1
|
Ta'an W, Hijazi D, Suliman M, Abu Al Rub R, Albashtawy M. Exploring the relationships between stress, resilience and job performance among nurses in Jordan. Nurs Manag (Harrow) 2024; 31:27-33. [PMID: 38116598 DOI: 10.7748/nm.2023.e2112] [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] [Accepted: 10/17/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Nurses are a crucial part of healthcare organisations, constituting around half of the global healthcare workforce. Therefore, it is important to examine the factors that may affect their job performance, which is central to the delivery of effective healthcare services. AIM To examine the relationships between stress, resilience and job performance within the nursing context in Jordan. METHOD A cross-sectional descriptive correlational design was used. A self-administered questionnaire comprising stress, resilience and job performance scales was completed by a convenience sample of 207 nurses working in five hospitals in the northern and middle regions of Jordan. RESULTS Overall, respondents self-reported moderate stress levels, normal resilience levels and moderate job performance. The study identified: a moderate positive correlation between stress and resilience; a weak negative correlation between stress and job performance; and a weak positive correlation between resilience and job performance. CONCLUSION It is essential that nurse managers, leaders and policymakers implement measures to mitigate the stressors encountered by nurses, increase resilience and foster effective coping mechanisms. Such measures could enhance nurses' resilience and job performance, ultimately improving patient care.
Collapse
Affiliation(s)
- Wafa'a Ta'an
- Deanship of Scientific Research, Community and Mental Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Duha Hijazi
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Suliman
- Community and Mental Health Department, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Raeda Abu Al Rub
- Community and Mental Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammed Albashtawy
- Community and Mental Health Department, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| |
Collapse
|
2
|
Ledford A, Luning CR, Dixon DP, Miles P, Lynch SM. The role of mindfulness and resilience in Navy SEAL training. MILITARY PSYCHOLOGY 2024; 36:286-300. [PMID: 38661469 PMCID: PMC11057574 DOI: 10.1080/08995605.2022.2062973] [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: 12/09/2020] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
Abstract
Mindfulness and resilience are thought to be essential qualities of the military's special operations community. Both are tested daily in Special Operations Forces (SOF) assessment and selection efforts to prepare candidates to persist through grueling training and complex combat situations; but these qualities are rarely measured. While military leadership places value on the concepts of mindfulness and resilience, there is minimal empirical research examining the role that they play in the completion of training. This longitudinal study followed three classes of SEAL candidates at Basic Underwater Demolition/SEAL (BUD/S) training over their six-month selection program. We estimated logit models predicting successful completion of BUD/S and specific types of failure in that training environment with indexes of mindfulness and resilience at the start of the program as predictors of completion. The results indicate that (1) mindfulness is unrelated to completion, while (2) resilience is positively related to completion, and (3) The results indicate that mindfulness is generally unrelated to completion, while resilience generally predicts completion.
Collapse
Affiliation(s)
- Andrew Ledford
- Department of Leadership, Ethics, and Law, United States Naval, Arnold, Maryland, USA
- Stockdale Center for Ethical Leadership, United States Naval, Annapolis, Maryland, USA
| | - Celeste Raver Luning
- Department of Leadership, Ethics, and Law, United States Naval, Arnold, Maryland, USA
- Stockdale Center for Ethical Leadership, United States Naval, Annapolis, Maryland, USA
| | - Deirdre P. Dixon
- TECO Energy Center for Leadership, The University of Tampa, Tampa, Florida, USA
- Sykes College of Business, The University of Tampa, Tampa, Florida, USA
| | - Patti Miles
- Maine Business School, University of MaineOrono, Maine, USA
| | - Scott M. Lynch
- Department of Sociology and Center for Population Health and Aging, Duke University, Durham, North Carolina, USA
| |
Collapse
|
3
|
Korpela S, Nordquist H. Supporting emergency service workers to cope with critical incidents that can lead to psychological burden at work - developing skills in the Post Critical Incident Seminar: a qualitative interview study. BMC Psychol 2024; 12:44. [PMID: 38254237 PMCID: PMC10804621 DOI: 10.1186/s40359-024-01534-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Emergency service workers face critical incidents causing psychological burden. This qualitative study investigates how attending a Post Critical Incident Seminar could affect the skills of emergency service workers to overcome incidents that can cause psychological burden at work and their consequences with the following research questions: (1) How did attending the Post Critical Incident Seminar impact the skills to overcome work incidents that can lead to psychological burden? and (2) How have these skills been manifested since attending the Post Critical Incident Seminar? METHODS The data consists of individual interviews with fifteen emergency services workers who attended a Post Critical Incident Seminar in April 2021 in Finland. The interviews were conducted six months after the Post Critical Incident Seminar and analysed using inductive content analysis. RESULTS The results of the first research question formed two main categories: improved performance abilities and improved self-regulation abilities. From the results of the second research question two main categories were created: new kind(s) of well-being and readiness to help. Several upper categories and sub-categories were discovered. CONCLUSIONS Based on the results, attending a Post Critical Incident Seminar may be effective in developing skills to overcome critical incidents that can lead to psychological burden. Further follow-up studies should investigate how acquired skills from the Post Critical Incident Seminar practically affect emergency service workers and their well-being in the longer term.
Collapse
Affiliation(s)
- Sanna Korpela
- South-Eastern Finland University of Applied Sciences, Pääskysentie 1, Kotka, 48220, Finland
| | - Hilla Nordquist
- South-Eastern Finland University of Applied Sciences, Pääskysentie 1, Kotka, 48220, Finland.
| |
Collapse
|
4
|
Witkowski K, Lofaro RJ, Headley AM, Contreras S, Remington CL, Ganapati NE. Understanding problematic substance use among first responders during the COVID-19 pandemic: A survey of law enforcement, fire, and EMS workers in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104261. [PMID: 38006639 DOI: 10.1016/j.drugpo.2023.104261] [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: 06/21/2023] [Revised: 09/27/2023] [Accepted: 11/09/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND First responders have experienced increased levels of stress, anxiety, and depression due to job-related pressures associated with the COVID-19 pandemic. However, little is known about the factors associated with first responder drug and alcohol use during this time. METHODS We conducted a nationwide survey of first responders (n = 2801) to understand the relationship between work pressures, workplace support strategies, and problematic substance use during the early stages of the COVID-19 pandemic. We employed structural equation modeling to analyze whether burnout mediated these relationships. RESULTS Descriptive statistics showed that 60.8 % reported no concerns with substance use. While general workplace support strategies were negatively associated with problematic substance use, specific COVID-related strategies, such as providing compensation during quarantine, were positively associated with problematic substance use. Burnout fully mediated relationships between workplace support strategies and problematic substance use. Finally, providing spaces at work to decompress was negatively associated with problematic substance use and burnout. CONCLUSION Although work pressures increased burnout and problematic substance use among first responders, general workplace support strategies (e.g., decompression spaces) reduced problematic substance use while some COVID-related strategies (e.g. compensation during quarantine) increased problematic substance use. Policy interventions to address problematic substance use should focus on providing spaces for first responders to decompress at work, as well as implementing strategies (e.g., access to mental health services, time off) to reduce burnout. However, organizations should be mindful that not all interventions will have their intended impact and some interventions may unintentionally contribute to negative employee outcomes.
Collapse
Affiliation(s)
- Kaila Witkowski
- Florida Atlantic University, Department of Public Administration, United States.
| | - Ryan J Lofaro
- Georgia Southern University, Department of Public and Nonprofit Studies, United States
| | | | - Santina Contreras
- University of Southern California, Department of Urban Planning and Spatial Analysis, United States
| | - Christa L Remington
- University of South Florida, Department of Public Administration, United States
| | - N Emel Ganapati
- Florida International University, Department of Public Policy and Administration, United States
| |
Collapse
|
5
|
Min B, Park H, Kim JI, Lee S, Back S, Lee E, Oh S, Yun JY, Kim BN, Kim Y, Hwang J, Lee S, Kim JH. The Effectiveness of a Neurofeedback-Assisted Mindfulness Training Program Using a Mobile App on Stress Reduction in Employees: Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e42851. [PMID: 37788060 PMCID: PMC10582822 DOI: 10.2196/42851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 06/14/2023] [Accepted: 08/18/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Mindfulness-based training programs have consistently shown efficacy in stress reduction. However, questions regarding the optimal duration and most effective delivery methods remain. OBJECTIVE This research explores a 4-week neurofeedback-assisted mindfulness training for employees via a mobile app. The study's core query is whether incorporating neurofeedback can amplify the benefits on stress reduction and related metrics compared with conventional mindfulness training. METHODS A total of 92 full-time employees were randomized into 3 groups: group 1 received mobile mindfulness training with neurofeedback assistance (n=29, mean age 39.72 years); group 2 received mobile mindfulness training without neurofeedback (n=32, mean age 37.66 years); and group 3 were given self-learning paper materials on stress management during their first visit (n=31, mean age 38.65 years). The primary outcomes were perceived stress and resilience scales. The secondary outcomes were mindfulness awareness, emotional labor, occupational stress, insomnia, and depression. Heart rate variability and electroencephalography were measured for physiological outcomes. These measurements were collected at 3 different times, namely, at baseline, immediately after training, and at a 4-week follow-up. The generalized estimating equation model was used for data analysis. RESULTS The 4-week program showed significant stress reduction (Wald χ22=107.167, P<.001) and improvements in psychological indices including resilience, emotional labor, insomnia, and depression. A significant interaction was observed in resilience (time × group, Wald χ42=10.846, P=.02). The post hoc analysis showed a statistically significant difference between groups 1 (least squares mean [LSM] 21.62, SE 0.55) and 3 (LSM 19.90, SE 0.61) at the posttraining assessment (P=.008). Group 1 showed a significant improvement (P<.001) at the posttraining assessment, with continued improvements through the 1-month follow-up assessment period (LSM 21.55, SE 0.61). Physiological indices were analyzed only for data of 67 participants (22 in group 1, 22 in group 2, and 23 in group 3) due to the data quality. The relaxation index (ratio of alpha to high beta power) from the right electroencephalography channel showed a significant interaction (time × group, Wald χ22=6.947, P=.03), with group 1 revealing the highest improvement (LSM 0.43, SE 0.15) compared with groups 2 (LSM -0.11, SE 0.10) and 3 (LSM 0.12, SE 0.10) at the 1-month follow-up assessment. CONCLUSIONS The study demonstrated that the neurofeedback-assisted group achieved superior outcomes in resilience and relaxation during the 4-week mobile mindfulness program. Further research with larger samples and long-term follow-up is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT03787407; https://clinicaltrials.gov/ct2/show/NCT03787407.
