1
|
Soto-Rubio A, Picazo C, Gil-Juliá B, Andreu-Vaillo Y, Pérez-Marín M, Sinclair S. Patient-reported assessment of compassion in Spanish: a systematic review. Front Med (Lausanne) 2024; 11:1352694. [PMID: 39055694 PMCID: PMC11270590 DOI: 10.3389/fmed.2024.1352694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/03/2024] [Indexed: 07/27/2024] Open
Abstract
Aims and objectives This systematic review aims to: (1) explore which tools have been used in Spanish to measure compassion; (2) know which of these tools could be used to assess compassion in healthcare settings from the perspective of patients; (3) evaluate the quality of these patient-reported measures in Spanish contexts; and (4) determine which of these instruments would be best suited to be used in healthcare settings. Background Compassion has been recognized as a fundamental dimension of quality healthcare. Methods Several scientific databases were consulted for relevant records published up to December 16th, 2021. In accordance with PRISMA guidelines, 64 studies were included. Results and conclusions while existing instruments, validated in Spanish, allow for the measurement of self-compassion or compassion to others, there are no valid and reliable measures currently available in Spanish to measure patient-reported compassion. Relevance to clinical practice In order to ensure and promote compassion in the health care context, it is essential to have a valid and reliable tool to measure this construct in a patient-informed way, and this is currently not possible in the Spanish-speaking context because of the lack of such an instrument in Spanish.
Collapse
Affiliation(s)
- Ana Soto-Rubio
- Developmental and Education Psychology Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Carmen Picazo
- Psychology and Sociology Department, University of Zaragoza, Zaragoza, Spain
| | - Beatriz Gil-Juliá
- Personality, Assessment, and Psychological Treatments Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Yolanda Andreu-Vaillo
- Personality, Assessment, and Psychological Treatments Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Marian Pérez-Marín
- Personality, Assessment, and Psychological Treatments Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - Shane Sinclair
- Compassion Research Lab, Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
2
|
Zhang Z, Chen H, Li X, Chen S, Wang Z, Yang J, Chen Z, Wang X, Tian Y, Zhou J. Differences in the depression and burnout networks between doctors and nurses: evidence from a network analysis. BMC Public Health 2024; 24:1668. [PMID: 38909182 PMCID: PMC11193897 DOI: 10.1186/s12889-024-19193-3] [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: 11/13/2023] [Accepted: 06/18/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Previous studies have demonstrated a strong association between depression and job burnout among healthcare professionals, but the results have been inconsistent, and there is a lack of in-depth exploration of such a relationship among different healthcare professions. The present study aims to investigate the interrelationships between depression and burnout among Chinese healthcare professionals and whether there are differences in the networks of these symptoms between doctors and nurses. METHODS The Maslach Burnout Inventory-General Survey and the 2-item Patient Health Questionnaire were employed to assess job burnout and depression among 3,684 healthcare professionals. The translation has been refined to ensure accuracy and academic suitability. Subsequently, network analysis was conducted on 2,244 participants with a higher level of job burnout to identify core symptoms and explore the associations between job burnout and depression. RESULTS The present study showed a network association between lack of interest and pleasure in things and being exhausted from work, excessive tiredness facing work, tendency to collapse at work, and lack of passion for work than before among healthcare professionals, as well as a notable difference in the network association between lack of interest and pleasure in things and lack of passion for work than before between nurses and doctors. CONCLUSIONS The depression-burnout network structures differ between doctors and nurses, highlighting the need for targeted intervention measures for both groups.
Collapse
Affiliation(s)
- Zheng Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
| | - Hui Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
| | - Xuting Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
| | - Shurui Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
| | - Ziyu Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
| | - Jiaxin Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
| | - Zengyu Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
| | - Xiaoping Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China
| | - Yusheng Tian
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China.
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China.
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, No.139, Renmin Road Central, Changsha, Hunan, 410011, China.
| |
Collapse
|
3
|
Mathews M, Idrees S, Ryan D, Hedden L, Lukewich J, Marshall EG, Brown JB, Gill P, McKay M, Wong E, Meredith L, Moritz L, Spencer S. System-Based Interventions to Address Physician Burnout: A Qualitative Study of Canadian Family Physicians' Experiences During the COVID-19 Pandemic. Int J Health Policy Manag 2024; 13:8166. [PMID: 39099487 PMCID: PMC11365089 DOI: 10.34172/ijhpm.8166] [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: 06/14/2023] [Accepted: 05/29/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Medical professionals experienced high rates of burnout and moral distress during the COVID-19 pandemic. In Canada, burnout has been linked to a growing number of family physicians (FPs) leaving the workforce, increasing the number of patients without access to a regular doctor. This study explores the different factors that impacted FPs' experience with burnout and moral distress during the pandemic, with the goal of identifying system-based interventions aimed at supporting FP well-being and improving retention. METHODS We conducted semi-structured qualitative interviews with FPs across four health regions in Canada. Participants were asked about the roles they assumed during different stages of the pandemic, and they were also encouraged to describe their well-being, including relevant supports and barriers. We used thematic analysis to examine themes relating to FP mental health and well-being. RESULTS We interviewed 68 FPs across the four health regions. We identified two overarching themes related to moral distress and burnout: (1) inability to provide appropriate care, and (2) system-related stressors and buffers of burnout. FPs expressed concern about the quality of care their patients were able to receive during the pandemic, citing instances where pandemic restrictions limited their ability to access critical preventative and diagnostic services. Participants also described four factors that alleviated or exacerbated feelings of burnout, including: (1) workload, (2) payment model, (3) locum coverage, and (4) team and peer support. CONCLUSION The COVID-19 pandemic limited FPs' ability to provide quality care to patients, and contributed to increased moral distress and burnout. These findings highlight the importance of implementing system-wide interventions to improve FP well-being during public health emergencies. These could include the expansion of interprofessional team-based models of care, alternate remuneration models for primary care (ie, non-fee-for-service), organized locum programs, and the availability of short-term insurance programs to cover fixed practice operating costs.
Collapse
Affiliation(s)
- Maria Mathews
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Samina Idrees
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Dana Ryan
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Faculty of Nursing, Memorial University, St. John’s, NL, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Julia Lukewich
- Faculty of Nursing, Memorial University, St. John’s, NL, Canada
| | - Emily Gard Marshall
- Department of Family Medicine Primary Care Research Unit, Dalhousie University, Halifax, NS, Canada
| | - Judith Belle Brown
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Paul Gill
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | | | - Eric Wong
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Leslie Meredith
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Lauren Moritz
- Department of Family Medicine Primary Care Research Unit, Dalhousie University, Halifax, NS, Canada
| | - Sarah Spencer
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| |
Collapse
|
4
|
Hu J, Zhai M, Fu D, Duan Z, Chen X. Mediating role of loneliness and emotional disturbance in the association between childhood trauma and occupational burnout among nurses: a cross-sectional study. Front Psychiatry 2024; 15:1394289. [PMID: 38827443 PMCID: PMC11140593 DOI: 10.3389/fpsyt.2024.1394289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Background The occupational burnout status of nurses in China warrants attention. Childhood trauma, loneliness, and emotional disturbance are significant predictors of this burnout, yet few studies have delved into the underlying mechanisms. This study seeks to explore the mediating pathway from childhood trauma to loneliness, emotional disturbance, and ultimately occupational burnout among nurses through a cross-sectional analysis. Method Data for the study were collected from Yunnan province, China, from 11 July to 26 July 2022. Key variables were measured using standardized scales: the Childhood Trauma Questionnaire Short Form for childhood trauma, the three-item loneliness scale for loneliness, the Patient Health Questionnaire and the Generalized Anxiety Disorder questionnaire for emotional disturbance, and the Maslach Burnout Inventory-Human Service Survey for occupational burnout. Mediation modeling analysis was employed for data analysis to test the effect of loneliness and emotional disturbance on the association between childhood trauma and occupational burnout. Data analysis was conducted using AMOS and SPSS software. Results Loneliness and emotional disturbance fully mediated the association between childhood trauma and emotional exhaustion [indirect effect (95% CI) = 0.228 (0.196, 0.270)]. Loneliness and emotional disturbance partially mediated the association between childhood trauma [indirect effect (95% CI) = -0.020 (-0.039, 0.002)] and personal accomplishment or depersonalization [indirect effect (95% CI) = 0.221 (0.186, 0.255)]. Conclusion Childhood trauma could affect occupational burnout through loneliness and emotional disturbance among nurses. Preventive strategies could include protective interventions like treatment of loneliness and emotional disturbance, especially in nurses who experienced childhood trauma.
