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Benavides-Gil G, Martínez-Zaragoza F, Fernández-Castro J, Sánchez-Pérez A, García-Sierra R. Mindfulness-based interventions for improving mental health of frontline healthcare professionals during the COVID-19 pandemic: a systematic review. Syst Rev 2024; 13:160. [PMID: 38902795 PMCID: PMC11188518 DOI: 10.1186/s13643-024-02574-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/30/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Mindfulness-based interventions (MBIs) appear to be effective for improving the mental health of healthcare professionals (HCPs). However, the effectiveness of MBIs on extreme psychological trauma caused by the coronavirus disease 2019 (COVID-19) pandemic is largely unknown. The aim of this paper was to systematically review empirical studies of MBIs for HCPs carried out during the COVID-19 pandemic, to evaluate them and their effectiveness in different areas of mental health. METHODS The electronic databases searched were Web of Science, Scopus, PubMed, and PsycINFO. The date when each database was last searched was September 15, 2023. Randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and non-randomized non-controlled trials (NRNCTs) focused on MBIs for health care staff who were working in healthcare centers during the COVID-19 pandemic were included. All of them employed standardized measures of mental health. The review followed the best practices and reported using PRISMA guidelines. A data collection form, adapted from the Cochrane handbook for systematic reviews of interventions, was used to extract and synthesize the results. The methods used to assess the risk of bias in the included studies were the Cochrane Risk of Bias Tool and the ROBINS-I Tool. RESULTS Twenty-eight studies were included in the systematic review. Overall, the methodological quality of the studies was moderate. The results showed the effectiveness of MBIs in improving levels of stress, mindfulness, and mental well-being. However, no conclusive results were found regarding the effectiveness of MBIs in improving the levels of burnout, anxiety, depression, sleep quality, and resilience of HCPs. CONCLUSIONS The MBIs for HCPs carried out during the COVID-19 pandemic have mainly contributed to improving stress, mindfulness, and mental well-being at a time of serious health emergency. However, more robust studies at a methodological level would have been desirable. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021267621.
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Affiliation(s)
- Gemma Benavides-Gil
- Department of Behavioral Sciences and Health, University Miguel Hernández, Campus de San Juan. Edf. Muhammad Al-Safra, Ctra. Alicante-Valencia, km. 87, 03550, Alicante, San Juan de Alicante, Spain
| | - Fermín Martínez-Zaragoza
- Department of Behavioral Sciences and Health, University Miguel Hernández, Campus de Elche. Edf. Altamira, Avda. de la Universidad, s/n, Elche, Alicante, 03202, Spain.
| | - Jordi Fernández-Castro
- Departament de Psicologia Bàsica, Evolutiva i de l'Educació, Facultat de Psicologia, Universitat Autònoma de Barcelona, Campus de Bellaterra, Barcelona, Cerdanyola del Vallès, 08193, Spain
| | - Alicia Sánchez-Pérez
- Department of Pathology and Surgery, Being + Doing & Becoming Occupational Research Group (B+D+b), Institute for Health and Biomedical Research (ISABIAL), University Miguel Hernández, Campus de San Juan. Edf. Muhammad Al-Safra, Ctra. Alicante-Valencia, km. 87, 03550, Alicante, San Juan de Alicante, Spain
| | - Rosa García-Sierra
- Unit Metropolitana Nord, Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), 08303, Mataró, Barcelona, Spain
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DeGraves BS, Titley H, Duan Y, Thorne TE, Banerjee S, Ginsburg L, Salma J, Hegadoren K, Angel C, Keefe J, Lanius R, Estabrooks CA. Workforce resilience supporting staff in managing stress: A coherent breathing intervention for the long-term care workforce. J Am Geriatr Soc 2024; 72:753-766. [PMID: 38156430 DOI: 10.1111/jgs.18727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/14/2023] [Accepted: 11/12/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Staff in long-term care (LTC) homes have long-standing stressors, such as short staffing and high workloads. These stressors increased during the COVID-19 pandemic; better resources are needed to help staff manage stress and well-being. The purpose of this study was to evaluate the effect of a simple stress management strategy (coherent breathing). METHODS We conducted a pre-post intervention study to evaluate a self-managed coherent breathing intervention from February to September 2022. The intervention included basic (breathing only) and comprehensive (breathing plus a biofeedback device) groups. Six hundred eighty-six participants were initially recruited (359 and 327 in the comprehensive and basic groups respectively) from 31 LTC homes in Alberta, Canada. Two hundred fifty-four participants completed pre-and post-intervention questionnaires (142 [55.9%] in comprehensive and 112 [44.1%] in basic). Participants were asked to use coherent breathing based on a schedule increasing from 2 to 10 min daily, 5-7 times a week over 8 weeks. Participants completed self-administered online questionnaires pre- and post-intervention to assess outcomes-stress, psychological distress, anxiety, depression, resilience, insomnia, compassion satisfaction, compassion fatigue, and burnout. We used a mixed-effects regression model to test the main effect of time (pre- and post-intervention) and group while testing the interaction between time and group and controlling for covariates. RESULTS We found statistically significant changes from pre- to post-intervention in stress (b = -2.5, p < 0.001, 95% CI = -3.1, -1.9), anxiety (b = -0.5, p < 0.001, 95% CI = -0.7, -0.3), depression (b = -0.4, p < 0.001, 95% CI = -0.6, -0.2), insomnia (b = -1.5, p < 0.001, 95% CI = -2.1, -0.9), and resilience (b = 0.2, p < 0.001, 95% CI = 0.1, 0.2). We observed no statistically significant differences between the two intervention groups on any outcome. CONCLUSIONS Our findings suggest that coherent breathing is a promising strategy for improving stress-related outcomes and resilience. This intervention warrants further, more rigorous testing.
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Affiliation(s)
| | - Heather Titley
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Yinfei Duan
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Trina E Thorne
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Liane Ginsburg
- School of Health Policy and Management, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Jordana Salma
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Cybele Angel
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Janice Keefe
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Ruth Lanius
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Shrimal PJ, Maharana S, Dave A, Metri KG, Raghuram N, Shrimal S. Impact of Yoga on anxiety, stress and sleep quality among health care professionals during public health crisis. Work 2024:WOR230061. [PMID: 38427518 DOI: 10.3233/wor-230061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024] Open
Abstract
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 It was a quasi-experimental study 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, RCT studies are warranted.
