Compassion, Mindfulness, and the Happiness of Healthcare Workers

Self-compassion and psychological well-being of radiographers at work

OBJECTIVES

The aim of this study was to assess how self-compassion affects the psychological well-being of radiographers at work.

METHODS

An online survey was sent to radiology and radiotherapy departments in Rhône-Alpes, a region of France (from October 2021 to February 2022). The study is mixed: quantitative data, with closed questions and two validated scales, and qualitative data, with open questions aimed at assessing perceptions among radiologists as regards self-compassion.

RESULTS

A total of 253 radiographers (mean age 32.9 years), took part in this survey. Radiographers reported a poor level of well-being and a moderate level of self-compassion. We found a link between well-being at work and self-compassion. Gender, age, number of years of experience and the desire to receive training on well-being appear to have an impact on the level of self-compassion. The perception of self-compassion by radiologists is essentially positive.

CONCLUSION

Particular attention should be paid to radiologists who are female, young, and with only a few years of experience. Self-compassion is a protective factor for radiologists and may help them take care of themselves to continue caring for others. Training related to self-compassion should be promoted in medical imaging departments.

Consistency between definitions and measurement of mindfulness in eating and physical activity behavior: a scoping review

Mindfulness (i.e., relating to one's internal and external awareness with non-evaluative attitudes) is increasingly applied as a determinant and strategy to change dietary and physical activity behaviours in the general adult population. However, current applications of mindfulness lack methodological standardisation, thereby limiting its comparison. The aim of this study was to examine currently applied conceptual definitions of mindfulness regarding their elements, their measurement, and the consistency between the defined elements and their measurement.Using scoping review methodology, we searched PubMed, PsycINFO, and Web of Science databases for peer-reviewed literature. Definitions were analyzed using an inductive content analysis approach. Consistency between defined elements and measurement was scored on an index. Across 57 records, less than half defined mindfulness as specific to a disposition, state, or action. One third described mindfulness as an attentional process without attitudinal elements. An additional 30% mentioned non-judgment as the singular attitudinal element underlying mindfulness. Empirical articles (n = 45) predominantly assessed dispositional mindfulness as a single score and frequently lacked measurement of defined attitudinal elements or measured elements that were not defined. To advance the systematic investigation of mindfulness, we present a conceptual model describing the measurement selection based on explicitly defined attentional and attitudinal mindfulness elements.

Compassion Dynamics in Medical Students: An Ecological Momentary Assessment Study

Effective interventions to support compassionate patient- and self-care requires an understanding of how to best assess compassion. Micro-ecological momentary assessment (micro-EMA), a method in which participants provide brief responses in real-time within their own environments, can capture changes in compassion across time and contexts. This study examined a micro-EMA approach for measuring the temporal dynamics of compassion in medical students during the COVID-19 pandemic. Medical students (N = 47) completed demographic information and self-report questionnaires assessing empathy and compassion for self and others. Participants then completed six bursts of micro-EMA smartphone-delivered surveys. Each burst was 14 days, with 28 days between bursts. During each burst, participants received four daily micro-EMA surveys assessing compassion, stress, positive affect, and negative affect. Dynamic structural equation modeling was used to examine micro-EMA responses. The overall micro-EMA response rate was 83.75%. On average, daily compassion did not significantly change across the academic year. However, there was significant within-person variability in medical students' compassion trajectories over the training year (b = 0.027, p < .01). At concurrent timepoints, micro-EMA assessed compassion was associated with greater happiness (b = 0.142, p < .001) and lower stress (b = -0.052, p < .05) but was not associated with sadness. In lagged analyses, higher micro-EMA assessed compassion predicted higher next day happiness (b = 0.116, p < .01) and vice versa (b = 0.185, p < .01). Results suggest it is feasible to use micro-EMA to assess daily levels of compassion among medical students. Additionally, there is wide variability in day-to-day fluctuations in compassion levels among medical students, with some students showing substantial increases in daily compassion across the training year and others showing decreases. Positive affect as opposed to negative affect may have particularly strong associations with compassion. Further examination of antecedents and consequences of fluctuations in daily compassion could inform potent intervention targets.

Effects of mindfulness on depression in college students: mediating role of psychological resilience and moderating role of gender

OBJECTIVE

A questionnaire was administered to 936 college students to investigate the mediating effect of psychological resilience in the association between mindfulness and college student depression, as well as the moderating role of gender.

METHODS

For this study, data was collected between 20 April and 1 May 2023 at three universities in Jiangxi Province using a random sampling method. 963 Chinese university students were surveyed using the Adolescent Mindfulness Scale, the Psychological Resilience Scale, and the Depression Self-Rating Scale.SPSS24.0 software was used for correlation analysis and linear regression analysis, and PROCESS v3.4 model 7 was used to analyze this mediated model with moderating effects.