Collapse
Affiliation(s)
- Jing Hu
- Department of Cardiovascular, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Mengxi Zhai
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Donghui Fu
- Department of Urology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Xiangfan Chen
- Department of Biobank, Nantong First People’s Hospital, Nantong, Jiangsu, China
| |
Collapse
|
5
|
Araújo D, Bártolo A, Fernandes C, Pereira A, Monteiro S. Intervention Programs Targeting Burnout in Health Professionals: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:997-1008. [PMID: 38912141 PMCID: PMC11188645 DOI: 10.18502/ijph.v53i5.15580] [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: 06/15/2023] [Accepted: 09/10/2023] [Indexed: 06/25/2024]
Abstract
Background Burnout is an occupational syndrome, with a higher prevalence in professionals whose close involvement with other people is significant. There is a great diversity of professionals at risk of burnout, and therefore the implementation of intervention programs is relevant, as helping people to maintain their mental and emotional health enables them to become more meaningfully involved in their communities and become more effective and active global citizens. We aimed to review systematically the characteristics of interventions targeting burnout in health professionals. Methods The search was conducted in three databases: Scopus, Web of Science, and PubMed, following the PRISMA model, and 16 eligible articles were identified between 2012 and 2023. Results Mindfulness showed great efficacy in preventing burnout, by reducing stress levels and promoting empathy. In addition, relaxation and breathing techniques, yoga, and music therapy showed to improve burnout and occupational stress levels. Balint groups have also helped slow the progression of burnout. Implications about the need for future research to foster the promotion of well-being and mental health of health professionals are mentioned. Conclusion Mindfulness, relaxation and breathing techniques, yoga, music therapy and balint groups proved to be effective in preventing burnout.
Collapse
Affiliation(s)
- Diana Araújo
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Ana Bártolo
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- CINTESIS@RISE, CINTESIS.UPT, Portucalense University, Porto, Portugal
- Research in Education and Community Intervention, Piaget Institute – ISEIT/Viseu, Viseu, Portugal
- Center for Global Studies, Open University, Lisboa, Portugal
| | - Claúdia Fernandes
- CATIM -Technological Center for the Metal Working Industry, Porto, Portugal
| | - Anabela Pereira
- Department of Psychology, Colégio Pedro da Fonseca, University of Évora, Évora, Portugal
- Center for Research in Education and Psychology (CIEP), University of Évora, Évora, Portugal
- William James Center for Research – WJCR/UA, Aveiro, Portugal
| | - Sara Monteiro
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- Center for Global Studies, Open University, Lisboa, Portugal
- Department of Social Sciences and Management, Universidade Aberta, Lisboa, Portugal
| |
Collapse
|
6
|
Giaume L, Jimenez A, Kedzierewicz R, Jost D, Pery M, Trouvé J, Burlaton G, Travers S, Prunet B, Trousselard M. FIRECARE: An Evidence-Based Prevention Program to Reduce Burnout among Prehospital Caregivers: Benefits of a Combined Mindfulness, Heart Coherence Training, and Positive Psychology Intervention. PREHOSP EMERG CARE 2023; 28:342-351. [PMID: 37698362 DOI: 10.1080/10903127.2023.2258204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/07/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Burnout among emergency health care professionals is well-described, especially during the COVID-19 pandemic. Prevention interventions, such as mindfulness, focus on the management of stress. OBJECTIVE To evaluate the effects of the FIRECARE program (a mindfulness intervention, supplemented by heart coherence training and positive psychology workshops) on burnout, secondary stress, compassion fatigue, and mindfulness among advanced life support ambulance staff of the Paris Fire Brigade. MATERIALS AND METHODS We used a non-randomized, two-group quasi-experimental study design with a waitlist control and before-and-after measurements in each group. The intervention consisted of six, once-weekly, 2.5-h sessions that included individual daily meditation and cardiac coherence practice. The study compared intervention and waitlist control groups, and investigated baseline, post-program, and 3-month follow-up change on burnout (measuring using the ProQOL-5 scale) and mindfulness (measuring using the FMI scores). Baseline burnout (measured using the ProQOL-5) was evaluated and used in the analysis. RESULTS Seventy-four 74 participants volunteered to participate; 66 were included in the final analysis. Of these, 60% were classified as suffering from moderate burnout, the 'burnout cluster'. A comparison of intervention and waitlist control groups found a decrease in the burnout score in the burnout cluster (p = 0.0003; partial eta squared = 0.18). However, while secondary stress fell among the burnout cluster, it was only for participants in the intervention group; scores increased for those in the waitlist group (p = 0.003; partial eta squared = 0.12). The pre-post-intervention analysis of both groups also showed that burnout fell in the burnout cluster (p = 0.006; partial eta squared = 0.11). At 3-month follow-up, the burnout score was significantly reduced in the intervention group (p = 0.02; partial eta squared = 0.07), and both the acceptance (p = 0.007) and mindfulness scores (p = 0.05; partial eta squared = 0.05) were increased in the baseline burnout cluster. CONCLUSION FIRECARE may be a useful approach to preventing and reducing burnout among prehospital caregivers.
Collapse
Affiliation(s)
- Louise Giaume
- Emergency Medical Department, Paris Fire Brigade, Paris, France
| | | | - Romain Kedzierewicz
- Unité d'instruction et d'intervention de la Sécurité civile, Brignoles, France
| | - Daniel Jost
- Emergency Medical Department, Paris Fire Brigade, Paris, France
| | - Marie Pery
- Emergency Medical Department, Paris Fire Brigade, Paris, France
| | - Julien Trouvé
- Psychology Department, Paris Fire Brigade, Paris, France
| | | | | | - Bertrand Prunet
- Hospital of Instruction of the Armed Forces Laveran, Marseille, France
| | | |
Collapse
|
7
|
Kennelly NR, Ray S. Efficacy of a Brief Mindfulness Intervention in Underserved Individuals Receiving Inpatient Treatment for Opioid Use Disorder: A Pilot Study. Cureus 2023; 15:e40525. [PMID: 37461794 PMCID: PMC10350319 DOI: 10.7759/cureus.40525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction A mindfulness intervention is a mind-body complementary health approach that focuses on the relationships between mind, body, brain, and behavior. Mindfulness-Based Stress Reduction (MBSR) and similar mindfulness programs have been shown to decrease drug craving and relapse and improve emotional regulation, stress, pain, and anxiety. To our knowledge, a very limited number of studies have examined its efficacy in individuals from underserved populations. Underserved populations experience disparities in healthcare access, and as a result, see poorer addiction-related outcomes. The goal of this pilot study was to utilize an evidence-based, neuroscience-informed brief mindfulness intervention to improve mental health and decrease substance use behavior in a vulnerable, underserved population in New Jersey suffering from opioid use disorder (OUD). Methods We implemented a brief MBSR intervention in 15 underserved individuals undergoing inpatient medication-assisted treatment (MAT) for OUD. Individuals received weekly intervention sessions lasting one hour over six weeks. Furthermore, they practiced mindfulness for 10 minutes daily. Participants completed pre-and post-mindfulness intervention surveys to examine their mental well-being, drug craving, perceived stress, and emotional regulation. Results Within-subjects t-test results showed that compared to pre-intervention, participants showed significantly decreased perceived stress (t(14) =2.401, p=.015) and significantly decreased difficulty in emotional regulation (t(13) =3.426, p=.002 ) at post-intervention. They also showed significantly decreased drug craving post-intervention (t(14) =5.501, p=.<001). Anxiety decreased post-intervention but was not statistically significant (t(14) =1.582, p=.068). Conclusion This pilot study demonstrates that a brief mindfulness intervention can be effective for underserved individuals with OUD. Consistent with our hypothesis, results showed that a six-week mindfulness intervention could reduce everyday stress, drug craving, and difficulties in emotional regulation. In the future, a large-scale randomized control trial should be conducted with a control group to demonstrate the efficacy of this useful intervention.
