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da Silva CCG, Bolognani CV, Amorim FF, Imoto AM. Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: a systematic review and meta-analysis. Syst Rev 2023; 12:79. [PMID: 37147732 PMCID: PMC10160720 DOI: 10.1186/s13643-023-02244-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 04/24/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Medical schools have used mindfulness meditation as a strategy to assist students in stress management. This study aimed to seek evidence regarding the effectiveness of mindfulness-based training programs in reducing psychological distress and promoting the well-being of medical students. METHODS We conducted a systematic review and meta-analysis. Cochrane Library, Embase, PubMed/MEDLINE, PsycINFO/PsycNet, LILACS/BVS, ERIC (ProQuest), Web of Science, OpenGrey, and Google Scholar were searched for randomized clinical trials published until March 2022, without time or language restrictions. Two authors independently screened the articles, extracted data using a standardized extraction form, and assessed the methodological quality of the included studies using the Cochrane's Risk of Bias 2 (ROB 2) tool and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS Of the 848 articles retrieved, 8 met the inclusion criteria. Mindfulness-based training improved the outcomes: mindfulness (small post-intervention effect: SMD = 0.29; 95% CI: 0.03 to 0.54; p = 0.03; I2 = 46%; high evidence quality, and small effect at follow-up: SMD = 0.37; 95% CI: 0.04 to 0.70; p = 0.03; I2 = 53%; low evidence quality), psychological well-being/health (there was no statistically significant difference between the groups in the post-intervention effect: SMD = - 0.27; 95% CI: - 0.67 to 0.13; p = 0.18; I2 = 76%; moderate evidence quality, and a significant difference at follow-up: SMD = - 0.73; 95% CI: - 1.23 to - 0.23; p = 0.004; I2 = 61%; low evidence quality), and stress (small post-intervention effect: SMD = - 0.29; CI of 95%: - 0.56 to - 0.02; p = 0.04; I2 = 57%; moderate evidence quality, and moderate effect at follow-up: SMD = - 0.45, 95% CI: - 0.67 to - 0.22, p = 0.0001, I2 = 0%, moderate evidence quality). The quality of evidence for the anxiety, depression, and resilience outcomes is low and for the empathy outcome, very low. CONCLUSION The results indicate that the students who participated in the mindfulness training perceived improvements in the stress and psychological distress symptoms and improved health perception and psychological well-being. However, the significant heterogeneity among studies should be considered when interpreting these findings. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020153169.
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Affiliation(s)
- Claudia Cardoso Gomes da Silva
- Programa de Pós-Graduação em Ciências da Saúde, Coordenação de Cursos Pós-Graduação Stricto Sensu, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil.
- Coordenação de Pesquisa e Comunicação Científica, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil.
| | - Cláudia Vicari Bolognani
- Coordenação de Pesquisa e Comunicação Científica, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil
| | - Fábio Ferreira Amorim
- Programa de Pós-Graduação em Ciências da Saúde, Coordenação de Cursos Pós-Graduação Stricto Sensu, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil
| | - Aline Mizusaki Imoto
- Programa de Pós-Graduação em Ciências da Saúde, Coordenação de Cursos Pós-Graduação Stricto Sensu, Escola Superior de Ciências da Saúde (ESCS), Setor Médico Hospitalar Norte, Conjunto A, Bloco 01, Edifício Fepecs - Asa Norte, Brasília, DF, 70710-907, Brazil
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Prata TSC, Calcides DAP, Vasconcelos EL, Carvalho AA, Melo EVD, Oliva-Costa EFD. Prevalence of Burnout Syndrome and associated factors in medical students under different educational models. Rev Assoc Med Bras (1992) 2021; 67:667-674. [DOI: 10.1590/1806-9282.20200937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/14/2021] [Indexed: 11/22/2022] Open
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Calcides DAP, Didou RDN, Melo EVD, Oliva-Costa EFD. Burnout Syndrome in medical internship students and its prevention with Balint Group. ACTA ACUST UNITED AC 2019; 65:1362-1367. [PMID: 31800898 DOI: 10.1590/1806-9282.65.11.1362] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/11/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND We intend to estimate the Burnout Syndrome prevalence and its associated factors among medical internship students at a public university in northeastern Brasil, besides investigating the Balint Group (BG) contribution in its prevention. METHODS We conducted a cross-sectional study in February/2018 with Medical Internship Students at the University researched. We applied a structured questionnaire developed by the authors about socio-demographic data, educational process with BG participation, and current psycho-emotional experiences, in addition to the Maslach Burnout Inventory - Student Survey (MBI-SS), for Burnout Syndrome screening. We performed descriptive data analysis, logistic regression, and cluster analysis. RESULTS A total of 184 students (98%) participated in the study, with a mean age of 25.9±3.9 years, of which 54.9% were men. The prevalence of Burnout Syndrome was 10.3% based on the three-dimensional criterion and 35.9% on two-dimensional criterion (Exhaustion and Cynicism); it was higher in those who thought about quitting the program (OR=2.14), were dissatisfied with the teaching strategies (OR=2.67) and their performance (OR=2.64) and made use of licit drugs (OR=2.37). The variables associated with Burnout Syndrome allowed individuals to be discriminated, classifying them into three subgroups. Burnout Syndrome prevalence decreased, and vulnerability factors were attenuated when there was a higher frequency of students participating in BG. CONCLUSIONS The prevalence of two-dimensional Burnout Syndrome was high, with factors associated with the educational process. Participation in BG was associated with a lower Burnout rate prevalence. Longitudinal studies should be conducted.
