The benefits of meditation and mindfulness practices during times of crisis such as COVID-19

Mindfulness and mental health: the importance of a clinical intervention to prevent the effects of a traumatic event. A pilot study

Numerous research studies show that mindfulness can mitigate the negative impact of trauma on mental health by reducing symptoms of anxiety, mediating the relationship between trauma exposure and mental health, and treating symptoms resulting from traumatic events. During the COVID-19 pandemic, which was considered a traumatic event, the wellbeing of adults and children was severely compromised. Although children seem less vulnerable to the physical effects of the virus, this does not seem to be true for the psychological effects. Indeed, a prolonged period of loss of family activities and routines can have a negative impact on the mental health of children and adolescents. To investigate how mindfulness can help preschool children cope with the effects of COVID-19, a study was conducted on 46 children aged 4-5 years. The programme, based on the work of Jon Kabat-Zinn and adapted to the age of the participants, consisted of eight weekly 45-min sessions. Qualitative and quantitative results showed positive feedback, indicating that mindfulness helps children make sense of their experiences and achieve functional post-traumatic growth. This approach is seen as a challenge to guide children toward the restoration of psychological wellbeing, which is essential for good psychological balance.

Indicators of emotional distress and mindfulness in undergraduate students: a cross-sectional study

OBJECTIVES

to assess the association between indicators of emotional distress and dispositional mindfulness in health students at a Brazilian federal public university.

METHODS

a cross-sectional study, developed with university students in the health area of a public institution from May to June 2022. In the analysis, multiple linear regression was used using SPSS software.

RESULTS

the sample was mostly female, ≤ 22 years old, non-white, studying the first semesters, with a higher prevalence for the medicine course. Students presented moderate dispositional mindfulness scores. It was observed that the variables of stress, depression and current suicide risk were associated with the capacity for mindfulness.

CONCLUSIONS

knowing the indicators of emotional distress that are related to the potential of mindfulness can contribute as a situational diagnosis to better design strategies that promote the improvement of emotional indicators of health students.

Art, meditation and cognitive science: a framework for museum-based community meditation programme during the COVID-19 pandemic in Singapore

In 2020, the COVID-19 pandemic caused mandatory lockdowns worldwide, exacerbating mental health issues created by social isolation. Aimed to improve mental health and maintain engagement, the Singapore Art Museum (SAM) rapidly deployed an online programme called Unwind with SAM to engage the public with the museum's contemporary art collection coupled with meditation. The programme focused on the positive effect of arts on mental health, combined with the cognitive benefits of meditation by 'slow-looking' at artworks. This practice-based report reflects on the processes and explores the potential between art, contemplation and cognitive sciences. The first section outlines the current landscape of art and wellness approaches in museums. The second section explains the philosophical framework that guides the programme, alongside a breakdown of components and design rationale. The final part provides a critical reflection and concludes with recommendations for practitioners, managers and scientists to utilise the framework for designing future programmes.

Factors Associated with Older People's Anxiety Symptom Positioning after COVID-19: Cross-Sectional Findings from a Canadian Sample

This study sheds light on the personal characteristics of older Canadians self-identifying as severely anxious and the coping strategies that they gravitated to mitigate their anxiety. Our studied sample consisted of 606 Canadians aged 60 and above who took part in an e-survey across all 10 of Canada's provinces, launched in July 2022, when social distancing was lifted across the country. Participants completed a personal characteristics questionnaire, the Geriatric Anxiety Scale or GAS-10, and a checklist of everyday coping strategies for mitigating anxiety. A seemingly greater number of severely anxious Canadians were born female, self-identified as a cisgender woman, and were in their 60s and in poor to fair health. A univariate logistic regression analysis revealed that all such personal characteristics were associated with statistically significantly greater odds of experiencing severe anxiety. In our multivariate logistic regression analysis, no significant differences were observed between the sexes (AOR = 0.590, p = 0.404), and non-binary and cisgender men (AOR = 0.689, p = 0.441) and women (AOR = 0.657, p = 0.397). Nor were there statistically significant differences in the odds of experiencing severe anxiety for those living with versus without a life partner and chronic illnesses. Older Canadians experiencing severe anxiety were far more likely to normalize their fear and anxiety (AOR = 4.76, p < 0.001), challenge their worries (AOR = 5.21, p < 0.001), and to relax or meditate (AOR = 2.36, p = < 0.001). They were less inclined to decrease other sources of stress in their lives, to stay active, and to get enough sleep. We offer anticipatory guidance for mental health program planners and practitioners, and fruitful avenues of inquiry for researchers.

Information seeking and subsequent affective well-being in Chinese young adults: the mediating effects of worry

OBJECTIVE

This study aimed to unravel micro-processes that link information seeking to subsequent affective well-being (i.e., positive and negative affect) at the within-person level, as well as the role of worry as a mediator in this relationship.

METHODS AND MEASURES

Within the initial weeks following the Chinese government's relaxation of its epidemic control measures, 184 participants completed experience sampling methods on information seeking, COVID-related worry, and affective well-being three times a day for 14 days.

RESULTS

According to dynamic structural equation models, information seeking was associated with high negative affect but not with low positive affect. COVID-related worry acted as a full mediator between information seeking at the previous time point (approximately 5 h ago) and the current negative affect, but not in positive affect.

CONCLUSION

These findings suggested that the impact of information seeking on affective well-being was different for the two dimensions of affect. Furthermore, the persistent impact of information seeking on negative affect was attributed to the indirect effect of worry, suggesting that worry should be a point of focus for intervention to mitigate the potentially negative effects of information seeking within the context of the public health crises.

The impact of mindfulness training on alleviating COVID-19 fear among international students in China: A quasi-experimental study

This study investigated the effects of mindfulness training on alleviating fear of the COVID-19 epidemic among international students in China during the academic year 2020. The training group participants (N = 41) and the control group participants (N = 44) were surveyed pre-and post-training with the two English questionnaires: The Five-Facet Mindfulness Questionnaire (FFMQ) and the fear of the COVID-19 scale (FCV-19S). The results showed that, regarding the relationship between the two main variables in the study, mindfulness is related negatively to the COVID-19 epidemic. Moreover, compared to the control group, results showed that individuals in the training group demonstrated significant improvements in mindfulness levels and decreased Fear of COVID-19. Thus, findings suggest that a short online mindfulness meditation training may reduce fear of the COVID-19 epidemic.

The effectiveness of mindfulness for the management of anxiety in the nursing staff: Systematic review and meta-analysis

A systematic review with meta-analysis following Joanna Briggs Institute recommendations. It aimed to determine the effectiveness of mindfulness for the management of anxiety symptoms in the nursing staff and stress as a secondary outcome. The databases searched were MEDLINE, Embase, LILACS, CINAHL, Web of Science, Scopus and Psycinfo. Search was conducted in October 2022. Independent reviewers used standardized methods to research, track, and code the included studies. Data meta-analysis was performed using random effects models. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used as an approach to assess the quality and certainty of evidence in research studies. The review examined the effectiveness of mindfulness on nursing staff in 13 studies. The meta-analysis revealed a statistically significant decrease in anxiety and stress after treatment, with an average reduction of 0.36 in anxiety and 0.48 in stress. The results emphasizes the possibility of mindfulness being an effective intervention to the management of anxiety and stress in nursing staff. However, the studies analyzed presented limitations in the design and sampling in the development of the intervention, which impact the conclusive statements about the effectiveness of mindfulness and the generalization of the results. The implications to the nursing field involve adopting evidence-based research and practices to improve the well-being and quality of life of nursing professionals, as well as strengthening the evidence base surrounding mindfulness interventions in nursing practice. This may lead to changes in healthcare policies, care practices, and recognition of the importance of nurses' well-being for effective healthcare delivery.