Collapse
|
8
|
Tamminga SJ, Emal LM, Boschman JS, Levasseur A, Thota A, Ruotsalainen JH, Schelvis RM, Nieuwenhuijsen K, van der Molen HF. Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database Syst Rev 2023; 5:CD002892. [PMID: 37169364 PMCID: PMC10175042 DOI: 10.1002/14651858.cd002892.pub6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions. OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms. SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022. SELECTION CRITERIA We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms. DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour); 2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise); 3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above. The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended). MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised. The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants. Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention. A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar. AUTHORS' CONCLUSIONS Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.
Collapse
Affiliation(s)
- Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lima M Emal
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Julitta S Boschman
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Alice Levasseur
- Faculté des sciences de l'éducation, Université Laval, Québec, Canada
| | | | - Jani H Ruotsalainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Roosmarijn Mc Schelvis
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Henk F van der Molen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| |
Collapse
|
9
|
Luo LX, Peng X, Hou J, Xie Y, Dong H, Peng S, Ma G, Zhang J. Effects of mindfulness decompression therapy on mental health and job burnout among nurses working in the frontline of the novel coronavirus pandemic: A retrospective study. J Occup Health 2023; 65:e12398. [PMID: 37038325 PMCID: PMC10086313 DOI: 10.1002/1348-9585.12398] [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: 04/23/2022] [Revised: 12/30/2022] [Accepted: 02/25/2023] [Indexed: 04/12/2023] Open
Abstract
OBJECTIVES As the coronavirus disease 2019 (COVID-19) pandemic continues to spread worldwide, nucleic acid detection is a key step in controlling it. Psychological issues and job burnout of nurses working in nucleic acid sampling roles for long periods have become apparent. This study aimed to explore the effects of mindfulness decompression therapy on mental health and job burnout in front-line nurses working in nucleic acid sampling during the pandemic. METHODS Nucleic acid sampling frontline nurses who were positive for burnout on both the Symptom Checklist-90 (SCL-90) and the Maslach Burnout Inventory-General Scale (MBI-GS) were selected as the participants. Frontline nurses in the nucleic acid testing area who received routine psychological nursing intervention from June 2020 to April 2021 were used as the control group. Nurses who received both routine psychological nursing and mindfulness decompression therapy from May 2021 to December 2021 formed the "mindfulness" subject group. We compared the two groups' primary outcome measures of SCL-90 and MBI-GS scores. RESULTS Before the intervention, there were no significant differences between the two groups in general data, SCL-90 scores, and MBI-GS scores. After the mindfulness decompression therapy, according to SCL-90 and MBI-GS scales, psychological distress and job burnout of nurses in the mindfulness group were significantly better than those in the control group. CONCLUSION Mindfulness decompression therapy can effectively improve mental health and relieve job burnout in frontline nurses in nucleic acid sampling areas, which is worthy of clinical application. Randomized controlled trials are still needed, however, to fully confirm the effects of mindfulness decompression therapy.
Collapse
Affiliation(s)
- Ling Xia Luo
- Teaching and Research Section of Clinical NursingXiangya Hospital of Central South UniversityChangshaChina
- Emergency DepartmentXiangya Hospital of Central South UniversityChangshaChina
- National Clinical and Medical Research Center for Geriatric Diseases (Xiangya Hospital)Xiangya Hospital of Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Xiaobei Peng
- Teaching and Research Section of Clinical NursingXiangya Hospital of Central South UniversityChangshaChina
- Emergency DepartmentXiangya Hospital of Central South UniversityChangshaChina
- National Clinical and Medical Research Center for Geriatric Diseases (Xiangya Hospital)Xiangya Hospital of Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Jianmei Hou
- Teaching and Research Section of Clinical NursingXiangya Hospital of Central South UniversityChangshaChina
- Emergency DepartmentXiangya Hospital of Central South UniversityChangshaChina
- National Clinical and Medical Research Center for Geriatric Diseases (Xiangya Hospital)Xiangya Hospital of Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Yanhui Xie
- Teaching and Research Section of Clinical NursingXiangya Hospital of Central South UniversityChangshaChina
- Emergency DepartmentXiangya Hospital of Central South UniversityChangshaChina
- National Clinical and Medical Research Center for Geriatric Diseases (Xiangya Hospital)Xiangya Hospital of Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Huiqian Dong
- Teaching and Research Section of Clinical NursingXiangya Hospital of Central South UniversityChangshaChina
- Emergency DepartmentXiangya Hospital of Central South UniversityChangshaChina
- National Clinical and Medical Research Center for Geriatric Diseases (Xiangya Hospital)Xiangya Hospital of Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Sha Peng
- Teaching and Research Section of Clinical NursingXiangya Hospital of Central South UniversityChangshaChina
- Emergency DepartmentXiangya Hospital of Central South UniversityChangshaChina
- National Clinical and Medical Research Center for Geriatric Diseases (Xiangya Hospital)Xiangya Hospital of Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Guiyuan Ma
- Teaching and Research Section of Clinical NursingXiangya Hospital of Central South UniversityChangshaChina
- Emergency DepartmentXiangya Hospital of Central South UniversityChangshaChina
- National Clinical and Medical Research Center for Geriatric Diseases (Xiangya Hospital)Xiangya Hospital of Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| | - Jinghui Zhang
- Teaching and Research Section of Clinical NursingXiangya Hospital of Central South UniversityChangshaChina
- Emergency DepartmentXiangya Hospital of Central South UniversityChangshaChina
- National Clinical and Medical Research Center for Geriatric Diseases (Xiangya Hospital)Xiangya Hospital of Central South UniversityChangshaChina
- Xiangya School of NursingCentral South UniversityChangshaChina
| |
Collapse
|
10
|
Higgins MC, Siddiqui AA, Kosowsky T, Unan L, Mete M, Rowe S, Marchalik D. Burnout, Professional Fulfillment, Intention to Leave, and Sleep-Related Impairment among Radiology Trainees across the United States (US): A Multisite Epidemiologic Study. Acad Radiol 2022; 29 Suppl 5:S118-S125. [PMID: 35241358 DOI: 10.1016/j.acra.2022.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To examine the prevalence of burnout among radiology trainees in the United States, and to study the relationships between burnout and professional fulfillment (PF), intent-to-leave (ITL), sleep-related impairment and self-compassion by gender. METHODS This cross-sectional study was conducted via an anonymous electronic survey sent to 11 large academic medical centers (Physician Wellness Academic Consortium) between January 2017 and September 2018. The survey included the Professional Fulfillment Index (PFI) and an abbreviated form of the PROMIS Sleep-related impairment (SRI) scale. Two-sample t-tests and chi-square exact tests were used for analysis (p < 0.05). RESULTS Two hundred forty-seven radiology residents responded to the survey. Out of these, 36.2% reported burnout, 37.4% endorsed PF, 64.8% reported sleep-related impairment, 7.6% expressed ITL. There were no significant differences between genders. Burnout was associated with reduced PF, increased sleep-impairment (p < 0.001 for both) and increased ITL (p = 0.02). Lower PF, peer support, perceived appreciation for and meaningfulness in work, alignment of organizational and personal values, self-compassion, and higher sleep impairment were associated with burnout (p < 0.001 for all). Burnout was associated with perceptions of less support from department leaders (p = 0.003), control over schedules (p = 0.001) and helpfulness of electronic health record systems (p = 0.01). ITL was associated with reduced PF, perceived work appreciation, and leadership support (p = 0.03, p = 0.04, and p = 0.007, respectively). DISCUSSION Burnout is prevalent among radiology residents. Many demonstrate sleep-impairment and reduced professional fulfillment, with a lesser fraction desiring to leave their institution. Key factors to burnout included peer and organizational support, electronic health record systems helpfulness, and personal factors like self-compassion and work appreciation.