RESULTS

In the mediated effects model, the direct effect of mindfulness on college depression levels was significant (95% CI -0.43, -0.31); the indirect effect of mindfulness on college depression through psychological resilience was also significant (95% CI -0.34, -0.23); the interaction effect of mindfulness and gender was also found to be significant (95% CI 0.03, 0.16) in the mediated model with moderation.

CONCLUSION

Mindfulness not only affect depression directly, but also indirectly through the mediating effect of psychological resilience. At the same time, the prediction of psychological resilience by mindfulness was also moderated by gender, with girls' psychological resilience being more affected by the level of mindfulness compared to boys.

Does mindfulness reduce perceived stress in healthcare professionals?

BACKGROUND

Healthcare professionals (HCPs) are exposed to multiple psychosocial risks that may lead to high levels of stress and low levels of life satisfaction and well-being. Mindfulness, defined as the awareness that arises by intentionally paying attention in the present moment and in a non-judgmental way, seems to be a moderator in the causal association between life stressors and well-being.

AIMS

The aim of the present study was to test the model of relationships between self-reported mindfulness, perceived stress, well-being index and life satisfaction in a sample of Tunisian HCPs.

METHODS

We performed a correlational cross-sectional study on a sample of HCPs at Hedi Chaker University Hospital, Tunisia. We used validated self-reporting instruments: the Mindful Attention Awareness Scale (MAAS), the Perceived Stress Scale (PSS), the World Health Organisation Well-Being Index (WHO-5) and the Satisfaction with Life Scale (SWLS). For data analysis, the SPSS version 23 program was used.

RESULTS

Participants (n=297) included staff nurses (49.2%), medical technicians (19.2%) and doctors (31.6%). The overall model revealed that reduced perceived stress (β=-0.30, P<0.000) and high levels of well-being (β=0.13, P=0.03) were associated with mindfulness, explaining 14% of the variance. Individually, perceived stress significantly predicted mindfulness explaining 13% of the variance.

CONCLUSION

The study explores a variety of elements that can support the development of mindfulness interventions for stress prevention, staff well-being, and improvement of services as a whole.

Understanding the Relationship Between the Multidimensional Perfectionism and Self-Compassion in Adults: The Effect of Age

Literature suggests that perfectionism is associated to self-compassion. However, the multiple relationships between the types of perfectionism (adaptive, maladaptive and non-perfectionists) and the multidimensional construct of self-compassion have not been thoroughly examined. To this end, the present study aimed (a) to examine the relationships between the types of perfectionism and the self-compassion components in an adult sample and (b) to check the effect of age on the relationship between the perfectionistic types and the self-compassion components. Participants were 509 adults aged 18 to 65 years. Self-report questionnaires were used to collect the data. Results indicated that High Standards positively predicted all self-compassion components while Discrepancy positively predicted Self-judgment and Isolation and overidentification and negatively predicted Self-Kindness and mindfulness and Common humanity. In addition, it was found that adaptive perfectionists and non-perfectionists reported higher levels on the positive components of self-compassion and lower levels on its negative components, compared to maladaptive perfectionists. With respect to age, participants in established (30-45 years) and middle (46-65 years) adulthood reported higher levels on the positive self-compassion components and lower levels on its negative components compared to young adults (18-29 years), while participants in emerging adulthood scored higher on both the dimensions of perfectionism (adaptive and maladaptive) compared to participants in established and middle adulthood. Finally, age moderated only the relationship between adaptive perfectionism and Isolation and overidentification. Future directions and implications are being discussed.

Level of happiness among medical students in Bihar-An online survey

BACKGROUND

Happiness is a state of mental well-being and influences the learning and performance of an individual. Medical education due to its academic culture and longer course duration affects the performance and happiness of the students. So, this study was done to assess the level of happiness and the factors associated with it among medical students in Bihar.

MATERIALS AND METHODS

A cross-sectional online survey was conducted among 321 medical students of all academic years from various medical colleges in Bihar. This study used a self-administered study tool using the online Google Form platform for data collection and assessed the level of happiness using Oxford Happiness Questionnaire. A multivariable binary logistic regression analysis was done to find out the predictors of happiness.

RESULTS

A total of 34.6% (95% CI: 29.5-39.9%) medical students were happy. Male (38.2%) students were found to be happier than female (29.2%) students. Age, place of stay, physical activity, meditation and yoga, frequent socialization, absence of psychiatric illness, and stressful situation in the family were the independent predictors of happiness. Around 42.4% of students had another career option, and 32.1% had a second thought about a career due to the COVID-19 pandemic. The presence of any psychiatric illness had a significant effect on the happiness level of the students.

