Should Mindfulness for Health Care Workers Go Virtual? A Mindfulness-Based Intervention Using Virtual Reality and Heart Rate Variability in the Emergency Department

Short Mindfulness Meditations During Breaks and After Work in Everyday Nursing Care: A Simple Strategy for Promoting Daily Recovery, Mood, and Attention?

BACKGROUND

Nurses experience high job demands, which makes recovery particularly necessary to maintain well-being and performance. However, these demands also make recovery challenging. Short mindfulness meditations could potentially help alleviate this paradox.

METHODS

Two ecological momentary intervention studies were conducted among geriatric nurses (Study 1: break study) and hospital nurses (Study 2: after-work study) to investigate whether short audio-guided mindfulness meditations are beneficial for recovery during breaks and psychological detachment after work. Furthermore, break recovery and after-work detachment were examined as mediators of the associations between mindfulness meditations and after-break/after-sleep mood and attention after respective recovery periods. Multilevel path models were based on a sample of 38 nurses and 208 after-break surveys in the break study and 26 nurses and 192 after-sleep surveys in the after-work study.

RESULTS

Compared to breaks spent as usual, breaks that incorporated short mindfulness meditations were associated with higher break recovery, which mediated the positive associations between mindful breaks and after-break calmness, valence, and energetic arousal. Only with certain constraints did mindfulness meditations predict a lower rate of attention failures. In the after-work study, short mindfulness meditations were positively related to psychological detachment, which mediated the positive associations between the intervention and after-sleep valence and calmness.

CONCLUSION/APPLICATION TO PRACTICE

Both pilot studies showed that short mindfulness meditations aid in recovery among nurses. However, to fully utilize the advantages of recovery-promoting breaks, structural changes are necessary to ensure that breaks of an appropriate duration are consistently implemented.

Online yoga programme for resident physicians in Québec: an evaluation of feasibility and impact on mental health

OBJECTIVES

To evaluate the feasibility of the Bali Yoga Programme for Residents (PYB-R), an 8-week virtual yoga-based intervention and determine its impact on the mental health of resident physicians.

DESIGN

Single-group repeated measures study.

SETTING

Associations from the four postgraduate medical education programmes in Québec, Canada.

PARTICIPANTS

Overall, 55 resident physicians were recruited to participate of which 53 (96.4%) completed the assessment pre-PYB-R. The postintervention assessment was completed by 43 residents (78.2%) and 39 (70.9%) completed all phases (including 3-month follow-up). Most were in their first year (43.4%) or second year (32.1%) of residency. The majority were female (81.1%) with a mean age of 28±3.6 years.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was feasibility as measured by participation in the PYB-R. Secondary outcome measures were psychological variables (anxiety, depression, burn-out, emotional exhaustion, compassion fatigue and compassion satisfaction) and satisfaction with the PYB-R. Residents were further subgrouped based on the quality of work life and a number of PYB-R sessions attended.

RESULTS

The attrition rate for programme completion was 19%. Of the 43 residents who completed the PYB-R, 90.6% attended between 6 and 8 sessions. Repeated-measures analysis of variances (ANOVAs) at three time points (baseline, PYB-R completion and 3-month follow-up) confirmed a decrease in scores for depression and anxiety, and an increase in scores for compassion satisfaction. No changes were observed in the other psychological variables evaluated. ANOVAs also confirmed that a better quality of life at work helps develop compassion satisfaction, a protective factor to compassion fatigue. Most participants (92.9%) indicated they were satisfied or very satisfied with the quality of the programme.

CONCLUSIONS

A virtual yoga-based programme is feasible and has lasting positive effects for up to 3 months on the mental health of resident physicians. Further research is warranted to validate these findings using a larger sample of residents with a control group.

Incorporating biofeedback into the Mindfulness in Motion Intervention for health care professionals: Impact on sleep and stress

CONTEXT

Health care providers (HCP) experience high stress and burnout rates. Mindfulness Based Interventions (MBI) with biofeedback may help improve resiliency but require further research.

DESIGN AND STUDY PARTICIPANTS

Aims were to evaluate changes in sleep patterns, nocturnal physiology, stress, mood disturbances, and perceived experience with biofeedback during the Mindfulness in Motion (MIM) intervention. Data from 66 HCP were included after removing those below 75 % compliance with wearable sensors and wellness surveys. Participants were enrolled in MIM, including eight weekly one-hour virtually delivered synchronous group meetings and ∼10 min of mindfulness home practice at least 3 times per week using a mobile application. Participants wore wearable sensors to monitor sleep and nocturnal physiology and completed short daily stress and mood disturbances.

RESULTS

According to mixed effect models, no sleep nor physiological metrics changed across MIM (p > 0.05). More time was spent in bed after MIM sessions (8.33±1.03 h) compared to night before (8.05±0.93 h; p = 0.040). Heart rate variability was lower nights after MIM (33.00±15.59 ms) compared to nights before (34.50±17.04 ms; p = 0.004) but was not clinically meaningful (effect= 0.033). Significant reductions were noted in perceived stress at weeks 3 through 8 compared to Baseline and lower Total Mood Disturbance at weeks 3, 5, 6, and 8 compared to Baseline (p < 0.001).

