Long-term follow-up of mind-body medicine practices among medical school graduates

Exploring the sustained impact of the Mindfulness-Based Stress Reduction program: a thematic analysis

Introduction

This study aimed to explore the time-varying impact of the Mindfulness-Based Stress Reduction (MBSR) program, specifically examining its effects on various variables 3 months, 1 year, and 3 years after program completion. Additionally, the study aimed to identify the barriers and facilitators in maintaining mindfulness practice over time and the preferred mindfulness practices among participants in three distinct time groups.

Methods

The study utilized a qualitative research design, conducting semi-structured interviews with 45 participants who had completed the 8-week MBSR program at different time points. Thematic analysis was employed to analyze the qualitative data obtained from the interviews, allowing for the identification of key themes and patterns.

Results

The findings revealed that the effectiveness of the MBSR program varied at different times and across different variables. Immediately after completing the program, participants experienced a significant decrease in stress levels and an increase in awareness. One year later, the program continued to have positive effects on inner calm, coping mechanisms, and relationships. Three years after completing the program, its long-term impact was observed in the adoption of a mindful lifestyle, increased compassion and kindness, and ongoing personal growth.

Discussion

The study highlights the transformative potential of the MBSR program beyond short-term symptom relief. The long-term effects observed in overall wellbeing emphasize the sustained efficacy of mindfulness-based interventions. The identified barriers and facilitators in maintaining mindfulness practice provide insights for program implementation and individual engagement. By understanding the long-term impact and preferences of participants, tailored interventions can be developed to maximize the benefits of the MBSR program for individuals over time.

Enhancing self-care education amongst medical students: a systematic scoping review

BACKGROUND

Reports of emotional, existential and moral distress amongst medical students witnessing death and suffering of patients during their clinical postings have raised awareness on the need for better psycho-emotional support during medical school. Furthermore, the stress experienced by medical students stemming from the rigours of their academic curriculum underlines the need for greater awareness on mental health issues and better self-care practices across medical training. With such programmes lacking in most medical schools, we propose a systematic scoping review (SSR) to map and address our research question, "what is known about self-care education interventions amongst medical students?".

METHODS

We adopted the Systematic Evidence-Based Approach to guide a systematic scoping review (SSR in SEBA) of relevant articles published between 1st January 2000 and 30th June 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles were independently and concurrently thematically and content analysed, with complementary categories and themes combined using the Jigsaw Approach. The domains created from the Funnelling Process framed the discussion.

RESULTS

A total of 6128 abstracts were identified, 429 full-text articles evaluated, and 147 articles included. The 6 domains identified were definition, topics, pedagogy, influences, outcomes and assessment. Most interventions were promising, though peer-led mindfulness-based interventions showed most promise in enhancing engagement, positively impacting personal wellbeing, and improving patient care. Overall, however, self-care education was poorly recognized, adopted and integrated into curricula.

CONCLUSION

Greater dedicated time and conducive practice environments within medical school curricula is required to enhance medical student wellbeing. Host organizations must ensure faculty are appropriately selected to instil the importance of self-care, be trained to assess and personalize self-care interventions and provide longitudinal assessment and support. Further study into assessing self-care capabilities is required.

Experiences of Clinical Clerkship Students With Mindfulness-Based Stress Reduction: A Qualitative Study on Long-Term Effects

Purpose

To explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction (MBSR) training.

Method

A qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was reached after 16 interviews.

Results

Most interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; (1) “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; (2) “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; (3) “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were (1) understanding and intention as “pre-conditions”; (2) practical, personal, and professional factors of students in maintaining practice.

Conclusion

Two years after participation in a MBSR training, many interviewees were still engaged in (mostly informal) mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals.

Impact of a University-Wide Interdisciplinary Mind-Body Skills Program on Student Mental and Emotional Well-Being

Background

Positive effects of mind-body skills programs on participant well-being have been reported in health professions students. The success seen with medical students at this university led to great interest in expanding the mind-body skills program so students in other disciplines could benefit from the program.

Objective

The purpose of this study was to assess the effects of a 9-week mind-body skills program on the mental and emotional well-being of multidisciplinary students compared to controls. We also sought to determine if the program’s effects were sustained at 1-year follow-up.

Methods

A cross-sectional pre-post survey was administered online via SurveyMonkey to participants of a 9-week mind-body skills program and a control group of students from 7 colleges at a public university from 2017–2019. Students were assessed on validated measures of stress, positive/negative affect, resilience, depression, anxiety, fatigue, sleep disturbance, mindfulness, empathy, and burnout. Scores were analyzed between-groups and within-groups using bivariate and multivariate analyses. A 1-year follow-up was completed on a subset of participants and controls.

Results

279 participants and 247 controls completed the pre-survey and post-survey (79% response rate; 71% female, 68% white, mean age = 25 years). Participants showed significant decreases in stress, negative affect, depression, anxiety, sleep disturbance, and burnout, while positive affect, resilience, mindfulness, and empathy increased significantly (P < .05). Only sleep disturbance showed a significant decrease in the control group. Follow-up in a subset of participants showed that only mindfulness remained elevated at 1-year (P < .05), whereas the significant changes in other well-being measures were not sustained.

