrating practice into daily life, and enhanced awareness. These mechanisms led to optimized work-relevant functioning: 1) emotional competencies, including nonjudgement, emotion regulation, and burnout prevention; and 2) patient-centered care, including improved listening, patience, and efficiency at work. CONCLUSION The resultant framework is discussed in the context of previous literature on MIHP and mindfulness theory more broadly. Implications for future disseminations of MIHP encourage the use of group interventions with emphasis on developing at-home practice and informal mindfulness integrated into daily work.
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Affiliation(s)
- Sarah Ellen Braun
- Virginia Commonwealth University, Department of Neurology, Richmond, VA, USA; Massey Cancer Center, Richmond, VA, USA.
| | - Samantha Mladen
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | - MaryKate Crawford
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | - Sarah Edwards
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | - Patricia Kinser
- Virginia Commonwealth University, School of Nursing, Richmond, VA, USA
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Use of Mobile Apps and Online Programs of Mindfulness and Self-Compassion Training in Workers: A Scoping Review. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 7:477-515. [PMID: 36091081 PMCID: PMC9444703 DOI: 10.1007/s41347-022-00267-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022]
Abstract
Mindfulness and self-compassion interventions are two strategies helpful in preventing and reducing burnout and work stress. However, professionals with overburdened schedules can experience obstacles in learning and practicing these interventions, originally taught with lengthy programs. The use of digital technologies could make these interventions more accessible to workers, as studied in a recent, growing body of evidence. The evidence available is diverse in terms of interventions, designs, outcomes, and populations. This calls for a review that can take into consideration this diversity while still rigorously synthesize it. Scoping reviews are designed to examine emerging evidence and summarize the evidence on a specific topic of interest. The present scoping review aims to assess the current state of the literature on the use of online programs and mobile applications of self-compassion, mindfulness, and meditation (digital mindfulness-based interventions; dMBIs) by workers. More specifically, information on the type of intervention, population, advantages, and disadvantages, measured outcomes, and advice for future research are gathered. MEDLINE (PubMed; Ovid), PsychInfo (Ovid), and Web of Science (Clarivate) were searched to identify all relevant articles. The screening process resulted in 56 articles being included in this scoping review. Inclusion criteria were (1) participants are workers; (2) the intervention is individual, digital, and mindfulness/self-compassion/meditation-based; and (3) articles were available in French or English language at the time of the review. Interventions used were mostly mindfulness-based, equally categorized under web-based and app-based interventions. Most interventions included information on mindfulness, meditation or self-compassion, meditation exercises, other types of exercises, instructions on how to use, and reminders. dMBIs are often studied in the healthcare population and predominantly in female samples. Although dMBIs present advantages (low cost, accessibility, practicality, feasibility), obstacles can arise in their implementation (low engagement and motivation, concerns about confidentiality). Included articles measured outcomes related to work, mindfulness or self-compassion, and other psychological variables (stress/anxiety, depression, resilience, wellbeing). Articles provided important directions to further research on dMBIs regarding methodological aspects, modality and intervention, and individual and organizational questions. dMBIs are becoming more popular and interventions are diverse. Although not without limitations, this scoping provided a synthesis on different aspects of the use of dMBIs within workers and highlighted pertinent future research directions.
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Cousins E, Preston N, Doherty J, Varey S, Harding A, McCann A, Harrison Dening K, Finucane A, Carter G, Mitchell G, Brazil K. Implementing and evaluating online advance care planning training in UK nursing homes during COVID-19: findings from the Necessary Discussions multi-site case study project. BMC Geriatr 2022; 22:419. [PMID: 35562712 PMCID: PMC9098790 DOI: 10.1186/s12877-022-03099-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advance care planning in nursing homes is important to ensure the wishes and preferences of residents are recorded, especially during the COVID-19 pandemic. However, care staff and family members frequently report feeling unprepared for these conversations. More resources are needed to support them with these necessary discussions. This research aimed to develop, implement and evaluate a website intervention for care staff and family members to provide training and information about advance care planning during COVID-19. METHODS The research was a primarily qualitative case study design, comprising multiple UK nursing home cases. Data collection included semi-structured interviews with care staff and family members which were coded and analysed thematically. A narrative synthesis was produced for each case, culminating in a thematic cross-case analysis of the total findings. Theoretical propositions were refined throughout the research. RESULTS Eight nursing homes took part in the study, involving 35 care staff and 19 family members. Findings were reported according to the RE-AIM framework which identified the reach, effectiveness, adoption, implementation and maintenance of the intervention. Themes included: website content that was well received; suggestions for improvement; implementation barriers and facilitators; examples of organisational and personal impact. CONCLUSIONS Four theoretical propositions relating to advance care planning in nursing homes are presented, relating to: training and information needs, accessibility, context, and encouraging conversations. Implications for practice and training include an awareness of diverse learning styles, re-enforcing the right to be involved in advance care planning and encouraging opportunities for facilitated discussion. TRIAL REGISTRATION ISRCTN registry (ID 18003630 ) on 19.05.21.
