Effects of Mindfulness-Based Stress Reduction on employees' mental health: A systematic review

Workplace-related determinants of mental health in food and bar workers in Western, high-income countries: A systematic review

BACKGROUND

This review synthesizes evidence from etiologic and intervention studies of workplace-related determinants of mental health in workers in food and bar workers in the hospitality industry in Western high-income countries.

METHODS

Peer-reviewed literature published between January 2000 and August 2023 was gathered from five bibliographic databases. Any study design was eligible. Study quality was assessed using the Joanna Briggs Institute tools for appraisal.

RESULTS

A narrative analysis was conducted for 26 included studies (total n = 15,069 participants) across Australia (3), Ireland (1), Norway (1), Spain (2), the United States (17) and the United Kingdom (2). Individual and task-related factors such as high emotional job demands and low job control were associated with high burnout and depression. Uncivil and hostile interpersonal interactions with customers, management, and colleagues were found to contribute to poor mental health outcomes, including depression, anxiety, and burnout.

CONCLUSION

Findings from included studies highlight the impact of workplace culture, including management practices and workplace social support, on mental health. Organization-level interventions may therefore be most effective for addressing individual, interpersonal, and organizational determinants of mental health in food and bar occupations, particularly when implemented as part of broader organizational efforts to support health and wellbeing. Industry-wide policy changes may also be necessary to address structural concerns, including job and financial insecurity, job strain and access to benefits, such as secure sick leave and minimum contract hours.

Effects of mindfulness-based stress reduction programs on Nurses' perceived stress levels

INTRODUCTION

Poor quality of care and patient safety, adverse patient outcomes, high rates of burnout and turnover, and increased job dissatisfaction are all linked to uncontrolled stress among nurses. Unmanaged nurse stress can lead to disorganized thinking, decreased ability to focus and concentrate, and can put patients at risk. The purpose of the integrative review was to determine the effects of a mindfulness-based stress reduction (MBSR) program to reduce the perceived stress levels of nurses.

RESEARCH METHODOLOGY

Included was a search of databases using key search terms and inclusion and exclusion criteria. Relevant peer-reviewed articles within the last five years were appraised to identify similarities and differences. This paper discusses the implications of unresolved stress on nurses and patients they care for including quality and safety of patient care, cost of nurse turnover rates related to stress, and poor work efficiency.

RESULTS AND DISCUSSION

Literature results suggest that implementation of a mindfulness-based stress reduction (MBSR) program leads to a reduction in perceived stress levels among nurses resulting in improved patient outcomes, increased job satisfaction, and reduction of organizational costs associated with the hiring and onboarding process.

CONCLUSIONS AND FURTHER RECOMMENDATIONS

It is the conclusion of this integrative review that implementation of a MBSR program leads to improvements in stress reduction and indirectly positively impacts patient outcomes. It is recommended that organizations implement a formal eight-week mindfulness-based stress reduction program.

MBSR IMPLEMENTATION RESOURCES

There are no conflicts of interest or financial gains for the recommendations for MBSR implementation resources. These resources are solely provided for additional learning and implementation purposes. There are both free resources and for purchase resources available that guides implementation and operationalization of the MBSR program.

Effectiveness of meditation on wellness management among corporate employees in India: An interventional study

Background and Aims

Urban corporate sector relies heavily on workplace well-being, with meditation being a potent stress reduction method that significantly enhances the quality of life (QoL) and wellness. The study aims to assess the effectiveness of meditation on wellness management among corporate employees in India.

Methods

The quasi-experimental controlled study design was employed from May to June 2021, which assessed stress, QoL, and wellness indices (satisfaction with life, well-being) with meditation practice as the intervention. The online questionnaire incorporates questions from the Depression, Anxiety, Stress Scale, World Health Organization (WHO) QoL Scale, Five-item Satisfaction with Life scale and WHO-5 Well-being Index. A nonrandom sampling technique selected 146 and 74 subjects in the intervention and control groups, respectively, among the employees of Star health- and allied insurance company. The data was analyzed using SPSS V27 (©IBM SPSS Statistics). The Wilcoxon signed rank test for the dependent groups, and Mann-Whitney U test for the independent groups (between subjects) was performed.

Results

Among a total of 220 subjects who enrolled in the recruitment survey, 146 subjects underwent the intervention thus providing a response rate of 66.4%. For the intervention group, the difference (within group) in mean scores between baseline and endline assessment shows a reduction in stress (0.02) and significant improvement in QoL (0.21) and wellness indices (satisfaction with life: 0.21, well-being: 0.24). The difference (between the experimental and control groups) in mean endline scores shows a decrease in stress (0.07), an increase in wellness indices (satisfaction with life: 0.12, well-being: 0.23), and a significant change in the QoL (0.17).

Conclusion

Meditation intervention in corporate wellness programs enhances the QoL, wellness, and stress management, establishing the effectiveness of health profile-raising ingenuities at the workplace.

Pilot study of an online brief mindfulness-based intervention to improve the well-being of managers and reduce their stress at work

Objectives. The COVID-19 pandemic, remote work and new technologies have heightened workplace pressures. Effective response and essential organizational changes require business leaders to be more adaptable, with managers' presence playing a pivotal role in successful implementation. The study assesses a brief mindfulness-based emotional regulation for managers (MBERM) intervention, to reduce workplace stress and enhance managerial well-being. Methods. An 8-week non-randomized controlled trial was conducted with a waiting list control group and an intervention group. Pre-post differences were measured by Student's t test or Wilcoxon test, and effect size calculated using the Hedge's g formula. The sample included 23 managers (17 men and six women) with average age 50 years. The study assessed anxiety and depressive symptoms, psychological flexibility, perceived self-efficacy, general work-related well-being, perceived stress and mindfulness. Results. Statistically significant changes were observed in the intervention group in depression, anxiety, work-related acceptance and action, general self-efficacy, exhaustion, alienation, stress and non-reactivity. The control group showed no statistically significant changes in any of the variables. Conclusion. The MBERM intervention could improve the emotional and work-related well-being of managers and reduce stress levels and burnout. Further study of this intervention is needed to promote adherence and ensure a long-term improvement.

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

CONTEXT

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

DESIGN AND STUDY PARTICIPANTS

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

RESULTS

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

CONCLUSIONS

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

Traumatic Cervical Spinal Cord Injury and Income and Employment Status

Importance

Spinal cord injury (SCI) causes drastic changes to an individual's physical health that may be associated with the ability to work.

Objective

To estimate the association of SCI with individual earnings and employment status using national administrative health databases linked to income tax data.

Design, Setting, and Participants

This was a retrospective, national, population-based cohort study of adults who were hospitalized with cervical SCI in Canada between January 2005 and December 2017. All acute care hospitalizations for SCI of adults ages 18 to 64 years were included. A comparison group was constructed by sampling from individuals in the injured cohort. Fiscal information from their preinjury years was used for comparison. The injured cohort was matched with the comparison group based on age, sex, marital status, province of residence, self-employment status, earnings, and employment status in the year prior to injury. Data were analyzed from August 2022 to January 2023.

Main outcomes and Measures

The first outcome was the change in individual annual earnings up to 5 years after injury. The change in mean yearly earnings was assessed using a linear mixed-effects differences-in-differences regression. Income values are reported in 2022 Canadian dollars (CAD $1.00 = US $0.73). The second outcome was the change in employment status up to 5 years after injury. A multivariable probit regression model was used to compare proportions of individuals employed among those who had experienced SCI and the paired comparison group of participants.

Results

A total of 1630 patients with SCI (mean [SD] age, 47 [13] years; 1304 male [80.0%]) were matched to patients in a preinjury comparison group (resampled from the same 1630 patients in the SCI group). The mean (SD) of preinjury wage earnings was CAD $46 000 ($48 252). The annual decline in individual earnings was CAD $20 275 (95% CI, -$24 455 to -$16 095) in the first year after injury and CAD $20 348 (95% CI, -$24 710 to -$15 985) in the fifth year after injury. At 5 years after injury, 52% of individuals who had an injury were working compared with 79% individuals in the preinjury comparison group. SCI survivors had a decrease in employment of 17.1 percentage points (95% CI, 14.5 to 19.7 percentage points) in the first year after injury and 17.8 percentage points (14.5 to 21.1 percentage points) in the fifth year after injury.

Conclusions and Relevance

In this study, SCI was associated with a decline in earnings and employment up to 5 years after injury for adults aged 18 to 64 years in Canada.