Collapse
|
11
|
Kashtanov A, Molotok E, Yavorovskiy A, Boyarkov A, Vasil’ev Y, Alsaegh A, Dydykin S, Kytko O, Meylanova R, Enina Y, Troitskiy V, Kapitonova M, Vaits S, Vaits T, Saleev R, Saleeva G, Saleev N. A Comparative Cross-Sectional Study Assessing the Psycho-Emotional State of Intensive Care Units' Physicians and Nurses of COVID-19 Hospitals of a Russian Metropolis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1828. [PMID: 35162851 PMCID: PMC8834761 DOI: 10.3390/ijerph19031828] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 11/16/2022]
Abstract
Working in intensive care units (ICUs) is stressful and potentially leads to various psycho-emotional disorders. Today, this issue represents a serious concern to the healthcare sector and affects the quality of healthcare provided. This study aimed to assess and compare the psycho-emotional state in COVID-19 and non-COVID-19 hospitals' ICU healthcare workers (HCWs). From January to July 2021, we conducted an anonymous cross-sectional web survey of ICU physicians and nurses (N = 1259) of various hospitals in a metropolis with a population of over 10 million people. The statistical distributions of non-COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 14.6%, average 30.8%, and high 54.6%); depersonalization levels (low 11.6%, average 16.5%, and high 71.9%); and reduced personal accomplishment levels (low 23.5%, average 40.3%, and high 36.2%). The statistical distributions of COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 16.5%, average 31.5%, and high 52%); depersonalization levels (low 7.4%, average 9.4%, and high 83.1%); and reduced personal accomplishment levels (low 25.4%, average 45.4%, and high 29.1%). This study found a strong correlation between emotional exhaustion, aggression, and depersonalization in non-COVID-19 ICU HCWs and also found a correlation between their age, aggression, emotional exhaustion, and occupational stress.
Collapse
Affiliation(s)
- Artem Kashtanov
- N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (A.K.); (A.Y.); (Y.V.); (S.D.); (O.K.); (R.M.); (V.T.)
| | - Ekaterina Molotok
- Institute of Psychological and Social Work, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia;
| | - Andrey Yavorovskiy
- N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (A.K.); (A.Y.); (Y.V.); (S.D.); (O.K.); (R.M.); (V.T.)
| | - Alexander Boyarkov
- Department of Anaesthesiology and Reanimation, City Clinical Hospital No. 40, Kommunarka, 115516 Moscow, Russia;
| | - Yuriy Vasil’ev
- N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (A.K.); (A.Y.); (Y.V.); (S.D.); (O.K.); (R.M.); (V.T.)
| | - Ali Alsaegh
- Department of General Dentistry, Belarusian Medical Academy of Postgraduate Education, 220013 Minsk, Belarus
| | - Sergey Dydykin
- N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (A.K.); (A.Y.); (Y.V.); (S.D.); (O.K.); (R.M.); (V.T.)
| | - Olesya Kytko
- N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (A.K.); (A.Y.); (Y.V.); (S.D.); (O.K.); (R.M.); (V.T.)
| | - Renata Meylanova
- N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (A.K.); (A.Y.); (Y.V.); (S.D.); (O.K.); (R.M.); (V.T.)
| | - Yulianna Enina
- E.V. Borovsky Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia;
| | - Vasiliy Troitskiy
- N.V. Sklifosovskiy Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia; (A.K.); (A.Y.); (Y.V.); (S.D.); (O.K.); (R.M.); (V.T.)
| | - Marina Kapitonova
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Kota Samarahan 94300, Sarawak, Malaysia;
| | - Sergey Vaits
- Institute of Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia; (S.V.); (T.V.)
| | - Tat’yana Vaits
- Institute of Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia; (S.V.); (T.V.)
| | - Rinat Saleev
- Faculty of Dentistry, Kazan State Medical University, 420012 Kazan, Russia; (R.S.); (G.S.); (N.S.)
| | - Gulshat Saleeva
- Faculty of Dentistry, Kazan State Medical University, 420012 Kazan, Russia; (R.S.); (G.S.); (N.S.)
| | - Nail Saleev
- Faculty of Dentistry, Kazan State Medical University, 420012 Kazan, Russia; (R.S.); (G.S.); (N.S.)
| |
Collapse
|
12
|
Epstein RM, Marshall F, Sanders M, Krasner MS. Effect of an Intensive Mindful Practice Workshop on Patient-Centered Compassionate Care, Clinician Well-Being, Work Engagement, and Teamwork. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 42:19-27. [PMID: 34459443 DOI: 10.1097/ceh.0000000000000379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Mindfulness-based interventions for health professionals have been linked to improvements in burnout, well-being, empathy, communication, patient-centered care, and patient safety, but the optimal formats and intensity of training have been difficult to determine because of the paucity of studies and the heterogeneity of programs. A 4-days residential "Mindful Practice" workshop for physicians and medical educators featuring contemplative practices, personal narratives, and appreciative dialogs about challenging experiences may hold promise in improving participants' well-being while also improving compassionate care, job satisfaction, work engagement, and teamwork. METHODS We collected baseline and 2-month follow-up data during four workshops conducted in 2018 to 2019 at conference centers in the United States and Europe. Primary outcomes were burnout, work-related distress, job satisfaction, work engagement, patient-centered compassionate care, and teamwork. RESULTS Eighty-five of 120 participants (71%) completed both surveys (mean age was 49.3 and 68.2% female). There were improvements (P < .01) in two of three burnout components (emotional exhaustion and depersonalization), work-related distress, job satisfaction, patient-centered compassionate care, work engagement and meaning, teamwork, well-being, positive emotion, mindfulness, somatic symptoms, and spirituality. Effect sizes (standardized mean difference of change) ranged from 0.25 to 0.61. With Bonferroni adjustments (P < .0031), teamwork, general well-being, and mindfulness became nonsignificant. DISCUSSION An intensive, multiday, mindfulness-based workshop for physicians had clinically significant positive effects on clinician well-being, quality of interpersonal care and work satisfaction, and meaning and engagement, all important indicators of improved health and sustainability of the health care workforce. Future iterations of the program should increase the focus on teamwork.