CONCLUSION

Only one in three medical students is happy. Promotion of physical activity, meditation and yoga, and socialization will improve the happiness and thereby learning among medical students.

Self-Compassion as a Key Factor of Subjective Happiness and Psychological Well-Being among Greek Adults during COVID-19 Lockdowns

The present study examined the association and complementary effect of self-compassion on the subjective happiness and psychological well-being of adults during the COVID-19 pandemic. The study was based on a concurrent correlational design to examine relationships between self-compassion, subjective happiness, psychological well-being, resilience, and the meaning in life. Data were collected via a battery of questionnaires and analyzed, focusing on the above variables. The sample of this study (N = 526) consisted of Greek professionals in education and university students. The results showed that there is a strong positive relationship between self-compassion and subjective happiness, and between self-compassion and psychological well-being. The findings suggest that an attitude of self-compassion may well influence the development of psychological well-being and increase the subjective happiness of adults during the distressing era of a long-term pandemic. The results also indicated a positive relationship between self-compassion and meaning in life and showed that self-compassion is a prerequisite for resilience, which in turn may serve as a moderator of psychological well-being and subjective happiness.

Examining the effects of teacher self-compassion, emotion regulation, and emotional labor strategies as predictors of teacher resilience in EFL context

Introduction

This study investigates the effects of teacher self-compassion, emotion regulation, and emotional labor strategies on teacher resilience in the English as a foreign language (EFL) context. The study aims to understand the relationships between these variables and their potential implications for promoting teacher resilience.

Methods

A sample of 711 Chinese EFL teachers participated in the study. Confirmatory factor analysis (CFA) was conducted to assess the psychometric properties of the instruments used to measure teacher self-compassion, emotion regulation, emotional labor strategies, and teacher resilience. Structural equation modeling (SEM) was employed to examine the relationships between these variables.

Results

The results of the study revealed that teacher self-compassion and emotional labor strategies had direct positive effects on teacher resilience. Specifically, higher levels of self-compassion and effective use of emotional labor strategies were associated with greater teacher resilience. Furthermore, teacher emotion regulation was found to indirectly predict teacher resilience through the mediation of emotional labor strategies. This suggests that the ability to regulate emotions influences the adoption of effective emotional labor strategies, which in turn contributes to higher levels of teacher resilience.

Discussion

The findings of this study highlight the importance of teacher self-compassion, emotion regulation, and emotional labor strategies in promoting teacher resilience in the EFL context. Interventions aimed at enhancing teacher emotional regulation skills and fostering self-compassion may have significant implications for supporting teachers in managing the demands and challenges of their profession, ultimately enhancing their resilience. These findings contribute to the understanding of factors that can promote teacher resilience and inform the development of targeted interventions in the EFL context.

The ABC Model of Happiness-Neurobiological Aspects of Motivation and Positive Mood, and Their Dynamic Changes through Practice, the Course of Life

Simple Summary

This article proposes a new model for exploring happiness primarily from a neurobiological perspective. Such understanding includes the dynamics of positive mood states and how they change throughout life. Happiness is not a cognitive construct: it is an immediate emotional experience—a feeling that relies on neurophysiological activation in the brain’s reward system. With this in mind, three types of happiness are proposed: (A) wanting, approaching, and pleasure, (B) avoiding, departing, and relief, (C) non-wanting, staying, and satisfaction. Behind this is a sophisticated (neuro)biological dynamic, ranging from the search for autonomy and ecstasy, which is particularly characteristic of young people, to the way we cope with stress, as we find it pronounced in the middle-aged, to deep contentment, peace, and inner joy, as it is mainly attributed to older people. Paradoxically, it is in fact the elderly who appear to be the happiest and most content—this phenomenon is also known as the “satisfaction paradox”. Apparently, these dynamic changes in happiness can be amplified with practice. Happiness is biological in this context, but can still be “learned”. Contemplative practices can serve as an example here to demonstrate this trainability, and they may themselves influence the course of happiness.

Abstract

Background: Happiness is a feeling, an immediate experience, not a cognitive construct. It is based on activity in the brain’s neurobiological reward and motivation systems, which have been retained in evolution. This conceptual review provides an overview of the basic neurobiological principles behind happiness phenomena and proposes a framework for further classification. Results: Three neurobiologically distinct types of happiness exist: (A) wanting, (B) avoiding, and (C) non-wanting. Behind these types lies a dynamic gradation, ranging from the more youthful anticipation, pleasure and ecstasy (A), to stress processing, escape and relief (B) as we find them accentuated in the middle-aged, to deep satisfaction, quiescence and inner joy (C), which is particularly attributed to older people. As a result, the development of happiness and satisfaction over the course of life typically takes the form of a U-curve. Discussion: The outlined triad and dynamic of happiness leads to the paradoxical finding that the elderly seem to be the happiest—a phenomenon that is termed “satisfaction paradox”. This assumed change in happiness and contentment over the life span, which includes an increasing “emancipation” from the idea of good health as a mandatory prerequisite for happiness and contentment, can itself be changed—it is trainable. Conclusions: Programs for mindfulness, contemplation, or stress reduction, including positive psychology and mind–body/behavioral medicine training, seem to be capable of influencing the course happiness over time: Happiness can be shaped through practice.