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Affiliation(s)
- Emily Cousins
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Nancy Preston
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Julie Doherty
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Sandra Varey
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Andrew Harding
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Adrienne McCann
- Innovation Value Institute, Maynooth University, Maynooth & Age Friendly Ireland, Ireland
| | - Karen Harrison Dening
- School of Nursing and Midwifery, Faculty of Health and Life Sciences, De Montfort University, Leicester & Dementia UK, London, UK
| | - Anne Finucane
- Clinical Psychology, University of Edinburgh, Edinburgh & Marie Curie Hospice Edinburgh, Edinburgh, UK
| | - Gillian Carter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
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Jang MH, Jeong YM, Park G. Influence of the sub-factors of self-compassion on burnout among hospital nurses: A cross-sectional study in South Korea. J Nurs Manag 2022; 30:993-1001. [PMID: 35246901 DOI: 10.1111/jonm.13572] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/14/2022] [Accepted: 03/01/2022] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to identify the effects of the sub-factors of self-compassion on hospital nurse burnout and provide basic knowledge for an intervention program to prevent nurse burnout. BACKGROUND Burnout in nurses has been reported to influence their own and patients' mental health and safety. Enhancing self-compassion can help to prevent burnout. METHODS This study involved descriptive research using a cross-sectional design. Data were collected at H University Hospital in Korea, from January to March, 2020. Of the 213 questionnaires collected, 208 were included in data analysis. RESULTS Burnout was higher when nurses were younger, unmarried, in poor health, general nurses, dissatisfied with their jobs, planning to leave their jobs, or receiving low social support from peers. There was a negative correlation between burnout and the self-compassion subscales. Multiple regression analysis showed that isolation and mindfulness among self-compassion, were significantly related to burnout. CONCLUSIONS Since individual variables and self-compassion are major elements impacting nurse burnout, it is important for nursing organizations to investigate nurses' individual variables, including sub-factors of self-compassion, to help them prevent burnout. IMPLICATIONS FOR NURSING MANAGEMENT Nurse burnout might be prevented by increasing self-compassion. Hospital and nurse managers may employ individualized strategies to enhance nurses' self-compassion.
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Affiliation(s)
- Mi Heui Jang
- College of Nursing, Kyung Hee University, Seoul, Seoul, Republic of Korea
| | - Yoo Mi Jeong
- College of Nursing, Dankook University, Cheonan-si, Chungcheongnam-do, South Korea
| | - Geuna Park
- Graduate, Department of Public Health Education, Graduate School of Education, Kyung Hee University, Seoul, Republic of Korea
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Takhdat K, Lamtali S, El Adib AR. The effects of mindfulness on health profession students' simulation training outcomes: An integrative review. NURSE EDUCATION TODAY 2021; 106:105082. [PMID: 34391989 DOI: 10.1016/j.nedt.2021.105082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/27/2021] [Accepted: 08/02/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED Health profession students (HPSs) continuously experience psychological issues which can exacerbate cognitive errors and harm emotional well-being. The Healthcare simulation environment is stressful and overwhelming in nature and may impair learning outcomes. Therefore, integrating psychological interventions into simulation-based learning (SBL) instructional design may alleviate students' psychological distress and improve their learning outcomes. OBJECTIVES to examine the effects of mindfulness on health professions students' SBL outcomes. DESIGN a literature review, based on Whittemore and Knafl's (2005) updated methodology was used in this study. DATA SOURCES We investigated PubMed, ERIC, ScienceDirect, and Google Scholar to find papers addressing the effects of mindfulness on health professions students' SBL outcomes. We targeted Results: This integrative review suggests that although mindfulness improves SBL outcomes, HPSs still struggle to transfer mindfulness benefits to real clinical practice. CONCLUSION research on mindfulness in healthcare SBL is in its infancy, thus, further research is needed to prove mindfulness effects on HPSs' SBL outcomes.