Collapse
Affiliation(s)
- Beomjun Min
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Heyeon Park
- Liberal Arts College, Dongduk Women's University, Seoul, Republic of Korea
| | - Johanna Inhyang Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Sungmin Lee
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Soyoung Back
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eunhwa Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | | | | | - Jeong-Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| |
Collapse
|
6
|
Bharti T, Mishra N, Ojha SC. Mindfulness and Subjective Well-Being of Indian University Students: Role of Resilience during COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:bs13050353. [PMID: 37232590 DOI: 10.3390/bs13050353] [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: 02/25/2023] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023] Open
Abstract
The coronavirus (COVID-19) pandemic is presently a global health issue that negatively affects the mental health and well-being of students globally. The latest investigations have recognized the role of mindfulness in individual subjective well-being. This study explores the mediating role of resilience in the overall relationship between mindfulness and subjective well-being among Indian university students during the COVID-19 pandemic. The data was collected between 10 August 2020 to 24 October 2020 via a self-administered questionnaire from 589 university students in India. Results revealed that resilience has a partial mediating role between mindfulness and subjective well-being. The results substantiate that resilience has an important role in mindfulness, exercising its advantageous effects on mental health of the students in higher education institutions. This research adds to the knowledge base of mindfulness and subjective well-being of university students, especially in contingent times. Lastly, the study contributes to the existing mindfulness theory.
Collapse
Affiliation(s)
- Teena Bharti
- Indian Institute of Management Bodh Gaya, Bihar 823234, India
| | - Nidhi Mishra
- Indian Institute of Management Bodh Gaya, Bihar 823234, India
| | - Satish Chandra Ojha
- School of Entrepreneurship and Management (formerly STEP-HBTI), Harcourt Butler Technical University, Kanpur 208002, India
| |
Collapse
|
7
|
Network analysis of distress, suicidality, and resilience in a treatment seeking sample of first responders. J Affect Disord 2023; 320:742-750. [PMID: 36179781 DOI: 10.1016/j.jad.2022.09.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 08/30/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION First responders are routinely and regularly exposed to traumatic events that can clinically manifest with a symptom constellation of posttraumatic stress disorder (PTSD), generalized anxiety, depression, and suicidality. METHODS We used network analysis to examine baseline data from treatment seeking first responders (n = 308) to examine the interrelatedness of those constructs, including a measure of resilience. We estimated two models: a regularized partial correlation network and a Bayesian Directed Acyclic Graph (DAG). RESULTS The models reveal converging evidence highlighting the central role of negative alterations in cognitions and mood PTSD cluster along with affective depression. These nodes did not significantly differ, though they were among the strongest in the partial correlation network and shared the most variance with the other nodes. The DAG results suggested that the negative alterations in cognitions and mood PTSD cluster predicted downstream constructs of affective depression; intrusion, hyperarousal, and avoidance PTSD clusters; and resilience. Only resilience and affective depression exhibited direct effects on suicidality. Both somatic depression and suicidality were endogenous endpoints in the DAG. Resilience exhibited an inverse path to suicide. However, resilience was relatively independent of the other constructs in the models and the DAG suggested that it was a consequence of PTSD related distress. LIMITATIONS The data is cross-sectional in nature that should be followed up in longitudinal studies. CONCLUSION Findings are discussed in respect to the role of distress and emotional dysregulation as common factors underlying a broad range of internalizing problems.
Collapse
|
8
|
Adapting to a jolt: A mixed methods study identifying challenges and personal resources impacting professional gig workers' well-being during COVID-19. JOURNAL OF VOCATIONAL BEHAVIOR 2022. [DOI: 10.1016/j.jvb.2022.103784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
9
|
Malik H, Annabi CA. The impact of mindfulness practice on physician burnout: A scoping review. Front Psychol 2022; 13:956651. [PMID: 36204751 PMCID: PMC9530040 DOI: 10.3389/fpsyg.2022.956651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022] Open
Abstract
Background Physician burnout is a growing phenomenon in current health systems worldwide. With the emergence of COVID-19, burnout in healthcare is progressively becoming a serious concern. Increasing emotional exhaustion, depersonalization, and reduced personal accomplishment threaten the effective delivery of healthcare. Compassion fatigue and moral injury are a considerable risk to the doctor-patient relationship. These issues can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in physicians. Methodology A scoping review was conducted to investigate the effects of mindfulness practice on physician burnout. High-ranking journals were targeted to analyze high-quality studies and synthesize common themes in the literature. Studies conducted on current practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Gray literature and studies conducted only on allied health personnel were excluded from this review. Results 31 studies were included in this scoping review. Mindfulness practice decreased emotional exhaustion and depersonalization while improving mood, responses to stress, and vigor. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to physician mindfulness practice. Conclusion Mindfulness was widely reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate physician leader will play a crucial role in addressing current practice gaps, prioritizing staff mental health, and providing a supportive platform for innovation.
Collapse
Affiliation(s)
- Hani Malik
- Department of Family Medicine, Royal College of Surgeons in Ireland, Medical University of Bahrain, Manama, Bahrain
- *Correspondence: Hani Malik,
| | - Carrie Amani Annabi
- Graduate School of Healthcare Management, Royal College of Surgeons in Ireland-Dubai, Dubai, United Arab Emirates
| |
Collapse
|
10
|
Bayazit H, Ozel M, Arac S, Dulgeroglu-Bayazit D, Joshi A. Posttraumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic. J Psychiatr Pract 2022; 28:354-361. [PMID: 36074104 PMCID: PMC9451609 DOI: 10.1097/pra.0000000000000661] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has taken a significant toll on people worldwide, and in particular, on the health care workers (HCWs) who have worked on the frontlines in the fight against the pandemic. The goal of this study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and related factors in HCWs in the era of COVID-19. METHODS This cross-sectional survey study was conducted between September 15, and October 15, 2020, among HCWs in Turkey. The survey consisted of self-administered questionnaires, which included questions about sociodemographic variables, experiences caring for patients with COVID-19, and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), a trauma screening tool. The online survey was completed by 1833 HCWs. Univariate and multivariate logistic regression analyses were used to identify independent predictors of PTSD. RESULTS The mean age of the participants was 32.7±7.0 years; 81.9% were physicians, and 56.5% were female. The rates of COVID-19 history in the respondents, a family member, or a coworker were 13.6%, 32.3%, and 12.6%, respectively. Among the HCWs who participated, 39.9% met the criteria for PTSD. Compared with the physicians, the nonphysician HCWs had a higher rate of PTSD (49.5% vs. 36%) (P<0.001) and higher PCL-5 scores (53.31±19.6 vs. 42.5±20.3) (P<0.001). In addition, 9.7% of the surveyed HCWs reported having suicidal ideation during the COVID-19 pandemic. Independent predictors of PTSD in HCWs were working on a COVID-19 unit, feeling isolated, suicidal ideation, being a nonphysician HCW, fear of spreading coronavirus to family, female sex, and a history of having COVID-19. CONCLUSIONS HCWs were at risk for impairment in mental well-being in the era of COVID-19, with a significant number experiencing PTSD as well as suicidal ideation. Therefore, HCWs, especially those who are working on a COVID-19 unit and are female, should be monitored regularly for PTSD.
Collapse
Affiliation(s)
- Huseyin Bayazit
- BAYAZIT: at the time the manuscript was written, Psychiatry Department, Texas Tech University Health Science Center, Lubbock, TX; currently, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Mehmet Ozel
- JOSHI: Psychiatry Department, Texas Tech University Health Science Center, Lubbock, TX
| | - Songul Arac
- OZEL and ARAC: Emergency Department, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Dilruba Dulgeroglu-Bayazit
- DULGEROGLU-BAYAZIT: Community-Based Treatment Team, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Astik Joshi
- BAYAZIT: at the time the manuscript was written, Psychiatry Department, Texas Tech University Health Science Center, Lubbock, TX; currently, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| |
Collapse
|
11
|
The effectiveness of psychological interventions for reducing PTSD and psychological distress in first responders: A systematic review and meta-analysis. PLoS One 2022; 17:e0272732. [PMID: 36001612 PMCID: PMC9401173 DOI: 10.1371/journal.pone.0272732] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 07/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background First responders are faced with stressful and traumatic events in their work that may affect their psychological health. The current review examined the effectiveness of psychological interventions to treat posttraumatic stress disorder (PTSD), anxiety, depression, stress and burnout in first responders. Methods Four databases were searched to identify controlled studies that examined the efficacy of psychological interventions to reduce PTSD symptoms (primary outcome) in first responders (including firefighters, police/law enforcement officers, search and rescue personnel, emergency and paramedics teams). Secondary outcomes were anxiety, depression, burnout, and stress. Results 15 studies were identified, including 10 studies that measured PTSD, 7 studies for anxiety, 10 studies for depression, 7 studies for stress and 1 for burnout. Interventions were associated with a significant reduction in PTSD (SDM = -0.86; 95% CI = -1.34 –- 0.39), depression (SDM = -0.63; 95% CI = -0.94 –-0.32), and anxiety (SDM = -0.38; 95% CI = -0.71 –-0.05) but not stress (SDM = -0.13; 95% CI = -0.51–0.25). CBT-based and clinician-delivered interventions were associated with significantly greater reductions in PTSD than other types of interventions and non-clinician interventions, but no differences were found for depression. There was evidence of moderate to high risk of bias across all studies. Conclusions Psychological interventions are effective in reducing PTSD, depression and anxiety symptoms but not stress in first responders. Further research is needed using high quality randomised designs over longer periods of follow-up.
Collapse
|
12
|
Reyes AT, Cross CL, Manzano ERM. The Moderating Role of Resilience on Mindfulness, Experiential Avoidance, and Posttraumatic Stress Disorder (PTSD) Symptoms of College Student Veterans: A Cross-Sectional Study. Issues Ment Health Nurs 2022; 43:721-729. [PMID: 35285759 DOI: 10.1080/01612840.2022.2051104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of the study was to investigate the moderating effect of resilience on the relationship between mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptom severity. A cross-sectional study design was used on a sample of 133 college student military veterans. We found a direct effect of mindfulness on PTSD and a significant mediating effect of experiential avoidance on the relationship between mindfulness and PTSD. Resilience also had a significant moderating effect on the relationship between mindfulness and PTSD. This study provides preliminary evidence on the usefulness of integrating resilience development in mindfulness-based interventions for trauma-related disorders.