Collapse
Affiliation(s)
- Ronald M Epstein
- Mr. Epstein: Professor of Family Medicine, Oncology and Medicine (Palliative Care), and American Cancer Society's Clinical Research Professor, Codirector, Center for Communication and Disparities Research, Departments of Family Medicine and Medicine and the Wilmot Cancer Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY. Mr. Marshall: Professor, Department of Neurology, Division of Geriatric Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY. Mr. Sanders: Senior Instructor, Department of Family Medicine, Center for Communication and Disparities Research, University of Rochester School of Medicine and Dentistry, Rochester, NY. Mr. Krasner: Professor of Clinical Medicine and Clinical Family Medicine, Departments Medicine and Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | | | | |
Collapse
|
13
|
Santamaría-Peláez M, González-Bernal JJ, Verdes-Montenegro-Atalaya JC, Pérula-de Torres LÁ, Roldán-Villalobos A, Romero-Rodríguez E, Hachem Salas N, Magallón Botaya R, González-Navarro TDJ, Arias-Vega R, Valverde FJ, Jiménez-Barrios M, Mínguez LA, León-del-Barco B, Soto-Cámara R, González-Santos J. Mindfulness-Based Program for Anxiety and Depression Treatment in Healthcare Professionals: A Pilot Randomized Controlled Trial. J Clin Med 2021; 10:jcm10245941. [PMID: 34945237 PMCID: PMC8708843 DOI: 10.3390/jcm10245941] [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: 11/10/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
In primary health care, the work environment can cause high levels of anxiety and depression, triggering relevant expert and individual change. Mindfulness-Based Stress Reduction (MBSR) programs reduce signs of anxiety and depression. The purpose of this sub-analysis of the total project, was to equate the effectiveness of the standard MBSR curriculum with the abbreviated version in minimizing anxiety and depression. This randomized controlled clinical trial enrolled 112 mentors and resident specialists from Family and Community Medicine and Nurses (FCMN), distributed across six teaching units (TU) of the Spanish National Health System (SNHS). Experimental group participants received a MBRS training (abbreviated/standard). Depression and anxiety levels were measured with the Goldberg Anxiety and Depression Scale (GADS) at three different time periods during the analysis: before (pre-test) and after (post-test) participation, as well as 3 months after the completion of intervention. Taking into account the pre-test scores as the covariate, an adjusted analysis of covariance (ANCOVA) showed significant depletion in anxiety and depression in general (F (2.91) = 4.488; p = 0.014; η2 = 0.090) and depression in particular (F (2, 91) = 6.653; p = 0.002; η2 = 0.128 at the post-test visit, maintaining their effects for 3 months (F (2.79) = 3.031; p = 0.050; η2 = 0.071-F (2.79) = 2.874; p = 0.049; η2 = 0.068, respectively), which is associated with the use of a standard training program. The abbreviated training program did not have a significant effect on the level of anxiety and depression. The standard MBSR training program had a positive effect on anxiety and depression and promotes long-lasting effects in tutors and resident practitioners. New research is needed to demonstrate the effectiveness of abbreviated versions of training programs.
Collapse
Affiliation(s)
- Mirian Santamaría-Peláez
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
| | - Jerónimo Javier González-Bernal
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
- Correspondence: (J.J.G.-B.); (J.G.-S.)
| | | | - Luis Ángel Pérula-de Torres
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | - Ana Roldán-Villalobos
- Carlos Castilla del Pino Health Center, Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | - Esperanza Romero-Rodríguez
- Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | | | - Rosa Magallón Botaya
- IIS-Aragon—Group B21-R17, Family and Community Medicine Teaching Department of Zaragoza Sector 1, Institute of Health Carlos III—REDIAPP 06/18, University of Zaragoza, 50018 Zaragoza, Spain;
| | | | - Raquel Arias-Vega
- Castello Health Center (Madrid), Institute Maimónides of Research Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | | | - María Jiménez-Barrios
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
| | | | - Benito León-del-Barco
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, 10071 Caceres, Spain;
| | - Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
| | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (M.S.-P.); (M.J.-B.); (R.S.-C.)
- Correspondence: (J.J.G.-B.); (J.G.-S.)
| |
Collapse
|
14
|
Sekhar P, Tee QX, Ashraf G, Trinh D, Shachar J, Jiang A, Hewitt J, Green S, Turner T. Mindfulness-based psychological interventions for improving mental well-being in medical students and junior doctors. Cochrane Database Syst Rev 2021; 12:CD013740. [PMID: 34890044 PMCID: PMC8664003 DOI: 10.1002/14651858.cd013740.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Mindfulness interventions are increasingly popular as an approach to improve mental well-being. To date, no Cochrane Review examines the effectiveness of mindfulness in medical students and junior doctors. Thus, questions remain regarding the efficacy of mindfulness interventions as a preventative mechanism in this population, which is at high risk for poor mental health. OBJECTIVES: To assess the effects of psychological interventions with a primary focus on mindfulness on the mental well-being and academic performance of medical students and junior doctors. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and five other databases (to October 2021) and conducted grey literature searches. SELECTION CRITERIA: We included randomised controlled trials of mindfulness that involved medical students of any year level and junior doctors in postgraduate years one, two or three. We included any psychological intervention with a primary focus on teaching the fundamentals of mindfulness as a preventative intervention. Our primary outcomes were anxiety and depression, and our secondary outcomes included stress, burnout, academic performance, suicidal ideation and quality of life. DATA COLLECTION AND ANALYSIS: We used standard methods as recommended by Cochrane, including Cochrane's risk of bias 2 tool (RoB2). MAIN RESULTS: We included 10 studies involving 731 participants in quantitative analysis. Compared with waiting-list control or no intervention, mindfulness interventions did not result in a substantial difference immediately post-intervention for anxiety (standardised mean difference (SMD) 0.09, 95% CI -0.33 to 0.52; P = 0.67, I2 = 57%; 4 studies, 255 participants; very low-certainty evidence). Converting the SMD back to the Depression, Anxiety and Stress Scale 21-item self-report questionnaire (DASS-21) showed an estimated effect size which is unlikely to be clinically important. Similarly, there was no substantial difference immediately post-intervention for depression (SMD 0.06, 95% CI -0.19 to 0.31; P = 0.62, I2 = 0%; 4 studies, 250 participants; low-certainty evidence). Converting the SMD back to DASS-21 showed an estimated effect size which is unlikely to be clinically important. No studies reported longer-term assessment of the impact of mindfulness interventions on these outcomes. For the secondary outcomes, the meta-analysis showed a small, substantial difference immediately post-intervention for stress, favouring the mindfulness intervention (SMD -0.36, 95% CI -0.60 to -0.13; P < 0.05, I2 = 33%; 8 studies, 474 participants; low-certainty evidence); however, this difference is unlikely to be clinically important. The meta-analysis found no substantial difference immediately post-intervention for burnout (SMD -0.42, 95% CI -0.84 to 0.00; P = 0.05, I² = 0%; 3 studies, 91 participants; very low-certainty evidence). The meta-analysis found a small, substantial difference immediately post-intervention for academic performance (SMD -0.60, 95% CI -1.05 to -0.14; P < 0.05, I² = 0%; 2 studies, 79 participants; very low-certainty evidence); however, this difference is unlikely to be clinically important. Lastly, there was no substantial difference immediately post-intervention for quality of life (mean difference (MD) 0.02, 95% CI -0.28 to 0.32; 1 study, 167 participants; low-certainty evidence). There were no data available for three pre-specified outcomes of this review: deliberate self-harm, suicidal ideation and suicidal behaviour. We assessed the certainty of evidence to range from low to very low across all outcomes. Across most outcomes, we most frequently judged the risk of bias as having 'some concerns'. There were no studies with a low risk of bias across all domains. AUTHORS' CONCLUSIONS: The effectiveness of mindfulness in our target population remains unconfirmed. There have been relatively few studies of mindfulness interventions for junior doctors and medical students. The available studies are small, and we have some concerns about their risk of bias. Thus, there is not much evidence on which to draw conclusions on effects of mindfulness interventions in this population. There was no evidence to determine the effects of mindfulness in the long term.