Mediating Effect of Compassion Competence on the Relationship between Caring Behaviors and Quality of Nursing Services in South Korea

This study aimed to investigate the mediating effect of compassion competence on the relationship between caring behaviors and the quality of nursing services. Participants included nurses working in South Korean hospitals. Data collected from 1 November to 31 December 2020 were analyzed using a t-test, analysis of variance (ANOVA), Pearson’s correlation coefficients, and hierarchical multiple regression. We found that caring behavior had a positive correlation with the quality of nursing services and compassion competence. Moreover, there was a positive correlation between the quality of nursing services and compassion competence. Compassion competence had a significant mediating effect on the relationship between caring behaviors and quality of nursing services. This suggests that nurses’ caring behaviors can enable high-quality nursing services influenced by compassion. Therefore, in order to improve the quality of nursing services, repeated and continuous implementation of training programs including education that can improve compassion competence is necessary.

Cultivating Compassion and Reducing Stress and Mental Ill-Health in Employees-A Randomized Controlled Study

Stress and mental ill-health carry considerable costs for both individuals and organizations. Although interventions targeting compassion and self-compassion have been shown to reduce stress and benefit mental health, related research in organizational settings is limited. We investigated the effects of a 6-week psychological intervention utilizing compassion training on stress, mental health, and self-compassion. Forty-nine employees of two organizations were randomly assigned to either the intervention (n = 25) or a physical exercise control condition (n = 24). Multilevel growth models showed that stress (p = 0.04) and mental ill-health (p = 0.02) decreased over 3 months in both groups (pre-intervention to follow-up: Cohen's d = -0.46 and d = 0.33, respectively), while self-compassion only increased in the intervention group (p = 0.03, between group d = 0.53). There were no significant effects on life satisfaction in any of the groups (p > 0.53). The findings show promising results regarding the ability of compassion training within organizations to decrease stress and mental ill-health and increase self-compassion.

Health-related behaviors, self-rated health, and predictors of stress and well-being in nursing students

BACKGROUND

Nursing students are at increased risk for the consequences of stress on wellbeing. Little is known about nursing students' health promoting behaviors and how these relate to health, stress, and well-being.

PURPOSE

The purpose was to describe perceived stress and measures of well-being (self-compassion, happiness, and life satisfaction) along with self-reported health promoting behaviors and health status in order to identify factors that could affect stress and well-being in nursing students.

METHODS

A multi-site team employed cross-sectional research methods to explore well-being, stress, and potential physical and emotional health-relevant factors in undergraduate nursing students. Baccalaureate Nursing students from three nursing programs in North Texas participated in a web-based survey. Undergraduate students (n = 417) reported being junior or senior level in a traditional (74.1%) or an alternative nursing training program (on-line, fast-track, or weekend nursing program; 24.9%) in the fall of 2019. Recruitment fliers went to a total of 2264 potential participants via university e-mail. Consenting students completed online surveys collecting demographic and health related factors as well as measures of well-being and stress.

RESULTS

More than half (56.6%) of students reported worsening health since starting nursing school. Exercise and meditation were related to higher measures of well-being and lower stress, but this relationship diminished in the multivariate model when considering individual demographic and health related factors. Our multivariate model suggests that self-rated health status remains a main potential predictor of reduced stress and improved well-being.

CONCLUSIONS

Self-reported health factors are related to wellbeing in nursing students. Targeted interventions to improve well-being among nursing students may be necessary and would fit with national recommendations for nursing education programs. Resiliency skills training with mindfulness practices may help nursing students reduce stress, improve overall well-being, and equip students to avoid burnout and stress-related illness once in the workforce.