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Affiliation(s)
- Pragya Jain Shrimal
- Department of Yoga & Life Science of SVYASA Deemed to be University, Bengaluru, India
| | - Satyapriya Maharana
- Division of Yoga & Life Sciences, SVYASA Deemed to be University, Bengaluru, India
| | - Anupama Dave
- Department of Obstetrics & Gynaecology, M.Y. Hospital & MGM Medical College, Indore, India
| | - Kashinath G Metri
- Department of Yoga, Central University of Rajasthan, Bandar Sindri, Kishangarh, Ajmer, Rajasthan, India
| | | | - Shivendra Shrimal
- ESIC MH Indore Ministry of Labour and Employment Government of India, India
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Korkmaz A, Bernhardsen GP, Cirit B, Koprucu Suzer G, Kayan H, Biçmen H, Tahra M, Suner A, Lehto SM, Sag D, Saatcioglu F. Sudarshan Kriya Yoga Breathing and a Meditation Program for Burnout Among Physicians: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2353978. [PMID: 38294813 PMCID: PMC10831575 DOI: 10.1001/jamanetworkopen.2023.53978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 12/08/2023] [Indexed: 02/01/2024] Open
Abstract
Importance Physicians are exposed to high stress and strain that results in burnout, which affects them, their families, their patients, and the entire health care system; thus, there is an urgent need to develop methods to increase the resiliency of physicians. Sudarshan Kriya Yoga (SKY) is a comprehensive yoga breathing and meditation-based program that is a potential approach to mitigate physician burnout. Objective To determine whether SKY can reduce psychological distress and improve wellness in physicians. Design, Setting, and Participants This randomized clinical trial assessed the potential efficacy of SKY compared with a stress management education (SME) training as control. This study was conducted online from November 11, 2021, to March 14, 2022, and included physicians from Turkey, Germany, and Dubai. Both the SKY and the SME control groups received 1.5 hours of training for 3 consecutive days via a group video conference call. Participants were physicians willing to do some form of relaxation exercise everyday for 2 months. Exclusion criteria included presence of major illness and maintaining a regular mind-body program practice. Statistical analysis took place from March to November 2023. Interventions Participants were randomly assigned 1:1 into 2 groups-the SKY group or the SME (control) group-using a computer algorithm. After the 3-day instruction period, the participants in the SKY group practiced for approximately 30 minutes per day on their own and participated in a weekly 1-hour, group-based online follow-up practice. After the 3-day instruction period, participants in the SME group reviewed and applied the notes from stress management education training at their initiative and had a weekly 1-hour group-based online follow-up session. Main Outcomes and Measures The primary outcomes were stress and depression (measured by the 42-item Depression, Anxiety, and Stress Scale [DASS-42]) and insomnia measured by the Regensburg Insomnia Scale (RIS) with primary end point at 8 weeks. Secondary outcomes included anxiety (DASS-42); optimism (Life Orientation Test-Revised [LOT-R]); professional fulfillment, work exhaustion, interpersonal disengagement, and overall burnout (Professional Fulfillment Index [PFI]); and self-reported professional errors (Self-Reported Professional Error Questionnaire). Results This study included 129 participants (SME, 63 participants [48.9%]; SKY, 66 participants [51.1%]; 115 females [89.2%]; 14 males [10.8%]; mean [SD] age, 46.2 [9.0] years). Compared with the SME control group, participants in the SKY group had significantly decreased stress on the DASS-42 at posttraining (difference, -6.8 points; 95% CI, -9.6 to -4.1 points; P = .006) and at postintervention (difference, -6.0 points; 95% CI, -8.8 to -3.3 points; P = .03), significantly decreased depression at posttraining (difference, -5.7 points; 95% CI, -8.6 to -2.8 points; P < .001) and postintervention (difference, -5.4 points; 95% CI, -8.3 to -2.5 points; P < .001), and significantly decreased anxiety at postintervention. In addition, there was a significant decrease in insomnia from baseline to postintervention in the SKY group (difference, -0.3 points; 95% CI, -2.3 to 1.7 points; P = .01). The SKY group also showed significantly increased professional fulfillment as well as significant decreases in work exhaustion, interpersonal disengagement, and burnout. There was no effect on self-reported medical errors. Conclusions and Relevance In this randomized clinical trial, physicians who regularly practiced SKY throughout a 2-month period experienced improvements in wellness and decreased burnout. These data suggest that SKY may be an effective, practical, and safe strategy to increase wellness and mitigate burnout in physicians. Trial Registration ClinicalTrials.gov Identifier: NCT05956470.