Collapse
Affiliation(s)
| | - Chad L Cross
- School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | | |
Collapse
|
13
|
Liu Y, Cao Z. The impact of social support and stress on academic burnout among medical students in online learning: The mediating role of resilience. Front Public Health 2022; 10:938132. [PMID: 35937240 PMCID: PMC9355500 DOI: 10.3389/fpubh.2022.938132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/01/2022] [Indexed: 01/23/2023] Open
Abstract
Background As the COVID-19 pandemic continues, online learning and long-term isolation from social and clinical settings has exacerbated mental health problems and symptoms of academic burnout among medical students. However, few studies have discussed symptoms of academic burnout as a result of reduced social support, and increased stress among medical students during the process of online learning. To fill this gap, this study investigated the influencing factors and mechanism of academic burnout in medical students' online learning process. Both the positive inhibition effect of positive factors such as social support, and the negative aggravation effect of negative factors such as stress were explored, while the mediating and protecting role of resilience is also discussed. Method We collected survey data from a total of 817 medical students from a medical school in China who participated in online learning during the fall 2021 semester. An online questionnaire was sent to the students in January, 2022. Items adapted from the DASS Scale developed by Lovibond and Lovibond were used to measure medical students' stress levels. The perceived social support of medical students was assessed by the Gregory MSPSS. Resilience was evaluated by the 10-Item Connor–Davidson Resilience Scale (CD-RISC). Items from the Maslach Burnout Inventory–Student Survey (MBI-SS) were used to calculate students' academic burnout. Descriptive analysis, correlation analysis, hierarchical linear regression analysis and structural equation modeling were used to analyze the collected data. Results The results identified that in the context of online learning there was a positive correlation between medical students' stress and academic burnout, and their resilience played a partial mediating role. However, social support did not directly affect academic burnout, but inhibited the prevalence of academic burnout through resilience. In addition, stress was negatively related to resilience, while social support was positively related to resilience. Resilience was found to be negatively related to medical students' academic burnout in online learning. Conclusion The results of this study can provide a reference for the future development of appropriate educational strategies and coping measures to ameliorate the academic burnout of medical students.
Collapse
Affiliation(s)
- Yue Liu
- School of Education Science, Nanjing Normal University, Nanjing, China
| | - Zhe Cao
- Department of Cardiology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Zhe Cao
| |
Collapse
|
14
|
A Qualitative Analysis of the Mental Health Training and Educational Needs of Firefighters, Paramedics, and Public Safety Communicators in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126972. [PMID: 35742221 PMCID: PMC9222833 DOI: 10.3390/ijerph19126972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 02/01/2023]
Abstract
Background—Public safety personnel (PSP) are at heightened risk of developing mental health challenges due to exposures to diverse stressors including potentially psychologically traumatic experiences. An increased focus on protecting PSP mental health has prompted demand for interventions designed to enhance resilience. While hundreds of available interventions are aimed to improve resilience and protect PSPs’ mental health, research evidence regarding intervention effectiveness remains sparse. Methods—Focus groups with PSP elicited a discussion of psychoeducational program content, preferred modes of program delivery, when such training should occur, and to whom it ought to be targeted. Results—The results of thematic analyses suggest that PSP participants feel that contemporary approaches to improving mental health and resilience are lacking. While welcomed, the provision of sporadic one-off mental health and resilience programs by organizations was seen as insufficient, and the available organizational mental health supports were perceived as being questionable. The available programs also left participants feeling insufficiently prepared to deal with personal mental health problems and in discussing mental health concerns with co-workers. Conclusions—Participants reported needing more engaging methods for delivering information, career-long mental health knowledge acquisition, and a systems approach to improve the workplace culture, particularly regarding mental health.
Collapse
|
15
|
Somohano VC, Vasquez A, Shank T, Irrgang M, Newman AG, Evans C, Wyse J, Denneson L, O'Neil M, Lovejoy T. Perceptions of Women With Comorbid PTSD and Substance Use Disorder on Mechanisms Underlying Mindfulness-Based Interventions. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
16
|
Deen H, Notebaert L, Van Bockstaele B, Clarke PJF, Todd J. For there is nothing either good or bad: a study of the mediating effect of interpretation bias on the association between mindfulness and reduced post-traumatic stress vulnerability. BMC Psychiatry 2022; 22:329. [PMID: 35550057 PMCID: PMC9097341 DOI: 10.1186/s12888-022-03950-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/20/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite increasing interest in the association between mindfulness and reduced trauma vulnerability, and the use of mindfulness in the latest interventions for Post-Traumatic Stress Disorder (PTSD), few studies have examined the mechanisms through which mindfulness may influence post-trauma psychopathology. The present study aimed to determine whether negative interpretation bias, the tendency to interpret ambiguous information as negative or threatening rather than positive or safe, mediates the association between higher levels of trait mindfulness and lower levels of PTSD symptoms. Negative interpretation bias was examined due to prior evidence indicating it is associated with being less mindful and post trauma psychopathology. METHODS The study examined 133 undergraduate students who reported exposure to one or more potentially traumatic events in their lifetime. Participants completed self-report measures of trait mindfulness (Five Facet Mindfulness Questionnaire - Short Form; FFMQ-SF) and PTSD symptoms (Post-Traumatic Stress Disorder Checklist - Civilian version; PCL-C) as well an interpretation bias task that assessed the degree to which participants interpreted a range of everyday hypothetical scenarios to be threatening to their physical and/or psychological wellbeing. RESULTS Results of a mediation analysis indicated a significant negative direct effect of trait mindfulness on PTSD symptomatology (p < .001). There was no evidence that negative interpretation bias mediated this relationship [BCa CI [-0.04, 0.03)], nor was it associated with trait mindfulness (p = .90) and PTSD symptomatology (p = .37). CONCLUSIONS The results of the current study provide further evidence of the link between trait mindfulness and reduced post-trauma psychopathology while providing no support for the role of negative interpretation bias in this relationship.
Collapse
Affiliation(s)
- Hannah Deen
- School of Psychology, University of Sydney, Sydney, Australia. .,The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia.
| | - Lies Notebaert
- grid.1012.20000 0004 1936 7910Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Bram Van Bockstaele
- grid.1012.20000 0004 1936 7910Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia ,grid.7177.60000000084992262Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Patrick J. F. Clarke
- grid.1032.00000 0004 0375 4078Affective, Behavioural, and Cognitive Neuroscience Research Group, Curtin University, Perth, Australia
| | - Jemma Todd
- grid.1013.30000 0004 1936 834XSchool of Psychology, University of Sydney, Sydney, Australia ,grid.1012.20000 0004 1936 7910Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
| |
Collapse
|
17
|
Wilson D, Rodrigues de Oliveira D, Palace-Berl F, de Mello Ponteciano B, Fungaro Rissatti L, Piassa Pollizi V, Sardela de Miranda F, D'Almeida V, Demarzo M. Fostering emotional self-regulation in female teachers at the public teaching network: A mindfulness-based intervention improving psychological measures and inflammatory biomarkers. Brain Behav Immun Health 2022; 21:100427. [PMID: 35243406 PMCID: PMC8881415 DOI: 10.1016/j.bbih.2022.100427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To examine the effect of a mindfulness-based program specifically designed for teachers in reducing perceived stress and improving the quality of experienced emotion in female active working teachers. A second outcome evaluated is the associated change in cellular inflammatory activity, measured by peripheral blood levels of cytokines. METHOD Eighty-eight female active teachers from public schools from São Paulo Municipality were recruited, and randomly allocated to an eight-week Mindfulness-Based Health Program for Educators (MBHP-Educa) or to Neuroscience for Education Program (Neuro-Educa: active control group). The venue of both programs were several public school facilities, where many of the teachers actually worked. Both groups received activities during eight weeks in a 2 h/week regimen, totalizing 16 h. Sixty-five participants completed the program and pre- and post-interventions measures were taken from the following scales: Interpersonal Multidimensional Reactivity Scale (IRI), Positive-and-Negative Affects Scale (PANAS), Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RISC), and a primary outcome in Ryff's Psychological Well-Being Scale (PBWS). At pre-and post-intervention, blood samples were collected for the measurement of several important inflammatory biomarkers, Tumor Necrosis Factor - α (TNF-α), Interleukin 1β (IL-1β), Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10) and Interleukin 12p70 (IL-12P70) through flow cytometry assay. Intervention effects were analyzed via Generalized mixed models (GLMM). RESULTS According to the GLMM, MBHP-Educa significantly reduced the scores of perceived stress (p < 0.0001), and negative affect (p < 0.0001) compared to active control group (Neuro-Educa). Conversely, an increase was observed on Psychological Well Being Scale in dimensions of Self-acceptance (p < 0.0001), and Autonomy (p = 0.001), as well as improvements in Resilience (p < 0.0001), and Positive Affect (p < 0.0001). MBHP-Educa also promoted a reduction in the levels of IL-6 (p = 0.003), IL-8 (p = 0.036), and increase in the levels of IL-10 (p < 0.0001) and IL-12p70 (p < 0.044). TNF-α, IL-1β, and IL-10p70 showed results below theoretical limit of detection accepted for CBA kit. CONCLUSIONS Our data suggest that mindfulness-based interventions introduced as a strategy for reducing stress, promoting well-being and improve immune function can be a useful asset in promoting psychological health among teachers in Basic Education.
Collapse
Affiliation(s)
- David Wilson
- Department of Preventive Medicine, Graduate Program in Collective Health, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Daniela Rodrigues de Oliveira
- Department of Preventive Medicine, Graduate Program in Collective Health, Universidade Federal de São Paulo, São Paulo, SP, Brazil.,Department of Pathology, Graduate Program in Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.,Laboratory of Medical Investigation (LIM-26), Department of Surgery, University of Sao Paulo Medical School, São Paulo, SP, Brazil.,Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Fanny Palace-Berl
- Department of Pathology, Graduate Program in Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.,Laboratory of Medical Investigation (LIM-26), Department of Surgery, University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | - Bárbara de Mello Ponteciano
- Department of Pathology, Graduate Program in Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.,Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Luciana Fungaro Rissatti
- Department of Pathology, Graduate Program in Pathology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Valéria Piassa Pollizi
- Department of Preventive Medicine, Graduate Program in Collective Health, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Flávia Sardela de Miranda
- Laboratory of Imunomodulation, Department of Imunology, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vânia D'Almeida
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Marcelo Demarzo
- Department of Preventive Medicine, Graduate Program in Collective Health, Universidade Federal de São Paulo, São Paulo, SP, Brazil.,Mente Aberta - Brazilian Center for Mindfulness and Health Promotion, Departamento de Medicina Preventiva, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
18
|
Reducing Psychological Stress of Chinese Adolescents by Mindfulness-Based Intervention: The Mediating Role of Resilience. CHILD & YOUTH CARE FORUM 2022. [DOI: 10.1007/s10566-022-09690-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
19
|
Reyes AT, Song H, Bhatta TR, Kearney CA. Exploring the relationships between resilience, mindfulness, and experiential avoidance after the use of a mindfulness- and acceptance-based mobile app for posttraumatic stress disorder. Perspect Psychiatr Care 2022; 58:776-784. [PMID: 34018197 DOI: 10.1111/ppc.12848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/23/2021] [Accepted: 05/02/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study used a mindfulness- and acceptance-based mobile app to examine the relationships between resilience, mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptoms. DESIGN AND METHODS A quasi-experimental pre-posttest, single-group study design was used. A total of 23 college student veterans used the app for 4 weeks. Outcomes of resilience, mindfulness, experiential avoidance, and PTSD were measured at three time-points (baseline, end of Week 2, and end of Week 4). FINDINGS All outcomes significantly improved at postintervention. Improvements in resilience and PTSD significantly correlated with improvement in mindfulness. PRACTICE IMPLICATIONS Mindfulness- and acceptance-based mobile apps can be safely used by individuals with PTSD as a complementary approach to enhance resilient coping with PTSD.