A Telephone-Adapted Mindfulness-Based Stress Reduction Program: Preliminary Effects among Healthcare Employees

Healthcare employees often experience high stress and may benefit from accessible psychosocial interventions. In this pilot study, we explored preliminary feasibility, acceptability, and psychological effects of a telephone-based adaption of mindfulness-based stress reduction (MBSR) for healthcare employees. Eleven participants (M age = 49.9; 27.3% ethnic/racial minority) were enrolled in an eight-session group-based MBSR program adapted for telephone delivery. Feasibility was assessed using rates of program attrition and session completion; acceptability was explored qualitatively via participants' responses to an open-ended item about their program experience. Participants also completed pre-and post-program assessments on psychosocial outcomes (distress (overall distress, depression, anxiety, somatization), mindfulness, and self-compassion). We characterized mean change scores, 95% confidence intervals, and effect sizes to explore preliminary program effects. With regard to preliminary feasibility, one participant dropped out prior to the intervention; of the remaining 10 participants, 90% completed at least half (≥4) of the sessions; 70% completed at least three-quarters (≥6 sessions). Feedback reflected positive experiences and included suggestions for program delivery. Participants reported reductions in distress post-program (M difference range = -5.0 to -9.4), showing medium to large effect sizes (d range = 0.68 to 1.11). Mindfulness scores increased from pre- to post-intervention (M difference range = 1.0 to 10.4), with small-to-medium effects (d range = 0.18 to 0.55). Almost all aspects of self-compassion remained stable over time, with the exception of common humanity, which increased post-program (M difference = 2.9, CI 95% 0.5 to 5.4, d = 0.91). Preliminary findings from our small pilot trial suggest that telephone-based adaptations of MBSR may be a useful mode of delivery for healthcare employees; however, larger studies are needed to provide further evidence of feasibility, acceptability, and program effects.

Bridging Intention and Action for Employee Well-Being Using the Intentional Action (InAct) Process: Workshop-Lecture Series

Background

Employee wellness programs can help manage stress and alleviate burnout.

Objective

To pilot and disseminate the Intentional Action(InAct) concept for employee wellbeing.

Methods

Five independent interactive workshop-lectures with an automated audience response system. Descriptive analysis of participant response data.

Results

Participants (n = 275): rated spirituality, physical environment and nutrition the most highly in contributing to their present well-being. Ninety-eight percent (n = 269) of participants identified a focus area to work on. The well-being area most selected was Exercise, (35% n = 95), however, other non-traditional areas, including Personal and Professional Development (18% n = 48), Relationships and Communication (17% n = 47), were selected, along with mind-body connection and mindful awareness (6% n = 15 and n = 16).

Conclusion

The pilot engaged employees to reflect and set goals for their future well-being. Healthcare institutions implementing programs should consider a broad range of whole person strategies addressing employee well-being, which go beyond the traditional focus on exercise and nutrition.

Online Mindfulness May Target Psychological Distress and Mental Health during COVID-19

Background

The COVID-19 pandemic has dramatically affected mental health, creating an urgent need for convenient and safe interventions to improve well-being. Online mindfulness interventions show promise for improving depression, anxiety, and general well-being.

Objective

To assess: 1) the impact of online mindfulness on psychological distress, 2) altruistic efforts, and 3) the quantity, quality, and availability of online mindfulness resources during the COVID-19 pandemic.

Methods

233 participants (203 U.S.; 20 international; 10 unknown) participated in this prospective, single-arm, non-randomized clinical trial of a single online mindfulness meditation session with pre- and post-surveys.

Main Outcome Measures

(a) Mindfulness session helpfulness, online platform effectiveness, and immediate pre- to post-session changes in momentary stress, anxiety, and COVID-19 concern; (b) qualitative themes representing how people are helping others during the pandemic; (c) absolute changes in quantity of mindfulness-oriented web content and free online mindfulness resource availability from May to August 2020.

Results

Most participants felt the online mindfulness session was helpful and the electronic platform effective for practicing mindfulness (89%, 95% CI: [82 to 93%]), with decreased momentary anxiety (76%; 95% CI: [69 to 83%]), stress (80%; [72 to 86%]), and COVID-19 concern (55%; [46 to 63%]), (p < 0.001 for each measure). Participants reported helping others in a variety of ways during the pandemic, including following public health guidelines, conducting acts of service and connection, and helping oneself in hopes of helping others. "Mindfulness + COVID" search results increased by 52% from May to August 2020. Most (73%) Academic Consortium for Integrative Medicine and Health member websites offer free online mindfulness resources.

Conclusions

Virtual mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress during this isolating public health crisis. Kindness and altruism are being demonstrated during the pandemic. The consolidated online mindfulness resources provided may help guide clinicians and patients.