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Affiliation(s)
- Asli Korkmaz
- Department of Genomic Sciences and Molecular Biotechnology, Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, Izmir, Turkey
- Izmir Biomedicine and Genome Center, Izmir, Turkey
| | - Guro Pauck Bernhardsen
- Division of Mental Health Services, Department of Research and Development, Akershus University Hospital, Lørenskog, Norway
| | - Burcu Cirit
- University of Health Sciences, Ataturk Chest Diseases Education and Research Hospital, Ankara, Turkey
| | | | | | | | - Muratcan Tahra
- School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Asli Suner
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Soili Marianne Lehto
- Division of Mental Health Services, Department of Research and Development, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Duygu Sag
- Department of Genomic Sciences and Molecular Biotechnology, Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, Izmir, Turkey
- Izmir Biomedicine and Genome Center, Izmir, Turkey
- Department of Medical Biology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Fahri Saatcioglu
- Department of Biosciences, University of Oslo, Oslo, Norway
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
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Önal R, Kutay Ordu Gökkaya N, Korkmaz S, Utku B, Yaşar E. Effect of yoga-based exercises on functional capacity, dyspnea, quality of life, depression, anxiety, and sleep of infected healthcare workers during the COVID-19 pandemic: A prospective clinical trial. Turk J Phys Med Rehabil 2023; 69:488-499. [PMID: 38766577 PMCID: PMC11099861 DOI: 10.5606/tftrd.2023.11605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/04/2023] [Indexed: 05/22/2024] Open
Abstract
Objectives The study aimed to investigate the effect of yoga-based exercises on functional capacity, dyspnea, quality of life, depression, anxiety, and sleep quality following coronavirus disease 2019 (COVID-19). Patients and methods Forty-one COVID-19-infected healthcare professionals (35 females, 6 males; mean age: 39.7±6.5 years; range, 28 to 55 years) who were actively working during the subacute period were included in the prospective controlled study between March 2021 and September 2021. The participants were divided into two groups: the yoga-based exercise group (YBEG; n=26) and the nonintervention group (n=15). Besides routine recommendations, the YBEG performed stretching, relaxation, isometric strengthening, breathing, and meditation exercises of 60 min twice a week for eight weeks. Clinical outcome was measured with flexibility tests (shoulder flexibility and sit and reach tests), hand grip strength, 6-min walk test, dyspnea score, Beck Depression and Anxiety Inventory, Short Form 36 (SF-36) quality of life, Pittsburgh sleep quality index (PSQI), and the International Physical Activity Questionnaire (IPAQ) before and after eight weeks in both groups. Results Beck anxiety scores, IPAQ scores, PSQI, SF-36 pain, and social functioning subparameters were positively statistically significant in the YBEG (p<0.05). The only parameter found to be insignificant in time and between groups was the SF-36 mental health subparameter (p>0.05). In addition, the YBEG had significant improvements in muscle strength, flexibility, functional capacity, physical activity level, quality of life, anxiety, depression levels, and sleep scores between before and after the eight-week intervention period (p<0.05). Conclusion Yoga programs have led to an increase in functional capacity and physical performance, a decrease in anxiety and depression complaints, and an increase in the quality of life in healthcare professionals who were in the process of returning to work during the post-COVID-19.
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Affiliation(s)
- Refiye Önal
- Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital, Hospital of Physical Medicine and Rehabilitation, Ankara, Türkiye
| | - Nilüfer Kutay Ordu Gökkaya
- Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital, Hospital of Physical Medicine and Rehabilitation, Ankara, Türkiye
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Gülhane Faculty of Medicine, Ankara, Türkiye
- Ankara Bilkent City Hospital, Hospital of Physical Medicine and Rehabilitation, Laboratory of Sports Science and Rehabilitation, Ankara, Türkiye
| | - Serap Korkmaz
- Ankara Bilkent City Hospital, Hospital of Physical Medicine and Rehabilitation, Laboratory of Sports Science and Rehabilitation, Ankara, Türkiye
| | - Burkay Utku
- Ankara Bilkent City Hospital, Hospital of Physical Medicine and Rehabilitation, Laboratory of Sports Science and Rehabilitation, Ankara, Türkiye
- Department of Sports Medicine, Ankara Bilkent City Hospital, Hospital of Physical Medicine and Rehabilitation, Ankara, Türkiye
| | - Evren Yaşar
- Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital, Hospital of Physical Medicine and Rehabilitation, Ankara, Türkiye
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Gülhane Faculty of Medicine, Ankara, Türkiye
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Bhardwaj P, Pathania M, Bahurupi Y, Kanchibhotla D, Harsora P, Rathaur VK. Efficacy of mHealth aided 12-week meditation and breath intervention on change in burnout and professional quality of life among health care providers of a tertiary care hospital in north India: a randomized waitlist-controlled trial. Front Public Health 2023; 11:1258330. [PMID: 38026380 PMCID: PMC10646346 DOI: 10.3389/fpubh.2023.1258330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Burnout is "Chronic workplace stress that has not been successfully managed." Professional quality of life (PQL) includes work related experiences of compassion satisfaction and compassion fatigue. Healthcare providers (HCPs) are highly susceptible to burnout and compassion fatigue due to their demanding work, which lowers PQL. Burnout leads to poor care, medical errors, and patient safety across healthcare disciplines. Yoga has been shown to improve resilience, reduce stress, and increase self-compassion and psycho-physiological coherence. This study compared HCPs in a mHealth-aided 12-week yoga-based meditation and breath intervention to waitlist controls for HCP burnout and PQL at a north Indian tertiary care hospital. Methods This was randomized waitlist-controlled trial. Total 98 HCPs (62 males and 36 females) with an average age of 28.26 ± 3.547 years were enrolled consecutively from March 2021 to November 2022. Randomization was done with opaque sealed envelopes numbered in a computer-generated sequence. The experimental group (n = 49) received 12 online weekly yoga sessions and performed daily home practice (6 days a week). The waitlisted control group (n = 49) continued their daily routine. Maslach's burnout inventory (MBI), professional quality of life (PQL) and anthropometric measurements were assessed at baseline and after 12 weeks. Results After 12 weeks, the MBI outcomes of emotional exhaustion, depersonalization, and personal accomplishment showed a highly significant difference between the two groups (p < 0.001). PQL outcomes of compassion satisfaction, burnout, and secondary trauma also differed significantly (p < 0.001). Within group analysis showed that MBI and PQL outcomes improved significantly (p < 0.001) for the experimental group after 12 weeks. Conclusion The current study contributes to the existing evidence on the effectiveness of Yoga in managing stress and developing resilience among doctors, nurses, and other medical professionals. Integrating yoga into healthcare settings is crucial for addressing the detrimental impact of burnout on decision-making and promoting positive patient outcomes. mHealth technologies have the potential to enhance the user-friendliness of yoga-based interventions by personalizing the practice space and time. Yoga-based interventions and mHealth technologies can effectively address physician burnout, in a simple and implementable manner.