Experiences of Awe and Gratitude and Related Triggers Among Religious Brothers and Sisters: Findings from a Cross-Sectional Study in Germany

A cross-sectional survey among religious brothers and sisters (n = 250) with their specific lifestyle and related spiritual practices stated moments of awe perceptions. They responded to both the Awe/Gratitude scale and to free text fields to substantiate their quantitative responses. Qualitative content analysis of their free text responses resulted in six main categories of awe triggers: (1) Nature, (2) Special Moments, (3) Transcendence Perceptions, (4) Religious practices, (5) Distinct People, and (6) Aesthetics, Art and Culture. Awe perceptions can be an immediate feeling and the outcome of a process of reflection in response to admiration, inspiration, and elevation. As these perceptions are related to psychological well-being and prosocial behaviors, their training can generate positive effects on quality of life.

Developing a prognostic model for stress reduction in patients with prolonged work-related stress

Mindfulness-based stress reduction (MBSR) is a 9-session group-treatment programme for managing stress. Research suggests variability in the outcomes of MBSR among participants. This prognostic (not causal) study develops a multivariable model that may support clinicians in forecasting expected MBSR outcomes. We used data of 763 patients collected from MBSR programs conducted between October 2015 and March 2022. Candidate prognostic factors at baseline included psychosocial work environment, sociodemographic, and clinical information. Multiple imputation was used to handle missing data (imputations = 200). Important prognostic factors were backward selected in ≥5% of the imputed datasets. The final prediction model including the selected prognostic factors was evaluated using linear regression with a four-fold internal cross-validation procedure. Reductions in perceived stress from baseline to end of the MBSR programme were predicted by a lower General Severity Index (β = 2.00, p < 0.01), higher baseline levels of stress (β = -0.88, p < 0.01), and somewhat by having managerial responsibility in the latest job (vs. no; β = -2.53, p = 0.07). The remaining prognostic factors were weaker predictors, for example, gender and income. Internal validity of the final model was indicated by consistent results from four randomly folded subsamples. This study developed a prognostic model predicting changes in stress levels in relation to the MBSR programme. A reduction in stress level was particularly predicted by milder psychological symptoms and higher baseline levels of perceived stress. These predictions cannot be taken as evidence of causal associations. Forecasting of the illness course should be cautiously practiced using clinical judgement regarding individual patients.

Factors Related to Post-traumatic Stress Disorder Symptoms Among Intensive Care Unit Nurses

PURPOSE

The aim of this study was to identify the factors affecting the post-traumatic stress disorder (PTSD) symptoms of intensive care unit (ICU) nurses. The variables include event experiences, cognitive flexibility, and co-worker support.

METHODS

A survey was conducted among 153 ICU nurses working in a general hospital or an advanced general hospital. The questionnaire was completed between October and December 2018, and 153 copies were used for the final analysis. Data were analyzed using multiple linear regression to determine the factors associated with PTSD symptoms among ICU nurses.

RESULTS

The level of PTSD symptoms of ICU nurses was 1.20 ± 0.82 out of 4. Full PTSD, signified by a total score of 25 or more, was reported by 45.1% of the study's 153 participants. The significant influencing factors of PTSD symptoms among ICU nurses were the "experience of traumatic events," "trusted alliance," which is a subarea of "coworker support," and both "control" and "alternative," which are subareas of "cognitive flexibility." The explanatory power (49.8%) was statistically significant.

CONCLUSIONS

These results suggest that a program to enhance the cognitive flexibility and coworker support of ICU nurses needs to be developed to reduce the PTSD symptoms of ICU nurses.

Enhancing Chronic Non-Cancer Pain Management: A Systematic Review of Mindfulness Therapies and Guided Imagery Interventions

Background and Objectives: There has been an increasing interest in the use of non-pharmacological approaches for the multidimensional treatment of chronic pain. The aim of this systematic review was to assess the effectiveness of mindfulness-based therapies and Guided Imagery (GI) interventions in managing chronic non-cancer pain and related outcomes. Materials and Methods: Searching three electronic databases (Web of Science, PubMed, and Scopus) and following the PRISMA guidelines, a systematic review was performed on Randomized Controlled Trials (RCTs) and pilot RCTs investigating mindfulness or GI interventions in adult patients with chronic non-cancer pain. The Cochrane Risk of Bias Tool was utilized to assess the quality of the evidence, with outcomes encompassing pain intensity, opioid consumption, and non-sensorial dimensions of pain. Results: Twenty-six trials met the inclusion criteria, with most of them exhibiting a moderate to high risk of bias. A wide diversity of chronic pain types were under analysis. Amongst the mindfulness interventions, and besides the classical programs, Mindfulness-Oriented Recovery Enhancement (MORE) emerges as an approach that improves interoception. Six trials demonstrated that mindfulness techniques resulted in a significant reduction in pain intensity, and three trials also reported significant outcomes with GI. Evidence supports a significant improvement in non-sensory dimensions of pain in ten trials using mindfulness and in two trials involving GI. Significant effects on opioid consumption were reported in four mindfulness-based trials, whereas one study involving GI found a small effect with that variable. Conclusions: This study supports the evidence of benefits of both mindfulness techniques and GI interventions in the management of chronic non-cancer pain. Regarding the various mindfulness interventions, a specific emphasis on the positive results of MORE should be highlighted. Future studies should focus on specific pain types, explore different durations of the mindfulness and GI interventions, and evaluate emotion-related outcomes.

The effects of mindfulness training for emergency department and intermediate care unit nurses

AIM

The aim of this study was to determine the effects of mindfulness and self-compassion skills on the experienced stress and work satisfaction of emergency department (ED) and intermediate care unit employees.

METHODS

All ED and intermediate care unit employees in the study hospital were invited to participate in an introductory lecture about mindfulness, compassion, and the intervention in January 2020. After the lecture, it was possible to enroll in training. This training was postponed due to Covid-19 and started in October 2020.

RESULTS

The most important findings of this study are that instructor-led mindfulness training, and the regular use of a smartphone mindfulness application can significantly reduce stress and burnout and promote mindfulness and well-being of ED and intermediate care unit personnel.

CONCLUSIONS

This study shows that compact mindfulness training via innovative digital technology has a positive effect in reducing ED and intermediate care unit employees stress and burnout, while improving mindfulness and well-being, and this is consistent with the wider literature.

KEY FINDINGS

The regular practice of smartphone-guided mindfulness can reduce stress and burnout, as well as promote mindfulness and well-being among ED and intermediate care unit employees.

Restoring Well-Being for Physicians Through Lifestyle Medicine

In the wake of the COVID-19 pandemic, physician burnout is a more relevant concern than ever. Pre-existing stressors in health care, such as poor work-life balance, perfectionism, and inadequate social support, have been exacerbated by uncertainty, increased risk exposure, and general anxiety. Burnout places not only physicians, but also patients, systems, and communities at risk. The promotion of physician well-being is critical to sustaining the health care system. Actions to reduce burnout and increase well-being can and should occur on multiple levels. Organizations and leaders must take steps to create a culture of support and respect for health care providers. Such steps may include improved time-off policies, destigmatizing the use of mental health services, and reducing administrative burden. Physician well-being may benefit from action on an individual level as well. The pillars of Lifestyle Medicine provide a framework for engaging in behaviors compatible with overall well-being, such as physical activity, social connection, and sleep. Lifestyle Medicine plays a key role in mitigating the impact of physician burnout, and will be essential to the success of the health care system moving forward.

Meditation for the primary and secondary prevention of cardiovascular disease

BACKGROUND

Interventions incorporating meditation to address stress, anxiety, and depression, and improve self-management, are becoming popular for many health conditions. Stress is a risk factor for cardiovascular disease (CVD) and clusters with other modifiable behavioural risk factors, such as smoking. Meditation may therefore be a useful CVD prevention strategy.

OBJECTIVES

To determine the effectiveness of meditation, primarily mindfulness-based interventions (MBIs) and transcendental meditation (TM), for the primary and secondary prevention of CVD.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, three other databases, and two trials registers on 14 November 2021, together with reference checking, citation searching, and contact with study authors to identify additional studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) of 12 weeks or more in adults at high risk of CVD and those with established CVD. We explored four comparisons: MBIs versus active comparators (alternative interventions); MBIs versus non-active comparators (no intervention, wait list, usual care); TM versus active comparators; TM versus non-active comparators.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methods. Our primary outcomes were CVD clinical events (e.g. cardiovascular mortality), blood pressure, measures of psychological distress and well-being, and adverse events. Secondary outcomes included other CVD risk factors (e.g. blood lipid levels), quality of life, and coping abilities. We used GRADE to assess the certainty of evidence.