Compassion toward others and self-compassion predict mental and physical well-being: a 5-year longitudinal study of 1090 community-dwelling adults across the lifespan

There is growing interest in the role of compassion in promoting health and well-being, with cross-sectional data showing an inverse correlation with loneliness. This is the first longitudinal study examining both compassion toward others (CTO) and compassion toward self (CTS) as predictors of mental and physical health outcomes including loneliness, across adult lifespan. We followed 552 women and 538 men in San Diego County for up to 7.5 (mean 4.8 and SD 2.2) years, using validated rating scales for CTO, CTS, and loneliness. Linear mixed-effects models were employed to examine age- and sex-related trajectories of CTO and CTS over time. Linear regression models were used to evaluate baseline and longitudinal relationships of CTO and CTS with mental well-being, physical well-being, and loneliness. CTS and CTO were weakly intercorrelated. Women had higher baseline CTO than men. While CTO was stable over time and across the lifespan, CTS scores had an inverse U-shaped relationship with age, peaking around age 77. There were significant baseline × slope interactions of both CTO and CTS predicting improvements in physical well-being in adults <60 years old. Increases in CTO and CTS predicted improvements in mental well-being. Higher baseline CTO and CTS as well as increases in CTO and CTS scores predicted lower loneliness scores at follow-up. Thus, CTO and CTS were associated with better mental well-being and loneliness across the adult lifespan, and physical well-being in younger adults, and are promising targets for interventions to improve health outcomes.

The value of intentional self-care practices: The effects of mindfulness on improving job satisfaction, teamwork, and workplace environments

BACKGROUND

Burnout rates among nurses have detrimental impact on job satisfaction, teamwork, and patient care. This costs millions of dollars in the healthcare system and challenges nurse leaders to address in order to keep up with the healthcare demands. Furthermore, burnout is especially relevant in our current healthcare climate, as frontline nurses have increased workload and multiple psychosocial stressors during the coronavirus disease (COVID-19) pandemic (Sultana, Sharma, Hossain, Bhattacharya, & Purohit, 2019). Literature also suggests that mindful self-care practices need to be reinforced in order to impact burnout long term (Chamorro-Premuzic & Lusk, 2017). Project7 Mindfulness Pledge© is an accessible and voluntary mindfulness tool that nurses can utilize in their individual practice to reduce burnout and does not require significant time commitment.

OBJECTIVE

To evaluate the effectiveness of intentional self-care practices on nurse burnout and workplace environment by measuring job satisfaction and teamwork among nurses.

METHODS

Comparisons between inpatient units on data from the National Database of Nursing Quality Indicators (NDNQI) with the Practice Environment Scale (PES), specifically on job enjoyment and teamwork, were done utilizing ANOVA.

RESULTS

Results show that nurses in an inpatient unit that implemented Project7 has significantly higher job satisfaction as compared to units that did not implement Project7.

CONCLUSIONS

This suggests that this tool provides an effective and accessible mindfulness framework managers and directors can utilize to improve job satisfaction, teamwork, and thereby reduce burnout to create healthier work environments.

Influence of Self-Compassion on the Health of Midwives and Nurses: Protocol for a Scoping Review

BACKGROUND

Self-compassion is recognized to have a positive effect upon a person's health. However, the influence of self-compassion on the health of midwives and nurses is less well understood. Midwives and nurses often work in highly demanding environments and situations, and are exposed to multiple work-based stressors simultaneously. Stressors such as a demanding clinical workload, high acuity, missing breaks, working more than their contracted hours, insufficient resources and staff, and poor patient outcomes can lead to midwives and nurses feeling physically exhausted and at increased risk of poor mental health. Self-compassion may act as a protective factor, assisting midwives and nurses to remain healthy.

OBJECTIVE

This scoping review will provide an overview of the evidence base relating to the influence of self-compassion on the health of midwives and nurses.

METHODS

The purpose of a scoping review is to comprehensively and systematically review the literature and identify key evidence or gaps. The search strategy for this protocol includes electronic databases such as Medline, Embase, Emcare, PsycInfo, Joanna Briggs Institute, Cochrane Library, and Scopus. Grey literature sources will be also searched, including ProQuest Central, internet search engines (Google Scholar), and manually searched key journals and reference lists of relevant articles. This scoping review will be undertaken in seven stages, guided by established scoping review methods and reporting guidelines: (1) identifying the research questions; (2) identifying relevant studies; (3) selecting the studies; (4) charting the data; (5) collating, summarizing, and reporting the results; (6) consulting; and (7) dissemination of knowledge. Data will be abstracted and presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and explanation by three independent researchers.

RESULTS

A preliminary search conducted in Medline (OVID) retrieved 194 results. Completion of the review is expected in December 2020 and will be published in early 2021.

CONCLUSIONS

To our knowledge, this will be the first scoping review of evidence-based literature relating to the influence of self-compassion on the health of midwives and nurses. It is anticipated that this analysis of the literature will contribute to understanding how midwives and nurses may use self-compassion in a proactive way to reduce work-based stressors such as burnout, stress, and compassion fatigue. Furthermore, the findings may inform educational needs with implications for clinical practice.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/21917.