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Affiliation(s)
- Praag Bhardwaj
- Deparment of Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Monika Pathania
- Deparment of Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Yogesh Bahurupi
- Deparment of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | | | | | - Vyas Kumar Rathaur
- Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
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Flaws D, Patterson S, Bagshaw T, Boon K, Kenardy J, Sellers D, Tronstad O. Caring for critically ill patients with a mental illness: A discursive paper providing an overview and case exploration of the delivery of intensive care to people with psychiatric comorbidity. Nurs Open 2023; 10:7106-7117. [PMID: 37443430 PMCID: PMC10563417 DOI: 10.1002/nop2.1935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/22/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
AIM To address the need for additional education in the management of mental illness in the critical care setting by providing a broad overview of the interrelationship between critical illness and mental illness. The paper also offers practical advice to support critical care staff in managing patients with mental illness in critical care by discussing two hypothetical case scenarios involving aggressive and disorganised behaviour. People living with mental illness are over-represented among critically unwell patients and experience worse outcomes, contributing to a life expectancy up to 30 years shorter than their peers. Strategic documents call for these inequitable outcomes to be addressed. Staff working in intensive care units (ICUs) possess advanced knowledge and specialist skills in managing critical illness but have reported limited confidence in managing patients with comorbid mental illness. DESIGN & METHODS A discursive paper, drawing on clinical experience and research of the authors and current literature. RESULTS Like all people, patients with mental illnesses draw on their cognitive, behavioural, social and spiritual resources to cope with their experiences during critical illness. However, they may have fewer resources available due to co-morbid mental illness, a history of trauma and social disadvantage. By identifying and sensitively addressing patients' underlying needs in a trauma-informed way, demonstrating respect and maximising patient autonomy, staff can reduce distress and disruptive behaviours and promote recovery. Caring for patients who are distressed and/or display challenging behaviours can evoke strong and unpleasant emotional responses. Self-care is fundamental to maintaining a compassionate approach and effective clinical judgement. Staff should be enabled to accept and acknowledge emotional responses and access support-informally with peers and/or through formal mechanisms as needed. Organisational leadership and endorsement of the principles of equitable care are critical to creation of the environment needed to improve outcomes for staff and patients. RELEVANCE TO CLINICAL PRACTICE ICU nurses hold an important role in the care of patients with critical illnesses and are ideally placed to empower, advocate for and comfort those patients also living with mental illness. To perform these tasks optimally and sustainably, health services have a responsibility to provide nursing staff with adequate education and training in the management of mental illnesses, and sufficient formal and informal support to maintain their own well-being while providing this care. PATIENT AND PUBLIC INVOLVEMENT This paper is grounded in accounts of patients with mental illness and clinicians providing care to patients with mental illness in critical care settings but there was no direct patient or public contribution.
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Affiliation(s)
- Dylan Flaws
- Caboolture HospitalCabooltureQueenslandAustralia
- Critical Care Research GroupThe Prince Charles HospitalChermsideQueenslandAustralia
- Queensland University of TechnologyBrisbane CityQueenslandAustralia
| | - Sue Patterson
- Critical Care Research GroupThe Prince Charles HospitalChermsideQueenslandAustralia
- School of DentistryUniversity of QueenslandBrisbane CityQueenslandAustralia
| | - Todd Bagshaw
- Caboolture HospitalCabooltureQueenslandAustralia
- The Prince Charles HospitalChermsideQueenslandAustralia
| | - Kym Boon
- Caboolture HospitalCabooltureQueenslandAustralia
| | - Justin Kenardy
- School of PsychologyUniversity of QueenslandBrisbane CityQueenslandAustralia
- Jamieson Trauma InstituteRoyal Brisbane and Women's HospitalHerstonQueenslandAustralia
| | - David Sellers
- The Prince Charles HospitalChermsideQueenslandAustralia
| | - Oystein Tronstad
- Critical Care Research GroupThe Prince Charles HospitalChermsideQueenslandAustralia
- The Prince Charles HospitalChermsideQueenslandAustralia
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López-Del-Hoyo Y, Fernández-Martínez S, Pérez-Aranda A, Barceló-Soler A, Bani M, Russo S, Urcola-Pardo F, Strepparava MG, García-Campayo J. Effects of eHealth interventions on stress reduction and mental health promotion in healthcare professionals: A systematic review. J Clin Nurs 2023; 32:5514-5533. [PMID: 36703266 DOI: 10.1111/jocn.16634] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/12/2022] [Accepted: 01/04/2023] [Indexed: 01/28/2023]
Abstract
AIMS To evaluate the effectiveness of eHealth interventions to reduce stress and promote mental health in healthcare professionals, and to compare the efficacy of different types of programs (guided vs. self-guided; 'third-wave' psychotherapies vs. other types). BACKGROUND Healthcare workers present high levels of stress, which constitutes a risk factor for developing mental health problems such as depression and anxiety. eHealth interventions have been designed to reduce these professional's stress considering that the characteristics of this delivery method make it a cost-effective and very appealing alternative because of its fast and easy access. DESIGN A systematic review of quantitative studies. METHODS A comprehensive database search for quantitative studies was conducted in PubMed, EMBASE and Cochrane (until 1 April 2022). The systematic review was conducted in accordance with the PRISMA and SWiM reporting guidelines. The quality of the studies was assessed using the National Heart, Lung and Blood Institute tools. RESULTS The abstracts of 6349 articles were assessed and 60 underwent in-depth review, with 27 fulfilling the inclusion criteria. The interventions were classified according to their format (self-guided vs. guided) and contents ('third-wave' psychotherapies vs. others). Twenty-two interventions emerged, 13 of which produced significant posttreatment reductions in stress levels of health professionals (9 self-guided, 8 'third wave' psychotherapies). Significant effects in improving depressive symptomatology, anxiety, burnout, resilience and mindfulness, amongst others, were also found. CONCLUSION The evidence gathered in this review highlights the heterogeneity of the eHealth interventions that have been studied; self-guided and 'third-wave' psychotherapy programs are the most common, often with promising results, although the methodological shortcomings of most studies hinder the extraction of sound conclusions. PROTOCOL REGISTRATION PROSPERO CRD42022310199. No Patient or Public Contribution.