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Affiliation(s)
- Kamal Takhdat
- Cadi Ayyad University, Faculty of Sciences Semlalia, Marrakesh, Morocco; Higher Institute of Nursing Professions and Health Techniques, Marrakesh, Morocco.
| | - Saloua Lamtali
- Cadi Ayyad University, Faculty of Sciences Semlalia, Marrakesh, Morocco; Higher Institute of Nursing Professions and Health Techniques, Marrakesh, Morocco
| | - Ahmed Rhassane El Adib
- Marrakesh Simulation and Innovation in Health Sciences Center, Faculty of Medicine and Pharmacy of Marrakesh, Cadi Ayyad University, Marrakesh, Morocco
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Meza RD, Triplett NS, Woodard GS, Martin P, Khairuzzaman AN, Jamora G, Dorsey S. The relationship between first-level leadership and inner-context and implementation outcomes in behavioral health: a scoping review. Implement Sci 2021; 16:69. [PMID: 34229706 PMCID: PMC8259113 DOI: 10.1186/s13012-021-01104-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 03/19/2021] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND First-level leadership is uniquely positioned to support evidence-based practice (EBP) implementation for behavioral health due to first-level leaders' access to and relationship with service providers. First-level leaders are individuals who directly supervise and manage frontline employees who do not manage others. However, first-level leadership is underrepresented in existing reviews of the impact of leadership on EBP implementation. This review describes the relationship between first-level leadership and implementation determinants and outcomes. METHODS A scoping review was performed to synthesize the literature on the relationship between first-level leadership and inner-context and implementation outcomes. A literature search was conducted in PubMed, Eric, PsycINFO, CINAHL, Scopus, and Web of Science. To be eligible, studies had to examine first-level leadership, be conducted in settings providing behavioral health services, and examine the relationship between first-level leadership and an implementation or inner-context outcome. Data extraction and synthesis were performed to describe study characteristics, leader-outcome relationships, and overlap in leadership frameworks. RESULTS Twenty-one records met our inclusion criteria. Studies primarily relied on observational designs and were often cross-sectional. Studies more often examined general leadership rather than leadership strategically focused on EBP implementation (i.e., strategic implementation leadership). Our findings suggest that several forms of first-level leadership are inconsistently related to a broad set of implementation determinants, with infrequent examination of specific implementation outcomes. The broad set of implementation determinants studied, limited number of replications, and inconsistent findings have resulted in sparse evidence for any specific leadership-outcome relationship. The greatest accumulation of evidence exists for general leadership's positive relationship with providers' EBP attitudes, most notably in the form of transformational leadership. This was followed by evidence for strategic implementation leadership facilitating general implementation. Our synthesis revealed moderate conceptual overlap of strategic implementation leadership behaviors described in the theory of implementation leadership and theory of middle managers' role in implementation. CONCLUSIONS Our findings suggest that first-level leadership may play an important role in shaping implementation determinants and outcomes, but consistent empirical support is sparse and confidence dampened by methodological issues. To advance the field, we need studies that adopt stronger methodological rigor, address the conceptual overlap in leadership frameworks, examine a broader set of implementation outcomes, and examine conditions under which leadership impacts implementation. TRIAL REGISTRATION This review was not registered.