Impact of Yoga on anxiety, stress and sleep quality among health care professionals during a public health crisis

BACKGROUND

Health care professionals (HCPs) working on the frontlines of health care emergencies/pandemics often experience elevated anxiety, stress and reduced quality of sleep. Yoga is a mind-body practice that has been proven to effective in improving physical and mental health.

OBJECTIVE

To evaluate the effectiveness of integrated Yoga intervention on mental health measures and sleep quality among HCPs working during the COVID-19 pandemic.

METHODS

This quasi-experimental study was conducted on 110 HCPs, including Doctors and nursing staff, with an age range of 20 to 65 years who were recruited through a convenience sampling method and assigned to a Yoga group (n = 55) or a control group (n = 55). The Yoga group received a weekly one-hour Yoga session followed by a 30-minute self-practice three times a week at home for one month. The control group followed routine activity. Heart rate (HR), Blood Pressure, stress measures (Perceived Stress and visual analogue Scale for Stress), COVID-related anxiety, Sleep Quality, Quality of life and Preservative Thinking were assessed before and after the intervention.

RESULTS

A significant decrease in stress measures, COVID-19-related anxiety and fear, and perseverative thinking was noticed in the Yoga group. Sleep quality and quality of life also improved significantly. The control group showed no significant change. At one month, the Yoga group showed significantly greater improvement in stress measures, COVID-19-related anxiety and fear, perseverative thinking, sleep quality and quality of life compared to the control group.

CONCLUSION

Yoga practice during the public health crisis would help reduce anxiety and stress and improve sleep among HCPs. Further randomized controlled trials are warranted.

The pandemic body: the lived body during the COVID-19 pandemic

In this study, we conduct a detailed analysis of qualitative survey data focusing on adult populations in the UK, Japan and Mexico to address the following question: How has the COVID-19 pandemic changed people's lived experience of their bodies, other people's bodies and the world? We identify five themes: (i) fear and danger, (ii) bodily doubt and hypervigilance, (iii) risk and trust, (iv) adapting and enduring and (v) changes in perspective. We use two theoretical frameworks: first, Mary Douglas' anthropological work on purity, risk, danger and symbolism is applied to understand how social and cultural meanings attached to the body have changed during the pandemic. Second, we use the concept of bodily doubt developed by Havi Carel to interpret how people experience their bodies and other people's bodies differently during the pandemic. While we recognise the significant variation in people's embodied experience of the pandemic, our findings suggest there are commonalities that span different countries and cultures. Specifically, we look at responses to COVID-19 protective countermeasures such as national lockdowns and physical distancing which we suggest have reduced people's ability to put faith in their own bodies, trust other people and trust the political leadership. We conclude by proposing that the changes to our lived experience during the COVID-19 pandemic have prompted changes in perspective and a renewed focus on what people consider important in life from a social, moral, cultural and political point of view.

The effect of a distance-delivered mindfulness-based psychoeducation program on the psychological well-being, emotional intelligence and stress levels of nursing students in Turkey: a randomized controlled study

Nursing students who started university during the COVID-19 pandemic had to attend via distance education, which increased their stress. This study aimed to determine the effect of a mindfulness-based psychoeducation program on the psychological well-being, emotional intelligence and stress levels of young adults in their first year of an undergraduate nursing program at a university in Turkey. The sample consisted of 59 students (mean age 19.3 years) who were randomized to the intervention group (n = 29) and control group (n = 30). Those in the intervention group participated in a mindfulness-based psychoeducation program twice a week for 4 weeks via video conference. The Perceived Stress Scale (PSS-14), Psychological Well-Being Scale (PWB) and Revised Schutte Emotional Intelligence Scale (SEIS) were used as measurement tools. Between the pretest and posttest assessments, students in the intervention group showed a significant decrease in perceived stress scores and increases in emotional intelligence and psychological well-being scores. There were statistically significant differences in perceived stress, emotional intelligence and psychological well-being scores between the intervention and control groups in the posttest. Online mindfulness psychoeducation via video conferencing can be a useful intervention for nursing students to reduce stress and support psychological well-being and emotional intelligence.

An Eight-Week Zen Meditation and Music Programme for Mindfulness and Happiness: Qualitative Content Analysis

Mental wellness can be related to healthier living, the learning process and working environments for people in the university community. A wide range of mental wellness programmes have been explored to provide students with pleasant and satisfying experiences. The purpose of this study is to explore the effects of integrating Zen meditation and music listening on the mindfulness and happiness levels of university music therapy students. A qualitative methodology was used, and data were collected through surveys and semi-structured interviews. To investigate various aspects of data regarding the role of the meditation and music (MM) programme for mindfulness and happiness, this study used thematic analysis within a qualitative research design. The findings of this study suggest that the 8-week Mindfulness Meditation (MM) programme is a potential approach for enhancing mindfulness, happiness and stress management. These results carry broader implications, particularly in terms of supporting mental health resources in higher education. Furthermore, the study contributes to the ongoing discussion regarding the positive impact of combining meditation and music to promote mental well-being. This integrated approach has the potential to strengthen coping strategies and further promote the integration of music and meditation practices in various contexts, including higher education.

Trait mindfulness, self-efficacy, and coping strategies during COVID-19

BACKGROUND

The worldwide COVID-19 pandemic may have negative impacts on individuals' mental health. At the same time, protective factors such as mindfulness, i.e., a moment-to-moment awareness of own experiences without judgment, may have positive effects on various psychological outcomes during the pandemic.

OBJECTIVES

The current study analyzed the associations between trait mindfulness and psychological outcomes during the COVID-19 pandemic at three measurement points, testing self-efficacy and coping strategies as further potential predictors.

DESIGN & METHODS

Altogether 207 students (85% female, mostly between 18 and 25 years old) participated in a longitudinal online survey from May to July 2020. At t1, t2, and t3, trait mindfulness, COVID-19-specific psychological well-being, depressiveness, anxiety, and stress were assessed. In addition, coping strategies were measured at t1 and self-efficacy at t2.

RESULTS

Psychological outcomes at t1 were associated with trait mindfulness and coping strategies. The change in psychological outcomes between t2 and t3 was predicted by trait mindfulness and self-efficacy and to some extent by maladaptive coping. In a cross-lagged panel design, trait mindfulness was a better predictor of the psychological outcomes than vice versa.

CONCLUSIONS

Our results support the value of trait mindfulness for psychological outcomes during the COVID-19 pandemic.

Positive influences of the COVID-19 pandemic on community dwelling adults in Trinidad and Tobago: a cross sectional study

BACKGROUND

Since the onset of the coronavirus (COVID-19) pandemic its negative effects have been highlighted globally. There is little literature that examines the positive impact on daily living.

AIMS

To examine the positive influences of government-imposed COVID-19 public health restrictions on adults throughout Trinidad and Tobago (TT) and their associated factors.

METHOD

A cross-sectional study, using an adapted pretested online survey instrument, was conducted amongst non-institutionalised, community-dwelling adults using convenience sampling.

RESULTS

Of 1287 completed and weighted responses, the mean age (S.D.) was 39.2 (14.6) years, 49% were males, and 61% completed secondary level education. The top 5 positive experiences were more time spent with family (80%), more down-time (78%), learning new skills (68%), more time for hobbies (66%), self-care (57%), more time spent with friends (55%) and eating healthier (50%). The importance of religion, working from home, and an increase in marijuana use emerged as positive correlates for certain positive experiences, while participants with chronic illness, and a positive anxiety or depression screen, were negatively associated with most positive experiences.

CONCLUSIONS

Despite the negative consequences of the COVID19 pandemic, several positives were highlighted in this study. These findings have implications for social policies toward building resilience within the community.