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Affiliation(s)
- Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Selene Fernández-Martínez
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
| | - Adrián Pérez-Aranda
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Navarra Medical Research Institute (IdiSNA), Pamplona, Spain
| | - Marco Bani
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Fernando Urcola-Pardo
- Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
- Research Group Water and Environmental Health (B43_20R), University Institute of Research in Environmental Science of Aragon, University of Zaragoza, Zaragoza, Spain
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
- Clinical Unit "Psicologia Clinica", Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS) RD21/0016/0005, Zaragoza, Spain
- Psychiatry Department, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
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9
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Swarbrick M, Middleton A. Yoga Practice: The Role of Nursing in Promoting Workforce Wellness. J Psychosoc Nurs Ment Health Serv 2023; 61:5-7. [PMID: 36853037 DOI: 10.3928/02793695-20230222-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Affiliation(s)
- Margaret Swarbrick
- Collaborative Support Program of New Jersey, Freehold, Rutgers Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Piscataway, New Jersey
| | - Allie Middleton
- Integrative Leadership Practices, New York Association for Psychiatric, Rehabilitation, Albany, New York, International Association of Yoga Therapists, Kripalu Center for Yoga and Health, Stockbridge,
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10
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Thai YC, Sim D, McCaffrey TA, Ramadas A, Malini H, Watterson JL. A scoping review of digital workplace wellness interventions in low- and middle-income countries. PLoS One 2023; 18:e0282118. [PMID: 36854022 PMCID: PMC9974126 DOI: 10.1371/journal.pone.0282118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
INTRODUCTION Digital technology-based interventions have gained popularity over the last two decades, due to the ease with which they are scalable and low in implementation cost. Multicomponent health promotion programmes, with significant digital components, are increasingly being deployed in the workplace to assess and promote employees' health behaviours and reduce risk of chronic diseases. However, little is known about workplace digital health interventions in low- and middle- income countries (LMICs). METHODS Various combinations of keywords related to "digital health", "intervention", "workplace" and "developing country" were applied in Ovid MEDLINE, EMBASE, CINAHL Plus, PsycINFO, Scopus and Cochrane Library for peer-reviewed articles in English language. Manual searches were performed to supplement the database search. The screening process was conducted in two phases and a narrative synthesis to summarise the data. The review protocol was written prior to undertaking the review (OSF Registry:10.17605/OSF.IO/QPR9J). RESULTS The search strategy identified 10,298 publications, of which 24 were included. Included studies employed the following study designs: randomized-controlled trials (RCTs) (n = 12), quasi-experimental (n = 4), pilot studies (n = 4), pre-post studies (n = 2) and cohort studies (n = 2). Most of the studies reported positive feedback of the use of digital wellness interventions in workplace settings. CONCLUSIONS This review is the first to map and describe the impact of digital wellness interventions in the workplace in LMICs. Only a small number of studies met the inclusion criteria. Modest evidence was found that digital workplace wellness interventions were feasible, cost-effective, and acceptable. However, long-term, and consistent effects were not found, and further studies are needed to provide more evidence. This scoping review identified multiple digital health interventions in LMIC workplace settings and highlighted a few important research gaps.
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Affiliation(s)
- Yi Chiann Thai
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
| | - Deanna Sim
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Tracy A. McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
- * E-mail: (JLW); (TAM)
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
| | - Hema Malini
- Faculty of Nursing, Universitas Andalas, West Sumatra, Indonesia
| | - Jessica L. Watterson
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- * E-mail: (JLW); (TAM)
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11
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Saatcioglu F, Cirit B, Koprucu Suzer G. The Promise of Well-Being Interventions to Mitigate Physician Burnout During the COVID-19 Pandemic and Beyond. JCO Oncol Pract 2022; 18:808-814. [PMID: 36162039 DOI: 10.1200/op.22.00108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The high degree of burnout in physicians, including oncologists, is detrimental to physicians themselves, their families, patients, health care organizations, and the health care systems as a whole. This dire situation has significantly worsened during the COVID-19 pandemic. It is well established that both organizational and individual measures are urgently needed to mitigate the negative consequences of physician burnout. Here, we review the research that has begun to indicate potential evidence-based individual approaches to promote physician well-being. We give an overview of these emerging programs and their importance, provide an example from our own experience, and enumerate considerations for future research. We also discuss the need for developing new approaches that are evidence-based and the best ways in which they can be incorporated in the health care setting. When judiciously combined with organizational approaches, preferentially as an integral part of them, individual wellness programs for physicians are poised to contribute significantly toward the much needed relief from physician burnout.
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Affiliation(s)
| | - Burcu Cirit
- University of Health Sciences, Ataturk Chest Diseases Education and Research Hospital, Ankara, Turkey
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12
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Rain M, Puri GD, Bhalla A, Avti P, Subramaniam B, Kaushal V, Srivastava V, Mahajan P, Singh M, Pandey N, Malhotra P, Goel S, Kumar K, Sachdeva N, Maity K, Verma P, Dixit N, Gupta SJ, Mehra P, Nadholta P, Khosla R, Ahuja S, Anand A. Effect of breathing intervention in patients with COVID and healthcare workers. Front Public Health 2022; 10:945988. [PMID: 36249235 PMCID: PMC9561424 DOI: 10.3389/fpubh.2022.945988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/29/2022] [Indexed: 01/21/2023] Open
Abstract
Background Regulated breathing facilitates ventilation and reduces breathlessness. However, the effect of Yogic breathing on patients with COVID remains unclear. We aimed to evaluate the efficacy of two breathing protocols, i.e., short breathing technique (SBT) and long duration breathing technique (LBDT). Methods Three groups including COVID-positive patients, COVID-recovered patients, and healthcare workers (HCWs) were included in the study and segregated into Yoga and control groups. SBT was administered to COVID-positive patients. Both SBT and LBDT were administered to COVID-recovered patients and HCWs. A total of 18 biochemical parameters, a 6-min walk test (6MWT), and a 1-min sit-stand test (1MSST) were assessed on 0th, 7th, and 15th days, where biochemical parameters were the primary outcome. Pre-post estimation of neuropsychological parameters (nine questionnaires) and heart rate variability (HRV) were carried out. The paired t-test or Wilcoxon rank test was applied for pre-post comparison and the Student's t-test or Mann-Whitney U test was used for group comparison. Repeated measures test was applied for data recorded at three time points. Results A significant elevation in white blood cell (WBC) count was observed in COVID-positive intervention (p < 0.001) and control groups (p = 0.003), indicating no role of intervention on change in WBC number. WBC count (p = 0.002) and D-dimer (p = 0.002) significantly decreased in the COVID-recovered intervention group. D-dimer was also reduced in HCWs practicing Yogic breathing as compared to controls (p = 0.01). D-dimer was the primary outcome, which remained below 0.50 μg/ml (a cutoff value to define severity) in the COVID-positive yoga group (CYG) and decreased in the COVID-recovered yoga group (RYG) and the HCW yoga group (HYG) after intervention. A 6-min walk test (6MWT) showed an increase in distance covered among the COVID-positive patients (p = 0.01) and HCWs (p = 0.002) after intervention. The high-frequency power (p = 0.01) was found to be reduced in the COVID-positive intervention group. No significant change in neuropsychological parameters was observed. Conclusion Yogic breathing lowered D-dimer, which is helpful in reducing thrombosis and venous thromboembolism in patients with COVID-19 besides lowering the chances of vaccine-induced thrombotic thrombocytopenia in vaccinated individuals. The breathing intervention improved exercise capacity in mild to moderate cases of COVID-19. Further studies can show if such breathing techniques can influence immunity-related genes, as reported recently in a study. We suggest that Yogic breathing may be considered an integrative approach for the management of patients with COVID. Trial registration http://ctri.nic.in/Clinicaltrials/login.php, identifier: CTRI/2020/10/028195.