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Affiliation(s)
- Rosemary D. Meza
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
| | - Noah S. Triplett
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
| | - Grace S. Woodard
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
| | - Prerna Martin
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
| | - Alya N. Khairuzzaman
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
| | - Gabrielle Jamora
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
| | - Shannon Dorsey
- Department of Psychology, University of Washington, Guthrie Hall 119A, Box 351525, Seattle, WA 98195 USA
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Daniels K, Watson D, Nayani R, Tregaskis O, Hogg M, Etuknwa A, Semkina A. Implementing practices focused on workplace health and psychological wellbeing: A systematic review. Soc Sci Med 2021; 277:113888. [PMID: 33865095 DOI: 10.1016/j.socscimed.2021.113888] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/21/2021] [Accepted: 03/27/2021] [Indexed: 02/08/2023]
Abstract
RATIONALE Workplace health and wellbeing practices (WHWPs) often fail to improve psychological health or wellbeing because of implementation failure. Thus, implementation should be evaluated to improve the effectiveness of WHWPs. OBJECTIVE We conducted a systematic review to identify critical success factors for WHWP implementation and gaps in the evidence. Doing so provides a platform for future theoretical development. METHODS We reviewed 74 separate studies that assessed the implementation of WHWPs and their effects on psychological health or psychological wellbeing. Most studies were from advanced industrial Western democracies (71). Intervention types included primary (e.g., work redesign, 37 studies; and health behavior change, 8 studies), secondary (e.g., mindfulness training, 11 studies), tertiary (e.g., focused on rehabilitation, 9 studies), and multifocal (e.g., including components of primary and secondary, 9 studies). RESULTS Tangible changes preceded improvements in health and wellbeing, indicating intervention success cannot be attributed to non-specific factors. Some interventions had beneficial effects through mechanisms not planned as part of the intervention. Three factors were associated with successful WHWP implementation: continuation, learning, and effective governance. CONCLUSIONS The review indicates future research could focus on how organizations manage conflict between WHWP implementation and existing organizational processes, and the dynamic nature of organizational contexts that affect and are affected by WHWP implementation. This systematic review is registered [PROSPERO: the International Prospective Register of Systematic Reviews ID: CRD42019119656].
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Affiliation(s)
- Kevin Daniels
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom.
| | - David Watson
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Rachel Nayani
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Olga Tregaskis
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Martin Hogg
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Abasiama Etuknwa
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Antonina Semkina
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
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13
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Valipoor S, Bosch SJ. In the Moment: Fostering Mindfulness and Reducing Stressors in the Healthcare Workplace. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:386-398. [PMID: 33535815 DOI: 10.1177/1937586720988243] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While healthcare design research has primarily focused on patient outcomes, there is a growing recognition that environmental interventions could do more by promoting the overall quality of care, and this requires expanding the focus to the health and well-being of those who deliver care to patients. Healthcare professionals are under high levels of stress, leading to burnout, job dissatisfaction, and poor patient care. Among other tools, mindfulness is recommended as a way of decreasing stress and helping workers function at higher levels. This article aims to identify potential environmental strategies for reducing work-related stressors and facilitating mindfulness in healthcare settings. By examining existing evidence on workplace mindfulness and stress-reducing design strategies, we highlight the power of the physical environment in not only alleviating stressful conditions but intentionally encouraging a mindful perspective. Strategies like minimizing distractions or avoiding overstimulation in the healthcare environment can be more effective if implemented along with the provision of designated spaces for mindfulness-based programs. Future research may explore optimal methods and hospital workers' preferences for environments that support mindfulness and stress management. The long-term goal of all these efforts is to enhance healthcare professionals' well-being, reignite their professional enthusiasm, and help them be resilient in times of stress.
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Affiliation(s)
- Shabboo Valipoor
- Department of Interior Design, College of Design, Construction and Planning, 3463University of Florida, Gainesville, FL, USA
| | - Sheila J Bosch
- Department of Interior Design, College of Design, Construction and Planning, 3463University of Florida, Gainesville, FL, USA
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14
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Kriakous SA, Elliott KA, Lamers C, Owen R. The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review. Mindfulness (N Y) 2020; 12:1-28. [PMID: 32989406 PMCID: PMC7511255 DOI: 10.1007/s12671-020-01500-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2020] [Indexed: 12/14/2022]
Abstract
Objectives Burnout and occupational stress are frequently experienced by healthcare professionals (HCPs). Mindfulness-based stress reduction (MBSR) has been found to improve the psychological health outcomes of HCPs. To date, systematic reviews and meta-analyses have primarily focused upon empirical investigations into the reduction of stress amongst HCPs using MBSR and are limited to empirical studies published before December 2019. This systematic review aimed to update the current evidence base and broaden our understanding of the effectiveness of MBSR on improving the psychological functioning of HCPs. Methods Three electronic databases (Medline, Psych Info and Web of Science) were searched without time frame restrictions. Quantitative studies included randomised controlled trials, clinical controlled trials, pre-post designs and studies with up to a 12-month follow-up period. All studies included in the review employed a MBSR programme, standardised measures of psychological functioning and qualified HCPs as participants. Results Using PRISMA guidelines thirty studies were included in the review. The reviewed literature suggested that MBSR was effective in reducing HCPs experiences of anxiety, depression and stress. MBSR was also found to be effective in increasing HCP levels of mindfulness and self-compassion. However, MBSR did not appear as effective in reducing burnout or improving resilience amongst HCPs. Abbreviated MBSR programmes were found to be as effective as the traditional 8-week MBSR programmes. Conclusions MBSR is an effective intervention which can help improve the psychological functioning of HCPs. Recommendations include improving the overall quality of the studies by employing more robust controlled designs with randomisation, increased sample sizes with heterogeneous samples, and making active comparisons between interventions used.