MAIN RESULTS

We included 81 RCTs (6971 participants), with most studies at unclear risk of bias. MBIs versus active comparators (29 RCTs, 2883 participants) Systolic (SBP) and diastolic (DBP) blood pressure were reported in six trials (388 participants) where heterogeneity was considerable (SBP: MD -6.08 mmHg, 95% CI -12.79 to 0.63, I2 = 88%; DBP: MD -5.18 mmHg, 95% CI -10.65 to 0.29, I2 = 91%; both outcomes based on low-certainty evidence). There was little or no effect of MBIs on anxiety (SMD -0.06 units, 95% CI -0.25 to 0.13; I2 = 0%; 9 trials, 438 participants; moderate-certainty evidence), or depression (SMD 0.08 units, 95% CI -0.08 to 0.24; I2 = 0%; 11 trials, 595 participants; moderate-certainty evidence). Perceived stress was reduced with MBIs (SMD -0.24 units, 95% CI -0.45 to -0.03; I2 = 0%; P = 0.03; 6 trials, 357 participants; moderate-certainty evidence). There was little to no effect on well-being (SMD -0.18 units, 95% CI -0.67 to 0.32; 1 trial, 63 participants; low-certainty evidence). There was little to no effect on smoking cessation (RR 1.45, 95% CI 0.78 to 2.68; I2 = 79%; 6 trials, 1087 participants; low-certainty evidence). None of the trials reported CVD clinical events or adverse events. MBIs versus non-active comparators (38 RCTs, 2905 participants) Clinical events were reported in one trial (110 participants), providing very low-certainty evidence (RR 0.94, 95% CI 0.37 to 2.42). SBP and DBP were reduced in nine trials (379 participants) but heterogeneity was substantial (SBP: MD -6.62 mmHg, 95% CI -13.15 to -0.1, I2 = 87%; DBP: MD -3.35 mmHg, 95% CI -5.86 to -0.85, I2 = 61%; both outcomes based on low-certainty evidence). There was low-certainty evidence of reductions in anxiety (SMD -0.78 units, 95% CI -1.09 to -0.41; I2 = 61%; 9 trials, 533 participants; low-certainty evidence), depression (SMD -0.66 units, 95% CI -0.91 to -0.41; I2 = 67%; 15 trials, 912 participants; low-certainty evidence) and perceived stress (SMD -0.59 units, 95% CI -0.89 to -0.29; I2 = 70%; 11 trials, 708 participants; low-certainty evidence) but heterogeneity was substantial. Well-being increased (SMD 0.5 units, 95% CI 0.09 to 0.91; I2 = 47%; 2 trials, 198 participants; moderate-certainty evidence). There was little to no effect on smoking cessation (RR 1.36, 95% CI 0.86 to 2.13; I2 = 0%; 2 trials, 453 participants; low-certainty evidence). One small study (18 participants) reported two adverse events in the MBI group, which were not regarded as serious by the study investigators (RR 5.0, 95% CI 0.27 to 91.52; low-certainty evidence). No subgroup effects were seen for SBP, DBP, anxiety, depression, or perceived stress by primary and secondary prevention. TM versus active comparators (8 RCTs, 830 participants) Clinical events were reported in one trial (201 participants) based on low-certainty evidence (RR 0.91, 95% CI 0.56 to 1.49). SBP was reduced (MD -2.33 mmHg, 95% CI -3.99 to -0.68; I2 = 2%; 8 trials, 774 participants; moderate-certainty evidence), with an uncertain effect on DBP (MD -1.15 mmHg, 95% CI -2.85 to 0.55; I2 = 53%; low-certainty evidence). There was little or no effect on anxiety (SMD 0.06 units, 95% CI -0.22 to 0.33; I2 = 0%; 3 trials, 200 participants; low-certainty evidence), depression (SMD -0.12 units, 95% CI -0.31 to 0.07; I2 = 0%; 5 trials, 421 participants; moderate-certainty evidence), or perceived stress (SMD 0.04 units, 95% CI -0.49 to 0.57; I2 = 70%; 3 trials, 194 participants; very low-certainty evidence). None of the trials reported adverse events or smoking rates. No subgroup effects were seen for SBP or DBP by primary and secondary prevention. TM versus non-active comparators (2 RCTs, 186 participants) Two trials (139 participants) reported blood pressure, where reductions were seen in SBP (MD -6.34 mmHg, 95% CI -9.86 to -2.81; I2 = 0%; low-certainty evidence) and DBP (MD -5.13 mmHg, 95% CI -9.07 to -1.19; I2 = 18%; very low-certainty evidence). One trial (112 participants) reported anxiety and depression and found reductions in both (anxiety SMD -0.71 units, 95% CI -1.09 to -0.32; depression SMD -0.48 units, 95% CI -0.86 to -0.11; low-certainty evidence). None of the trials reported CVD clinical events, adverse events, or smoking rates.

AUTHORS' CONCLUSIONS

Despite the large number of studies included in the review, heterogeneity was substantial for many of the outcomes, which reduced the certainty of our findings. We attempted to address this by presenting four main comparisons of MBIs or TM versus active or inactive comparators, and by subgroup analyses according to primary or secondary prevention, where there were sufficient studies. The majority of studies were small and there was unclear risk of bias for most domains. Overall, we found very little information on the effects of meditation on CVD clinical endpoints, and limited information on blood pressure and psychological outcomes, for people at risk of or with established CVD. This is a very active area of research as shown by the large number of ongoing studies, with some having been completed at the time of writing this review. The status of all ongoing studies will be formally assessed and incorporated in further updates.

Positive Well-Being, Work-Related Rumination and Work Engagement among Chinese University Logistics Staff

Logistics personnel in Chinese universities are facing unbalanced costs and benefit from overloaded work with minimum wages, which impede school development and their well-being. However, the logistics staff population has been neglected in past investigations pertaining to psychological health conditions. The present study aimed to examine the positive well-being, work-related rumination, and work engagement of logistics staff, their correlations, and the factors affecting well-being in 282 Chinese university logistics staff via the Smith Well-being Questionnaire, the Work-Related Rumination Questionnaire, and the Utrecht Work Engagement Scale. The results indicated low levels of well-being and high levels of work-related rumination and work engagement among Chinese university logistics staff. The presence of positive attitudes towards life and work and high levels of work engagement predicts enhanced well-being, while the presence of negative characteristics and work-related rumination predicts decreased well-being. In situations where the working hours and work duties are challenging to change, universities can regularly schedule psychological counselling sessions for logistics staff to improve their well-being.

The Evolution of Mindfulness-Based Stress Reduction Teacher Training Programs for People Who Serve Historically Underrepresented Racial and Ethnic Groups

Background

There is a lack of mindfulness instructors from underserved/underrepresented communities who have completed systematic mindfulness teacher-training programs to meet the growing demand for culturally responsive mindfulness training in those communities.

Objectives

To investigate strategies for increasing the representation of Mindfulness-Based Stress Reduction (MBSR) teachers who serve historically underrepresented racial and ethnic groups.

Methods

Conducted through 4 one-hour Zoom focus groups (n = 54; women = 74%), this study queried individuals with experience serving underrepresented racial and ethnic communities, and had mindfulness experience, on how to increase participation from underrepresented communities in mindfulness. Thematic analysis of transcripts of participant responses involved double-coding by three team members, supporting rigorous evaluation of the data. All respondents who expressed interest in participating enrolled (no dropout from study enrollment to participation in focus groups).

Results

The study identified four key themes that illuminate challenges and essential adaptations for MBSR teacher training aimed at individuals serving historically underrepresented racial and ethnic groups. These themes include: (1) Cost and time commitment; (2) Trauma sensitivity; (3) Cultural Awareness; and (4) Diversity in teachers.

Conclusion

Participants provided actionable recommendations poised to facilitate the expansion of MBSR into more diverse communities, emphasizing optimal benefits and effective communication of inherent healing strengths within these communities. The findings underscore the compelling interest among leaders in marginalized communities to extend the reach of MBSR through culturally responsive approaches. This involves guiding pertinent adjustments and encouraging greater involvement of underserved communities in MBSR teacher training programs.

Take a break! Leisure participation moderates the workaholism-work stress relationship

Our primary aim was to gain a better understanding of how leisure activities (i.e., physical activity, mindfulness, and vacation) may beneficially relate to workaholism and work stress. Secondary aims included exploring motivations for participating in the three types of leisure activities. The job demands-resources theory; conservation of resources theory; and detachment-recovery, autonomy, mastery, meaning, and affiliation model provided context for hypothesized relationships among the variables. Full-time employees in the United States (N = 367) were recruited via Amazon's Mechanical Turk community, and they completed an online survey. Leisure participation significantly moderated the relationship between workaholism and work stress (weakening it). The majority of motivations for mindfulness and vacation were related to mental/emotional health, with a more even split between mental/emotional health and physical health/appearance motivations for physical activities. Several policy and practice-based recommendations for prioritizing leisure engagement are provided.