Collapse
Affiliation(s)
- Praba Sekhar
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Qiao Xin Tee
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Gizem Ashraf
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Darren Trinh
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Jonathan Shachar
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Jiang
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Jack Hewitt
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Sally Green
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Tari Turner
- Cochrane Australia, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|
15
|
Effectiveness of a Mindfulness and Self-Compassion Standard Training Program versus an Abbreviated Training Program on Stress in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910230. [PMID: 34639532 PMCID: PMC8507764 DOI: 10.3390/ijerph181910230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 12/18/2022]
Abstract
Stress is one of the most common problems among healthcare professionals, as they are exposed to potentially stressful and emotionally challenging situations in the workplace. Mindfulness-based stress reduction (MBSR) training programs have been shown to decrease stress. The objective of this study was to compare the effectiveness of an abbreviated 4-weeks MBSR training program in relation to a standard 8-weeks one on the stress levels. A controlled and randomized clinical trial was designed, in which 112 tutors and resident intern specialists in Family and Community Medicine and Nursing of six Spanish National Health System teaching units (TUs) participated. Participants included in the experimental groups (EGs) received a MBRS training program (standard or abbreviated), while control group (CG) participants did not receive any intervention. The stress levels were assessed by the Perceived Stress Questionnaire (PSQ) in three different moments during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant reduction in stress (F(2,91) = 5.165; p = 0.008; η2 = 0.102) in the post-test visit, attributable to the implementation of the standard training program, but without the maintenance of its effects over time. No significant impact of the abbreviated training program on stress levels was observed in the intergroup comparison. A standard 8-weeks MBSR training program aimed at tutors and resident intern specialists in Family and Community Medicine and Nursing produces significant improvements in stress levels compared with the abbreviated intervention and no intervention. New studies about abbreviated training programs are needed to provide effective treatments which improve well-being of these professionals.
Collapse
|
16
|
Jung SE, Ha DJ, Park JH, Lee B, Kim MS, Sim KL, Choi YH, Kwon CY. The Effectiveness and Safety of Mind-Body Modalities for Mental Health of Nurses in Hospital Setting: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8855. [PMID: 34444604 PMCID: PMC8393251 DOI: 10.3390/ijerph18168855] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/18/2022]
Abstract
The mental health of nurses including burnout is an important issue. The purpose of this systematic review was to evaluate whether mind-body modalities improve burnout and other mental health aspects of nurses. A comprehensive search was conducted using six electronic databases. Randomized controlled trials using mind-body modalities on the mental health of nurses, up to January 2021, were included. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool. Seventeen studies were included in the review. Data on mindfulness-based interventions (MBIs) and yoga were available for burnout, and there was no evidence that multimodal resilience programs including MBIs statistically significantly improved burnout levels compared to no intervention or active control groups. However, one study reported that yoga could significantly improve emotional exhaustion and depersonalization, which are subscales of burnout, compared to usual care. In addition, the effects of MBIs, relaxation, yoga, and music on various mental health outcomes and stress-related symptoms have been reported. In conclusion, there was some evidence that yoga was helpful for improvement in burnout of nurses. However, due to the heterogeneity of interventions and outcomes of the studies included, further high-quality clinical trials are needed on this topic in the future.
Collapse
Affiliation(s)
- Su-Eun Jung
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Da-Jung Ha
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Jung-Hyun Park
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Boram Lee
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon 34054, Korea;
| | - Myo-Sung Kim
- Department of Nursing, College of Nursing, Healthcare Sciences & Human Ecology, Dong-eui University, Busan 47340, Korea;
| | - Kyo-Lin Sim
- Department of Music, Graduate School, Pyeongtaek University, Pyeongtaeksi 17869, Gyeonggi-do, Korea;
| | - Yung-Hyun Choi
- Department of Biochemistry, College of Korean Medicine, Dong-eui University, Busan 47227, Korea;
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-eui University, Busan 47227, Korea
| |
Collapse
|
17
|
Abdollahi A, Taheri A, Allen KA. Perceived stress, self-compassion and job burnout in nurses: the moderating role of self-compassion. J Res Nurs 2021; 26:182-191. [PMID: 35251240 PMCID: PMC8894998 DOI: 10.1177/1744987120970612] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Job burnout is more prevalent among nurses than other medical team members and may have adverse effects on the mental and physical health of both nurses and their patients. AIMS To evaluate the associations between job burnout as a dependent variable with perceived stress and self-compassion as independent variables, and test the buffering role of self-compassion in the link between perceived stress and job burnout in nurses. METHODS This is a cross-sectional study with a convenience sampling method. A total of 150 nurses from four hospitals in Tehran, Iran participated in this study and completed three questionnaires, namely the Perceived Stress Scale, the Self-Compassion Scale and the Copenhagen Burnout Inventory. RESULTS Partial least square-structural equation modelling showed greater levels of perceived stress associated with greater levels of job burnout (β = 0.795, p < 0.001), and greater levels of self-compassion associated with lower levels of job burnout (β = -0.512, p < 0.001) in nurses. The results of the interaction-moderation analysis showed that self-compassion diminished the effect of perceived stress on job burnout in nurses. CONCLUSIONS The results of this study not only showed a significant association between perceived stress and job burnout in nurses, but also increased our understanding about the buffering role of self-compassion in the link between perceived stress and job burnout in nurses.
Collapse
Affiliation(s)
- Abbas Abdollahi
- Abbas Abdollahi, Department of Counselling, Faculty of Education and Psychology, Alzahra University, Tehran, Post code: 1993893973, Iran.
| | - Azadeh Taheri
- PhD Student, Department of Counselling, Alzahra University, Iran
| | | |
Collapse
|
18
|
Vitale E. The Mindfulness and the Emotional Regulation Skills in Italian Nurses During the COVID-19 Pandemic: A Descriptive Survey-Correlational Study. J Holist Nurs 2021; 39:345-355. [PMID: 34048291 DOI: 10.1177/08980101211015804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose: To analyze the differences in mindfulness level and emotional regulation skills, as cognitive reappraisal and expressive suppression subdimensions, according to sex and years of work experience in a sample of Italian nurses directly involved in the care of coronavirus disease 2019 (COVID-19) patients. Then, correlations were also performed in order to evidence relationships between the mindfulness tendency and the emotional regulation skills, both in cognitive reappraisal and expressive suppression, too. Design of study: Descriptive correlational study. Methods: In June 2020, an online questionnaire was administered. Data relating to sex and years of work experience, the Mindfulness Attention Awareness Scale (MAAS), and the Emotion Regulation Questionnaire (ERQ) in the cognitive reappraisal and expressive suppression subdimensions were collected. Findings: Two hundred nurses were enrolled. Males recorded higher MAAS values compared to females (p = .001). No significant differences were registered in the MAAS scores according to years of work experience and regarding the ERQ subscales according to sex and work of experience, too. Also, any correlations were reported between MAAS and ERQ subscales. Conclusions: Future training on the basic principles of mindfulness and Emotion Regulation were considered a priority in nurses to better self-modulate their own beings, particularly during the pandemic period.