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Affiliation(s)
| | - Katie Ann Elliott
- Forensic Clinical Psychology Department, North Wales Forensic Psychiatric Service, Ty Llywelyn Medium Secure Unit, Ysbyty Bryn y Neuadd, Llanfairfechan, LL33 0HH Conwy, UK
| | - Carolien Lamers
- North Wales Clinical Psychology Programme, Bangor University, LL57 2DG Bangor, UK
| | - Robin Owen
- Early Interventions in Psychosis, Hergest Unit, Ysbyty Gwynedd, Gwynedd, LL57 2PW Bangor, UK
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15
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Knudsen RK, Gregersen T, Ammentorp J, Tousig CG, Timmermann C. Healthcare professionals' experiences of using mindfulness training in a cardiology department - a qualitative study. Scand J Caring Sci 2020; 35:892-900. [PMID: 32852094 DOI: 10.1111/scs.12906] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/02/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE AND AIM Person-centred communication and healthcare professionals' ability to be attentively present in their encounter with patients are essential aspects of patients' experiences of well-being, ability to cope with illness-related challenges and feelings of being recognised. However, the ability to be attentive in relational encounters can be challenging for healthcare staff for many reasons, such as time constraints and a high work pace. Research suggests that mindfulness training could increase staff attentiveness and compassion, but only few qualitative studies have explored the subject. The aim of the current study was to explore doctors' and nurses' individual experiences of how attending an 8-week Mindfulness-Based Stress Reduction course (MBSR) influenced their clinical practice and encounters with colleagues and patients in a cardiology department. METHOD Qualitative interviews were held with six doctors and nurses who had completed the 8-week MBSR course. Interpretative phenomenological analysis was applied to explore and understand the meaning of the participants' accounts. FINDINGS The MBSR course appeared to have changed the healthcare professionals' thoughts and actions, especially regarding their ability to stay focused on the task at hand, to prioritise and to stay calm in an unpredictable and busy work environment. This was facilitated by using concrete techniques learned during the course, such as breathing and taking small breaks to clear their heads and help them be attentive in relation to themselves, colleagues and patients. Furthermore, they described an increased acceptance of their own limitations, better understanding of their colleagues and greater awareness of the unique patient. CONCLUSION These findings suggest that changing healthcare professionals' actions, mindset, awareness and understanding of others may result in a more compassionate work environment and more person-centred care.