CONCLUSIONS

Participating in the MIM with mobile applications and wearable sensors reduced perceived stress and mood disturbances but did not induce physiological changes. Additional research is warranted to further evaluate objective physiological outcomes while controlling for confounding variables (e.g., alcohol, medications).

Effects of a mindfulness-based program on the occupational balance and mental health of university students. Protocol for a randomized controlled trial

OBJECTIVE

The aim is to examine whether the addition of Virtual Reality (VR) meditation training to a standard 8-week Mindfulness-Based Health Care Program (MBHC-VR) results in a significantly increased improvement in occupational, mental health, and psychological functioning versus MBHC-only in university students.

MATERIALS AND METHODS

A randomized controlled clinical trial with three arms (MBHC, MBHC-VR, Control Group), four assessment time points (pre-intervention, inter-session, post-intervention, and 3-month follow-up), and mixed methodology will be proposed. University students (undergraduate, master, or doctoral) interested in participating and who meet the inclusion/exclusion criteria will be included over two years. Data will be collected from different ad hoc questionnaires, several standardized tests, and an Ecological Momentary Assessment. We will use R software to carry out descriptive analyses (univariate and bivariate), multilevel modeling, and structural equation models to respond to the proposed objective. The qualitative analysis will be carried out using the MAXQDA program and the technique of focus groups.

DISCUSSION

It is expected that with the proposed intervention university students will learn to relate in a healthier way with their mental processes, so as to improve their occupational balance (OB) and their psychological well-being.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT05929430.

Digitally Assisted Mindfulness in Training Self-Regulation Skills for Sustainable Mental Health: A Systematic Review

The onset of the COVID-19 pandemic has led to an increased demand for mental health interventions, with a special focus on digitally assisted ones. Self-regulation describes a set of meta-skills that enable one to take control over his/her mental health and it is recognized as a vital indicator of well-being. Mindfulness training is a promising training strategy for promoting self-regulation, behavioral change, and mental well-being. A growing body of research outlines that smart technologies are ready to revolutionize the way mental health training programs take place. Artificial intelligence (AI); extended reality (XR) including virtual reality (VR), augmented reality (AR), and mixed reality (MR); as well as the advancements in brain computer interfaces (BCIs) are ready to transform these mental health training programs. Mindfulness-based interventions assisted by smart technologies for mental, emotional, and behavioral regulation seem to be a crucial yet under-investigated issue. The current systematic review paper aims to explore whether and how smart technologies can assist mindfulness training for the development of self-regulation skills among people at risk of mental health issues as well as populations with various clinical characteristics. The PRISMA 2020 methodology was utilized to respond to the objectives and research questions using a total of sixty-six experimental studies that met the inclusion criteria. The results showed that digitally assisted mindfulness interventions supported by smart technologies, including AI-based applications, chatbots, virtual coaches, immersive technologies, and brain-sensing headbands, can effectively assist trainees in developing a wide range of cognitive, emotional, and behavioral self-regulation skills, leading to a greater satisfaction of their psychological needs, and thus mental wellness. These results may provide positive feedback for developing smarter and more inclusive training environments, with a special focus on people with special training needs or disabilities.

Effects and safety of virtual reality-based mindfulness in patients with psychosis: a randomized controlled pilot study

Virtual reality (VR) technology can be a supporting tool to enhance mindfulness. Recently, many research using VR-based mindfulness (VBM) has been carried out in various psychiatric disorders but not in psychosis. We investigated safety and effects of virtual reality-based mindfulness (VBM) in patients with psychosis as a pilot study. Sixty-four patients were randomly assigned to VBM or to VR control. For VBM, education and meditation videos were provided. For VR control, 3-dimensional natural scenes were shown. Both programs consisted of 8 weekly sessions, each lasting about 30 min. Pre- and post-assessments were performed using the experiences questionnaire (EQ), psychotic symptom rating scales-delusion (PSYRATS-D), PSYRATS-auditory hallucinations (AH), motivation and pleasure scale-self rating (MAP-SR) and etc. The safety questionnaire was also surveyed after 1st and 8th session. Physiological measures such as skin conductance level (SCL), heart rate (HR) and RR interval, were collected during the VR interventions. Limited individuals participated in the safety questionnaire and physiological measures. All the results were presented in mean and standard deviation. We did not observe significant results in group x time interaction and main effects of group and time in the decentering and clinical scales. However, within group comparison showed that patients randomized to VBM showed increased decentering (p = 0.029) and decreased amount (p = 0.032) and duration of preoccupation (p = 0.016) in the PSYRATS-D. For the feelings and motivations about close caring relationships of the MAP-SR, we observed a significant group x time interaction (p = 0.027). The frequency of VR sickness was high but its severity was mild. There were significant differences only in HR over time in the VBM group (p = 0.01). These results suggest that VBM was not more effective in reducing decentering and psychiatric symptoms than VR control but its adversity was modest.