Conclusion

Participation in a 9-week mind-body skills program led to significant improvement in indicators of well-being in multidisciplinary students. A pilot 1-year follow-up suggests that effects are only sustained for mindfulness, but not other parameters. Future programming should focus on implementing mind-body skills booster sessions to help sustain the well-being benefits.

Mindfulness for undergraduate health and social care professional students: Findings from a qualitative scoping review using the 3P model

CONTEXT

With many health and social care schools offering mindfulness training (MT) there is a need for deeper understanding about pedagogical issues. Despite encouraging findings showing relationships between MT and student stress reduction, there is little qualitative synthesis of the literature about best principles for teaching and learning.

METHODS

We report on a qualitative scoping review using the stages of Arksey and O'Malley's framework. The search identified papers from MEDLINE, PsychINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and SCOPUS over 15 years. The included papers were synthesised using the 3P model of teaching and learning to explore current MT for presage (teaching set-up), process (teaching delivery) and product (outcomes) factors.

RESULTS

A total of 16 articles were included in the review. There was a lack of consensus on definition of MT, facilitator training and the intervention used. The majority of studies involved small self-selected, mainly female cohorts. For the set-up (presage factors), the majority of curricula included MT for stress management and well-being, delivered in the early years. Providing appropriate facilitators was a concern, whereas process factors revealed enormous variability in delivery. Few studies had formal assessment, although many had outcome evaluation measures (product factors).

CONCLUSIONS

The qualitative review has highlighted additional benefits from MT aside from stress reduction; most noticeably, student self-awareness, peer cohesion and group support, ability to attend to patients, and student insights into health and social education culture. Seeking presage, process and product factors has illuminated variability in how MT is being adapted within health and social care curricula. This review highlights the next steps and recommendations for the future.

Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study

BACKGROUND

Primary care physicians are subjected to a high workload, which can lead to stress and a high incidence of burnout. A mindfulness training course was developed and implemented for primary care physicians to better cope with stress and improve job functioning.

AIM

To gain insight into the effects of the mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians.

DESIGN & SETTING

A pragmatic mixed-methods pre-post design in which physicians received 8 weeks of mindfulness training.

METHOD

Participants completed validated questionnaires on perceived stress (Perceived Stress Scale [PSS]), self-compassion (Self-Compassion Scale [SCS]), and self-reflection (Groningen Reflection Ability Scale [GRAS]) before the training, directly after, and 6 months later. Semi-structured interviews were conducted with six participants after the training and a content analysis was performed to gain in depth understanding of experiences.

RESULTS

A total of 54 physicians participated in the study. PSS was reduced (mean difference [MD] -4.5, P<0.001), SCS improved (MD = 0.5, P<0.001), and GRAS improved (MD = 3.3, P<0.001), directly after the 8-week training compared with before training. Six months later, PSS was still reduced (MD = -2.9, P = 0.025) and SCS improved (MD = 0.7, P<0.001). GRAS did not remain significant (MD = 2.5, P = 0.120). Qualitative analysis revealed four themes: being more aware of their own feelings and thoughts; being better able to accept situations; experiencing more peacefulness; and having more openness to the self and others.

CONCLUSION

Mindfulness training might be an effective approach for improving stress resilience, self-compassion, and self-reflection in primary care physicians.

Mind-body therapies: an intervention to reduce work-related stress in veterinary academia

Studies investigating perceived stress and mindfulness awareness support mind-body therapy (MBT) effectiveness in reducing stress and anxiety and, thus, has potential to decrease work-related stress. A pre/postexperimental design involved 30 faculty and staff working at Ross University School of Veterinary Medicine, Saint Kitts and Nevis, who experienced a two-day MBT intervention programme. An additional 16 faculty and staff not involved in MBT who went about their daily work schedules served as contemporary controls. Demographics, Perceived Stress Scale 10 (PSS-10), Mindful Attention Awareness Scale (MAAS), 16 Personality Factor (16PF) Openness to Change subscale and saliva cortisol concentrations were analysed. Control participants reported significantly perceived less stress (PSS-10: M=13; sd=1.4) than intervention participants (M=20; sd=6.6) during pretest. However, at post-test the intervention group reported a significant decrease in perceived stress (M=11; sd=6.0). MAAS pretest results indicated the intervention group displayed a lower average score (M=54; sd=15.3) than control participants (M=68; sd=2.0). Post-MAAS intervention scores showed improvements in mindfulness (M=63; sd=15.3). Correlations between the 16PF Openness to Change subscale and MAAS were r=0.03 and r=-0.17 for the intervention and control groups, respectively. Mean concentrations of saliva cortisol indicated a larger and significant decline in cortisol for the intervention group both during day 1 (P=0.0001) and day 2 (P=0.0008). In conclusion, these preliminary results provide support that MBTs in veterinary academia can improve psychological and physiological aspects of personal wellbeing.