Collapse
Affiliation(s)
- Andrew T Reyes
- School of Nursing, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Huaxin Song
- School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Tirth R Bhatta
- Department of Sociology, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | | |
Collapse
|
20
|
Bajaj B, Khoury B, Sengupta S. Resilience and Stress as Mediators in the Relationship of Mindfulness and Happiness. Front Psychol 2022; 13:771263. [PMID: 35185720 PMCID: PMC8850270 DOI: 10.3389/fpsyg.2022.771263] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/10/2022] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to examine the mediation effects of resilience and stress, two perceived opposite constructs, in the relationship between mindfulness and happiness. Mindful Attention Awareness Scale, Connor-Davidson Resilience Scale, Subjective Happiness Scale, Depression Anxiety Stress Scales short version-21 were administered to 523 undergraduate university students in India. Structural Equation Modeling with bootstrapping was applied to test the mediating effects of resilience and stress. Results showed that resilience and stress partially mediated the mindfulness-happiness relationship. In addition, resilience partially mediated the relationship of mindfulness to stress. Findings suggest that mindfulness may play an influential role in enhancing happiness through the mediating effects of resilience and stress.
Collapse
Affiliation(s)
- Badri Bajaj
- Humanities and Social Sciences, Jaypee Institute of Information Technology, Noida, India
| | - Bassam Khoury
- Department of Educational & Counselling Psychology, McGill University, Montreal, QC, Canada
| | | |
Collapse
|
21
|
Self-Reported Coping Strategies for Managing Work-Related Stress among Public Safety Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042355. [PMID: 35206541 PMCID: PMC8872359 DOI: 10.3390/ijerph19042355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 11/21/2022]
Abstract
Public safety personnel (PSP) experience a disproportionately high number of on-the-job stressors compared to the general population. PSP develop self-initiated actions, or coping strategies, that either confront the situation (approach strategies) or avoid the situation (avoidance strategies) to reduce the impact of stressors on their well-being. Understanding how PSP cope with stress is critical to ensuring their safety and that of the public. In the current study, we examined the coping strategies of PSP (n = 828 in the total sample). Participants managed their experiences of occupational stress or distress using three primary approach coping strategies: education (learning about mental illness and their causes), self-reliance (processes of self-reflection), and treatment (pharmaceutical, psychotherapy) that were considered adaptive. Results demonstrate PSP used multiple coping strategies simultaneously to deal with occupational stress. PSP who reported doing better tended to attribute their success to treatment, specifically psychotherapy, either alone or in combination with other interventions, and almost always emphasizing important supports from co-workers, families, and friends. Changing workplace culture could help to de-pathologize the effects of stress reactions being perceived as individual “failings”.
Collapse
|
22
|
Kennedy B, Atari M, Davani AM, Yeh L, Omrani A, Kim Y, Coombs K, Havaldar S, Portillo-Wightman G, Gonzalez E, Hoover J, Azatian A, Hussain A, Lara A, Cardenas G, Omary A, Park C, Wang X, Wijaya C, Zhang Y, Meyerowitz B, Dehghani M. Introducing the Gab Hate Corpus: defining and applying hate-based rhetoric to social media posts at scale. LANG RESOUR EVAL 2022. [DOI: 10.1007/s10579-021-09569-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Pace TWW, Zeiders KH, Cook SH, Sarsar ED, Hoyt LT, Mirin NL, Wood EP, Tatar R, Davidson RJ. Feasibility, Acceptability, and Preliminary Efficacy of an App-Based Meditation Intervention to Decrease Firefighter Psychological Distress and Burnout: A One-Group Pilot Study (Preprint). JMIR Form Res 2021; 6:e34951. [PMID: 35675115 PMCID: PMC9218885 DOI: 10.2196/34951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/15/2022] Open
Abstract
Background Firefighters are often exposed to occupational stressors that can result in psychological distress (ie, anxiety and depression) and burnout. These occupational stressors have only intensified with the onset of the COVID-19 pandemic and will likely persist in the postpandemic world. Objective To address occupational stressors confronting firefighters, we pilot tested a novel, cost-effective, smartphone app–based meditation intervention created by Healthy Minds Innovations that focused on mindfulness (awareness) training along with practices designed to cultivate positive relationships (connection), insight into the nature of the self (insight), and a sense of purpose in the context of challenge (purpose) with a sample of professional firefighters from a large metropolitan area in southwestern United States. Methods A total of 35 participants were recruited from a closed online group listserv and completed the self-guided 10-unit meditation app over the course of 10 days, at 1 unit per day. We assessed anxiety symptoms, depression symptoms, burnout, and negative affect as well as saliva diurnal cortisol rhythm, an objective indicator of stress-related biology, before and after use of the meditation app. Results This study demonstrated the meditation app was both feasible and acceptable for use by the majority of firefighters. We also found significant reductions in firefighters’ anxiety (P=.01), burnout (P=.05), and negative affect (P=.04), as well as changes in cortisol diurnal rhythm, such as waking cortisol (P=.02), from before to after use of the meditation app. Conclusions Our study findings call for future research to demonstrate the efficacy of this meditation app to reduce psychological distress and burnout in firefighters.
Collapse
Affiliation(s)
- Thaddeus W W Pace
- Division of Biobehavioral Health Science, College of Nursing, University of Arizona, Tucson, AZ, United States
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
- Department of Psychology, College of Science, University of Arizona, Tucson, AZ, United States
| | - Katharine H Zeiders
- Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Stephanie H Cook
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY, United States
| | - Evelyn D Sarsar
- Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Lindsay T Hoyt
- Department of Psychology, Fordham University, Bronx, NY, United States
| | - Nicholas L Mirin
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Erica P Wood
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Raquel Tatar
- Healthy Minds Innovation, Madison, WI, United States
| | - Richard J Davidson
- Department of Psychology, University of Wisconsin, Madison, WI, United States
| |
Collapse
|
24
|
Edgelow M, Scholefield E, McPherson M, Mehta S, Ortlieb A. A review of workplace mental health interventions and their implementation in public safety organizations. Int Arch Occup Environ Health 2021; 95:645-664. [PMID: 34628523 DOI: 10.1007/s00420-021-01772-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Workplace mental health is relevant to public safety organizations due to the exposure that many public safety personnel (PSP) have to psychological trauma in the course of their daily work. While the importance of attending to PSP mental health has been established, the implementation of workplace mental health interventions is not as well understood. This scoping review describes workplace mental health interventions and their implementation in public safety organizations. METHODS English published primary studies with any publication date up to July 3, 2020 were considered. JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was followed. RESULTS 89 citations met inclusion criteria out of the 62,299 found. Articles and reports found were largely published within the last decade, most frequently from Western nations, and most often applied to police, followed by firefighters. The focus of interventions was commonly stress management and resilience, and a frequent implementation strategy was multi-session group training. Comprehensive quality improvement initiatives, a focus on supervisors and managers, and interventions across primary, secondary, and tertiary prevention, were infrequent. CONCLUSION Public safety organizations are frequently reporting on stress management and resilience interventions for police and firefighters, implemented through multi-session group training. A focus across a range of PSP, including paramedics, corrections officers, and emergency dispatchers, using implementation strategies beyond group training, is suggested. This area of research is currently expanding, with many studies published within the past decade; ongoing evaluation of the quality of interventions and implementation strategies is recommended.
Collapse
Affiliation(s)
- Megan Edgelow
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada.
| | - Emma Scholefield
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada
| | - Matthew McPherson
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada
| | - Sonam Mehta
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada
| | - Aquila Ortlieb
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, LDA Building, 31 George Street, Kingston, ON, K7L 3N6, Canada
| |
Collapse
|
25
|
Heyen JM, Weigl N, Müller M, Müller S, Eberle U, Manoliu A, Vetter S, Brown AD, Berger T, Kleim B. Multimodule Web-Based COVID-19 Anxiety and Stress Resilience Training (COAST): Single-Cohort Feasibility Study With First Responders. JMIR Form Res 2021; 5:e28055. [PMID: 33999835 PMCID: PMC8189283 DOI: 10.2196/28055] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/31/2021] [Accepted: 04/17/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Since the emergence of COVID-19, health care workers and first responders have been at a high risk for mental health symptoms owing to their exposure to the virus and increased work stress during the pandemic. Although interventions exist to address mental health issues following exposure to disasters, emergencies, and humanitarian crises, considerably less is known about web-based unguided interventions to help mitigate the negative impacts of such events. Additionally, in contexts in which emergencies reduce access to in-person care, remote forms of support are critical, yet there are limited studies on the use of such interventions. Evidence-based, easy-to-use, scalable interventions are direly needed for this population. OBJECTIVE This study aimed to develop and test the feasibility of an unguided electronic mental health program, COVID-19 Anxiety and Stress Resilience Training (COAST), tailored to first responders and health care personnel, based on scientific evidence and empirically based techniques. METHODS We developed COVID-19-specific training modules focusing on several domains that are previously reported as key to resilience and stress recovery: self-efficacy, mindfulness, sleep quality, and positive thinking. The program was made available to 702 first responders between May and August 2020, during the COVID-19 pandemic. Sociodemographic, work-, and COVID-19-related information was collected, and psychometric questionnaires were completed. We examined user acceptance and user activity, including module choice and participant feedback. RESULTS In total, 52 of 702 (7%) first responders to whom we reached out used the program at least once. COAST use was independent of age, sex, or baseline levels of self-efficacy, mindful awareness, sleep quality, and positive thinking (for all, P>.39). First responders who had tested positive and those who had been quarantined were more likely to engage in the program. A click count analysis per module showed that participants used the self-efficacy and mindfulness modules most often, with 382 and 122 clicks, respectively, over 15 weeks. Overall, first responders expressed satisfaction with the program. CONCLUSIONS Engagement of first responders in the multimodule web-based COAST program was feasible and the first responder cohort expressed overall satisfaction with the program. Those in more difficult circumstances, including those in quarantine and those who tested positive, may be more likely to engage in such programs. Further controlled studies could pave the way for efficacy studies and the development of additional modules, including just-in-time interventions or blended interventions combining individual use of an unguided self-help intervention, such as COAST, with subsequent individual psychotherapy for those who continue to experience stress and psychological symptoms.