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Affiliation(s)
- Randi Karkov Knudsen
- Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark.,Health Services Research Unit, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
| | - Trine Gregersen
- Health Services Research Unit, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jette Ammentorp
- Health Services Research Unit, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Connie Timmermann
- Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark.,Health Services Research Unit, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
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16
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Nedelcu A, Grégoire S. Evaluating the Implementation of an Intervention Based on Acceptance and Commitment Therapy in Postsecondary Institutions. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2020. [DOI: 10.1080/87568225.2020.1806162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Alexandra Nedelcu
- Department of Psychology Faculty of Letters and Human Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Simon Grégoire
- Department of Education and Pedagogy, University of Quebec at Montreal, Montreal, Quebec, Canada
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17
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Wasson RS, Barratt C, O'Brien WH. Effects of Mindfulness-Based Interventions on Self-compassion in Health Care Professionals: a Meta-analysis. Mindfulness (N Y) 2020; 11:1914-1934. [PMID: 32421083 PMCID: PMC7223423 DOI: 10.1007/s12671-020-01342-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives Health care professionals have elevated rates of burnout and compassion fatigue which are correlated with poorer quality of life and patient care, and inversely correlated with self-compassion. Primary studies have evaluated the extent to which mindfulness-based interventions increase self-compassion with contradictory findings. A meta-analytic review of the literature was conducted to quantitatively synthesize the effects of mindfulness-based interventions on self-compassion among health care professionals. Methods Twenty-eight treatment outcome studies were identified eligible for inclusion. Five cumulative effect sizes were calculated using random-effects models to evaluate differences of changes in self-compassion for treatment and control groups. Within and between group comparisons were evaluated. Sub-group and moderator analyses were conducted to explore potential moderating variables. Results Twenty-seven articles (k = 29, N = 1020) were utilized in the pre-post-treatment meta-analysis. Fifteen samples (52%) included health care professionals and fourteen (48%) professional health care students. Results showed a moderate effect size between pre-post-treatment comparisons (g = .61, 95% CI = .47 to .76) for self-compassion and a strong effect size for pre-treatment to follow-up (g = .76, 95% CI = .41 to 1.12). The effect size comparing post-treatment versus post-control was moderate. One exploratory moderator analysis was significant, with stronger effects for interventions with a retreat component. Conclusions Findings suggest mindfulness-based interventions improve self-compassion in health care professionals. Additionally, a variety of mindfulness-based programs may be useful for employees and trainees. Future studies with rigorous methodology evaluating effects on self-compassion and patient care from mindfulness-based interventions are warranted to extend findings and explore moderators.
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Affiliation(s)
- Rachel S Wasson
- Department of Psychology, Bowling Green State University, 822 E Merry Ave, Bowling Green, OH 43403 USA
| | - Clare Barratt
- Department of Psychology, Bowling Green State University, 822 E Merry Ave, Bowling Green, OH 43403 USA
| | - William H O'Brien
- Department of Psychology, Bowling Green State University, 822 E Merry Ave, Bowling Green, OH 43403 USA
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18
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Simpson R, Simpson S, Wood K, Mercer SW, Mair FS. Using normalisation process theory to understand barriers and facilitators to implementing mindfulness-based stress reduction for people with multiple sclerosis. Chronic Illn 2019; 15:306-318. [PMID: 29699410 DOI: 10.1177/1742395318769354] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives To study barriers and facilitators to implementation of mindfulness-based stress reduction for people with multiple sclerosis. Methods Qualitative interviews were used to explore barriers and facilitators to implementation of mindfulness-based stress reduction, including 33 people with multiple sclerosis, 6 multiple sclerosis clinicians and 2 course instructors. Normalisation process theory provided the underpinning conceptual framework. Data were analysed deductively using normalisation process theory constructs (coherence, cognitive participation, collective action and reflexive monitoring). Results Key barriers included mismatched stakeholder expectations, lack of knowledge about mindfulness-based stress reduction, high levels of comorbidity and disability and skepticism about embedding mindfulness-based stress reduction in routine multiple sclerosis care. Facilitators to implementation included introducing a pre-course orientation session; adaptations to mindfulness-based stress reduction to accommodate comorbidity and disability and participants suggested smaller, shorter classes, shortened practices, exclusion of mindful-walking and more time with peers. Post-mindfulness-based stress reduction booster sessions may be required, and objective and subjective reports of benefit would increase clinician confidence in mindfulness-based stress reduction. Discussion Multiple sclerosis patients and clinicians know little about mindfulness-based stress reduction. Mismatched expectations are a barrier to participation, as is rigid application of mindfulness-based stress reduction in the context of disability. Course adaptations in response to patient needs would facilitate uptake and utilisation. Rendering access to mindfulness-based stress reduction rapid and flexible could facilitate implementation. Embedded outcome assessment is desirable.
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Affiliation(s)
- Robert Simpson
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Sharon Simpson
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Karen Wood
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Stewart W Mercer
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Frances S Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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Nita M. 'Spirituality' in Health Studies: Competing Spiritualities and the Elevated Status of Mindfulness. JOURNAL OF RELIGION AND HEALTH 2019; 58:1605-1618. [PMID: 30806896 PMCID: PMC6759664 DOI: 10.1007/s10943-019-00773-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The article investigates discourses of 'spirituality' in the field of Health Studies, among scholarly voices and the voices of the practitioners and patients these studies reflect. It examines current trends in contemporary spirituality as well as links with debates involving science, religion and secularisation. The article argues that, in the public domain, 'spirituality' is beginning to denote a collective practice rather than an individual search for meaning. Furthermore, the article identifies some common understandings of spirituality in the context of Health Studies and health environments, such as it being a tool that can facilitate closeness and emotional exchanges. Finally, it proposes that the success and, as I will show, elevated status of 'mindfulness' in this field points to 'competing spiritualities', despite shared understandings.