Freshmen anxiety and COVID-19: Practical implications from an online intervention for supporting students affected by health inequities

OBJECTIVE

This study explored how college freshmen, particularly those affected by health inequities, are affected by COVID-19 and whether they would use a university-created online wellness intervention for help.

PARTICIPANTS

Nine-hundred and eighty-nine freshmen at a large southeastern university.

METHOD

Students responded to an online survey regarding their anxiety, worry, number of life disruptions, perceived resilience and their use of the online intervention during the pandemic (June to mid-September 2020).

RESULTS

During COVID-19, Latinx, Black, women and non-heterosexual students reported significantly greater worry, daily life disruptions than their non-Latinx, white, male and heterosexual counterparts. Women and non-heterosexual students also reported greater anxiety and less resilience. Additionally, Latinx students reported using the university's online intervention for help during COVID-19 more than others. Overall, freshmen, especially Black and women students, reported the online intervention would help them with struggles.

CONCLUSIONS

Universities should identify unique worries faced by students during a health crisis and provide institutional support. Practical implications are discussed.

Evaluation of the Effect of Mindfulness-Based Training on the Quality of Work-Life and Motivations of Nurses Working During the COVID-19 Pandemic

OBJECTIVE

This study aims to determine the effect of mindfulness stress training given to nurses working during the COVID-19 pandemic period on the quality of work-life and motivation of nurses.

MATERIALS AND METHODS

The research was carried out as a pre-test and post-test control group quasi-experimental model from nurses working in a university hospital in eastern Turkey between September 2021 and December 2021. The study population consisted of 850 nurses working in the hospital. The sample consisted of 42 nurses (21 experimental, 21 control group) who agreed to participate in the study and met the inclusion criteria. In the study, selection bias was controlled by randomized assignment and concealing randomization. The nurses' names were grouped alphabetically and randomized using the research randomizer program. Within the scope of the research, the mindfulness Stress Training Program was applied to the nurses in the experimental group. Data were collected using the Personal Information Form, Nurse WorkLife Quality Scale, and Nurse Work Motivation Scale. Chi-square test, Mann-Whitney U test, and Wilcoxon marking tests were used to analyze the data.

RESULTS

It was determined that the total score of the work motivation scale of the nurses in the experimental group was 48.42 ± 5.39 before the training, 59.52 ± 6.52 after the training, and the total score of the nurse work-life quality scale was 81.00 ± 12.46 before the intervention and 91.08 ± 11.06 after the intervention. The post-test scores of the control and experimental groups were statistically significant (P < .05).

CONCLUSION

It was found that the Mindfulness-Based Stress Reduction program was effective in nurses' work motivation and quality of work-life during the pandemic period.

Impact of personal protective equipment on patient safety and health care workers

Background

The study aims to assess the effect of personal protective equipment (PPE) on the physical and psychological well-being of health care workers (HCWs) and its impact on patient safety.

Methods

After ethical approval, a 14-point questionnaire was circulated offline and online among the HCWs of ours institute, who were involved in performing invasive procedures while wearing a PPE. The responses were analysed using the SPSS software version 26.

Results

Of 198 responses, the mean duration of PPE use was 4.6 ± 1.52 h. Seventy percent of respondents suggested <4 h of continuous use of PPE. Seventy-seven percent found difficulties during the procedures while wearing PPE and agreed to errors while performing a procedure. Poor visibility (95.5%), fogging (84.9%), communication difficulty (75.3%), sweating (74.2%), posture-related discomfort (56.1%) and poor concentration (51%) were major causes. Anxiety (39.9%) and fear of spreading an infection to the family (42.9%) were major psychological effects. Eighty percent of HCWs raised concern over the quality of PPE, N95 mask and eye protector. The HCWs felt the need to improve the quality of PPEs, use extra padding around the ears, sealing the N95 mask with adhesive tape, besides using sign language for communication for more safety. Fifty percent graded the procedure-related difficulty level >6 on a Likert scale of 1-10.

Conclusion

PPE-related discomfort is common among the HCWs and could contribute to errors during an invasive procedure. Efforts to alleviate the physical and psychological well-being of the HCWs will be essential for reducing procedural error while wearing a PPE.

Can mindfulness play a role in building social-emotional capacities among youth exposed to screens?

Introduction

Increased screen time coupled with public safety restrictions may pose a serious challenge to adequate social-emotional development in youth during the pandemic. Social-emotional competence (resilience, self-esteem, and self-compassion) are essential for youth to adapt to the "new normal" in the prolonged pandemic timeline. The current study investigated the efficacy of a mindfulness-based intervention on youth social-emotional capacity while accounting for screen time.

Methods

One hundred and seventeen youth participated in a 12-week, online mindfulness-based program and completed pre-, post- and follow-up surveys across five cohorts during the COVID-19 pandemic (spring 2021 to spring 2022). Changes in youths' resilience (RS), self-esteem (SE), and self-compassion (SC) between the three-time points were examined using linear regression analyses (unadjusted, partially adjusted for screen time, and fully adjusted for demographic and screen time variables). The regression models accounted for demographic (age, sex), baseline mental health status, and screen time (passive, social media, video games, and educational types of screen-based behaviours) factors.

Results

In an unadjusted regression model, resilience [β = 3.68, 95%CI = 1.78-5.50, p < 0.001], self-compassion [β = 0.50, 95%CI = 0.34-0.66, p < 0.001], and self-esteem [β = 2.16, 95%CI = 0.98-3.34, p < 0.001] significantly increased after the mindfulness program, and the effects were maintained in the follow-up. The efficacy of the mindfulness program persisted after controlling for five types of screen time [RS: β = 2.73, 95%CI = 0.89-4.57, p < 0.01; SC: β = 0.50, 95%CI = 0.32-0.67, p < 0.001; SE: β = 1.46, 95%CI = 0.34-2.59, p < 0.01] and in a fully adjusted model which additionally accounted for the baseline mental health status and demographic factors [RS: β = 3.01, 95%CI = 1.20, p < 0.01; SC: β = 0.51, 95%CI = 0.33-0.68, p < 0.001; SE: β = 1.64, 95%CI = 0.51-2.77, p < 0.01] and maintained its impact in the follow-up.

Discussion

Our findings reinforce the evidence base on the efficacy of mindfulness and support the use of online mindfulness programs in building social-emotional competencies (i.e., self-compassion, self-esteem, and resilience) among youth exposed to screens during the pandemic.

Induced Relaxation Enhances the Cardiorespiratory Dynamics in COVID-19 Survivors

Most COVID-19 survivors report experiencing at least one persistent symptom after recovery, including sympathovagal imbalance. Relaxation techniques based on slow-paced breathing have proven to be beneficial for cardiovascular and respiratory dynamics in healthy subjects and patients with various diseases. Therefore, the present study aimed to explore the cardiorespiratory dynamics by linear and nonlinear analysis of photoplethysmographic and respiratory time series on COVID-19 survivors under a psychophysiological assessment that includes slow-paced breathing. We analyzed photoplethysmographic and respiratory signals of 49 COVID-19 survivors to assess breathing rate variability (BRV), pulse rate variability (PRV), and pulse-respiration quotient (PRQ) during a psychophysiological assessment. Additionally, a comorbidity-based analysis was conducted to evaluate group changes. Our results indicate that all BRV indices significantly differed when performing slow-paced breathing. Nonlinear parameters of PRV were more appropriate for identifying changes in breathing patterns than linear indices. Furthermore, the mean and standard deviation of PRQ exhibited a significant increase while sample and fuzzy entropies decreased during diaphragmatic breathing. Thus, our findings suggest that slow-paced breathing may improve the cardiorespiratory dynamics of COVID-19 survivors in the short term by enhancing cardiorespiratory coupling via increased vagal activity.