Collapse
Affiliation(s)
- Janna Marie Heyen
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
- Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Noé Weigl
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
| | | | - Urs Eberle
- Zurich Schutz und Rettung, Zürich, Switzerland
| | - Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
- McLean Hospital Belmont, Harvard Medical School, Boston, MA, United States
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
| | - Adam D Brown
- Department of Psychology, New School for Social Research, New York, NY, United States
- Department of Psychiatry, New York University, New York, NY, United States
| | - Thomas Berger
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland
- Department of Psychology, University of Zurich, Zürich, Switzerland
| |
Collapse
|
26
|
Medlicott E, Phillips A, Crane C, Hinze V, Taylor L, Tickell A, Montero-Marin J, Kuyken W. The Mental Health and Wellbeing of University Students: Acceptability, Effectiveness, and Mechanisms of a Mindfulness-Based Course. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6023. [PMID: 34205114 PMCID: PMC8199969 DOI: 10.3390/ijerph18116023] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 05/31/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022]
Abstract
Mental health problems are relatively common during university and adversely affect academic outcomes. Evidence suggests that mindfulness can support the mental health and wellbeing of university students. We explored the acceptability and effectiveness of an 8-week instructor-led mindfulness-based course ("Mindfulness: Finding Peace in a Frantic World"; Williams and Penman, 2011) on improving wellbeing and mental health (self-reported distress), orientation and motivation towards academic goals, and the mechanisms driving these changes. Eighty-six undergraduate and post-graduate students (>18 years) participated. Students engaged well with the course, with 36 (48.0%) completing the whole programme, 52 (69.3%) attending 7 out of 8 sessions, and 71 (94.7%) completing at least half. Significant improvements in wellbeing and mental health were found post-intervention and at 6-week follow-up. Improvements in wellbeing were mediated by mindfulness, self-compassion, and resilience. Improvements in mental health were mediated by improvements in mindfulness and resilience but not self-compassion. Significant improvements in students' orientation to their academic goal, measured by "commitment" to, "likelihood" of achieving, and feeling more equipped with the "skills and resources" needed, were found at post-intervention and at 6-week follow-up. Whilst exploratory, the results suggest that this mindfulness intervention is acceptable and effective for university students and can support academic study.
Collapse
|
27
|
Mindfulness and well-being among socioeconomically disadvantaged college students: Roles of resilience and perceived discrimination. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01796-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
28
|
Fleuren BPI, Poesen LT, Gifford RE, Zijlstra FRH, Ruwaard D, van de Baan FC, Westra DD. We're Not Gonna Fall: Depressive Complaints, Personal Resilience, Team Social Climate, and Worries about Infections among Hospital Workers during a Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4701. [PMID: 33925036 PMCID: PMC8124912 DOI: 10.3390/ijerph18094701] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/16/2021] [Accepted: 04/23/2021] [Indexed: 12/23/2022]
Abstract
Maintaining hospital workers' psychological health is essential for hospitals' capacities to sustain organizational functioning during the COVID-19 pandemic. Workers' personal resilience can be an important factor in preserving psychological health, but how this exactly works in high stakes situations, such as the COVID-19 pandemic, requires further exploration. Similarly, the role of team social climate as contributor to individual psychological health seems obvious, but how it exactly prevents workers from developing depressive complaints in prolonged crises remains under investigated. The present paper therefore applies conservation of resources theory to study the relationships between resilience, team social climate, and depressive complaints, specifically focusing on worries about infections as an important explanatory mechanism. Based on questionnaire data of 1126 workers from five hospitals in the Netherlands during the second peak of the pandemic, this paper estimates a moderated-mediation model. This model shows that personal resilience negatively relates to depressive complaints (β = -0.99, p < 0.001, 95%CI = -1.45--0.53), partially as personal resilience is negatively associated with worries about infections (β = -0.42, p < 0.001, 95%CI = -0.50--0.33) which in turn are positively related to depressive complaints (β = 0.75, p < 0.001, 95% CI = 0.31-1.19). Additionally, team social climate is associated with a lower effect of worries about being infected and infecting others on depressive complaints (β = -0.88, p = 0.03, 95% CI = -1.68--0.09). These findings suggest that resilience can be an important individual level resource in preventing depressive complaints. Moreover, the findings imply that hospitals have an important responsibility to maintain a good team social climate to shield workers from infection related worries building up to depressive complaints.
Collapse
Affiliation(s)
- Bram P. I. Fleuren
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.T.P.); (F.R.H.Z.)
| | - Lieze T. Poesen
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.T.P.); (F.R.H.Z.)
| | - Rachel E. Gifford
- Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (R.E.G.); (D.R.); (F.C.v.d.B.); (D.D.W.)
| | - Fred R. H. Zijlstra
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.T.P.); (F.R.H.Z.)
| | - Dirk Ruwaard
- Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (R.E.G.); (D.R.); (F.C.v.d.B.); (D.D.W.)
| | - Frank C. van de Baan
- Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (R.E.G.); (D.R.); (F.C.v.d.B.); (D.D.W.)
| | - Daan D. Westra
- Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (R.E.G.); (D.R.); (F.C.v.d.B.); (D.D.W.)
| |
Collapse
|
29
|
Colgan DD, Eddy A, Bowen S, Christopher M. Mindful Nonreactivity Moderates the Relationship between Chronic Stress and Pain Interference in Law Enforcement Officers. JOURNAL OF POLICE AND CRIMINAL PSYCHOLOGY 2021; 36:56-62. [PMID: 34421195 PMCID: PMC8372831 DOI: 10.1007/s11896-019-09336-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION With high levels of both chronic stress and chronic pain, law enforcement provides a unique population in which to study the potential mitigating impact of cognitive and affective reactivity on the stress-pain link. The primary aim of the present study was to examine the moderating role of mindful nonreactivity in the relationship between chronic stress and pain interference in law enforcement officers (n = 60). METHODS A regression analysis was conducted to determine if chronic stress predicted pain interference, and subsequently, to compute an estimate of the interaction effect of the chronic stress and mindful nonreactivity on pain interference. RESULTS Results demonstrated the overall model was significant, F (3,55) = 5.29, p =.003, R2 = .47. When controlling for mindful nonreactivity, chronic stress significantly predicted pain interference, b = .76, t (55) = 3.40, p = .001, such that every one unit increase in chronic stress was associated with a .76 unit increase in pain interference. Results also demonstrated a significant interaction effect of mindful nonreactivity and chronic stress on pain interference, b = -.04, t (55) = -2.86, p = .006. The Johnson-Neyman technique was conducted and revealed among individuals with low levels of mindful nonreactivity, chronic stress significantly predicted pain interference. However, for individuals with greater levels of mindful nonreactivity, chronic stress no longer predicted pain interference. CONCLUSIONS Findings contribute to a growing understanding of how mindfulness can mitigate harmful effects of stress.
Collapse
Affiliation(s)
- Dana Dharmakaya Colgan
- Neurology Department, Oregon Health and Science University, 3181 Sam Jackson Park Road, Portland, Or. 97239
| | - Ashley Eddy
- Pacific University, School of Graduate Psychology, 222 SE 8th Ave, Suite 212, Hillsboro, OR 97123
| | - Sarah Bowen
- Pacific University, School of Graduate Psychology, 222 SE 8th Ave, Suite 212, Hillsboro, OR 97123
| | - Michael Christopher
- Pacific University, School of Graduate Psychology, 222 SE 8th Ave, Suite 212, Hillsboro, OR 97123
| |
Collapse
|
30
|
Trombka M, Demarzo M, Campos D, Antonio SB, Cicuto K, Walcher AL, García-Campayo J, Schuman-Olivier Z, Rocha NS. Mindfulness Training Improves Quality of Life and Reduces Depression and Anxiety Symptoms Among Police Officers: Results From the POLICE Study-A Multicenter Randomized Controlled Trial. Front Psychiatry 2021; 12:624876. [PMID: 33716824 PMCID: PMC7952984 DOI: 10.3389/fpsyt.2021.624876] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/21/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Police officers' high-stress levels and its deleterious consequences are raising awareness to an epidemic of mental health problems and quality of life (QoL) impairment. There is a growing evidence that mindfulness-based interventions are efficacious to promote mental health and well-being among high-stress occupations. Methods: The POLICE study is a multicenter randomized controlled trial (RCT) with three assessment points (baseline, post-intervention, and 6-month follow-up) where police officers were randomized to mindfulness-based health promotion (MBHP) (n = 88) or a waiting list (n = 82). This article focuses on QoL, depression and anxiety symptoms, and religiosity outcomes. Mechanisms of change and MBHP feasibility were evaluated. Results: Significant group × time interaction was found for QoL, depression and anxiety symptoms, and non-organizational religiosity. Between-group analysis showed that MBHP group exhibited greater improvements in QoL, and depression and anxiety symptoms at both post-intervention (QoL d = 0.69 to 1.01; depression d = 0.97; anxiety d = 0.73) and 6-month follow-up (QoL d = 0.41 to 0.74; depression d = 0.60; anxiety d = 0.51), in addition to increasing non-organizational religiosity at post-intervention (d = 0.31). Changes on self-compassion mediated the relationship between group and pre-to-post changes for all QoL domains and facets. Group effect on QoL overall health facet at post-intervention was moderated by mindfulness trait and spirituality changes. Conclusion: MBHP is feasible and efficacious to improve QoL, and depression and anxiety symptoms among Brazilian officers. Results were maintained after 6 months. MBHP increased non-organizational religiosity, although the effect was not sustained 6 months later. To our knowledge, this is the first mindfulness-based intervention RCT to empirically demonstrate these effects among police officers. Self-compassion, mindfulness trait, and spirituality mechanisms of change are examined. Clinical Trial Registration: www.ClinicalTrials.gov. identifier: NCT03114605.