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Affiliation(s)
- Manjari Rain
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Goverdhan Dutt Puri
- Department of Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aashish Bhalla
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pramod Avti
- Department of Biophysics, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Pramod Avti
| | | | - Vipin Kaushal
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Srivastava
- College of Health and Behavioral Sciences, Fort Hays State University, Hays, KS, United States
| | - Pranay Mahajan
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mini Singh
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Navin Pandey
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Kumar
- Department of Psychiatry, Post Graduate 30 Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kalyan Maity
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Prashant Verma
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Interdisciplinary Centre for Swami Vivekananda Studies, Panjab University, Chandigarh, India
| | - Nishant Dixit
- Department of Psychology, Panjab University, Chandigarh, India
| | - Sheetal Jindal Gupta
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Priya Mehra
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Department of Biotechnology, Panjab University, Chandigarh, India
| | - Pooja Nadholta
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Khosla
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Akshay Anand
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Centre of Phenomenology and Cognitive Sciences, Panjab University, Chandigarh, India,CCRYN-Collaborative Center for Mind Body Intervention Through Yoga, Post Graduate Institute of Medical Education and Research, Chandigarh, India,*Correspondence: Akshay Anand
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13
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Kanchibhotla D, Harsora P, Gupte P, Mehrotra S, Sharma P, Trehan N. Alleviating Work Exhaustion, Improving Professional Fulfillment, and Influencing Positivity Among Healthcare Professionals During COVID-19: A Study on Sudarshan Kriya Yoga. Front Psychol 2022; 13:670227. [PMID: 35910997 PMCID: PMC9326464 DOI: 10.3389/fpsyg.2022.670227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/06/2022] [Indexed: 12/02/2022] Open
Abstract
Demanding work-life and excessive workload, the conflict between professional and personal lives, problems with patients and those related to the occurrence of death and high risk for their own life are a few factors causing burnout, disengagement, and dissatisfaction in the professional lives of healthcare professionals (HCPs). The situation worsened during the COVID-19 pandemic. It is of utmost importance to find effective solutions to mitigate the stress and anxiety adversely affecting the mental well-being and professional lives of HCPs. This study was designed to examine the efficacy of Sudarshan Kriya Yoga (SKY) for alleviating work exhaustion, improving Professional Fulfillment, and influencing positivity among HCPs during COVID-19. In a comparative observation before the intervention (Pre), after the intervention (Post), and 30 days after the intervention (Day 30) in the Experimental Group (29 physicians) and Control Group (27 physicians), it was found that immediately after SKY, HCPs experienced a significant improvement in Professional Fulfillment (p = 0.009), work exhaustion (0.008), positive affect (p = 0.02), and negative affect (p < 0.001) compared to the Control Group. The effect of SKY continued until Day 30 for Professional Fulfillment and had positive and negative effects. Findings suggest that SKY elevated Professional Fulfillment among HCPs during the COVID-19 pandemic and reduced their work exhaustion and the negative effect on their mental health. SKY can aid HCPs in maintaining their well-being when faced with unprecedented challenges.
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Affiliation(s)
- Divya Kanchibhotla
- Sri Sri Institute for Advanced Research, Bangalore, India
- *Correspondence: Divya Kanchibhotla,
| | | | - Poorva Gupte
- Sri Sri Institute for Advanced Research, Bangalore, India
| | | | - Pooja Sharma
- Medanta – The Medicity, Gurgaon, India
- Pooja Sharma,
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14
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Systematic Review of Mind–Body Modalities to Manage the Mental Health of Healthcare Workers during the COVID-19 Era. Healthcare (Basel) 2022; 10:healthcare10061027. [PMID: 35742076 PMCID: PMC9222815 DOI: 10.3390/healthcare10061027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 12/12/2022] Open
Abstract
Healthcare workers (HCWs) have suffered physical and psychological threats since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. Mind-body modalities (MBMs) can reduce the long-term adverse health effects associated with COVID-specific chronic stress. This systematic review aims to investigate the role of MBMs in managing the mental health of HCWs during the COVID-19 pandemic. A comprehensive search was conducted using 6 electronic databases, resulting in 18 clinical studies from 2019 to September 2021. Meta-analysis showed that MBMs significantly improved the perceived stress of HCWs (standardized mean difference, −0.37; 95% confidence intervals, −0.53 to −0.21). In addition, some MBMs had significant positive effects on psychological trauma, burnout, insomnia, anxiety, depression, self-compassion, mindfulness, quality of life, resilience, and well-being, but not psychological trauma and self-efficacy of HCWs. This review provides data supporting the potential of some MBMs to improve the mental health of HCWs during COVID-19. However, owing to poor methodological quality and heterogeneity of interventions and outcomes of the included studies, further high-quality clinical trials are needed on this topic in the future.