Enhancing Emergency Nurses' Disaster Nursing Ability and Psychological Resilience: A Randomized Controlled Trial

Objective

This study aimed to investigate emergency nurses' disaster nursing ability and psychological resilience, validate the effectiveness of a training system for disaster nursing ability based on psychological resilience, and verify the relationship between psychological resilience and disaster nursing ability among emergency nurses.

Methods

A training system was developed to enhance psychological resilience and disaster nursing ability. A multicenter, randomized controlled experiment was conducted in five Grade III hospitals in Sichuan Province. A total of 93 emergency nurses were randomly assigned to the following three groups: the blank group, intervention group, and control group. The corresponding interventions were as follows: no intervention, psychological resilience, and nurses' disaster nursing ability training. Personal information forms, the Connor-Davidson Resiliency Scale, and the Nurses' Disaster Nursing Ability Assessment Scale were used in the survey.

Results

There was no significant difference in the scores of psychological resilience and disaster nursing ability in the blank group in the pretest and posttest (P > 0.05). The disaster nursing ability of both the intervention and control groups significantly improved in the posttest (P < 0.05). Compared with the control group, the intervention group demonstrated significant improvement in psychological resilience in the posttest (P < 0.05). However, there was no statistical difference in psychological resilience scores in the control group in the pretest and posttest (P > 0.05).

Conclusion

The study concluded that the psychological resilience and disaster nursing ability of emergency nurses could be enhanced through the implemented training system.

Doing what matters in times of stress: No-nonsense meditation and occupational well-being in COVID-19

While the COVID-19 pandemic challenged the general public's health and well-being, it exacerbated the pre-existing well-being issues in the educational sector in many countries. Mindfulness-based interventions are often applied to protect and promote occupational well-being. To investigate how the well-being benefits of these interventions arise, we selected one accessible technique that is used in most of them: focused attention meditation. In the middle of the COVID-19 pandemic, 199 teachers voluntarily practiced five to ten minutes of meditation together with their pupils, every morning for six months. We employed a three-wave longitudinal design to follow any changes in the meditating teachers' well-being and compared these changes to a waitlist control condition of 42 teachers. Three dimensions of well-being were measured at baseline, half-time, and post-intervention: emotional, cognitive, and physical well-being. Latent growth curve models revealed that the meditation technique not only improves well-being but also prevents the development of well-being problems. The practice of focused attention meditation resulted in improvements in emotional and physical well-being and prevented the development of cognitive well-being problems that were observed within the control condition. The effects were strongest for emotional and cognitive well-being and followed a linear trend. This paper shows that the well-being effects of mindfulness-based interventions are at least in part due to the focused attention meditation that is practiced in them. Occupational groups that experience emotional, cognitive, or physical well-being issues can benefit from a few minutes of focused attention meditation per day. Trial registration: ISRCTN ISRCTN61170784 (https://doi.org/10.1186/ISRCTN61170784).

The relationship between trait mindfulness and resilience: A meta-analysis

Resilience is a positive psychological resource that promotes health. Trait mindfulness was found to be related to resilience. However, previous studies on this relationship have shown contradictory results. The current meta-analysis explored the relationship between trait mindfulness and resilience based on a three-level random-effects meta-analysis model. A significant and positive relationship between trait mindfulness and resilience (r = 0.385; p < 0.0001) was revealed by analyzing 197 effect sizes from 103 studies. Furthermore, the subsequent moderator analysis found that the facet of mindfulness (e.g., awareness, nonjudging) (F(6, 190)  = 6.181; p < 0.001), measurement of mindfulness (e.g., the Mindful Attention Awareness Scale) (F(7, 191)  = 4.758; p < 0.001), aspect of resilience (e.g., family resilience) (F(5, 191)  = 3.455; p < 0.05), measurement of resilience (e.g., the Connor-Davidson Resilience Scale) (F(11, 185)  = 2.256; p < 0.05), and age (F(1, 150)  = 4.588; p < 0.05) acted as significant moderators. Overall, this study confirmed the positive relationship between trait mindfulness and resilience, suggesting that people with higher levels of trait mindfulness were more likely to have higher levels of resilience. The current findings provided insightful information for interventions targeted at improving resilience.

Mindfulness Practice Reduces Hair Cortisol, Anxiety and Perceived Stress in University Workers: Randomized Clinical Trial

BACKGROUND

Anxiety and stress are common mental health conditions reported by university workers. Practices of mindfulness represent one promising approach as an effective and feasible means to reduce stress, improve mental health and promote well-being; however, there are no clinical trials that have combined long-term stress biomarkers (hair cortisol) and psychometric assessments in a sample of university workers.

OBJECTIVE

This study investigated the effectiveness of a mindfulness-based program on long-term stress, by measuring hair cortisol concentration and perceived stress and anxiety among workers who were undergoing high levels of stress.

METHOD

We conducted a randomized clinical trial at work among the employees of a public university. We compared a group that received the eight-week mindfulness intervention with the wait list group who received no intervention.

RESULTS

A total of 30 participants were included in the study, with n = 15 subjects in the intervention group and n = 15 in the control group. Hair cortisol, perceived stress and anxiety significantly reduced after the intervention compared to the control group, which had no appreciable decline in the measured variables.

CONCLUSION

This clinical trial showed the effectiveness of a mindfulness program on mental health psychometric measures (perceived stress and anxiety) and on a long-term stress biomarker (hair cortisol). It can be concluded that an eight-week mindfulness program could be implemented as an effective strategy to reduce stress biomarkers (hair cortisol) as well as perceived stress and anxiety, improving the mental health of university workers.

Design and development of a mobile-based self-care application for patients with depression and anxiety disorders

BACKGROUND AND AIM

Depression and anxiety can cause social, behavioral, occupational, and functional impairments if not controlled and managed. Mobile-based self-care applications can play an essential and effective role in controlling and reducing the effects of anxiety disorders and depression. The aim of this study was to design and develop a mobile-based self-care application for patients with depression and anxiety disorders with the goal of enhancing their mental health and overall well-being.

MATERIALS AND METHODS

In this study we designed a mobile-based application for self -management of depression and anxiety disorders. In order to design this application, first the education- informational needs and capabilities were identified through a systematic review. Then, according to 20 patients with depression and anxiety, this education-informational needs and application capabilities were approved. In the next step, the application was designed.

RESULTS

In the first step, 80 education-information needs and capabilities were identified. Finally, in the second step, of 80 education- informational needs and capabilities, 68 needs and capabilities with a mean greater than and equal to 3.75 (75%) were considered in application design. Disease control and management, drug management, nutrition and diet management, recording clinical records, communicating with physicians and other patients, reminding appointments, how to improve lifestyle, quitting smoking and reducing alcohol consumption, educational content, sedation instructions, introducing health care centers for depression and anxiety treatment and recording activities, personal goals and habits in a diary were the most important features of this application.

CONCLUSION

The designed application can encourage patients with depression and stress to perform self-care processes and access necessary information without searching the Internet.

Technology-Enabled Intervention to Enhance Mindfulness, Safety, and Health Promotion Among Corrections Professionals: Protocol for a Prospective Quasi-Experimental Trial

BACKGROUND

Correction professionals are a highly stressed workforce with heightened risks for depression, suicide, obesity, cardiovascular disease, and injury. These professionals, largely hidden from view, have received little study concerning means to improve their safety, health, and well-being. In other settings, mindfulness has resulted in lowered stress, along with other benefits. We hypothesized that a program that promoted mindfulness combined with more typical health and safety components could uniquely benefit corrections professionals.

OBJECTIVE

This project will assess a novel scalable, self-administered program to enhance the mindfulness, safety, and health of a vulnerable worker group.

METHODS

In partnership with the Oregon Department of Corrections, we are conducting a prospective quasi-experimental trial of a safety, health, and mindfulness program among 100 corrections professionals from 2 institutions. Survey and physiologic data will be collected at enrollment, upon weekly program completion (3 months), and at 9 months after enrollment. Primary outcome behaviors promoted by the program are being mindful, healthier eating, more physical activity, and greater restorative sleep. Secondary downstream benefits are anticipated in stress level, mood, positive feelings about the organization, vascular health, and cellular aging, along with job performance, injuries, and economic costs. Participants will meet in-person or in a Zoom-type meeting as 3- to 5-member coworker groups during their usual work hours for 30-minute sessions once a week for 12 weeks. The program uses self-guided web-based learning modules that include brief mindfulness practice, and it is accessible by smartphone, tablet, or laptop. Daily mindfulness practice is encouraged between sessions, which is facilitated by the study website and group format. The modules' structure emphasizes prerequisite knowledge, peer support, skill practice, self-monitoring, and enhancing self-efficacy for change. The program continues through self-directed use of the Headspace app following the 12 weekly sessions.

RESULTS

Participants are being enrolled, and the intervention is ready to launch.