Collapse
Affiliation(s)
- Marcelo Trombka
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Innovations and Interventions for Quality of Life Research Group, Porto Alegre, Brazil
- Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Marcelo Demarzo
- Mente Aberta, Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain
- Grupo de Investigación en Salud Mental en Atención Primaria, Miguel Servet University Hospital, Zaragoza, Spain
| | - Sonia B. Antonio
- Mente Aberta, Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Karen Cicuto
- Mente Aberta, Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Ana L. Walcher
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Innovations and Interventions for Quality of Life Research Group, Porto Alegre, Brazil
- Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Javier García-Campayo
- Grupo de Investigación en Salud Mental en Atención Primaria, Miguel Servet University Hospital, Zaragoza, Spain
| | - Zev Schuman-Olivier
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Center for Mindfulness and Compassion, Cambridge, MA, United States
| | - Neusa S. Rocha
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Innovations and Interventions for Quality of Life Research Group, Porto Alegre, Brazil
- Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| |
Collapse
|
31
|
Kluge MG, Maltby S, Walker N, Bennett N, Aidman E, Nalivaiko E, Walker FR. Development of a modular stress management platform (Performance Edge VR) and a pilot efficacy trial of a bio-feedback enhanced training module for controlled breathing. PLoS One 2021; 16:e0245068. [PMID: 33529187 PMCID: PMC7853514 DOI: 10.1371/journal.pone.0245068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
This paper describes the conceptual design of a virtual reality-based stress management training tool and evaluation of the initial prototype in a pilot efficacy study. Performance Edge virtual-reality (VR) was co-developed with the Australian Defence Force (ADF) to address the need for practical stress management training for ADF personnel. The VR application is biofeedback-enabled and contains key stress management techniques derived from acceptance and commitment and cognitive behavioural therapy in a modular framework. End-user-provided feedback on usability, design, and user experience was positive, and particularly complimentary of the respiratory biofeedback functionality. Training of controlled breathing delivered across 3 sessions increased participants' self-reported use of breath control in everyday life and progressively improved controlled breathing skills (objectively assessed as a reduction in breathing rate and variability). Thus the data show that a biofeedback-enabled controlled breathing protocol delivered through Performance Edge VR can produce both behaviour change and objective improvement in breathing metrics. These results confirm the validity of Performance Edge VR platform, and its Controlled Breathing module, as a novel approach to tailoring VR-based applications to train stress management skills in a workplace setting.
Collapse
Affiliation(s)
- Murielle G. Kluge
- Centre for Advanced Training Systems, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Steven Maltby
- Centre for Advanced Training Systems, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Nicole Walker
- Army School of Health, Latchford Barracks, Bonegilla, VIC, Australia
| | | | - Eugene Aidman
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- Land Division, Defence Science & Technology Group, Edinburgh, SA, Australia
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Eugene Nalivaiko
- Centre for Advanced Training Systems, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Frederick Rohan Walker
- Centre for Advanced Training Systems, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, The University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
32
|
Dobson H, Malpas CB, Burrell AJC, Gurvich C, Chen L, Kulkarni J, Winton-Brown T. Burnout and psychological distress amongst Australian healthcare workers during the COVID-19 pandemic. Australas Psychiatry 2021; 29:26-30. [PMID: 33043677 PMCID: PMC7554409 DOI: 10.1177/1039856220965045] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine psychological distress in healthcare workers (HCWs) during the COVID-19 pandemic in April-May 2020. METHODS A cross-sectional survey examining demographic, employment and mental health characteristics of HCWs in a large metropolitan hospital in Australia. RESULTS HCWs showed significant symptoms of moderate-severe level depression (21%), anxiety (20%) and posttraumatic stress disorder (PTSD; 29%), associated with burnout, prior psychiatric history, profession and resilience. CONCLUSION Despite low levels of COVID contact, moderate to high levels of psychological distress were reported. Continued monitoring and support for HCWs' mental well-being is warranted as the COVID-19 pandemic develops.
Collapse
Affiliation(s)
- Hannah Dobson
- />Department of Psychiatry, The Alfred Hospital,
Melbourne, VIC, Australia
- />The Monash Alfred Psychiatry Research Centre,
Monash University, VIC, Australia
| | - Charles B Malpas
- Department of Neuroscience, Central Clinical
School, Monash University, Melbourne, VIC, Australia
| | - Aidan JC Burrell
- Department of Intensive Care, The Alfred
Hospital, Melbourne, VIC, Australia
| | - Caroline Gurvich
- The Monash Alfred Psychiatry Research Centre,
Monash University, Melbourne, VIC, Australia
| | - Leo Chen
- The Monash Alfred Psychiatry Research Centre,
Monash University, Melbourne, VIC, Australia
| | - Jayashri Kulkarni
- The Monash Alfred Psychiatry Research Centre,
Monash University, Melbourne, VIC, Australia
| | - Toby Winton-Brown
- />Department of Psychiatry, The Alfred Hospital,
Melbourne, VIC, Australia
- />Department of Neuroscience, Central Clinical
School, Monash University, VIC, Australia
| |
Collapse
|
33
|
LEMOS IS, CARVALHO JVSD, MENDES MTG, BRYS I. Mindfulness and relaxation: the effects of a program with university hospital workers. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2021. [DOI: 10.1590/1982-0275202138e190128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Our study compared the effects of mindfulness and relaxation interventions on stress, quality of life, resilience, and mindfulness levels. A total of 29 workers, recruited at a university hospital in the northeastern region of Brazil and distributed in two groups: Mindfulness (89.5% female, age mean 37.5 ± 6.23 years old); and Relaxation (90.0% female, age mean 34.2 ± 8.66). After eight weeks of daily mindfulness or relaxation practices, both groups significantly reduced the perceived stress and stress at work, and increased their mindfulness and resilience levels, as well as the physical and psychological quality of life domains. Our results suggest that both interventions may be effective in the organizational environment, assisting in health promotion and increasing the ability of individuals to recover from an adversity (resilience).
Collapse
Affiliation(s)
| | | | | | - Ivani BRYS
- Universidade Federal do Vale do São Francisco, Brasil
| |
Collapse
|
34
|
Kaplan J, Bergman AL, Green K, Dapolonia E, Christopher M. Relative Impact of Mindfulness, Self-Compassion, and Psychological Flexibility on Alcohol Use and Burnout Among Law Enforcement Officers. J Altern Complement Med 2020; 26:1190-1194. [PMID: 33017172 PMCID: PMC7757569 DOI: 10.1089/acm.2020.0178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: In the present study, we investigated the relative impact of improvements in mindfulness, self-compassion, and psychological flexibility in predicting decreased burnout and alcohol use in a sample of law enforcement officers (LEOs) participating in a mindfulness-based intervention (MBI). Design: This study is a secondary analysis of pre/post data collected as part of a larger randomized controlled trial of mindfulness-based resilience training (MBRT). Subjects: This secondary analysis comprises pre/post data from 28 LEOs recruited from a metropolitan area and its outlying regions in the Pacific Northwest. Intervention: MBRT is a MBI tailored specifically to the culture and needs of LEOs and other first responders. Outcome measures: All included data were obtained through self-report measures. Mindfulness was assessed by the Five Facet Mindfulness Questionnaire-Short Form, self-compassion was assessed by the Self-Compassion Scale-Short Form, psychological flexibility was assessed by the Acceptance and Action Questionnaire-II, alcohol use was measured by the PROMIS® (v1.0) Alcohol Use-Short Form, and burnout was assessed by the Oldenburg Burnout Inventory. Results: In the first regression, only increases in mindfulness significantly predicted decreased postintervention problematic alcohol use. In the second regression, only increases in self-compassion significantly predicted decreased postintervention burnout. Conclusions: This study builds upon a growing body of literature on the relative impact of mindfulness, self-compassion, and psychological flexibility in predicting outcomes among high-stress cohorts. Results suggest that different components of MBIs may be emphasized to achieve unique benefits. The Clinical Trial Registration number for the parent study is NCT02521454.
Collapse
Affiliation(s)
- Josh Kaplan
- School of Graduate Psychology, Pacific University, Forest Grove, OR, USA
| | - Aaron L. Bergman
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Kaylie Green
- School of Graduate Psychology, Pacific University, Forest Grove, OR, USA
| | - Eli Dapolonia
- School of Graduate Psychology, Pacific University, Forest Grove, OR, USA
| | | |
Collapse
|
35
|
Can Resilience be Measured and Used to Predict Mental Health Symptomology Among First Responders Exposed to Repeated Trauma? J Occup Environ Med 2020; 61:285-292. [PMID: 30575696 DOI: 10.1097/jom.0000000000001526] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To examine whether baseline measures of resilience among active first responders predicts future mental health symptomology following trauma exposure. METHODS Multivariate linear regression examined the associations between baseline resilience and future mental health symptomatology following repeated trauma exposure. Symptomatology at 6-month follow-up was the dependent variable. RESULTS The associations between baseline resilience and future posttraumatic stress disorder (PTSD) (P = 0.02) and depression (P = 0.03) symptoms were statistically significant. Those reporting higher resilience levels had lower symptomology at 6-month follow-up. Eighty percent of first-responders who screened positive for low resilience went on to develop more PTSD symptoms. CONCLUSIONS Examining resilience may serve as a more effective means of screening, given resilience is a malleable construct which can be enhanced via targeted interventions. Higher levels of resilience may protect the long-term mental health of first-responders, particularly in regard to future PTSD.
Collapse
|
36
|
Christopher M, Bowen S, Witkiewitz K. Mindfulness-based resilience training for aggression, stress and health in law enforcement officers: study protocol for a multisite, randomized, single-blind clinical feasibility trial. Trials 2020; 21:236. [PMID: 32111233 PMCID: PMC7048059 DOI: 10.1186/s13063-020-4165-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/12/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force, as well as mental health consequences, including post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. Mindfulness training is a promising approach with high-stress populations that has been shown effective for increasing resilience and improving negative mental health outcomes common among LEOs. METHOD Implemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multisite trial assessing effects of mindfulness-based resilience training versus an attention control (stress management education) and a no-intervention control on physiological, behavioral, and psychological outcomes. To prepare for this future clinical trial, the current study is designed to: enhance efficiency of recruitment, engagement, and retention; optimize laboratory, assessment, and data management procedures; optimize intervention training and ensure fidelity to intervention protocols; and assess participant experience and optimize outcome measures across two sites. Herein, we describe the protocol and methodology of this multisite, randomized, single-blind clinical feasibility trial. DISCUSSION The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience and mental health among LEOs, as well as yield significant benefits for the communities and residents they serve. TRIAL REGISTRATION ClinicalTrials.gov, NCT03784846. Registered on 24 December 2018.