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Affiliation(s)
- Maria Nita
- Department of Theology and Religion, University of Birmingham, Birmingham, B15 2TT, UK.
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Abstract
Ongoing professional development is essential across the career development life span. Coaching is emerging as an effective intervention to support career, personal, and leadership development of both individuals and teams in health care, given the high levels of volatility, uncertainty, complexity, and ambiguity that our physicians and organizations face. Coaches, in contrast to mentors, avoid giving direct advice to clients, while still providing self-awareness and other-awareness and accountability to their goals. The use of coaches increases the flexibility of supporting our psychiatrists with a team of supporters, distilling the time of busy mentors to advise primarily on their content expertise.
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Affiliation(s)
- Mary S Ahn
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655-0002, USA.
| | - Douglas Ziedonis
- University of California San Diego, UC San Diego Health, Biomedical Sciences Building, 9500 Gilman Drive #0602, La Jolla, CA 92093-0602, USA
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21
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Santiago PHR, Valle Serra E Meira LR, Colussi CF. Feasibility evaluation of a mindfulness-based stress reduction program for primary care professionals in Brazilian national health system. Complement Ther Clin Pract 2019; 35:8-17. [PMID: 31003691 DOI: 10.1016/j.ctcp.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE In the last decades, an increasing body of scientific studies has shown mindfulness-based interventions as efficacious for reducing stress, including among primary care professionals. Despite the strength of the evidence, mindfulness-based interventions still are not widely adopted as a clinical practice in national health systems. The aim of the present study was to conduct a feasibility evaluation of a mindfulness-based stress reduction program for primary care professionals in Brazilian national health system. MATERIALS AND METHODS A pilot mindfulness program was conducted through the course of four weekly encounters in the municipality of Biguaçu with the participation of 26 primary care professionals. Data was collected through direct observations and four self-report questionnaires. The information was used to complete an evaluation matrix and reach a value judgment about the feasibility level of the components of the mindfulness-based program. RESULTS The subdimensions Integration, Demand, and Acceptability were judged as "Highly Feasible", the subdimension Practicality was judged as "Feasible" and the subdimension Adaptation was judged as "Lowly Feasible". The results indicated that there is a high demand for stress-reduction interventions within the context of primary care and the acceptability by the stakeholders (participants and management) was excellent. However, the two main barriers found were the need for a brief version of the program to accommodate the restrictive timetable of the primary care professionals and the low retention rates. CONCLUSION The implementation of a mindfulness-based program for primary care professionals in Brazilian national health system was judged as "Feasible". Further studies need to conduct the feasibility evaluation in other municipalities and with larger sample sizes to ensure the generalizability of these results.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina (UFSC), Endereço: Campus Reitor João David Ferreira Lima, Rua Delfino Conti, s/n, Bloco H, Brasil.
| | - Leonardo Rodrigues Valle Serra E Meira
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina (UFSC), Endereço: Campus Reitor João David Ferreira Lima, Rua Delfino Conti, s/n, Bloco H, Brasil.
| | - Cláudia Flemming Colussi
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina (UFSC), Endereço: Campus Reitor João David Ferreira Lima, Rua Delfino Conti, s/n, Bloco H, Brasil.
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Braun SE, Kinser PA, Rybarczyk B. Can mindfulness in health care professionals improve patient care? An integrative review and proposed model. Transl Behav Med 2019; 9:187-201. [PMID: 29945218 DOI: 10.1093/tbm/iby059] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Mindfulness in health care professionals (HCPs) is often discussed as a tool for improving patient care outcomes, yet there has not been a critical evaluation of the evidence, despite a growing body of research on mindfulness-based interventions (MBIs). Numerous mechanisms exist by which mindfulness in HCPs may have an effect on patient care, and the field lacks an integrated model to guide future investigations into how MBIs may exert effects. The primary goals of this integrative review are to evaluate the evidence for the impact of MBIs in HCPs on patient care outcomes and to propose a causal model to guide future research. Databases were systematically searched for eligible studies investigating either an MBI or a measure of dispositional mindfulness in HCPs on patient care outcomes. Studies were critically evaluated using a previously developed tool. Twenty-six studies were identified (N = 1,277), which provide strong support for effects of mindfulness on HCP-reported patient care. Moderate support was found for patient safety, patient treatment outcomes, and patient-centered care. There was overall weak evidence to support a relationship between HCP-mindfulness on patient satisfaction. Mindfulness in HCPs may be related to several aspects of patient care.