CONCLUSIONS

Although mindfulness training has gained traction for worker well-being, its usual format requires a skilled trainer, an initial retreat, and weekly 2-hour meetings for several weeks. The content is limited to mindfulness without safety or health promotion aspects. The need for skilled trainers and time commitment limits the scalability of the usual mindfulness interventions. The planned program is an innovative combination of technology, e-learning, and a group format to add mindfulness to a safety and health curriculum. If acceptable and effective, the format would facilitate its widespread use.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05608889; https://classic.clinicaltrials.gov/ct2/show/NCT05608889.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/45535.

The Influence of Authoritarian-Benevolent Leadership on Subordinates' Work Engagement: A Social Information Processing Perspective

Purpose

The dynamic and complex external environment calls for leaders to be both benevolent and authoritarian to cope with the mutually exclusive demands in the management process. But few research paid attention to the dark side of leaders' inconsistent behaviors on employees' work outcomes. Based on social information processing theory, this study investigated the impact of authoritarian-benevolent leadership on subordinates' work engagement and explored the mediating role of leader-member exchange ambivalence and the moderating role of trait mindfulness.

Methods

A two-wave time-lagged survey approach was employed and data from 309 employees from three Chinese companies were collected. R 4.2.1 and SPSS 26.0 were used to test our hypotheses.

Results

The findings demonstrated how subordinates were influenced in their work engagement by authoritarian-benevolent leadership and leader-member exchange ambivalence and emphasized the value of maintaining a high level of trait mindfulness. This study indicated that (1) authoritarian-benevolent leadership was negatively associated with work engagement, which was mediated by leader-member exchange ambivalence; (2) subordinates' trait mindfulness moderated the relationship between leader-member exchange ambivalence and work engagement; (3) the indirect effect of authoritarian-benevolent leadership on subordinates' work engagement through leader-member exchange ambivalence was moderated by subordinates' trait mindfulness.

Conclusion

This study reveals the dark side of authoritarian-benevolent leadership and deepens our understanding of the mechanism underlying the effect of authoritarian-benevolent leadership on subordinates' work engagement from a new theoretical perspective. Practical implications are provided for managers to effectively develop authoritarian-benevolent leadership skills and improve subordinates' work engagement.

Cognitive behavioral therapy for patients suffering with tinnitus distress

ABSTRACT

Of the 21% of the US population with tinnitus, between 3% and 6% develop tinnitus distress, a sudden, traumatic, and severe emotional response to tinnitus. Cognitive behavioral therapy (CBT) is the most effective therapy for reducing the initial and secondary emotional stresses caused by tinnitus distress. The skills taught in CBT lead to habituation and desensitization, providing relief for the patient. This article describes tinnitus distress, CBT, and resources that clinicians can use immediately in their practices.

Age and sex-specific differences of mindfulness traits with measurement invariance controlled in Chinese adult population: A pilot study

Objectives

To examine the relationships of age and sex with mindfulness traits among Chinese adults with controlling for measurement invariance.

Methods

A total of 1777 participants completing the Five-Facet Mindfulness Questionnaire were included for analysis. Their age and sex information were also collected. Descriptive analysis, Pearson's Chi-Square test and analysis of variance were performed to test the age- and sex-specific differences, measurement invariance was examined by confirmatory factor analysis.

Results

Excellent data fit to the model indicated configural, metric, and scalar invariance across age and sex. Participants aged 60 or above scored significantly higher in dimensions of acting with awareness, nonjudging of inner experience, nonreactivity to inner experience, and the total scores than younger individuals, who had higher scores in the observing domain. In addition, females scored higher in describing and observing than males, while the latter had higher score in nonreactivity to inner experience.

Conclusions

The Five-Facet Mindfulness Questionnaire Mindfulness showed acceptable measurement invariance across age and sex in Chinese adult population. The old and the young differs in the traits of awareness, observing, nonjudging of inner experience, nonreactivity to inner experience and the total mindfulness level, while males and females varied in describing, observing and nonreactivity to inner experience. Individual differences should be considered and well addressed in future studies on mindfulness.

Sex Differences in the Neurobiology of Stress

This review highlights the existing knowledge and data that explain the physiologic impacts of stress, especially pertaining to neurobiology, and how these impacts differ by sex. Furthermore, this review explains the benefits of interventions aimed at preventing or mitigating the adverse effects of stress, because of both the significant toll of stress on the body and the disproportionate impact of these changes experienced by women.

Effects of a mindfulness-based interventions on stress, burnout in nurses: a systematic review and meta-analysis

Background

Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure on medical staff globally, highlighting the potential benefits of mindfulness-based interventions in reducing nurses' stress levels. Despite numerous studies exploring the effect of mindfulness-based training on nurses, the results remain inconclusive.

Objective

To systematically evaluate the impact of mindfulness training on nurse's performance and increase the certainty of existing evidence.

Methods

This study searched various databases, including EBSCO, Embase, Web of Science, PubMed, ProQuest, Scopus, Cochrane Online Library, Wanfang, SinoMed, CNKI, and VIP, for randomized controlled trials on the impact of mindfulness-based interventions for nurses up until 02 December 2022. Two investigators independently screened and extracted data from the articles, while also assessing the risk of bias. The data was analyzed using RevMan 5.4 software.

Results

This review identified 15 studies out of the 2,171 records retrieved, consisting of a total of 1,165 participants who were randomized. Post-intervention analysis provided very-low certainty evidence of moderate effectiveness of mindfulness-based training in reducing stress [standardized mean difference (SMD) = -0.81; 95% confidence interval (CI) = -1.11 to -0.52], with no significant effect on anxiety (SMD = -0.30; 95% CI = -0.72 to 0.13) or depression (SMD = -0.24; 95% CI = -0.55 to 0.07). However, the training was effective in reducing burnout, as demonstrated by the lower scores for emotional exhaustion (SMD = -4.27; 95% CI = -5.94 to -2.59) and depersonalization (SMD = -2.89; 95% CI = -4.24 to -1.54) and higher scores for personal accomplishment (SMD = 2.81; 95% CI = 0.12 to 5.50). There was a sustained improvement in stress levels in the short-term (≤3 months), with delayed benefits for burnout. However, only two studies were available for later follow-ups, and there was no significant evidence of long-term effects.

Conclusion

Mindfulness-based training may be a viable intervention for improving the psychological wellbeing of nurses, including reducing stress, burnout.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023387081.

Effect of aerobic exercise, slow deep breathing and mindfulness meditation on cortisol and glucose levels in women with type 2 diabetes mellitus: a randomized controlled trial

Background: Aerobic exercise combined with breathing exercise can be an integral part of diabetes mellitus treatment. This single-center, randomized, parallel-group study investigated the effect of the combination of aerobic exercise with slow deep breathing and mindfulness meditation on the glucose and cortisol levels of women with type 2 diabetes mellitus (T2DM). Materials and Methods: Fifty-eight middle-aged women with T2DM (mean age: 45.67 ± 2.92 years) were randomly assigned to either the aerobic training group (AT: n = 29; mean age [46.1 ± 2.7 years]) or the aerobic exercise combined with slow deep breathing and mindfulness meditation (AT + DMM: n = 29; mean age [45.24 ± 3.14 years]). Aerobic exercise was performed at 60%-75% of the maximum heart rate. The women in each group were asked to perform the training three times weekly over a 6-week period. The duration of each session was 40 min for the AT group and 60 min for the AT + DMM group. The two groups were asked to perform aerobic exercise at 60%-75% of the maximum heart rate. Their fasting blood glucose (FBG) and serum cortisol levels were measured at the baseline and after the 6 weeks. Results: Compared with the AT group, the group undertaking 6 weeks of aerobic training combined with slow, deep breathing exercises and mindfulness meditation showed significantly lower levels of FBG (p = 0.001) and cortisol levels (p = 0.01) than the AT group. Conclusion: The addition of slow deep breathing and mindfulness meditation to aerobic exercise can better control the glucose and cortisol levels of women with T2DM and thereby improve their outcomes and decrease their cardiometabolic risk.

The effect of environmental change, planned and unplanned life events on the long-term outcome of common mental disorders

PURPOSE

To examine the nature of positive and negative environmental change on clinical outcome in 210 patients presenting with anxiety and depression and followed up over 30 years.

METHODS

In addition to clinical assessments, major environmental changes, particularly after 12 and 30 years, were recorded in all patients by a combination of self-report and taped interviews. Environmental changes were separated into two major groups, positive or negative, determined by patient opinion.