Relationship between COVID-19 Pandemic-Related Life Behavior, Dispositional Mindfulness, and Psychological Health: Evidence from a Sample of Japanese Working Adults

The present study investigated how altered daily life behavior and its self-evaluation associated with the coronavirus disease 2019 (COVID-19) pandemic relate to psychological health in Japanese working adults, and how such relationships may be moderated by dispositional mindfulness. A total of 1000 participants completed an online survey comprising questions on how they used time and self-evaluated life behavior before and during the pandemic, as well as scales on mindfulness and psychological health. The results revealed that after the pandemic, participants spent significantly more time at home and using a PC/smartphone. They were also more likely to perceive frequent exposure to COVID-19-related media reports and less likely to find their work going well. Many of these variables were significantly correlated with lower psychological health. Moreover, hierarchical multiple regression analyses revealed the moderating effects of mindfulness, such that the perceived frequency of exposure to pandemic-related media reports and poorer views that work was going well were less likely to predict lower psychological health when mindfulness was high. These findings suggest that altered daily life behavior and its self-evaluation after the pandemic are associated with deteriorated psychological health, but that mindfulness can serve as a protective factor against psychological distress among Japanese workers.

Stress management protocol for nurses working in the COVID-19 wards

Purpose

Due to necessity of immediate support strategies for nurses during COVID-19 pandemic and lack of comprehensive and applied standard guidelines, the present study was conducted to develop stress management protocol for nurses working in COVID-19 wards with an approach based on the best scientific evidences.

Methods

This descriptive methodological and validation study was conducted with evidence-based approach based on Stetler model in two hospitals of Iran in 2020. In order to identify the resources of stress and the solutions provided to deal with it to design the protocol, a comprehensive literature review was performed. After extracting evidence, they were ranked based on the levels of evidence and designed as a protocol. Quality appraisal of guideline was done using AGREEII instrument by an expert panel. The applicability of the protocol was assessed by a group of nurses through focus group discussion.

Results

Out of 184 studies, 28 articles related to the topic were selected. According to the expert panel, in the AGREEII domains, Scope and Purpose (87.5%) and Applicability (70.5%) were the highest and the lowest scores respectively. The "Stress Management Protocol for Nurses Working in COVID-19 Wards" was designed in six sections, which was elaborated relative to each stress resources. Members of the focus group mostly considered the evidence-based recommendations feasible by making suggestions to some items.

Conclusion

This study emphasized the important role of proper planning by health care system officials according to the designed protocol to manage stress and increase the self-efficacy of nurses in critical situations.

Investigating the mediating effect of anxiety and fear of a third wave of COVID-19 among students in South India

The COVID-19 pandemic, which is a global health emergency, has potentiality had a serious impact on students' mental health. An online cross-sectional survey design that included 534 senior year college students from South India revealed a significant and direct positive effect of the fear of a third wave of COVID-19 on academic anxiety which in turn showed a significant and direct positive effect on COVID-19 burnout. Academic anxiety was also found to mediate the relationship between the fear of a third wave of COVID-19 and subsequent cases of burnout. The study suggested measures to be taken by policy makers for the broader interest and wellbeing of student communities. Managerial implications, limitations and future studies were also examined in the paper.

Experimental Mindfulness Intervention in an Emergency Department for Stress Management and Development of Positive Working Environment

Mindfulness-based interventions have increasingly gained the interest of health professionals in the last decade, especially practices that are short, economical, easily accessible, and physically, cognitively, and psychologically compelling. Nurses of Emergency Departments are a special, dynamic, but at the same time vulnerable group of health professionals who work in shifts and face multiple challenges. Considering the recent literature and the fact that stress and a hostile work environment are the top ranked health professionals’ challenges, there is a need for a further study of the use of mindfulness. This study aimed to investigate the effect of the application of mindfulness on nurses in the Emergency Department on several factors related to daily nursing practice and that directly affect these specific health professionals. This experimental study was performed on 14 participating nurses in the Emergency Department of a Public General Hospital in Athens, randomized into two groups: a control and an intervention group. The data collection tools were two digital smart devices, participatory observation, and semi-structured interviews. By practicing mindfulness meditation, the participating nurses in the intervention group showed improvement in their cognitive functions (attention, thinking, memory, concentration), professional interpersonal relationships, personal satisfaction and communication with patients and caregivers, sleep rate, negative emotions, and behaviors. The findings suggest that the application of mindfulness practices should be considered an easy, affordable, economical, accessible, and effective method that nurses can use to strengthen and empower themselves, enjoying its multiple benefits. The effectiveness of the application of mindfulness remains an important issue for future research in other health professionals as well.

The Impact of Mindful Meditation on Health Care Workers During the COVID-19 Pandemic

Background

The COVID-19 pandemic placed a spotlight on health care workers as the world struggled with mental health crises. As the number of COVID-19 cases rose exponentially, this also paralleled health care workers' perceived stress burden and increased risk for mental health trauma. This research project assessed the impact of a mobile mindful meditation application on health care workers' perceived stress levels during a pandemic.

Methodology

Through quasi-experimental design, researchers assessed the effect of using a mobile mindful meditation (Synctuition) app on health care workers' stress levels. Participants listened for 20 to 30 minutes daily for 30 days. Participants perceived stress levels were measured with Cohen's Perceived Stress Scale.

Results

Of the 100 participants, there was a statistically significant decrease in perceived stress reduction between the groups across various categories. The pretest perceived stress scores were reduced from moderate to low stress postintervention after using the mindful meditation application.

Implications for Practice

Reducing stress in health care workers can potentially increase the quality of life for health care workers. and lowering stress levels can potentially improve the quality of care provided.

COVID-19 Spotlights Connections between Disease and Multiple Lifestyle Factors

The SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2), and the disease it causes (COVID-19), have had a profound impact on global human society and threaten to continue to have such an impact with newly emerging variants. Because of the widespread effects of SARS-CoV-2, understanding how lifestyle choices impact the severity of disease is imperative. This review summarizes evidence for an involvement of chronic, non-resolving inflammation, gut microbiome disruption (dysbiosis with loss of beneficial microorganisms), and impaired viral defenses, all of which are associated with an imbalanced lifestyle, in severe disease manifestations and post-acute sequelae of SARS-CoV-2 (PASC). Humans' physiological propensity for uncontrolled inflammation and severe COVID-19 are briefly contrasted with bats' low propensity for inflammation and their resistance to viral disease. This insight is used to identify positive lifestyle factors with the potential to act in synergy for restoring balance to the immune response and gut microbiome, and thereby protect individuals against severe COVID-19 and PASC. It is proposed that clinicians should consider recommending lifestyle factors, such as stress management, balanced nutrition and physical activity, as preventative measures against severe viral disease and PASC.

Research and Public Interest in Mindfulness in the COVID-19 and Post-COVID-19 Era: A Bibliometric and Google Trends Analysis

Public and research interest in mindfulness has been growing, and the Coronavirus disease 2019 (COVID-19) pandemic seems to have accelerated this growth. This study was conducted to investigate the public and research interest in mindfulness in the context of COVID-19. The term 'Mindfulness' was searched in Google Trends, and data were collected from December 2004 to November 2022. The relationship between the relative search volume (RSV) of 'Mindfulness' and that of related topics was analyzed, and 'Top related topics and queries' for the search term 'Mindfulness' were investigated. For bibliometric analysis, a search was conducted in the Web of Science database. Keyword co-occurrence analysis was conducted, and a two-dimensional keyword map was constructed using VOSviewer software. Overall, the RSV of 'Mindfulness' increased slightly. The RSVs of 'Mindfulness' and 'Antidepressants' showed an overall significant positive correlation (r = 0.485) but a statistically significant negative correlation during the COVID-19 era (-0.470). Articles on mindfulness in the context of COVID-19 were closely related to depression, anxiety, stress, and mental health. Four clusters of articles were identified, including 'mindfulness', 'COVID-19', 'anxiety and depression', and 'mental health'. These findings may provide insights into potential areas of interest and identify ongoing trends in this field.