Collapse
Affiliation(s)
- Michael Christopher
- School of Graduate Psychology, Pacific University, 190 SE 8th Ave, Suite 260, Hillsboro, OR 97123 USA
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, 190 SE 8th Ave, Suite 260, Hillsboro, OR 97123 USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, 2001 Redondo S Dr, Albuquerque, NM 87106 USA
| |
Collapse
|
37
|
Denkova E, Zanesco AP, Rogers SL, Jha AP. Is resilience trainable? An initial study comparing mindfulness and relaxation training in firefighters. Psychiatry Res 2020; 285:112794. [PMID: 32078885 DOI: 10.1016/j.psychres.2020.112794] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 12/17/2022]
Abstract
Motivated by the growing interest in promoting resilience in first responders and other professionals who face threatening professional circumstances, the current study investigated the effectiveness of offering a short-form mindfulness training (MT) program to firefighters. The overarching question was to determine if psychological and cognitive markers of resilience are bolstered via MT. Firefighters (n = 121) were assigned to an MT program (n = 42), an active-comparison relaxation training program (RT, n = 31), or served as no-training controls (NTC, n = 48). Both the MT and RT programs were contextualized for firefighters and consisted of 4, 2-h training sessions delivered over 4 weeks by the same expert trainer, as well as 10-15 min of daily out-of-class practice. Intent-to-treat analyses revealed a significantly greater increase in psychological resilience from baseline (T1) to post-training (T2) in firefighters who received MT vs. RT or no training. In addition, positive affect and objective attentional task performance demonstrated a greater increase over time (from T1 to T2) with more days per week of out-of-class practice for the MT group but not for the RT group. These results suggest that MT moreso than RT bolsters markers of resilience in firefighters.
Collapse
Affiliation(s)
- Ekaterina Denkova
- Department of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables 33146, FL, USA
| | - Anthony P Zanesco
- Department of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables 33146, FL, USA
| | | | - Amishi P Jha
- Department of Psychology, University of Miami, 5665 Ponce de Leon, Coral Gables 33146, FL, USA.
| |
Collapse
|
38
|
Behnke A, Rojas R, Karabatsiakis A, Kolassa IT. Childhood maltreatment compromises resilience against occupational trauma exposure: A retrospective study among emergency medical service personnel. CHILD ABUSE & NEGLECT 2020; 99:104248. [PMID: 31731138 DOI: 10.1016/j.chiabu.2019.104248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/20/2019] [Accepted: 10/25/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) compromises resilience against stress and trauma throughout life. Therefore, it could present a major risk factor for the health of frequently trauma-exposed professionals such as emergency medical service (EMS) personnel. OBJECTIVE We investigated, whether EMS personnel's history of CM increased their risk for mental and physical stress symptoms after occupational trauma exposure. PARTICIPANTS AND SETTING Data from 103 German EMS personnel (age: Mdn±QD = 26.00 ± 8.50 years) were collected as part of a cross-sectional survey distributed among employees of the regional German Red Cross EMS division (response rate 46.6%). The sample corresponded well to the division's entire staff in terms of socio-anagraphic characteristics. METHODS CM and occupational trauma exposure as well as posttraumatic, depressive, and somatic symptoms were assessed with self-report questionnaires. RESULTS Moderation analyses indicated stronger positive associations between occupational trauma exposure and the severity of posttraumatic (β = .30, p < .001), depressive (β = .20, p = .026), and somatic symptoms (β = .18, p = .059) among EMS personnel who reported a higher exposure to CM. CONCLUSIONS Our study provides initial evidence that CM could increase the EMS personnel's vulnerability to the detrimental consequences of critical incidents on duty. Future research is needed (i) to replicate and generalize our observation on various trauma-exposed professions as well as (ii) to develop preventive measures for targeting the mediating and protective factors which influence the relationship between CM and the negative consequences of occupational trauma exposure.
Collapse
Affiliation(s)
- Alexander Behnke
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.
| | - Roberto Rojas
- University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexander Karabatsiakis
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Iris-Tatjana Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| |
Collapse
|
39
|
Dong X, Xiang Y, Zhao J, Li Q, Zhao J, Zhang W. How mindfulness affects benign and malicious envy from the perspective of the mindfulness reperceiving model. Scand J Psychol 2019; 61:436-442. [DOI: 10.1111/sjop.12596] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/10/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Xia Dong
- Department of Psychology Hunan Normal University Changsha China
- Cognition and Human Behavior Key Laboratory of Hunan Province Hunan Normal University Changsha China
| | - Yanhui Xiang
- Department of Psychology Hunan Normal University Changsha China
- Cognition and Human Behavior Key Laboratory of Hunan Province Hunan Normal University Changsha China
| | - Jiaxu Zhao
- Department of Psychology Hunan Normal University Changsha China
- Cognition and Human Behavior Key Laboratory of Hunan Province Hunan Normal University Changsha China
| | - Qingyin Li
- Department of Psychology Hunan Normal University Changsha China
- Cognition and Human Behavior Key Laboratory of Hunan Province Hunan Normal University Changsha China
| | - Jingjing Zhao
- Department of Psychology Hunan Normal University Changsha China
- Cognition and Human Behavior Key Laboratory of Hunan Province Hunan Normal University Changsha China
| | - Wenrui Zhang
- Department of Psychology Hunan Normal University Changsha China
- Cognition and Human Behavior Key Laboratory of Hunan Province Hunan Normal University Changsha China
| |
Collapse
|
40
|
Hunsinger M, Christopher M, Schmidt AM. Mindfulness Training, Implicit Bias, and Force Response Decision-making. Mindfulness (N Y) 2019; 10:2555-2566. [PMID: 34413908 PMCID: PMC8372824 DOI: 10.1007/s12671-019-01213-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The goal of this study was to assess the preliminary efficacy of a Mindfulness-Based Training (Mindfulness-based Resilience Training; MBRT) in improving weapon identification among Law Enforcement Officers (LEOs). METHODS Participants (N = 61) were randomly assigned to either MBRT or a no-intervention control group (NIC). A self-report questionnaire assessing mindfulness and a computerized measure assessing implicit stereotype reliance were administered at baseline, post-training, and three months following intervention completion. We also collected information about meditation practice outside of the training for LEOs in the MBRT group. RESULTS Inferential analyses yielded improvements in mindfulness in the MBRT group compared to NIC. Analyses did not provide evidence for implicit stereotype reliance at baseline and therefore did not yield a significant impact of MBRT versus NIC on implicit stereotype reliance, ps > .05; however, participants across both conditions exerted more control when responding to Black male targets compared to White male targets, F(1,74) = 3.98, p = .05, 95% CI [-.05, -.01], d = .36. CONCLUSIONS Our results do not provide evidence for the impact of MBRT on weapon identification, but do suggest that LEOs exerted more effort when responding to images of Black males compared to White males. We discuss recommendations for future clinical trials assessing implicit stereotype reliance, viz., that researchers utilize measures more sensitive to a wider range of LEO samples and with higher ecological validity, and we discuss potential reasons why our results do not align with past research.
Collapse
Affiliation(s)
- Matthew Hunsinger
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | | | - Andi M. Schmidt
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| |
Collapse
|
41
|
Chisholm-Burns MA. Building resilience to combat stress, burnout, and suicidal ideation among pharmacists. Am J Health Syst Pharm 2019; 76:1364-1367. [PMID: 31505558 DOI: 10.1093/ajhp/zxz172] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Marie A Chisholm-Burns
- University of Tennessee Health Science Center College of PharmacyMemphis, Knoxville, and Nashville, TN
| |
Collapse
|
42
|
Lilly M, Calhoun R, Painter I, Beaton R, Stangenes S, Revere D, Baseman J, Meischke H. Destress 9-1-1-an online mindfulness-based intervention in reducing stress among emergency medical dispatchers: a randomised controlled trial. Occup Environ Med 2019; 76:705-711. [PMID: 31138676 DOI: 10.1136/oemed-2018-105598] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/01/2019] [Accepted: 05/06/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Emergency medical dispatchers (EMDs) experience significant stress in the workplace. Yet, interventions aimed at reducing work-related stress are difficult to implement due to the logistic challenges associated with the relatively unique EMD work environment. This investigation tested the efficacy of a 7-week online mindfulness-based intervention (MBI) tailored to the EMD workforce. METHODS Active-duty EMDs from the USA and Canada (n=323) were randomly assigned to an intervention or wait list control condition. Participants completed surveys of stress and mindfulness at baseline, post intervention, and 3 months follow-up. Repeated measures mixed effects models were used to assess changes in stress and mindfulness. RESULTS Differences between the intervention group and control group in pre-post changes in stress using the Calgary Symptoms of Stress Inventory were statistically significant, with a difference of -10.0 (95% CI: -14.9, -5.2, p<0.001) for change from baseline to post intervention, and a difference of -6.5 (95% CI: -11.9, -1.1, p=0.02) for change from baseline to 3 months follow-up. Change in mindfulness scores did not differ between groups. However, increases in mindfulness scores were correlated with greater reductions in stress for all participants, regardless of group (r=-0.53, p<0.001). CONCLUSIONS Development of tailored online MBIs for employees working in challenging work environments offer a promising direction for prevention and intervention. This study found that a short, weekly online MBI for EMDs resulted in reductions in reports of stress. Implications of online MBIs in other emergency responding populations and directions for future research are discussed.
Collapse
Affiliation(s)
- Michelle Lilly
- Psychology, Northern Illinois University, DeKalb, Illinois, USA
| | - Rebecca Calhoun
- Northwest Center for Public Health Practice, University of Washington, DeKalb, Illinois, USA
| | - Ian Painter
- Northwest Center for Public Health Practice, University of Washington, DeKalb, Illinois, USA
| | - Randal Beaton
- Northwest Center for Public Health Practice, University of Washington, DeKalb, Illinois, USA
| | - Scott Stangenes
- Northwest Center for Public Health Practice, University of Washington, DeKalb, Illinois, USA
| | - Debra Revere
- Northwest Center for Public Health Practice, University of Washington, DeKalb, Illinois, USA
| | - Janet Baseman
- Northwest Center for Public Health Practice, University of Washington, DeKalb, Illinois, USA
| | - Hendrika Meischke
- Northwest Center for Public Health Practice, University of Washington, DeKalb, Illinois, USA
| |
Collapse
|
43
|
Abstract
Resilience is defined as the dynamic ability to adapt successfully in the face of adversity, trauma, or significant threat. Some of the key early studies of resilience were observational studies in children. They were followed by research in adults, studies testing interventions to promote resilience in different populations, and a recent upsurge of studies on the underlying genomic and neurobiological mechanisms. Neural and molecular studies in preclinical models of resilience are also increasingly identifying active stress adaptations in resilient animals. Knowledge gained from animal and human studies of resilience can be harnessed to develop new preventive interventions to enhance resilience in at-risk populations. Further, treatment interventions focused on enhancing potentially modifiable protective factors that are consistently linked to psychological resilience can enrich currently available treatment interventions for individuals with posttraumatic stress disorder (PTSD). Translating our expanding knowledge of the neurobiology of resilience additionally promises to yield novel therapeutic strategies for treating this disabling condition. This review summarizes the vast field of resilience research spanning genomic, psychosocial, and neurobiological levels, and discusses how findings have led and can lead to new preventive and treatment interventions for PTSD.