RESULTS

In all analyses positive changes were found to be associated with better outcome at 12 years with respect to accommodation (P = 0.009), relationships (P = 007), and substance misuse (P = 0.003), with fewer psychiatric admissions (P = 0.011) and fewer social work contacts at 30 years (P = 0.043). Using a consolidated outcome measure positive changes were more likely than negative ones to be associated with a good outcome at 12 and 30 years (39% v 3.6% and 30.2% v 9.1%, respectively). Those with personality disorder at baseline had fewer positive changes (P = 0.018) than others at 12 years and fewer positive occupational changes at 30 years (P = 0.041). Service use was greatly reduced in those with positive events with 50-80% more time free of all psychotropic drug treatment (P < 0.001). Instrumental positive change had greater effects than imposed changes.

CONCLUSIONS

Positive environmental change has a favourable impact on clinical outcome in common mental disorders. Although studied naturalistically in this study the findings suggest that if harnessed as a therapeutic intervention, as in nidotherapy and social prescribing, it would yield therapeutic dividends.

Mindfulness improves the mental health of infertile women: A systematic review

Infertility in women causes mental health problems, the bad ones. Women with infertility need psychological treatment using mindfulness interventions. This study's purpose was to analyze mindfulness's effect on the mental health of women with infertility through a systematic review. The method used in this systematic review was by searching through the following databases; ProQuest database, Wiley Library, Pubmed, Scopus, Science Direct, Sage Journal, Cochrane Library, and Cambridge Core from January 2011 to December 2021. Nine articles met the inclusion criteria. Results show that the use of mindfulness was found to be effective in reducing mental disorders in women with infertility. Nine articles that meet the criteria for inclusion. According to a study on the effects of mindfulness on infertile women, affect increasing mental health levels by reducing mental health disorder scores. Mindfulness has been proven to be an effective intervention for women undergoing infertility-related mental disorders such as stress, anxiety, and depression. However, different types of mindfulness-based interventions are used to target different mental health issues. For example, Mindfulness-Based Stress Reduction (MBSR) targets stress and anxiety while Mindfulness-Based Cognitive Therapy (MBCT) targets depression. Additionally, specific mindfulness for example, for the midwifery profession can be developed to improve the quality and treatment outcomes of healthcare for women struggling with infertility problems.

At the heart of the matter: how mental stress and negative emotions affect atrial fibrillation

Atrial fibrillation (AF) is the most common form of cardiac arrhythmia, affecting 2%-3% of the world's population. Mental and emotional stress, as well as some mental health conditions (e.g., depression) have been shown to significantly impact the heart and have been suggested to act both as independent risk factors and triggers in the onset of AF. In this paper, we review the current literature to examine the role that mental and emotional stress have in the onset of AF and summarise the current knowledge on the interaction between the brain and heart, and the cortical and subcortical pathways involved in the response to stress. Review of the evidence suggests that mental and emotional stress negatively affect the cardiac system, potentially increasing the risk for developing and/or triggering AF. Further studies are required to further understand the cortical and sub-cortical structures involved in the mental stress response and how these interact with the cardiac system, which may help in defining new strategies and interventions to prevent the development of, and improve the management of AF.

A multicenter feasibility study on implementing a brief mindful breathing exercise into regular university courses

Practicing mindfulness is associated with stress reduction and with positive effects in the context of learning and teaching. Although effects on student populations have been studied extensively, there are few studies implementing mindfulness exercises in university courses directly. For this reason, we aimed to investigate whether the use of a brief mindfulness exercise in regular university courses, guided by the lecturers, is feasible and has immediate effects on the students' mental states. We conducted a preregistered multicenter study with one observational arm, following an ABAB design. In total, N = 325 students from 19 different university courses were included at baseline and n = 101 students at post measurement. Students were recruited by N = 14 lecturers located in six different universities in Germany. Lecturers started their courses either by guiding a brief mindfulness exercise (intervention condition) or as they regularly would, with no such exercise (control condition). In both conditions, the mental states of students and lecturers were assessed. Over the semester, n = 1193 weekly observations from students and n = 160 observations from lecturers were collected. Intervention effects were analyzed with linear mixed-effects models. The brief mindfulness exercise, compared to no such exercise, was associated with lower stress composite scores, higher presence composite scores, higher motivation for the courses, as well as better mood in students. Effects persisted throughout a respective course session. Lecturers also reported positive effects of instructing mindfulness. Implementing a brief mindfulness exercise in regular university teaching sessions is feasible and has positive effects on both students and lecturers.

The Sussex Oxford Compassion for the Self Scale validity in a working sample using classical test theory, item response theory and network analysis

Self-compassion is a relatively new construct in the scientific literature, and there is currently a lack of robust psychometric measures of self-compassion in the workplace. Therefore, validating the Sussex Oxford Compassion for the Self Scale (SOCS-S) in various cultural settings is essential to add to the existing research on the psychometric properties of the scale. This study aimed to evaluate the validity of the SOCS-S in a Chinese working sample of 1,132 participants (39.4% males) using classical test theory (CTT), item response theory (IRT), and Network Analysis. The results supported the validity of the SOCS-S's five-factor structure, with high internal consistency and measurement invariance across genders. IRT was applied using a graded response model (GRM) to assess the overall SOCS-S scale items, indicating that all 20 items had sufficient discrimination indices and acceptable difficulty indices. Moreover, it is worth noting that the results of the network analysis are consistent with those of the IRT analysis. In summary, the study confirms the validity of the SOCS-S as a scale for assessing self-compassion among Chinese occupational groups.

Comparison of two brief mindfulness interventions for anxiety, stress and burnout in mental health professionals: a randomised crossover trial

Background

Anxiety, stress and burnout are a growing reality among mental health professionals, impacting negatively on them and their clients. Mindfulness-based interventions (MBIs) have demonstrated effectiveness in mitigating these sufferings. Nevertheless, there is a lack of knowledge on the impact of MBIs in Cuba.

Objectives

To compare the effectiveness of two brief mindfulness-based interventions for reducing anxiety, work stress and burnout.

Methods

A total of 104 mental health professionals from Havana (Cuba) participated in a randomised crossover trial. Group A received first an intervention involving body-centred practices (body scan and Hatha yoga) and a second intervention involving mind-centred practices (focused attention and open monitoring meditation). Group B received the same interventions but in reverse order. Four measures (anxiety, stress, burnout syndrome, and antecedents of burnout) were measured at baseline, posttest1, posttest2, and 6-months follow-up.

Results

After the first intervention, there was a between-group difference for burnout syndrome, but the ES was similar for both groups. After the second intervention (implementing both practises), groups showed the largest effect sizes, and there was a between-group difference for antecedents of burnout. Results were partially maintained at 6-month follow-up.

Conclusion

These results suggest that mind-centred practises can be as effective as body-centred practises for stress, anxiety and burnout reduction. The combination of both types of practises could be the most effective way of teaching mindfulness. About the sequence of implementation, teaching mind-centred practises first and then body-centred practises could be most effective for reducing antecedents of burnout.Clinical Trial Registration: www.clinicaltrials.gov NCT03296254.

The First Attempt to Apply an Online Mindfulness Program to Nursing Staff in a Traditional Korean Medicine Clinic in COVID-19 Era: A Case Series

The importance of medical personnel's mental health is emphasized in the COVID-19 era. The characteristics of traditional Korean medicine (KM) may affect the mental health of nursing staff working at KM clinics. In this case series, we report the first attempt to apply an online mindfulness program to the nursing staff in a KM clinic in Korea. For three female nursing assistants, an online mindfulness program consisting of five sessions was offered for two months. After the program, a decrease in emotional labor was observed in two participants, and a decrease in the level of burnout was observed in all participants. One participant showed an increase in their emotional labor level, which was associated with an increase in deep acting. The participants expressed a high level of satisfaction with this program in terms of recommendations for peers and willingness to participate again. As this report is a case series, larger studies are needed to fully evaluate the benefits of the program on emotional labor and burnout of KM clinic nursing staff. However, the potential benefits of emotional labor and burnout, high satisfaction, and some challenges identified in this case series can be considered in future extensions and modifications of the program.

Psychological intervention for negative emotions aroused by COVID-19 pandemic in university students: A systematic review and meta-analysis

The COVID-19 pandemic has been suggested to cause psychological problems such as anxiety, depression, panic, and insomnia. This systematic review and meta-analysis aims to assess the efficacy of psychological interventions (including CBT, DBT, and mindfulness based interventions) in reducing distressing feelings in college students during the COVID-19 pandemic. Randomized controlled trials (RCTs) on psychological interventions for reducing negative emotions among college students during the COVID-19 epidemic were searched in databases Web of Science, PubMed, Cochrane Library, Embase, Scopus, PsychInfo, CNKI, WanFang, and VIP. We utilized Cochrane risk of bias assessment technique to assess the quality of included RCTs. The data were analyzed using RevMan 5.4. Eight RCTs were finally included involving 1,496 participants. According to the meta-analysis results, psychotherapies could significantly alleviate anxiety, depression, and stress symptoms among university students, [MD = -0.98, 95%CI (-1.53, -0.43), p<0.001] [SMD = -0.47, 95%CI (-0.77, -0.16), p = 0.003] [MD = -1.53, 95%CI (-2.23, -0.83), p <0.001]. The difference in attenuation of somatization symptoms between the two groups was not statistically significant [SMD = -0.42, 95%CI (-1.41, 0.56), p = 0.40]. Psychotherapy might effectively alleviate anxiety, depression, and stress in university students caused by the COVID-19 pandemic. It could be considered the preferred strategy for reducing negative emotions and improving the quality of life of university students.