Effect of Heartfulness Meditation Among Long-Term, Short-Term and Non-meditators on Prefrontal Cortex Activity of Brain Using Machine Learning Classification: A Cross-Sectional Study

Background Meditation is a mental practice with health benefits and may increase activity in the prefrontal cortex of the brain. Heartfulness meditation (HM) is a modified form of rajyoga meditation supported by a unique feature called "yogic transmission." This feasibility study aimed to explore the effect of HM on electroencephalogram (EEG) connectivity parameters of long-term meditators (LTM), short-term meditators (STM), and non-meditators (NM) with an application of machine learning models and determining classifier methods that can effectively discriminate between the groups. Materials and methods EEG data were collected from 34 participants. The functional connectivity parameters, correlation coefficient, clustering coefficient, shortest path, and phase locking value were utilized as a feature vector for classification. To evaluate the various states of HM practice, the categorization was done between (LTM, NM) and (STM, NM) using a multitude of machine learning classifiers. Results The classifier's performances were evaluated based on accuracy using 10-fold cross-validation. The results showed that the accuracy of machine learning models ranges from 84% to 100% while classifying LTM and NM, and accuracy from 80% to 93% while classifying STM and NM. It was found that decision trees, support vector machines, k-nearest neighbors, and ensemble classifiers performed better than linear discriminant analysis and logistic regression. Conclusion This is the first study to our knowledge employing machine learning for the classification among HM meditators and NM The results indicated that machine learning classifiers with EEG functional connectivity as a feature vector could be a viable marker for accessing meditation ability.

Heart rate variability during mindful breathing meditation

We discuss Heart Rate Variability (HRV) measured during mindful breathing meditation. We provide a pedagogical computation of two commonly used heart rate variability metrics, i.e. the root mean square of successive differences (RMSSD) and the standard deviation of RR intervals (SDRR), in terms of Fourier components. It is shown that the root mean square of successive differences preferentially weights higher frequency Fourier modes, making it unsuitable as a biosignal for mindful breathing meditation which encourages slow breathing. We propose a new metric called the autonomic balance index (ABI) which uses Respiratory Sinus Arrhythmia to quantify the fraction of heart rate variability contributed by the parasympathetic nervous system. We apply this metric to heart rate variability data collected during two different meditation techniques, and show that the autonomic balance index is significantly elevated during mindful breathing, making it a good signal for biofeedback during meditation sessions.

Anxious and Angry: Early Emotional Adaptation of Medical Students in a Situational Crisis on the Example of the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic is an example of a situational crisis resulting in emotional destabilization. The aim of the study was to analyze changes in the level of anxiety and anger in medical students during the early adaptation to the situational crisis, and to estimate the risk factors for fear and anger in this group.

METHODS

Participants were 949 medical students (M = 22.88, SD = 4.10) in the first stage on March 2020, and 748 (M = 22.57, SD = 3.79) in the second stage on June 2020. The STAI, STAXI-2, and our own questionnaire were used.

RESULTS

First vs the second stage: anxiety state (p < 0.001), anger state (p = 0.326), and feeling angry (p < 0.05). The regression model (F(14.1681) = 79.01, p < 0.001) for the level of anxiety state explains 39% of the dependent variable variance (r² = 0.39). The model for the anger-state level (F(6.1689) = 68.04, p < 0.001)-19% (r² = 0.19).

CONCLUSIONS

During the early adaptation to the situational crisis, the general level of anxiety decreased, but anger was at the same level. The anxiety was explained by contact with potentially or objective infected persons, and the level of anger was based on the need for greater social support.

Designing mindfulness information for interaction in social media: The role of information framing, health risk perception and lay theories of health

In the post-pandemic era, our health is facing unprecedented challenges, and people are more willing to obtain health-related information or interact with each other than ever before. In this context, people’s interest in mindfulness information is also growing. However, not enough attention has been paid to the relationship between mindfulness information design and information interaction. The purpose of this study is to assess the impact of information design based on the gain and loss framework on people’s willingness to interact with mindfulness information, and to identify the framework for achieving better results. Through two experimental studies, we find that information design based on the framework of gains and losses can produce different effects. Specifically, the findings of the first experiment (N = 282) shows the individuals are more willing to interact mindfulness information when they are exposed to gain-framed information rather than loss-framed. In the second experiment (N = 308), we find that loss framing, compared with gain framing, led to greater health risk perception, which in turn make participants more likely to interact with mindfulness information with others. Additionally, our results show that the lay theories of health plays a moderating role in the direct effect of information framework on willingness to interact with mindfulness information in social media. When individuals hold incremental lay theories, they are more willing to interact with mindfulness information under the gain-framed information condition compared with the loss-framed information condition. However, when individuals are in entity condition, there is no significant difference in the willingness to interact with mindfulness information between the gain-framed and loss-framed information. Our studies of integrating information framework into designing mindfulness information suggest a promising strategy of health information interaction in social media.

Efficacy of integrated tele yoga intervention on physiological and psychological variables in asymptomatic COVID-19 positive patients: A Randomized Control Trial

BACKGROUND

A study was conducted on asymptomatic COVID-19 positive patients admitted in a COVID-19 hospital in Indore, India during first wave of the pandemic. The objective of the study was to assess the efficacy of an integrated tele-yoga intervention as an adjunct to conventional management on physiological, psychological and mindfulness variables.

METHODS

In a confirmatory randomized control trial, 60 asymptomatic COVID-19 patients in hospital confinement were randomly allocated to experimental and control groups (n=30). The tele-yoga intervention included breathing exercise, pranayama and meditation and delivered over 30 minutes for 7 days to the experimental group while, the control group continued treatment as usual. Assessment of physiological variables & psychological variables was carried out before intervention and on day seven immediately after intervention. Data was analyzed using SPSS (V.16.0).

RESULTS

Mann Whitney U test shows that there was a statistically significant difference between groups regarding all variables (p<0.001). The physiological and psychological variables which included Oxygen Saturation (2.07%), Heart Rate (8.21%), Respiratory Rate (10.04%), Systolic Blood Pressure (6.14%), Diastolic Blood Pressure (8.38%), Visual Analog Scale for Stress (62.78 %), Covid-19 Peritraumatic Distress Index (68.44 %), and State Mindful Attention Awareness Scale (72.72 %) showed significant changes in the experimental group compared to control group.

CONCLUSION

The results of this study suggest that integrated tele-yoga might have therapeutic benefits in improving physiological, psychological, and mindfulness variables in asymptomatic COVID- 19 patients.

Designing mindfulness information for interaction in social media: The role of information framing, health risk perception and lay theories of health

In the post-pandemic era, our health is facing unprecedented challenges, and people are more willing to obtain health-related information or interact with each other than ever before. In this context, people's interest in mindfulness information is also growing. However, not enough attention has been paid to the relationship between mindfulness information design and information interaction. The purpose of this study is to assess the impact of information design based on the gain and loss framework on people's willingness to interact with mindfulness information, and to identify the framework for achieving better results. Through two experimental studies, we find that information design based on the framework of gains and losses can produce different effects. Specifically, the findings of the first experiment (N = 282) shows the individuals are more willing to interact mindfulness information when they are exposed to gain-framed information rather than loss-framed. In the second experiment (N = 308), we find that loss framing, compared with gain framing, led to greater health risk perception, which in turn make participants more likely to interact with mindfulness information with others. Additionally, our results show that the lay theories of health plays a moderating role in the direct effect of information framework on willingness to interact with mindfulness information in social media. When individuals hold incremental lay theories, they are more willing to interact with mindfulness information under the gain-framed information condition compared with the loss-framed information condition. However, when individuals are in entity condition, there is no significant difference in the willingness to interact with mindfulness information between the gain-framed and loss-framed information. Our studies of integrating information framework into designing mindfulness information suggest a promising strategy of health information interaction in social media.