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15
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Hui BPH, Parma L, Kogan A, Vuillier L. Hot Yoga Leads to Greater Well-being: A Six-week Experience-sampling RCT in Healthy Adults. INTERVENCION PSICOSOCIAL 2022; 31:67-82. [PMID: 37360056 PMCID: PMC10268545 DOI: 10.5093/pi2022a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/18/2021] [Indexed: 06/28/2023]
Abstract
Practicing hot yoga may bring significant psychological benefits, but it is largely unstudied. We examined the effects of hot yoga on multifaceted well-being indicators with 290 healthy yoga-naïve volunteers partaking in a six-week randomized controlled trial. Participants completed questionnaires pre- and post-intervention, and reported their emotional experiences four times per day throughout an experience-sampling study. Results revealed that the hot yoga group (n = 137) improved their well-being from pre- to post-treatment, comparing to the wait-list control group (n = 153). These improvements included life satisfaction, general health, mindfulness, peace of mind, and eudaimonic well-being (ΔR2 ranging from .01 to .08)-but not flourishing, which describes major aspects of social-psychological functioning. Multilevel analyses demonstrated that momentary positive emotional experiences increased significantly throughout the trial in the yoga group only (conditional R2 = .68), particularly when attending a yoga class (conditional R2 = .50). Interestingly, this increase in momentary positive emotion explained the improvement in post-intervention mindfulness, peace of mind, and general health by 21%, 31%, and 11%, respectively. Finally, the benefits of hot yoga were more notable in individuals with lower levels of baseline eudaimonic well-being (conditional R2 = .45), flourishing (conditional R2 = .61), and mental well-being (conditional R2 = .65), even after ruling out any possible ceiling effects. To sum up, this study demonstrated multiple psychological benefits of hot yoga and its potential to be an effective positive psychology intervention. Future research-especially considering an active control group-is warranted.
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Affiliation(s)
- Bryant P. H. Hui
- Hong Kong Polytechnic UniversityHong KongHong Kong Polytechnic University, Hong Kong SAR
| | - Laurie Parma
- University of CambridgeUnited KingdomUniversity of Cambridge, United Kingdom
| | - Aleksandr Kogan
- University of CambridgeUnited KingdomUniversity of Cambridge, United Kingdom
| | - Laura Vuillier
- Bournemouth UniversityUnited KingdomBournemouth University, United Kingdom
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16
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dos Santos GM, Verlengia R, Ribeiro AG, Corrêa CA, Ciuldim M, Crisp AH. Status of yoga and mental health among Brazilian practitioners during COVID-19: An internet-based cross-sectional survey. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:127-132. [PMID: 35574287 PMCID: PMC9076580 DOI: 10.1016/j.smhs.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
This study aimed to describe yoga practice and verify its association with depression, anxiety, and stress during the COVID-19 pandemic among Brazilian practitioners. A cross-sectional anonymous online survey was conducted in all regions of Brazil using a snowball sampling strategy among yoga practitioners. A total of 860 participants (87% female, aged: 19–82 years) completed the survey. Sociodemographic data, lifestyle factors, yoga practice during the pandemic, and the Depression Anxiety and Stress Scale (DASS-21) scores were collected between July 9 and July 15, 2021. Overall, 9.5%, 9.3%, and 5.6% of participants exhibited some traits (mild to severe) of depression, anxiety, and stress, respectively. Hatha yoga (48%) was the most commonly practiced yoga style. In the adjusted analysis, a higher yoga experience (> 5 years) was associated with better anxiety (odds ratio; bootstrap 95% confidence interval: 2.42; 1.32, 4.49) and stress status (1.80; 1.06, 3.00) than beginners (< 1 year). Practitioners who reported higher time and days of yoga practice during the study period were more likely to show normal levels of depression (odds ratio: 2.56–6.49; p < 0.05), anxiety (odds ratio: 3.68–8.84; p < 0.05), and stress (odds ratio: 2.15–5.21; p < 0.05). Moreover, the maintenance of practice frequency during the pandemic was associated with higher odds of normal levels of depression (2.27; 1.39–3.79), anxiety (1.97; 1.25–3.10), and stress (1.97; 1.32–2.96). In conclusion, our findings indicated that a higher level of yoga practice was associated with better mental health levels during the COVID-19 pandemic.