A Prospective Observational Pilot Study on the Effects of the Activity-Based Stress Release Program on the Mental State and Autonomic Nervous System in Psychiatric Patients

BACKGROUND

In our pilot study, we investigated the psychological (well-being and personal coping strategies) and physiological (assessed by heart rate variability (HRV)) effects of the newly developed activity-based stress release (ABSR) program for people with depressive disorders, also in combination with burnout symptoms and/or anxiety disorders.

METHODS

A single-arm prospective observational study was carried out. Twenty participants diagnosed with depression and burnout or anxiety disorders were invited to participate in the 8-week ABSR program. All participants filled in two questionnaires (the multidimensional mental state questionnaire and the Ehrenfeld inventory on coping style) before, directly after and 2 months after the 8-week ABSR program. In addition, all participants were offered a 24-hour Holter ECG measurement before, directly after and 2 months after the 8-week ABSR program to measure HRV.

RESULTS

Calmness and serenity showed a statistically significant improvement after the 8-week ABSR program. However, complete questionnaire sets were not available from all of the participants. In the four individuals who had agreed to a 24-hour Holter ECG, the overall HRV and parasympathetic activity increased.

CONCLUSIONS

The ABSR program is an encouraging novel therapeutic approach: A significant improvement in calmness and serenity was observed after ABSR. A larger and controlled trial of this treatment option in depression and burnout is recommended. It should be further investigated how ABSR affects task-evoked and resting brain activity, and what effects it has on the cardiovascular system in general (better blood flow and normalization of activity are to be expected).

Effectiveness of brief mindfulness intervention for college students' problematic smartphone use: The mediating role of self-control

BACKGROUND

Mainland China has the most smartphone users worldwide, especially among college students, while mindfulness intervention can significantly alleviate the level of problematic smartphone use. We examined the effects of a brief mindfulness intervention on problematic smartphone use and investigated if this effect is mediated by self-control.

METHODS

Participants were recruited randomly from a university in Beijing of China. Forty-four college students were assigned to a mindfulness group or a control group. The mindfulness group took part in a brief (30 min) single-session mindfulness intervention. The control group was instructed to listen to a neutral news audio recording for the same duration (30 min). The Freiburg Mindfulness Inventory, Mobile Phone Addiction Tendency Scale, and Self-control Scale were used to measure state mindfulness, problematic smartphone use, and self-control of college students at pre-intervention and post-intervention, respectively.

RESULTS

Two-way repeated-measures ANOVA revealed that the mindfulness group had significant improvements in state mindfulness (p = .049) and self-control (p = .012), and had significant alleviation in problematic smartphone use (p < .001) at post-intervention. In the regression model, self-control had a mediating effect between mindfulness intervention and problematic smartphone use (95% CI [0.490, 7.216]).

CONCLUSIONS

A brief single-session mindfulness intervention can alleviate the level of problematic smartphone use and increase the level of state mindfulness and self-control compared to the control group. Self-control can completely mediate the efficacy of the mindfulness intervention in reducing problematic smartphone use.

Impacting employees' and managers' mental health skills using a workplace-adapted mindfulness-based intervention

Background

During the past decades, the mental health of the population has been declining. Mindfulness-based stress reduction (MBSR) has been found effective in enhancing well-being along with reducing perceived stress and symptoms of anxiety and depression. Mindfulness-based interventions (MBIs) in the workplace have shown promising results relating to the mental health of employees and managers. However, the research field of organizational-level MBIs being offered to entire companies is still nascent. Practicing mindfulness may affect skills related to good mental health. Thus, the objective of this study was to investigate the impact of an organizational-level MBI on the mental health skills of employees and managers.

Methods

This qualitative study was part of a quasi-experimental multi-method study. Four small and medium-sized private enterprises with a total of 368 employees and managers were included. The intervention contained: 1. An obligatory introductory session on mental health and mindfulness, 2. Voluntary participation in a 10-week live online workplace-adapted MBSR course, and 3. A workshop for selected employee representatives and managers on further implementation of mindfulness in the organization. A total of 27 focus group interviews including 76 respondents were conducted pre- and post-intervention. Verbatim transcription was performed. Data was analyzed using inductive qualitative content analysis.

Results

Through analysis, four pre-intervention categories emerged: 1. Bodily sensations and awareness in stressful situations, 2. Reactive and passive behavior during stressful situations, 3. Differences in perception as a stressor, 4. Self-criticism and low ability to practice self-care. Six post-intervention categories were identified: 1. Enhanced ability to be aware in the present moment, 2. Increased acknowledgement of how others may view things differently from oneself, 3. Increased kindness to oneself and being able to practice self-care, 4. Moving from reactive to responsive behavior in stressful situations, 5. Mindfulness as an accelerator for an ongoing personal process and 6. Practicing mindfulness – setting time aside or being mindful in everyday life.

Conclusion

This study indicates that it is possible to enhance employees’ and managers’ mental health skills using an organizational-level MBI. Enhanced awareness in the present moment transcended through post-intervention categories, facilitating increased self-kindness and responsive behavior in stressful situations.

Stressors and Destressors in Working From Home Based on Context and Physiology From Self-Reports and Smartwatch Measurements: International Observational Study Trial

Background

The COVID-19 pandemic has greatly boosted working from home as a way of working, which is likely to continue for most companies in the future, either in fully remote or in hybrid form. To manage stress levels in employees working from home, insights into the stressors and destressors in a home office first need to be studied.

Objective

We present an international remote study with employees working from home by making use of state-of-the-art technology (ie, smartwatches and questionnaires through smartphones) first to determine stressors and destressors in people working from home and second to identify smartwatch measurements that could represent these stressors and destressors.

Methods

Employees working from home from 3 regions of the world (the United States, the United Kingdom, and Hong Kong) were asked to wear a smartwatch continuously for 7 days and fill in 5 questionnaires each day and 2 additional questionnaires before and after the measurement week. The entire study was conducted remotely. Univariate statistical analyses comparing variable distributions between low and high stress levels were followed by multivariate analysis using logistic regression, considering multicollinearity by using variance inflation factor (VIF) filtering.

Results

A total of 202 people participated, with 198 (98%) participants finishing the experiment. Stressors found were other people and daily life getting in the way of work (P=.05), job intensity (P=.01), a history of burnout (P=.03), anxiety toward the pandemic (P=.04), and environmental noise (P=.01). Destressors found were access to sunlight (P=.02) and fresh air (P<.001) during the workday and going outdoors (P<.001), taking breaks (P<.001), exercising (P<.001), and having social interactions (P<.001). The smartwatch measurements positively related to stress were the number of active intensity periods (P<.001), the number of highly active intensity periods (P=.04), steps (P<.001), and the SD in the heart rate (HR; P<.001). In a multivariate setting, only a history of burnout (P<.001) and family and daily life getting in the way of work (P<.001) were positively associated with stress, while self-reports of social activities (P<.001) and going outdoors (P=.03) were negatively associated with stress. Stress prediction models based on questionnaire data had a similar performance (F1=0.51) compared to models based on automatic measurable data alone (F1=0.47).

Conclusions

The results show that there are stressors and destressors when working from home that should be considered when managing stress in employees. Some of these stressors and destressors are (in)directly measurable with unobtrusive sensors, and prediction models based on these data show promising results for the future of automatic stress detection and management.

Trial Registration

Netherlands Trial Register NL9378; https://trialsearch.who.int/Trial2.aspx?TrialID=NL9378

Experience of nature and times of silence as a resource to cope with the COVID-19 pandemic and their effects on psychological wellbeing-Findings from a continuous cross-sectional survey in Germany

Background

The COVID-19 pandemic with its lockdowns affected social relations and mental health conditions of people worldwide. We aimed to analyze the relevance of nature and times of silence as resources to cope with the pandemic. Of interest were how experiences of nature and times of silence are related to the perception of wondering awe and gratitude and psychological wellbeing and how these have changed during the different phases of the pandemic. Finally, we asked whether Nature/Silence would mediate the link between Awe/Gratitude and wellbeing.