Psychological Resilience, Anxiety, and Well-Being of Health Care Providers During the COVID-19 Pandemic

Background

On the frontlines of the pandemic, healthcare providers (HCPs) are overworked, anxious, and fearful. Yet, despite all the fear and anxiety, the facilitation of protective resilience and psychological well-being has become crucial to ensure that minimal intangible psychological losses are incurred due to the pandemic.

Aim

The present study aimed to examine the psychological resiliency, state anxiety, trait anxiety, and psychological well-being of frontline HCPs during the COVID-19 and to determine the association among resiliency, state-trait anxiety, and psychological well-being and their links with demographic and workplace factors.

Design and Settings

A cross-sectional study concerning frontline HCPs was conducted at two of the largest hospitals in the eastern province of Saudi Arabia.

Results

A significant inverse correlation was determined between resilience and state anxiety (r=-0.417, p<0.05) and between resilience and trait anxiety (r=-0.536, p<0.05). Likewise, a positive intermediate correlation between resilience and the age of the individual (r=0.263, p<0.05) and a weak positive correlation with years of experience (r=0.211, p<0.05) were established. Also, the resilience score of volunteer workers (50.9) was lower than that of regular staff (66.8) (p=0.028).

Conclusion

Resilience is a crucial factor affecting the training of individuals, which will further promote their work output and mental health capacity, thus improving their overall concept of survival in adversity.

Diabetes Prevention and Measures to Ensuring a Healthy Lifestyle during COVID-19 Pandemic and after

The incidence of diabetes mellitus (DM) is increasing exponentially globally, with 90% of the confirmed cases being type 2 DM. The global incidence of DM is expected to increase by 48% during 2017-2045. The coronavirus disease 2019 (COVID-19) pandemic continues to have a massive impact on human health, causing sudden lifestyle changes through quarantine measures, such as lockdown, social distancing, various curfews, and isolation at home. This in turn might increase the risk of developing numerous chronic diseases, such as DM, obesity, and cardiovascular diseases, which increase the severity of COVID-19. To this end, we performed a comprehensive review to determine viable measures for the prevention of DM and its subsequent upsurge globally. Additionally, we have determined strategies that should be adopted globally to ensure a healthy lifestyle during the COVID-19 pandemic and later.

Prediction and comparison of psychological health during COVID-19 among Indian population and Rajyoga meditators using machine learning algorithms

Issues of providing mental health support to people with emerging or current mental health disorders are becoming a significant concern throughout the world. One of the biggest effects of digital psychiatry during COVID-19 is its capacity for early identification and forecasting of a person's mental health decline resulting in chronic mental health issues. Therefore, through this study aims at addressing the hological problems by identifying people who are more likely to acquire mental health issues induced by COVID-19 epidemic. To achieve this goal, this study includes 1) Rajyoga practitioners' perceptions of psychological effects, levels of anxiety, stress, and depression are compared to those of the non practitioners 2) Predictions of mental health disorders such as stress, anxiety and depression using machine learning algorithms using the online survey data collected from Rajyoga meditators and general the population. Decision tree, random forest, naive bayeBayespport vector machine and K nearest neighbor algorithms were used for the prediction as they have been shown to be more accurate for predicting psychological disorders. The support vector machine showed the highest accuracy among all other algorithms. The f1 score was also the highest for support vector machine.

The association of mindfulness and psychological well-being among individuals who have recovered from COVID-19 in Jianghan District, Wuhan, China: A cross-sectional study

BACKGROUND

In the global pandemic of the coronavirus disease 2019 (COVID-19), depression and post-traumatic stress disorder (PTSD) have commonly occurred among COVID-19 patients, whose experiences of infection and subsequent treatment might develop negative consequences on their mental well-being even after recovery. Despite the general recognition of efficacy of mindfulness-based interventions in reducing psychological distress among various populations, there were insufficient studies on the relationship between mindfulness and mental health among individuals who have recovered from COVID-19.

OBJECTIVE

The current study aims to identify the prevalence of common mental health challenges among recovered COVID-19 patients in Jianghan District, Wuhan, China and to explore the potential mechanism through which mindfulness alleviate depression and PTSD.

METHODS

A cross-sectional survey on mental health was conducted among a convenience sample of adults recovered from COVID-19 in Jianghan District, Wuhan, China. The study participants completed questionnaires under the assistance of trained investigators. The questionnaire included Chinese version of Five Facets of Mindfulness Questionnaire-Short Form (FFMQ-SF), Generalized Anxiety Disorder Questionnaire (GAD-7), Resilience Style Questionnaire (RSQ), Impact of Events Scale-Revised (IES-R), and Patient Health Questionnaire (PHQ-9) to measure mindfulness, anxiety, resilience, PTSD, and depression respectively. Structural equation modeling was used to explore the relationship between mindfulness and mental health outcomes of this population.

RESULTS

1541 respondents (654 [42.4 %] men and 887 [57.6 %] women) completed the questionnaire between June 10 and July 25, 2021, of whom 36.2 % and 27.1 % had mild and severe levels of depressive and anxiety symptoms respectively, and 15.2 % was indicated with PTSD. The average score of mindfulness of the study participants was (3.100 ± 0.387), and that of resilience was (3.560 ± 0.877). The structural equation model fit the data well, demonstrating that mindfulness was negatively associated with depressive symptoms directly (β = -0.031, P = 0.021) or indirectly through the mediation effect of resilience (β = -0.019, P = 0.009) and anxiety symptoms (β = -0.208, P < 0.001), and was negatively associated with PTSD through the mediation effect of anxiety symptoms (β = -0.142, P < 0.001).

CONCLUSION

Individuals who have recovered from COVID-19 commonly experienced psychological distress. Mindfulness is associated with alleviation of depressive and PTSD symptoms directly or indirectly. Interventions based on mindfulness are suggested to improve the mental well-being of this population.

Reliability and factor analysis of Hindi version of IES-R scale: Effect of Rajyoga meditation on perceiving the impact of COVID-19

The purpose of this study is to present the Hindi translation and validation of the Impact of Event Scale-Revised and to evaluate psychometric qualities of this scale in a sample of regular Rajyoga meditators to examine the psychological impact of Coronavirus on them. The convenience sampling method was used to collect the data from 801 Rajyoga meditators through online survey. Data were analysed using SPSS 26.0. The Hindi version of IES-R demonstrated good internal consistency with the value of alpha coefficient being 0.91 for the scale and ranging between 0.81 to 0.83 for the subscales. The correlations between the subscales varied between 0.55 and 0.66. Principal components analysis using Varimax rotation was run with three-factor solution based on eigen value greater than one. This solution explained 54 percent of the total variance. It generated mainly two factors, an intrusion hyperarousal factor and an avoidance factor and third factor with one item only. Only 4.7 percent of the meditators rated the outbreak's psychological impact as moderate or severe. The mean score of IES-R was 10.01 (with an S.D. of 11.107). Significant positive correlations were found among IES-R scores and the presence of COVID symptoms. Thus, in clinical and research contexts, the scale appears to be a valid measure of post-trauma occurrences. The present study was conducted to generate a validated Hindi version of the IES-R that is easier and more compatible for use in the Indian population.