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17
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Ben-Arye E, Gressel O, Samuels N, Stein N, Eden A, Vagedes J, Kassem S. Complementary and integrative medicine intervention in front-line COVID-19 clinicians. BMJ Support Palliat Care 2022:bmjspcare-2021-003333. [PMID: 35383045 PMCID: PMC9002254 DOI: 10.1136/bmjspcare-2021-003333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/08/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the impact of a multidisciplinary complementary and integrative medicine (CIM) intervention on physical and emotional concerns among front-line COVID-19 healthcare providers (HCPs). METHODS A multimodality CIM treatment intervention was provided by integrative practitioners to HCPs in three isolated COVID-19 departments. HCPs' two main concerns were scored (from 0 to 6) before and following the CIM intervention using the Measure Yourself Concerns and Wellbeing questionnaire. Postintervention narratives identified reflective narratives specifying emotional and/or spiritual keywords. RESULTS Of 181 HCPs undergoing at least one CIM treatment, 119 (65.7%) completed post-treatment questionnaires. While HCPs listing baseline emotional-related concerns benefited from the CIM intervention, those who did not express emotional or spiritual concerns improved even more significantly following the first session, for both leading concerns (p=0.038) and emotional-related concerns (p=0.023). Nevertheless, it was shown that following subsequent treatments HCPs who expressed emotional and spiritual concerns improved more significantly than those who did not for emotional-related concerns (p=0.017). CONCLUSIONS A CIM intervention for front-line HCPs working in isolated COVID-19 departments can significantly impact emotional-related concerns, more so after the first treatment and among HCPs not using emotional-spiritual keywords in post-treatment narratives. Referral of HCPs to CIM programmes for improved well-being should avoid referral bias to those not expressing emotional/spiritual concerns.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin, Carmel, and Zebulun Medical centers, Clalit Health Services, Haifa, Israel
- Ruth and Bruch Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Orit Gressel
- Integrative Oncology Program, The Oncology Service, Lin, Carmel, and Zebulun Medical centers, Clalit Health Services, Haifa, Israel
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nili Stein
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Arieh Eden
- Lady Davis Carmel Medical Center, Haifa, Israel
| | - Jan Vagedes
- Department of Pediatrics, University Hospital Tubingen, Tubingen, Germany
| | - Sameer Kassem
- Department of Internal Medicine, Lady Davis Carmel Medical Center, Haifa, Israel
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18
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Bazán PR, de Azevedo Neto RM, Lacerda SS, Ribeiro MW, Balardin JB, Amaro E, Kozasa EH. COVID-19 news valence effects on emotion and its modulation by a relaxation: A randomized online experiment during COVID-19 pandemic. Internet Interv 2021; 26:100472. [PMID: 34697586 PMCID: PMC8529560 DOI: 10.1016/j.invent.2021.100472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 12/14/2022] Open
Abstract
This study evaluated how news with positive and negative content about COVID-19, as well as a relaxation pause, affect the emotional state. We also investigated the association between emotional state and practicing meditation/yoga, physical activity or having a mental disease. For that, a sample of 717 participants, recruited through social media, were randomly assigned to listen to negative or positive news about COVID-19. After that, both groups were guided through a short relaxation pause. Their emotional state was measured before they listened to the audios and after each audio. Mixed linear models were used to evaluate the effects of news group, relaxation pause, mental health and well-being practices. Negative news worsened their emotional state, whereas positive news improved it. A brief relaxation pause improved the effects of negative news content and may mitigate the effects of this valence of information. Practicing physical activity, meditation/yoga was associated with better emotional responses.
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Affiliation(s)
| | | | | | | | | | - Edson Amaro
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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19
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Rain M, Subramaniam B, Avti P, Mahajan P, Anand A. Can Yogic Breathing Techniques Like Simha Kriya and Isha Kriya Regulate COVID-19-Related Stress? Front Psychol 2021; 12:635816. [PMID: 33935886 PMCID: PMC8081973 DOI: 10.3389/fpsyg.2021.635816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 12/19/2022] Open
Abstract
The global impact of Coronavirus Disease 2019 (COVID-19) is tremendous on human life, not only affecting the physical and mental health of population but also impacting the economic system of countries and individual itself. The present situation demands prompt response toward COVID-19 by equipping the humans with strategies to overcome the infection and stress associated with it. These strategies must not only be limited to preventive and therapeutic measures, but also aim at improving immunity and mental health. This can be achieved by yogic breathing techniques. In this perspective, we emphasize the importance of yogic breathing, Simha Kriya and Isha kriya, the simple yet effective breathing techniques.
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Affiliation(s)
- Manjari Rain
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Balachundhar Subramaniam
- Center for Anesthesia Research Excellence, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Pramod Avti
- Department of Biophysics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranay Mahajan
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Anand
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre for Mind Body Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre of Phenomenology and Cognitive Sciences, Panjab University, Chandigarh, India
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20
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Nagarathna R, Anand A, Rain M, Srivastava V, Sivapuram MS, Kulkarni R, Ilavarasu J, Sharma MNK, Singh A, Nagendra HR. Yoga Practice Is Beneficial for Maintaining Healthy Lifestyle and Endurance Under Restrictions and Stress Imposed by Lockdown During COVID-19 Pandemic. Front Psychiatry 2021; 12:613762. [PMID: 34239456 PMCID: PMC8257944 DOI: 10.3389/fpsyt.2021.613762] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 05/11/2021] [Indexed: 01/04/2023] Open
Abstract
Uncertainty about Coronavirus disease 2019 (COVID-19) and resulting lockdown caused widespread panic, stress, and anxiety. Yoga is a known practice that reduces stress and anxiety and may enhance immunity. This study aimed to (1) investigate that including Yoga in daily routine is beneficial for physical and mental health, and (2) to evaluate lifestyle of Yoga practitioners that may be instrumental in coping with stress associated with lockdown. This is a pan-India cross-sectional survey study, which was conducted during the lockdown. A self-rated scale, COVID Health Assessment Scale (CHAS), was designed by 11 experts in 3 Delphi rounds (Content valid ratio = 0.85) to evaluate the physical health, mental health, lifestyle, and coping skills of the individuals. The survey was made available digitally using Google forms and collected 23,760 CHAS responses. There were 23,290 valid responses (98%). After the study's inclusion and exclusion criteria of yogic practices, the respondents were categorized into the Yoga (n = 9,840) and Non-Yoga (n = 3,377) groups, who actively practiced Yoga during the lockdown in India. The statistical analyses were performed running logistic and multinomial regression and calculating odds ratio estimation using R software version 4.0.0. The non-Yoga group was more likely to use substances and unhealthy food and less likely to have good quality sleep. Yoga practitioners reported good physical ability and endurance. Yoga group also showed less anxiety, stress, fear, and having better coping strategies than the non-Yoga group. The Yoga group displayed striking and superior ability to cope with stress and anxiety associated with lockdown and COVID-19. In the Yoga group, participants performing meditation reportedly had relatively better mental health. Yoga may lead to risk reduction of COVID-19 by decreasing stress and improving immunity if specific yoga protocols are implemented through a global public health initiative.
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Affiliation(s)
- Raghuram Nagarathna
- Divison of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Akshay Anand
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre for Mind Body Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre of Phenomenology and Cognitive Sciences, Panjab University, Chandigarh, India
| | - Manjari Rain
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Srivastava
- College of Health and Behavioral Sciences, Fort Hays State University, Hays, KS, United States
| | - Madhava Sai Sivapuram
- Department of General Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Avutapalli, India
| | - Ravi Kulkarni
- Division of Yoga and Physical Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Judu Ilavarasu
- Division of Yoga and Physical Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Manjunath N K Sharma
- Divison of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Amit Singh
- Divison of Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
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