Meaning, Joy, and Critical Care Nurse Well-Being: A Call to Action

Healthy nurses are essential for optimizing population health, patient care experiences, and health care cost-efficiency. Critical care nurses are at increased risk of developing physical and psychological symptoms due to their high-stress work environment and exposure to traumatic events. There is growing recognition for the value of implementing nurse-centered, team-based, and organizational-wide levels of intervention designed to mitigate the impact of high work stress and trauma on health professionals. The central assertion of this article is that meaning and joy in nursing practice are contributors to professional well-being and part of the solution for achieving the quadruple aim.

Happiness among dentists: a multi-scale, multi-national study from 21 countries

OBJECTIVES

The extent to which dentists are happy with their profession and their life has not been well studied. The present study aimed to explore the level of happiness, satisfaction with life and psychological well-being among a sample of dental professionals from 21 countries.

MATERIALS AND METHODS

The sample comprised 2,200 dentists from 21 countries. Three scales - Subjective Happiness Scale (SHS), Satisfaction With Life Scale (SWLS), and Affect Balance Scale (ABS) - were used to measure the subjective responses. Data related to demographic and social characteristics were recorded. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Scales were correlated, and multiple linear regression analyses were employed to identify the independent determinants of SHS, SWLS and ABS. Data were analysed using the SPSS software program; a value of P <0.05 was considered significant.

RESULTS

The overall mean scores of SHS, SWLS and ABS were 18.53 ± 5.06, 23.06 ± 6.25 and 1.26 ± 2.40, respectively, with significant differences found across countries: dentists working in Croatia, Peru and Serbia recorded the highest scores, unlike dentists practicing in Yemen, Syria, and Iraq, who recorded the lowest scores. There were significant, moderately positive correlations between the various scales: SHS and SWLS: r = 0.535, P < 0.001; SHS and ABS: r = 0.58, P < 0.001; and SWLS and ABS: r = 0.533, P < 0.001. Country of practice, age, qualification and monthly income were the significant independent predictors of SHS, SWLS and ABS.

CONCLUSION

Country of residence and social characteristics were associated with dentists' responses regarding their feelings and subjective well-being.

The mediating role of cognitive and affective empathy in the relationship of mindfulness with engagement in nursing

BACKGROUND

The work of health professionals is characterized by a high demand for psychological and emotional resources and high levels of stress. Therefore, the promotion of commitment and job well-being through strategies such as increased mindfulness, is important among nursing workers. Although mindfulness has shown positive effects in the health field, few studies have explored the mechanisms and processes underlying these results. We investigated the mediating role of empathy (cognitive/affective) in the effect of mindfulness on the dimensions of engagement in nursing professionals.

METHODS

Sample was comprised of 1268 Spanish nurses between 22 and 62 years old, that completed the Utrecht Labor Engagement Scale and the adapted versions of Mindful Attention Awareness Scale and Basic Empathy Scale. The relationship between variables to be included in the regression analyses, bivariate correlations were carried out, and the descriptive statistics of these variables were also found. To estimate the mediation model was used, in this case for multiple mediation effects.

RESULTS

Mindfulness is found to affect the Vigor and Dedication factors of engagement through cognitive empathy. While for the Absorption factor, the affective component of empathy also exerts a mediating role, although weaker than cognitive empathy. Cognitive empathy, as an individual factor, was shown to have a mediating effect between mindfulness and the factors of engagement in healthcare workers.

CONCLUSIONS

The level of mindfulness influences engagement of nursing professionals positively, and this result is mediated mainly by cognitive empathy. Both mindfulness and empathy are modifiable individual factors, so their intervention by designing and implementing specific programs, can increase the commitment and wellbeing of professionals generating benefits to workers and to their patients.

Implementation of a Mindfulness-Based Crisis Intervention for Frontline Healthcare Workers During the COVID-19 Outbreak in a Public General Hospital in Madrid, Spain

Introduction: The COVID-19 outbreak is having an impact on the well-being of healthcare workers. Mindfulness-based interventions have shown effectiveness in reducing stress and fostering resilience and recovery in healthcare workers. There are no studies examining the feasibility of brief mindfulness-based interventions during the COVID-19 outbreak. Materials and Methods: This is an exploratory study with a post intervention assessment. We describe an on-site brief mindfulness intervention and evaluate its helpfulness, safety, and feasibility. Results: One thousand out of 7,000 (14%) healthcare workers from La Paz University Hospital in Madrid (Spain) participated in at least one session. One hundred and fifty out of 1,000 (15%) participants filled out a self-report questionnaire evaluating the helpfulness of the intervention for on-site stress reduction. Ninety two subjects (61%) participated in more than one session. Most of the participants were women (80%) with a mean age of 38.6 years. Almost half of the sample were nurses (46%). Sessions were perceived as being helpful with a mean rating of 8.4 on a scale from 0 to 10. Only 3 people (2%) reported a minor adverse effect (increased anxiety or dizziness). Discussion: Our data supports the utility, safety and feasibility of an on-site, brief mindfulness-based intervention designed to reduce stress for frontline health workers during a crisis. There is a need to continue testing this type of interventions, and to integrate emotion regulation strategies as an essential part of health workers' general training. Clinical Trial Registration number: NCT04555005.