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Affiliation(s)
- Sarah Ellen Braun
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Patricia Anne Kinser
- Department of Family and Community Health, School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Bruce Rybarczyk
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Physician Wellness and Practice Sustainability. Int Anesthesiol Clin 2018; 57:95-113. [PMID: 30520751 DOI: 10.1097/aia.0000000000000212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ribeiro Santiago PH, Colussi CF. Feasibility evaluation of a mindfulness-based intervention for primary care professionals: Proposal of an evaluative model. Complement Ther Clin Pract 2018; 31:57-63. [PMID: 29705481 DOI: 10.1016/j.ctcp.2018.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 01/30/2018] [Indexed: 10/18/2022]
Abstract
A critical issue in the contemporary field of public health is the organizational stress experienced by healthcare professionals. An integrative and complementary therapy that research has shown as efficacious in helping healthcare professionals to cope with stress is mindfulness meditation. An intervention, however, can't merely be efficacious, it also needs to be feasible to be implemented in a specific political and organizational context. This paper proposes a theoretical logical model and evaluation matrix of the feasibility of a mindfulness-based stress reduction program for primary care professionals. The literature review about the topic was the source for the construction of the theoretical logical model and evaluation matrix, and the validation of those was given by consensus methods, gathering data from experts in the field.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Department of Public Health, Campus Reitor João David Ferreira Lima, Delfino Conti Street, s/n, Bloco H, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
| | - Cláudia Flemming Colussi
- Department of Public Health, Campus Reitor João David Ferreira Lima, Delfino Conti Street, s/n, Bloco H, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
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Duggan K, Julliard K. Implementation of a Mindfulness Moment Initiative for Healthcare Professionals: Perceptions of Facilitators. Explore (NY) 2017; 14:44-58. [PMID: 29175223 DOI: 10.1016/j.explore.2017.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 08/29/2017] [Accepted: 09/24/2017] [Indexed: 12/30/2022]
Abstract
CONTEXT Mindfulness practices in the workplace have experienced rapid growth, with initial evidence suggesting positive outcomes. Even so, little is known about implementing mindfulness-based interventions (MBI), especially internally driven programs led by volunteers rather than experts. OBJECTIVE This study qualitatively explores volunteer facilitators' perceptions of a short-dose MBI (the mindfulness moment initiative) before and 6 weeks after implementation. METHODS Mindfulness moments were 1-3-minute-guided periods of mindfulness led at the beginning of various staff meetings at an inner-city community medical center. Facilitators' perceptions were collected through thirty-one 30-minute semi-structured interviews before and after the MMI's first 6 weeks. Categorizing and connecting strategies were employed to explore the emergence of themes and patterns across responses. RESULTS Mindfulness moment facilitators interviewed before the intervention expected their groups to experience several intra- and interpersonal benefits. After implementation, they perceived all of these benefits to have occurred, but some benefits were mentioned more frequently before than after implementation and vice versa. Five of six expected obstacles were reported after implementation, with timing issues emerging as the most frequently mentioned theme. Facilitators believed that benefits outweighed obstacles. Our data also suggested that mindfulness moments may provide managers with an additional way to address moments of tension occurring between co-workers. Most facilitators intended to continue leading mindfulness moments and wished to expand the practice to new departments. CONCLUSION The mindfulness moment intervention may provide a way to bring mindfulness into organizations that is not dependent on formal training programs, a large time commitment, or a commitment to extended training. Prior knowledge of the obstacles and benefits found here may result in a more successful intervention.
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Affiliation(s)
- Karen Duggan
- Clinical Research Office, NYU Langone Hospital-Brooklyn, 150 55th Street, Brooklyn, NY 11220
| | - Kell Julliard
- Clinical Research Office, NYU Langone Hospital-Brooklyn, 150 55th Street, Brooklyn, NY 11220.
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