Collapse
|
19
|
Schwill S, Krug K, Valentini J, Rentschler A, Nikendei C, Szecsenyi J, Bugaj TJ. How to strengthen basic competencies in self-care - a pre-post interventional study with postgraduate trainees in family medicine in Germany. Postgrad Med 2021; 133:572-580. [PMID: 33843446 DOI: 10.1080/00325481.2021.1916298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Self-care includes taking care of our psychosocial health. Many experts agree that self-care should be included in training for Family Medicine (FM) residents, though it is unclear to what extent and by what means. Objective: The aim of this study was to evaluate competencies of FM residents in self-care and changes in knowledge, skills and attitudes after an educational compact intervention.Methods: The authors performed a pre-post comparison on residents who were registered in the FM residency program KWBW VerbundweiterbildungPLUS© (n = 401). FM residents were offered participation in a self-care training (270 minutes featuring a broad spectrum of input and practical experience). The intervention group (IG) completed a questionnaire directly before the seminar (T1) and 10 weeks afterwards (T2). Non-attendees (=control group; CG) were asked to fill out a basic questionnaire once. Basic questionnaires for IG and CG covered previous experiences and skills while the follow-up questionnaire at T2 also focused on change of competencies and attitudes. All questionnaires contained free-text questions to capture qualitative impressions.Results: 287 FM residents (IG: n = 212; CG: n = 75) participated in the study. Generally, 86.4% of FM residents had worried that their profession might endanger their personal health (T1: n = 180, CG: n = 68). At T2, 59.5% of IG (n = 66/111) declared that they would not worry about their personal health anymore (T1:T2, p < .01). IG learned to facilitate time for recreation (T1:T2, p = .04) and to use relaxation techniques (T1:T2, p = .01). Gain in competence was described in awareness of stress, self-reward, activation of personal resources, and time management. A total of 85.6% of IG reflected their attitudes towards psychosocial health of physicians in general (n = 95/111) and 22.5% of IG changed the views on their own health (n = 25/111) in terms of improved risk-awareness, increased intention for self-care and change of behavior.Conclusion: A compact intervention in self-care strengthens competencies, increases awareness, and helps FM residents identify their psychosocial health risks. Further research is necessary to specify the effectiveness of similar compact interventions in self-care and their long-term results.
Collapse
Affiliation(s)
- S Schwill
- Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany
| | - K Krug
- Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany
| | - J Valentini
- Institute of General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - A Rentschler
- Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany
| | - C Nikendei
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - J Szecsenyi
- Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany
| | - T J Bugaj
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| |
Collapse
|
20
|
Wu X, Hayter M, Lee AJ, Zhang Y. Nurses' experiences of the effects of mindfulness training: A narrative review and qualitative meta-synthesis. NURSE EDUCATION TODAY 2021; 100:104830. [PMID: 33684834 DOI: 10.1016/j.nedt.2021.104830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/18/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore nurses' experiences of the effects of undertaking mindfulness training. DESIGN Qualitative meta-synthesis. DATA SOURCES Qualitative literature from seven scientific databases: Pubmed, Cochran Library, Science Direct, EBSCO, Web of Science, Scopus and PsycINFO were searched. REVIEW METHODS The PRISMA flow diagram was used to report the phases of the literature search. The Critical Appraisal Skills Program (CASP) qualitative research checklist, and the Mixed-Methods Appraisal Tool (MMAT) for mixed method studies were used as appraisal framework. Data synthesis was conducted using Thematic synthesis. The review steps were guided by Adams, Chamberlain, & Giles, 2019 and Whittemore & Knafl, 2005. RESULTS 4 qualitative studies and 3 mixed-methods studies were included in the review. Four interpretive themes were generated to show how nurses experience of the effects of mindfulness training: 1. Stress conceptualisation and management; 2. Nurses' valued aspects of mindfulness training strategies; 3. Self-care awareness and strategies; 4. Challenges of mindfulness training. CONCLUSION Conducting mindfulness-based interventions among nursing professionals helps to reduce work-related stress and has positive effects on work and life.
Collapse
Affiliation(s)
- Xiaxin Wu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Mark Hayter
- Faculty of Health Science, University of Hull, Cottingham Road, Hull, HU6 7RX Hull, UK.
| | - Amanda J Lee
- Faculty of Health Science, University of Hull, Cottingham Road, Hull, HU6 7RX Hull, UK
| | - Yu Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| |
Collapse
|
21
|
Pérula-de Torres LÁ, Verdes-Montenegro-Atalaya JC, Melús-Palazón E, García-de Vinuesa L, Valverde FJ, Rodríguez LA, Lietor-Villajos N, Bartolomé-Moreno C, Moreno-Martos H, García-Campayo J, González-Santos J, Rodríguez-Fernández P, León-del-Barco B, Soto-Cámara R, González-Bernal JJ. Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4340. [PMID: 33923868 PMCID: PMC8073262 DOI: 10.3390/ijerph18084340] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022]
Abstract
Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.
Collapse
Affiliation(s)
- Luis Ángel Pérula-de Torres
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, Institute Maimónides of Research Córdoba (Imibic), Reina Sofía University Hospital, University of Córdoba, 14001 Cordoba, Spain;
| | | | - Elena Melús-Palazón
- Family and Community Medicine Teaching Department of Zaragoza Sector 1, 5018 Zaragoza, Spain; (E.M.-P.); (C.B.-M.)
| | - Leonor García-de Vinuesa
- Multi-Professional Teaching Unit for Family and Community Care of Córdoba, Healthcare District of Córdoba and Guadalquivir, 14001 Córdoba, Spain;
| | | | - Luis Alberto Rodríguez
- Family and Community Medicine Teaching Department of Ponferrada, Ponferrada, 24400 León, Spain;
| | - Norberto Lietor-Villajos
- Family and Community Medicine Teaching Department of Jaen, 23007 Jaen, Spain; (F.J.V.); (N.L.-V.)
| | - Cruz Bartolomé-Moreno
- Family and Community Medicine Teaching Department of Zaragoza Sector 1, 5018 Zaragoza, Spain; (E.M.-P.); (C.B.-M.)
| | - Herminia Moreno-Martos
- Multi-Professional Teaching Unit for Family and Community Care of Almería, 04009 Almería, Spain;
| | | | - Josefa González-Santos
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (P.R.-F.); (J.J.G.-B.)
| | | | - Benito León-del-Barco
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, 10071 Caceres, Spain;
| | - Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (P.R.-F.); (J.J.G.-B.)
| | | | | |
Collapse
|
22
|
Ortega-Campos E, Cañadas-De la Fuente GA, Albendín-García L, Gómez-Urquiza JL, Monsalve-Reyes C, de la Fuente-Solana EI. A Multicentre Study of Psychological Variables and the Prevalence of Burnout among Primary Health Care Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3242. [PMID: 31487862 PMCID: PMC6788181 DOI: 10.3390/ijerph16183242] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/02/2019] [Accepted: 09/03/2019] [Indexed: 02/06/2023]
Abstract
Nurses in primary health care (PHC) have multiple responsibilities but must often work with limited resources. The study's aim was to estimate burnout levels among PHC nurses. A Quantitative, observational, cross-sectional, multicentre study of 338 nurses working in PHC in the Andalusian Public Health Service (Spain) is presented. A total of 40.24% of the nurses studied had high levels of burnout. The dimensions of emotional exhaustion and depersonalisation were significantly associated with anxiety, depression, neuroticism, on-call duty and seniority-profession and inversely related to agreeableness. In addition, depersonalisation was significantly associated with gender, and emotional exhaustion correlated inversely with age. Personal achievement was inversely associated with anxiety and depression and positively correlated with agreeableness, extraversion and responsibility. There is a high prevalence of burnout among nurses in PHC. Those most likely to suffer burnout syndrome are relatively young, suffer from anxiety and depression and present high scores for neuroticism and low ones for agreeableness, responsibility and extraversion.