Parental burnout and resilience intervention among Chinese parents during the COVID-19 pandemic

INTRODUCTION

Parental burnout is a mental state that combines long-term stress and depression with an overwhelming feeling of parental pressure.

METHODS

In Study 1, we conducted a web-based survey of 390 Chinese parents (75.1% mothers) with children aged 1-18 years old (Mean age = 9.05 years, SD = 5.098) to examine the parental burnout during the COVID-19 global pandemic and to identify associated factors during the national lockdown. In Study 2, eight weeks of resilience intervention was administered to 20 parents to compare parental resilience and parental burnout before and after the intervention.

RESULTS

The correlational study showed that greater parental burnout occurred in parents with the lower educational levels and in parents of school-age children. The risk factors of parental burnout included household burden and children's interference with work; while protective factors included living materials, family atmosphere, and parent-child meeting frequency. The intervention study showed the effectiveness of meditation intervention in resilience and parental burnout, suggesting that meditation training can effectively increase parental resilience and reduce parental burnout.

DISCUSSION

These findings demonstrate the risk and protective factors associated with parental burnout during the COVID-19 lockdown and highlight the positive role of meditation in mitigating parental burnout.

Supporting MRT mental health: Through COVID-19 and beyond

The COVID-19 pandemic has had an exceptional impact on the healthcare profession, and in particular, on the mental health and wellbeing of healthcare workers. The Canadian Association of Medical Radiation Technologists (CAMRT) has been working on ways to prioritize the mental health of their members while increasing advocacy efforts. Conducting a national survey on mental health and interviewing medical radiation technologists (MRTs) highlighted the challenges that exist while also informing which support system components are most needed to improve wellbeing. The purpose of the research is to share the lived experience of Canadian MRTs in relation to their mental health during the pandemic. It adds to the knowledge gained from the survey by exploring in depth accounts of what MRTs felt and experienced during COVID-19. Understanding this challenging time period may aid in developing additional resources and support for MRTs in the workplace. The overall message in healthcare should be, optimize your wellbeing and your patients will be taken care of too. Recommendations to foster this message includes empowering MRTs to advocate for their mental health and wellbeing, promoting timely and adequate supports, monitoring the mental health of our professional landscape and welcoming others to join the conversation. This paper examines what mental health supports are recommended by the MRTs who were interviewed, and the information gathered from the CAMRT Mental Health of Medical Radiation Technologists in Canada 2021 Survey.

Linking University Students' Mindfulness to Positive Adjustment Amidst COVID-19 Pandemic: a 6-month Cross-Lagged Panel Design

Objectives

In the face of a global pandemic, research on wellness-fostering resources is urgently needed, especially with longitudinal designs and diverse samples. According to the mindfulness-to-meaning theory and broaden-and-build theory, this study examined the reciprocal associations among a group of Chinese university students' trait mindfulness, positive and negative affect, and use of positive coping strategies, including positive reappraisal, planning, and seeking of emotional support during the COVID-19 pandemic.

Methods

Participants were 247 Hong Kong university students (M _age = 20.96, SD = 2.38; female = 86%) who completed survey measures of mindfulness, positive and negative affect, and positive coping strategies at baseline and 6-month follow-up. Data were analysed using a cross-lagged panel design, controlling for participants' age.

Results

The proposed reciprocal model exhibited an excellent fit with the data. There was a reciprocal association between trait mindfulness and positive affect over time. However, no significant reciprocal effect was found among mindfulness, negative affect, and positive coping strategies.

Conclusions

Theoretically, the current findings extended the two theories to a non-Western population during a critical time and suggested a long-term reciprocal association between positive affect and mindfulness. Our study provided important insight into university students' positive well-being during COVID-19 and demonstrated the wellness-fostering effect of mindfulness.

Modeling the relationship between perceived service quality, tourist satisfaction, and tourists’ behavioral intentions amid COVID-19 pandemic: Evidence of yoga tourists’ perspectives

Purpose

This study aims to investigate the impact of perceived service quality (PSQ) on tourist satisfaction and behavioral intentions and explore the potential mediating role of tourist satisfaction in the relationship between service quality and behavioral intentions in the yoga tourism context during the COVID-19 pandemic. Further, this is to examine to what extent yoga tourist satisfaction directly affects their behavioral intentions.

Design/methodology/approach

Based on a review of literature, the study proposes a conceptual model to test four hypothesized relationships among the constructs of perceived service quality, tourist satisfaction, and behavioral intentions. Data was collected by using a self-administrated questionnaire that was developed and directed to a convenience sample of yoga tourists (380 forms). Structural equation modeling (SEM) was employed to determine the relationship between study constructs.

Findings

The results of SEM illustrated that all the hypothesized relationships are supported. The findings confirm that yoga tourists’ behavioral intentions are significantly affected directly and indirectly (through tourist satisfaction) by perceived service quality. Additionally, tourist satisfaction significantly partially mediates the relationship between PSQ and tourists’ behavioral intentions.

Research limitations

The subject of this study was yoga tourists staying in yoga retreats/studios in Egyptian destinations (South Sinai Governorate). Future research may focus on other geographical destinations and other influential variables of yoga tourists’ satisfaction and behavioral intentions should be investigated.

Practical implications

For improving tourists’ satisfaction and behavioral intentions, yoga service providers should take care by giving tourists personalized attention, and understanding, fulfilling their specific needs. Health and hygiene practices must be considered during the COVID-19 pandemic.

Originality/value

This study is perhaps the first empirical study that examines the relationship between PSQ and tourists’ satisfaction and behavioral intentions in the yoga tourism context. A new integrated conceptual model that combined three service quality dimensions, namely, tangibles, intangibles as well as health and hygiene was developed and validated.

Effectiveness of a Mindful Compassion Care Program in reducing burnout and psychological distress amongst frontline hospital nurses during the COVID-19 pandemic: a study protocol for a randomized controlled trial

BACKGROUND

Recent studies have shown that nurses have been more affected by the COVID-19 pandemic than any other group of hospital workers in terms of anxiety, depression, and burnout. Several clinical studies had previously demonstrated the effectiveness of mindfulness and compassion interventions in reducing burnout and emotional distress amongst healthcare professionals.

METHODS AND ANALYSIS

A parallel-group randomized controlled trial will assess the feasibility, acceptability, and efficacy of a mindfulness and compassion-focused programme on frontline nurses who had been working during the COVID-19 pandemic. Seventy-two participants will be recruited from Verona University Hospital Trust (Veneto Region, north-east Italy) and will be divided equally into an intervention group and a control group. Primary outcome will be assessed using the Emotional Exhaustion subscale of the Maslach Burnout Inventory General Survey (MBI-GS). Secondary outcomes will be measured by the Cynicism and Professional Efficacy subscales of the MBI-GS, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), the Insomnia Severity Index (ISI), the Impact of Stressful Events (IES-R), the Perceived Stress Scale (PSS), the Five Facet Mindfulness Questionnaire (FFMQ), and the Forms of Self-Criticising/attacking and Self-Reassuring Scale (FSCRS).

DISCUSSION

The study aims to fill a gap in the literature and present a scientifically validated intervention for those healthcare professionals most exposed to the stressful conditions of working during the COVID-19 pandemic.

TRIAL REGISTRATION

ClinicalTrials.gov; Identifier: NCT05308537.