Methods

A cross-sectional survey with standardized questionnaires (i.e., PCQ, GrAw-7, BMLSS-10, WHO-5) enrolling participants during the different phases of the COVID-19 pandemic was conducted. The total sample of 5,155 participants from Germany consisted of 65% women and 34% men, with a mean age of 45.0 ± 14.0 years.

Results

Directly after the first lockdown, Nature/Silence and Awe/Gratitude scores were high and decreased along with wellbeing with the onset of the second lockdown in winter 2020, while perceived burden constantly increased. Nature/Silence was rated lowest by people with reduced wellbeing (eta2 = 0.058) and feeling lonely or socially isolated (eta2 = 0.042). Predictor analyses revealed that wellbeing as a dependent variable was predicted best by corona-related perception of burden, Awe/Gratitude, reflection of life, and Nature/Silence and further by perceived changes in terms of relationships and spirituality (R2 = 0.55). In mediation analyses, Awe/Gratitude proved to be a significant predictor for Nature/Silence (β = 0.55, p< 0.0001) and wellbeing (β = 0.05, p < 0.0001). The mediation analysis explained 37% of the variability in the data. The direct influence of Awe/Gratitude on wellbeing was estimated as β = 0.09 (p < 0.0001), and the mediation effect of Nature/Silence on the link between Awe/Gratitude and wellbeing was significant, too (β = 0.03, p < 0.0001), explaining 25% of the total effect.

Conclusion

Nature/Silence and Awe/Gratitude were used as relevant resources during the pandemic, although they cannot fully buffer the negative effects of the social restrictions that resulted in decreases in wellbeing and increases in perceived burden. Perception of nature as a sensitizer of positive experiences particularly during difficult phases of life could be trained to stabilize wellbeing and thus to contribute to public health.

Contemplative Practices Behavior Is Positively Associated with Well-Being in Three Global Multi-Regional Stanford WELL for Life Cohorts

Positive associations between well-being and a single contemplative practice (e.g., mindfulness meditation) are well documented, yet prior work may have underestimated the strength of the association by omitting consideration of multiple and/or alternative contemplative practices. Moreover, little is known about how contemplative practice behavior (CPB) impacts different dimensions of well-being. This study investigates the relationship of CPB, consisting of four discrete practices (embodied somatic-observing, non-reactive mindfulness, self-compassion, and compassion for others), with multiple dimensions of well-being. As with other canonical lifestyle behaviors, multiple contemplative practices can be integrated into one's daily routine. Thus, it is critical to holistically consider these behaviors, extending them beyond a simple uni-dimensional measure (e.g., daily mindfulness meditation practice). We developed an integrative measure of four types of contemplative practice and found it to be significantly associated with a multi-dimensional measure of well-being. Importantly, our findings were from three large global multi-regional cohorts and compared against better-understood lifestyle behaviors (physical activity). Data were drawn from California/San Francisco Bay Area, (n = 6442), Hangzhou City (n = 10,268), and New Taipei City (n = 3033). In all three cohorts, we found statistically significant (p < 0.05) positive associations between CPB and well-being, both overall and with all of the constituent domains of well-being, comparable to or stronger than the relationship with physical activity across most well-being outcomes. These findings provide robust and cross-cultural evidence for a positive association between CPB and well-being, illuminate dimensions of well-being that could be most influenced by CPB, and suggest CPB may be useful to include as part of fundamental lifestyle recommendations for health and well-being.

Factor Analysis and Mental Health Prevention of Employee Turnover under the Profit-Centered Development of Modern Service Industry

Recently, the employee turnover rate of the modern service industry has continued to increase, leading to a decline in the service quality, customer turnover, and an increase in human costs. Meanwhile, fierce competition and enterprises' internal pressure have brought great psychological trauma to employees and affected their mental health. Understanding and finding out the factors that affect employees' resignations are the solutions to employees' mental health problems. The research innovation lies in building a relationship model between turnover intention, psychological contract, and job satisfaction; analyzing the influence mechanism and interaction of various variables in the model; and providing reference and thinking for the service industry to solve the problem of excessive turnover of employees. Besides, the questionnaire design and investigation are carried out, and 60 front-line employees of a service company are selected as the research objects. The results show that the overall internal consistency coefficient of SCL-90 is 0.96, and the overall consistency coefficient is directly proportional to the scale's reliability. The validity coefficient of SCL-90 is 0.79, which has good compatibility validity. Moreover, the correlation coefficient between the psychological contract and turnover intention is 0.621, and the Sig value is 0.00. The correlation coefficient between job satisfaction and turnover intention is −0.663, and the Sig value is 0.00. The psychological contract is positively correlated with turnover intention, and job satisfaction is negatively correlated with turnover intention. After the standard dance experiment, the P values of psychological indicators such as somatization, interpersonal relationship, depression, anxiety, and psychosis factors of employees in the control and experimental groups are all less than 0.05, indicating a significant correlation. Therefore, through 12 weeks of standard dance practice, all psychological indicators of the experimental group are significantly improved. However, the change results of the terror factor and paranoia factor are P > 0.05, showing no significant difference. After the standard dance experiment, there is a significant difference between the control and experimental groups in mental health factors, but no significant difference in terror and paranoia factors. This study has significant reference value for the prevention of employee turnover and mental health.

Effectiveness of Digital Interventions for Deficit-Oriented and Asset-Oriented Psychological Outcomes in the Workplace: A Systematic Review and Narrative Synthesis

BACKGROUND

Digital psychological interventions can target deficit-oriented and asset-oriented psychological outcomes in the workplace. This review examined: (a) the effectiveness of digital interventions for psychological well-being at work, (b) associations with workplace outcomes, and (c) associations between interventions' effectiveness and their theory-base.

METHODS

six electronic databases were searched for randomised controlled trials (RCT) and quasi-experimental studies. The methodological quality of studies that used randomisation was conducted with the "Cochrane Collaboration's Risk of Bias" tool, while the "JBI Critical Appraisal Checklist" was used for non-randomised studies. Studies' theory-base was evaluated using an adaptation of the "theory coding scheme" (TSC). Due to heterogeneity, narrative synthesis was performed.

RESULTS

51 studies were included in a synthesis describing four clusters of digital interventions: (a) cognitive behavioural therapy, (b) stress-management interventions and workplace well-being promotion, (c) meditation training and mindfulness-based interventions, and (d) self-help interventions. Studies demonstrated a high risk of contamination effects and high attrition bias. Theory-informed interventions demonstrated greater effectiveness. Cognitive behavioural therapy demonstrated the most robust evidence for reducing depression symptoms among healthy employees. With the exception of the Headspace application, there was weak evidence for meditation training apps, while relaxation training was a key component of effective stress-management interventions.

Anxiety and employment discrimination: Implications for counseling and return to work practice

BACKGROUND: The most prevalent mental health diagnosis is anxiety disorder, which remains largely undertreated. OBJECTIVE: This investigation considered differences in workplace discrimination against adults with anxiety disorders during two eras of legal history: the original Americans with Disabilities Act (ADA, 1990-2008) and the ADA Amendments Act (ADAAA, 2009-present). METHOD: Research questions addressed differential (a) numbers and types of allegations (b) case resolutions, and (c) demographic characteristics of the charging parties. RESULTS: Results indicated substantially more allegations and merit-based resolutions filed by charging parties with anxiety disorders post-ADAAA. Furthermore, the post-ADAAA era revealed increases in allegations from women and people from non-white racial groups. CONCLUSION: These findings can inform advocacy and counseling and rehabilitation services for clients who experience anxiety.

Effectiveness of mindfulness-based intervention in the improvement of maternal role adaptation among first time mothers: A randomized controlled trial

BACKGROUND AND PURPOSE

Mindfulness-based intervention (MBI) has been suggested as a method to alleviate mental health difficulties during the perinatal period. However, few studies have examined its use in improving maternal role adaptation. This study aimed to investigate the effectiveness of mindfulness in maternal role adaptation among first-time mothers.

MATERIALS AND METHODS

This randomized controlled trial study was performed on 40 first-time mothers who were randomly assigned into experimental (n = 20) and control (n = 20) groups. Research instruments included a demographic questionnaire and a validated Maternal Role Adaptation Questionnaire (MRAQ). In addition to receiving routine care, mothers in the experimental group attended eight 90-min sessions of mindfulness-based intervention. The control group, however, received only routine care. Both groups completed MRAQ before intervention, and immediately, one month, and two months after it.

RESULTS

After intervention, there was a significant increase in the mean scores of MRAQ and its seven domains in the experimental group at all three follow-up intervals (P < 0.001). These domains included "support and strengthening of the couples' relationships", "hardship and dissatisfaction", "mother-infant attachment", "stress and anxiety", "emotional growth", "functionality" and "social adaptation development".

CONCLUSION

The intervention implemented in this study could be effective in promoting maternal role adaptation.