Mindfulness for Healthcare Providers: The Role of Non-Reactivity in Reducing Stress

CONTEXT

There is strong evidence in the literature that the cultivation of mindfulness through programs such as Mindfulness-Based Stress Reduction (MBSR) has a profound impact on perceived stress for healthcare providers. The mechanism of the latter association is still being studied. However, it has been hypothesized that in particular, the cultivation of non-reactivity as a mindfulness skill may be particularly associated with the salutary effect of MBSR to reduce stress in health care providers even if adjusted for the benefit on quality of life gained after MBSR. The latter may represent important mechanistic information to build customized mindfulness interventions for health care providers.

OBJECTIVE

Determine whether the change in non-reactivity to inner experience after MBSR is associated with the adjusted changes in perceived stress after MBSR.

DESIGN

a Cross-sectional study.

SETTING

A large, Midwestern teaching hospital.

PARTICIPANTS

100 health care providers.

INTERVENTION

8-week standard MBSR course.

MAIN OUTCOME MEASURES

Perceived Stress Scale-10, Linear Analog Scale Assessment to measure Quality of life, and the mindfulness domain non-reactivity to inner experience was assessed by the non-reactivity subscale of the Five Facet Mindfulness Questionnaire. All measures were administered at baseline and completion of the intervention.

RESULTS

The change from baseline to completion of MBSR was significant for all variables, with moderate-to-robust effect sizes. There was a significant negative correlation between non-reactivity and perceived stress both at baseline (p < 0.0001) and when comparing changes in scores from baseline to post-intervention (p < 0.0001). Change in non-reactivity to inner experience was robustly associated with the change in perceived stress (p < 0.0001) after MBSR (97% in 5000 bootstrapped models).

CONCLUSION

Non-reactivity to inner experience is a key aspect of MBSR that is independently associated with a change in perceived stress in health care providers.

A Worksite Wellness Intervention: Improving Happiness, Life Satisfaction, and Gratitude in Health Care Workers

Objective

To assess the effect of a 12-week Stress Management and Resilience Training (SMART) program on happiness, life satisfaction, gratitude, mindfulness, spirituality, and stress in health care workers.

Participants and Methods

Participants were members of an employee wellness center at an academic health care center. Participants were enrolled as cohorts of 12 to 18 individuals and received the intervention at an employee wellness center from February 19, 2013, to February 27, 2017. The study was designed as a prospective, nonrandomized, single-arm clinical trial that included a 3-month in-person SMART program (defined as the intervention), with an additional 3-month postintervention follow-up period (6 months total). Outcomes were assessed at baseline (T0), end of intervention (T3), and after the postintervention follow-up period (T6) and included Subjective Happiness Survey, Satisfaction with Life Scale, Gratitude Scale, Mindful Attention Awareness Scale, Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being, and Perceived Stress Scale.

Results

Of the 110 participants who enrolled and provided consent, 98 participants (89%) completed the T0 and T3 assessments and 85 participants (77%) completed the T0, T3, and T6 assessments. On comparing the T0 and T6 responses, we observed statistically significant improvements (P<.001) in all the domains studied: subjective happiness (baseline average, 4.6; T6 average, 5.5; average difference, 0.9; 95% CI, 0.6-1.0), life satisfaction (baseline average, 22.8; T6 average, 27.5; average difference, 4.7; 95% CI, 3.6-5.9); gratitude (baseline average, 35.8; T6 average, 39.3; average difference, 3.5; 95% CI, 2.6-4.5), mindfulness (baseline average, 3.5; T6 average, 4.2; average difference, 0.7; 95% CI, 0.6-0.9), Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being (baseline average, 29.9; T6 average, 37.4; average difference, 7.5; 95% CI, 6.0-9.2), and percentage of people reporting high stress (baseline, 97.6%; T6, 67.1%). Similar results were observed when comparing the T0 and T3 responses.

Conclusion

In health care workers, training in the SMART program was associated with statistically significant improvements in happiness, satisfaction with life, gratitude, mindfulness, spirituality, and stress (P<.001). Given the importance of stress in the workplace, larger randomized trials and broader dissemination of the program in health care workers is warranted.