Collapse
Affiliation(s)
- Elena Ortega-Campos
- Faculty of Psychology, University of Almería. Carretera de Sacramento s/n, 04120 Almería, Spain.
| | | | - Luis Albendín-García
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 18016 Granada, Spain.
| | - José L Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 18016 Granada, Spain.
| | - Carolina Monsalve-Reyes
- Departamento de Ciencias Sociales, Universidad Católica de La Santísima Concepción, Avenida Alonso de Ribera, 2850 Concepción, Chile.
| | - E Inmaculada de la Fuente-Solana
- Brain, Mind and Behaviour Research Center (CIMCYC), University of Granada, Campus Universitario de Cartuja, 18071 Granada, Spain.
| |
Collapse
|
23
|
Meng R, Yu Y, Chai S, Luo X, Gong B, Liu B, Hu Y, Luo Y, Yu C. Examining psychometric properties and measurement invariance of a Chinese version of the Self-Compassion Scale - Short Form (SCS-SF) in nursing students and medical workers. Psychol Res Behav Manag 2019; 12:793-809. [PMID: 31565007 PMCID: PMC6722437 DOI: 10.2147/prbm.s216411] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/15/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Self-compassion has been regarded as a key psychological construct and a protective factor of mental health status. The focus of the present study was to adapt the Self-Compassion Scale (SCS) into Chinese, assess the validity and reliability of the measure and test measurement invariance (MI) across nursing students and medical workers. METHODS The current study assessed the psychometric properties and invariance of the SCS-Short Form (SCS-SF) in two samples of 2676 from nursing students and medical workers. For construct validity, confirmatory and exploratory factor analyses (CFAs and EFAs) were conducted. Using Perceived Stress Questionnaire , Short Form-8 Health Survey (SF-8) and Goldberg Anxiety and Depression Scale, we evaluated concurrent validity and convergent/divergent validity. For reliability, internal consistency and test-retest analysis were employed. Multi-group analyses were conducted to examine MI of the different SCS-models across populations. RESULTS CFA showed that the proposed six-factor second-order model could not be replicated and the six-factor first-order model was a reasonable to mediocre fitting model in both samples. EFA supported a three-factor structure which consisted of one positive and two negative factors. CFA confirmed that the hypothesized three-factor structure with 10 items ultimately was considered as the optimal model on the fitted results. The SCS-SF-10 (10 items form) also demonstrated acceptable internal consistency and test-retest reliability, as well as strong concurrent validity with measures of stress perception, health status, anxious and depressive symptoms. Convergent/divergent validity was not satisfactory. Multi-group CFAs provided support for the validity of the established models. CONCLUSION The Chinese version of the SCS-SF-10 has sound psychometric properties and can be applied to efficiently assess self-compassion in Chinese-speaking populations. The current study contributes to the identification and measurement of self-compassion after adversities.
Collapse
Affiliation(s)
- Runtang Meng
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan430071, People’s Republic of China
- Centre of Health Administration and Development Studies, Hubei University of Medicine, Shiyan442000, People’s Republic of China
| | - Yong Yu
- Centre of Health Administration and Development Studies, Hubei University of Medicine, Shiyan442000, People’s Republic of China
- School of Public Health and Management, Hubei University of Medicine, Shiyan442000, People’s Republic of China
| | - Shouxia Chai
- School of Nursing, Hubei University of Medicine, Shiyan442000, People’s Republic of China
| | - Xiangyu Luo
- Department of Cardiothoracic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan442000, People’s Republic of China
| | - Boxiong Gong
- Department of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan442000, People’s Republic of China
| | - Bing Liu
- Centre of Health Administration and Development Studies, Hubei University of Medicine, Shiyan442000, People’s Republic of China
- School of Public Health and Management, Hubei University of Medicine, Shiyan442000, People’s Republic of China
| | - Ying Hu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan430071, People’s Republic of China
- Global Health Institute, Wuhan University, Wuhan430072, People’s Republic of China
| | - Yi Luo
- School of Nursing, Ningbo College of Health Sciences, Ningbo315100, People’s Republic of China
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan430071, People’s Republic of China
- Global Health Institute, Wuhan University, Wuhan430072, People’s Republic of China
| |
Collapse
|
24
|
Luo Y, Meng R, Li J, Liu B, Cao X, Ge W. Self-compassion may reduce anxiety and depression in nursing students: a pathway through perceived stress. Public Health 2019; 174:1-10. [PMID: 31265974 DOI: 10.1016/j.puhe.2019.05.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/11/2019] [Accepted: 05/14/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Nursing students report high levels of anxiety and depression, which requires urgent attention. A growing amount of evidence indicates that self-compassion may indirectly (through perceived stress) and directly influence anxiety and depression, yet the research to date has not fully examined the reasons for this association. The present study examines the effects of self-compassion on anxiety and depression through perceived stress and may thus provide an innovative starting point for developing effective interventions for affected nursing students. STUDY DESIGN This is a cross-sectional study. METHODS Using structural equation modelling (SEM), we estimated the strength of the pathways between self-compassion, perceived stress and anxiety and depression among 1453 nursing students in Ningbo, China. The measurements included demographics, the Self-Compassion Scale-Short Form, the Chinese version of the Perceived Stress Questionnaire and the Goldberg Anxiety and Depression Scale. RESULTS Nursing students had an average score of 4.50 ± 2.44 on the Goldberg Anxiety Scale (GAS) and 3.58 ± 2.34 on the Goldberg Depression Scale (GDS), indicating high levels of anxiety and depression. The GAS and GDS scores were significantly different by the academic year, part-time employment and career prospects. The average scores for self-compassion and perceived stress were 38.99 ± 4.55 and 0.40 ± 0.14, respectively. The SEM results suggested that self-compassion was negatively associated with anxiety and depression (-0.44, P < 0.001). Perceived stress was positively associated with anxiety and depression (0.64, P < 0.001). Self-compassion was negatively associated with perceived stress (-0.65, P < 0.001). Self-compassion had no significant correlation with anxiety and depression in the effect of perceived stress (-0.14, P = 0.127). Thus, self-compassion indirectly influences anxiety and depression through perceived stress. CONCLUSIONS Self-compassion might reduce nursing students' anxiety and depression through perceived stress. Interventionists can consider using self-compassion training to alleviate perceived stress, anxiety and depression in nursing students.
Collapse
Affiliation(s)
- Y Luo
- School of Nursing, Ningbo College of Health Sciences, PR China
| | - R Meng
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, PR China; Center of Health Administration and Development Studies, Hubei University of Medicine, PR China.
| | - J Li
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, USA
| | - B Liu
- Center of Health Administration and Development Studies, Hubei University of Medicine, PR China.
| | - X Cao
- School of Nursing, Ningbo College of Health Sciences, PR China
| | - W Ge
- School of Nursing, Ningbo College of Health Sciences, PR China
| |
Collapse
|