Collapse
|
44
|
Joyce S, Shand F, Lal TJ, Mott B, Bryant RA, Harvey SB. Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders. J Med Internet Res 2019; 21:e12894. [PMID: 30777846 PMCID: PMC6399574 DOI: 10.2196/12894] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/13/2019] [Accepted: 01/20/2019] [Indexed: 12/15/2022] Open
Abstract
Background A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time. Objective This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers. Methods We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills. Results Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002). Conclusions The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12615000574549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368296 (Archived by WebCite at http://www.webcitation.org/75w4xtrpw).
Collapse
Affiliation(s)
- Sadhbh Joyce
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia.,The Black Dog Institute, Hospital Road, Randwick, Australia
| | - Fiona Shand
- The Black Dog Institute, Hospital Road, Randwick, Australia
| | - Tara J Lal
- Fire and Rescue New South Wales, Sydney, Australia
| | - Brendan Mott
- Fire and Rescue New South Wales, Sydney, Australia
| | - Richard A Bryant
- University of New South Wales, School of Psychology, Sydney, Australia
| | - Samuel B Harvey
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia.,The Black Dog Institute, Hospital Road, Randwick, Australia
| |
Collapse
|
45
|
Yeo CJJ, Román GC, Kusnerik D, Burt T, Mersinger D, Thomas S, Boone T, Powell SZ. Trainee Responses to Hurricane Harvey: Correlating Volunteerism With Burnout. Front Public Health 2018; 6:224. [PMID: 30211142 PMCID: PMC6121183 DOI: 10.3389/fpubh.2018.00224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/24/2018] [Indexed: 11/30/2022] Open
Abstract
Background: Natural disasters take a heavy toll not only on their victims, but also on physicians who suffer vicarious trauma and burnout. New trainees in Houston, from entering PGY1 residents to entering fellows, underwent even more upheaval and stress during Hurricane Harvey. Many responded to calls for volunteer help. Objective: To investigate the impact of Hurricane Harvey on new trainees at our institution, and correlate volunteerism with measures of burnout and resilience. Methodology: Thirty three new trainees out of 90 (43% of population) from all specialties in our institution voluntarily responded to an online survey on the impact of Hurricane Harvey on their lives, whether or not they volunteered and in what form, and answered questions drawing from the abbreviated Maslach burnout survey and Resiliency Quiz. Statistical analyses were conducted using GraphPad Prism and Excel data analysis. Results: The top areas impacted were emotional health (32%), eating habits (29%), family (25%) and finances (25%). The main voluntary activities were covering for colleagues who could not make it to hospital (50%), donating money and supplies (36%), and cleaning and rebuilding (36%). Volunteering was associated with feelings of appreciation (76%), happiness (62%), thankfulness (57%), purposefulness (43%) and pride (33%). Fewer volunteers scored lowly in personal achievement as compared to non-volunteers (10 vs. 38%, p = 0.05). Significance: Hurricane Harvey affected health, finances and family of new trainees, more than half of whom volunteered to help. Volunteers had a greater sense of personal achievement as compared to non-volunteers. This may be due to having more volunteers among less burnt-out trainees or because volunteering reduced burnout and stress responses/trauma. These results suggest that volunteer opportunities should be made available in programs targeting resident burnout.
Collapse
Affiliation(s)
| | - Gustavo C. Román
- Houston Methodist Neurological Institute, Houston, TX, United States
| | - David Kusnerik
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Trevor Burt
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Dottie Mersinger
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Shaylor Thomas
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Timothy Boone
- Graduate Medical Education, Houston Methodist Hospital, Houston, TX, United States
| | - Suzanne Z. Powell
- Houston Methodist Neurological Institute, Houston, TX, United States
| |
Collapse
|
46
|
Trombka M, Demarzo M, Bacas DC, Antonio SB, Cicuto K, Salvo V, Claudino FCA, Ribeiro L, Christopher M, Garcia-Campayo J, Rocha NS. Study protocol of a multicenter randomized controlled trial of mindfulness training to reduce burnout and promote quality of life in police officers: the POLICE study. BMC Psychiatry 2018; 18:151. [PMID: 29801444 PMCID: PMC5970505 DOI: 10.1186/s12888-018-1726-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Police officers experience a high degree of chronic stress. Policing ranks among the highest professions in terms of disease and accident rates. Mental health is particularly impacted, evidenced by elevated rates of burnout, anxiety and depression, and poorer quality of life than the general public. Mindfulness training has been shown to reduce stress, anxiety, burnout and promote quality of life in a variety of settings, although its efficacy in this context has yet to be systematically evaluated. Therefore, this trial will investigate the efficacy of a mindfulness-based intervention versus a waitlist control in improving quality of life and reducing negative mental health symptoms in police officers. METHODS This multicenter randomized controlled trial has three assessment points: baseline, post-intervention, and six-month follow-up. Active police officers (n = 160) will be randomized to Mindfulness-Based Health Promotion (MBHP) or waitlist control group at two Brazilian major cities: Porto Alegre and São Paulo. The primary outcomes are burnout symptoms and quality of life. Consistent with the MBHP conceptual model, assessed secondary outcomes include perceived stress, anxiety and depression symptoms, and the potential mechanisms of resilience, mindfulness, decentering, self-compassion, spirituality, and religiosity. DISCUSSION Findings from this study will inform and guide future research, practice, and policy regarding police offer health and quality of life in Brazil and globally. TRIAL REGISTRATION ClinicalTrials.gov NCT03114605 . Retrospectively registered on March 21, 2017.
Collapse
Affiliation(s)
- Marcelo Trombka
- Hospital de Clínicas de Porto Alegre, 2350, Ramiro Barcelos Street, Porto Alegre, Brazil
| | - Marcelo Demarzo
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion - Universidade Federal de São Paulo, 545, Padre José Maria Avenue, São Paulo, Brazil
| | | | - Sonia Beira Antonio
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion - Universidade Federal de São Paulo, 545, Padre José Maria Avenue, São Paulo, Brazil
| | - Karen Cicuto
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion - Universidade Federal de São Paulo, 545, Padre José Maria Avenue, São Paulo, Brazil
| | - Vera Salvo
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion - Universidade Federal de São Paulo, 545, Padre José Maria Avenue, São Paulo, Brazil
| | | | - Letícia Ribeiro
- Pacific University, 2043 College Way, Forest Grove, Oregon USA
| | | | | | - Neusa Sica Rocha
- Hospital de Clínicas de Porto Alegre, 2350, Ramiro Barcelos Street, Porto Alegre, Brazil
| |
Collapse
|
47
|
Meischke H, Lilly M, Beaton R, Calhoun R, Tu A, Stangenes S, Painter I, Revere D, Baseman J. Protocol: a multi-level intervention program to reduce stress in 9-1-1 telecommunicators. BMC Public Health 2018; 18:570. [PMID: 29716576 PMCID: PMC5930694 DOI: 10.1186/s12889-018-5471-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 04/17/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Nationwide, emergency response systems depend on 9-1-1 telecommunicators to prioritize, triage, and dispatch assistance to those in distress. 9-1-1 call center telecommunicators (TCs) are challenged by acute and chronic workplace stressors: tense interactions with citizen callers in crisis; overtime; shift-work; ever-changing technologies; and negative work culture, including co-worker conflict. This workforce is also subject to routine exposures to secondary traumatization while handling calls involving emergency situations and while making time urgent, high stake decisions over the phone. Our study aims to test the effectiveness of a multi-part intervention to reduce stress in 9-1-1 TCs through an online mindfulness training and a toolkit containing workplace stressor reduction resources. METHODS/DESIGN The study employs a randomized controlled trial design with three data collection points. The multi-part intervention includes an individual-level online mindfulness training and a call center-level organizational stress reduction toolkit. 160 TCs will be recruited from 9-1-1 call centers, complete a baseline survey at enrollment, and are randomly assigned to an intervention or a control group. Intervention group participants will start a 7-week online mindfulness training developed in-house and tailored to 9-1-1 TCs and their call center environment; control participants will be "waitlisted" and start the training after the study period ends. Following the intervention group's completion of the mindfulness training, all participants complete a second survey. Next, the online toolkit with call-center wide stress reduction resources is made available to managers of all participating call centers. After 3 months, a third survey will be completed by all participants. The primary outcome is 9-1-1 TCs' self-reported symptoms of stress at three time points as measured by the C-SOSI (Calgary Symptoms of Stress Inventory). Secondary outcomes will include: perceptions of social work environment (measured by metrics of social support and network conflict); mindfulness; and perceptions of social work environment and mindfulness as mediators of stress reduction. DISCUSSION This study will evaluate the effectiveness of an online mindfulness training and call center-wide stress reduction toolkit in reducing self-reported stress in 9-1-1 TCs. The results of this study will add to the growing body of research on worksite stress reduction programs. TRIAL REGISTRATION ClinicalTrials.gov Registration Number: NCT02961621 Registered on November 7, 2016 (retrospectively registered).
Collapse
Affiliation(s)
- Hendrika Meischke
- Northwest Center for Public Health Practice, University of Washington, 1107 NE 45th St. Suite 400, Seattle, WA, 98105, USA
| | - Michelle Lilly
- Department of Psychology, Psychology-Computer Science Building, Northern Illinois University, DeKalb, IL, 60115, USA
| | - Randal Beaton
- Department of Psychosocial and Community Health, University of Washington, Box 357263, Seattle, WA, 98195, USA
| | - Rebecca Calhoun
- Center for Child and Family Well-Being, University of Washington, Box 351525, Seattle, WA, 98195, USA
| | - Ann Tu
- OEM Program, University of Washington, Box 359739, 325 9th Ave, Seattle, WA, 98104, USA
| | - Scott Stangenes
- Northwest Center for Public Health Practice, University of Washington, 1107 NE 45th St. Suite 400, Seattle, WA, 98105, USA.
| | - Ian Painter
- Northwest Center for Public Health Practice, University of Washington, 1107 NE 45th St. Suite 400, Seattle, WA, 98105, USA
| | - Debra Revere
- Department of Health Services, University of Washington, Box 354809, Seattle, WA, 98195, USA
| | - Janet Baseman
- Department of Epidemiology, University of Washington, Box 354809, Seattle, WA, 98195, USA
| |
Collapse
|