The Value of Contemplative Practices: A Mixed Methods Approach Exploring Associations between Resilience and Experiences of the COVID-19 Pandemic among Older Adults

The aim of this study was to explore the association between resilience and experiences of the COVID-19 pandemic among older adults. We used a sequential explanatory mixed methods study design to recruit older adults who spoke English and were 60 and above during the pandemic. Survey data investigated older adults' resilience, post-traumatic growth, well-being, and demographics. Extreme case purposeful sampling of their resilience score was used to select interviewees. Qualitative data sought to understand the relationship between resilience and how older adults responded to the COVID-19 pandemic. Exploring the relationship between resilience (well-being in the face of challenge) and one's experience of the COVID-19 pandemic revealed that participants categorized as having high resilience had long held behaviors of contemplative practices that helped them effectively adapt to the COVID-19 pandemic. As we continue to face global challenges, we must redefine care, guide interventions, and promote healthy aging by incorporating contemplative practices into the lives of older adults.

A qualitative analysis of free text comments of participants from a massive open online mindfulness course

Introduction

Mindfulness-based interventions are associated with improved health and wellbeing. Online mindfulness interventions offer potential scalability and cost advantages over face-to-face interventions. However, little is known about the experiences of learners, what they identify as being helpful to developing a practice of mindfulness and what outcomes they experience from undertaking an online mindfulness program.

Methods

The Mindfulness for Wellbeing and Peak Performance Massive Open Online Course is a 4-week mindfulness program which includes psychoeducation, mindfulness meditation, applications and moderated discussion forums. Of the 3,335 participants who completed the March 2020 course, 527 (16%) responded to the final forum which invited participants to describe the highlights of the course. In order to enhance understanding of participant experiences and perceived outcomes of undertaking the course, a qualitative analysis of these free text comments was conducted using reflexive thematic analysis.

Results

Two overarching themes were identified: (1) internal mechanisms of developing mindfulness (subthemes: paying attention to the present moment, learning to let go and find acceptance, cultivating an attitude of gentleness, and learning through a sense of belonging) and (2) the translation of mindfulness into daily living (subthemes: mindfulness being a support to mental wellbeing, learning to deal with uncertainty and adversity, living a more conscious life, a greater connection with self and others and channeling attention into productivity).

Discussion

The themes and subthemes provided insights into the mechanisms learners used to develop mindfulness and how they translated mindfulness into their lives in a variety of beneficial ways. This understanding of learners' experiences could inform delivery of future online mindfulness interventions.

"Stranger in a mask" midwives' experiences of providing perinatal bereavement care to parents during the COVID-19 pandemic in Ireland: A qualitative descriptive study

OBJECTIVE

To explore the experiences and perceptions of midwives providing perinatal bereavement care during the COVID-19 pandemic and to identify the barriers and facilitators to providing compassionate bereavement care.

DESIGN

A qualitative descriptive design was utilized to address the research question. Following ethical approval, in depth, semi structured interviews were undertaken to explore midwives' experiences of providing care to parents following perinatal bereavement. Narrative data was analyzed using thematic analysis.

SETTING

A standalone regional maternity hospital located in a large metropolitan center in the Republic of Ireland.

PARTICIPANTS

A purposeful sample of eleven midwives, who cared for bereaved parents during the COVID-19 pandemic volunteered to participate in the study.

FINDINGS

Two main themes were identified, each with associated subthemes (1) Challenges of providing compassionate bereavement care during a pandemic (2) Psychological effect and coping strategies utilised by midwives during a pandemic.

CONCLUSION

The COVID-19 pandemic brought unprecedented challenges when providing perinatal bereavement care. The mandatory infection prevention and control measures significantly disrupted human communication and connections. Participants in the study utilized techniques to optimize care while adhering to COVID-19 guidelines, and simultaneously putting their own fear and anxieties aside.

Public health emergency and psychological distress among healthcare workers: a scoping review

Background

Pandemics and natural disasters are immensely stressful events for frontline healthcare workers, as they provide patient care to a population undergoing the impacts of the disaster while experiencing such impacts to their personal lives themselves. With increased stressors to an already demanding job, frontline healthcare workers are at a higher risk of adverse effects to their mental health. The current COVID-19 pandemic has already shown to have had significant impact on the mental health of healthcare workers with increased rates of burnout, anxiety and depression. There is already literature showing the utility of individual programs at improving mental health, however, interventions at the organizational level are not well explored. This scoping review aims to provide an overview and determine the utility of a systematic review of the current body of literature assessing the effectiveness of mental health interventions at the organizational level for healthcare workers during or after a public health emergency.

Methods

Electronic databases such as Medline on OVID, CENTRAL, PsycINFO on OVID and Embase on OVID were searched. A targeted search of the grey literature was conducted to identify any non-indexed studies. The population, concept and context approach was used to develop the eligibility criteria. Articles were included if (1) they assessed the impact of interventions to improve wellbeing or reduce the distress on healthcare personnel, first responders or military actively providing medical care; (2) provided quantitative or qualitative data with clearly defined outcomes that focused on established mental health indicators or qualitative descriptions on distress and wellbeing, validated scales and workplace indicators; (3) focused on organizational level interventions that occurred in a public health crisis.

Results

The literature search resulted in 4007 citations and 115 potentially relevant full-text papers. All except 5 were excluded. There were four review articles and one experimental study. There were no other unpublished reports that warranted inclusion.

Conclusions

There is a distinct lack of research examining organizational interventions addressing mental resilience and well-being in healthcare workers in disaster settings. A systematic review in this area would be low yield. There is a clear need for further research in this area.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13761-1.

Role of an Online Skill-Based Mindfulness Program for Healthcare Worker's Resiliency During the COVID-19 Pandemic: A Mixed-Method Study

The COVID-19 pandemic has highlighted the mental health care needs of health care workers. The primary aim of this study was to explore the effects of an online mindfulness program on resiliency in health care workers during the pandemic using a mixed-methods approach. An online 4-week mindfulness program was delivered to healthcare workers (N = 130) in Ontario, Canada. Resiliency was assessed at 3-time points (i.e., pre, post, and 1-month follow-up), and the mindfulness program's efficacy on resiliency was analyzed using linear regression. Semi-structured interviews (N = 10) were conducted to substantiate their experiences. Healthcare workers' resiliency significantly increased after the mindfulness program compared to the baseline, maintaining the effect after 1 month in both unadjusted and adjusted regression models. These findings were further bolstered by the positive experiences shared by participants highlighting the program's efficacy on empathy and resiliency. Evidence suggests that mindfulness is associated with promoting resiliency in healthcare workers and may be an important strategy to promote resiliency in this population.

Online Short-Term Mindfulness-Based Intervention During COVID-19 Quarantine in Italy: Effects on Wellbeing, Stress, and Anxiety

To limit the first spread of COVID-19 in March 2020, the Italian government imposed strict lockdown measures to the population. Despite necessary to reduce the virus transmission and the burden to the hospitals, social isolation has caused detrimental effects on psychological wellbeing and mental health. Moreover, during this period, it was also difficult to deliver psychological treatments and psychiatric assistance. A short (a weekly session for 9 weeks) mindfulness-based meditation program, named Integral Meditation (IM), was administered entirely online to healthy adults from Italy. This is a two-groups pre–post-quasi-experimental study in which the two groups, treated and control, were not randomized. Through matching procedures aimed at overcoming the absence of randomization, we analyzed a sample of 84 subjects (42 for each group). By applying linear mixed effect models, we tested the hypothesis of a beneficial effect of IM on wellbeing, perceived stress, and state anxiety, as measured by three self-reported questionnaires (WEMWBS, PSS, and STAI-X1, respectively), assuming that this effect could be different according to the level of baseline trait anxiety, as measured by STAI-X2. The results showed a statistically significant effect of STAI-X1 (β = −8.24 [95%CI −15.39; −1.09], p = 0.02) and WEMWBS (β = 4.61 [95%CI 0.94; 8.29], p = 0.01) in the higher trait anxiety subgroup only. No statistically significant effect of IM was observed for PSS. These results suggest that our IM, delivered online, may increase mental wellbeing and decrease anxiety specifically in subjects with higher trait anxiety.