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Affiliation(s)
| | | | | | - Edméa Fontes de Oliva-Costa
- Professora Doutora Associada II Coord. de Psiquiatria do DME/UFS, Aracaju, SE, Brasil.,Líder do Grupo de Estudos em Psiquiatria, Saúde Mental e Educação para as Profissões da Saúde (GEPS/CNPQ); Coord. do Projeto PIBIC/UFS; Aracaju, SE, Brasil.,Fellow of Foundation for Advancement of International Medical Education and Research (FAIMER- BR); Fortaleza, CE, Brasil
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Cangussu Silva A, Ezequiel ODS, Damiano RF, Granero Lucchetti AL, DiLalla LF, Dorsey JK, Lucchetti G. Translation, Transcultural Adaptation, and Validation of the Empathy, Spirituality, and Wellness in Medicine Scale to the Brazilian Portuguese Language. TEACHING AND LEARNING IN MEDICINE 2018; 30:404-414. [PMID: 29630412 DOI: 10.1080/10401334.2018.1445532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 01/11/2018] [Accepted: 02/06/2018] [Indexed: 06/08/2023]
Abstract
Construct: The Empathy, Spirituality, and Wellness in Medicine Scale (ESWIM) is a 43-item multidimensional scale developed to investigate different dimensions of physicians and medical students. Background: Medical education research requires the use of several different instruments with dozens of items that evaluate each construct separately, making their application slow and increasing the likelihood of students providing a large number of incomplete or missing responses. To provide an alternative measure, this study aims to translate, adapt, and validate the multidimensional ESWIM instrument for Brazilian medical students. This is a very promising instrument because it is multidimensional, relatively short, and cost free; it evaluates important constructs; and it has been explicitly designed for use in the medical context. Approach: The English-language instrument was translated and adapted into the Brazilian Portuguese language using standard procedures: translation, transcultural adaptation, and back-translation. ESWIM was administered to students in all years of the medical curriculum. A retest was given 45 days later to evaluate reliability. To assess validity, the questionnaire also included sociodemographic data, the Duke Religion Index, the Empathy Inventory, the brief version of the World Health Organization Quality of Life (WHOQOL-Bref), and the Oldenburg Burnout Inventory. Results: A total of 776 medical students (M age = 22.34 years, SD = 3.11) were assessed. The Brazilian Portuguese version of ESWIM showed good internal consistency for the factor of Empathy (α = 0.79-0.81) and borderline internal consistency for the other factors: Openness to Spirituality (α = 0.61-0.66), Wellness (α = 0.57-0.68), and Tolerance (α = 0.56-0.65). The principal component analysis revealed a four-factor structure; however, the confirmatory factor analysis showed a better fit for a three-factor structure. We found a significant positive correlation between ESWIM empathy and empathy measured by the Empathy Inventory (r = .444, p < .01), as well as negative correlations between ESWIM empathy and burnout (r = -.145 to -.224, p < .01). ESWIM openness to spirituality was also significantly correlated with different subscales of religiosity (r = .301-.417, p < .01), and ESWIM wellness was significantly correlated with the WHOQOL-Bref factors (r = .390-.673, p < .01). The test-retest reliability (applied to 83 students) was high for all factors except Tolerance. Conclusion: This study provides supportive evidence regarding the reliability and validity of ESWIM empathy scores. The ESWIM scale opens a new field of research in relation to openness to spirituality by introducing a scale that measures this openness attitude. Despite borderline internal consistency, ESWIM wellness was strongly associated with quality of life and had good test-retest reliability. Thus, ESWIM appears to be a valid option for evaluating these constructs in medical students.
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Affiliation(s)
- Alexander Cangussu Silva
- a Department of Medical Education , School of Medicine, Federal University of Juiz de Fora , Brazil
| | | | - Rodolfo Furlan Damiano
- a Department of Medical Education , School of Medicine, Federal University of Juiz de Fora , Brazil
| | | | - Lisabeth Fisher DiLalla
- b Department of Family and Community Medicine , Southern Illinois University School of Medicine , Carbondale , Illinois , USA
| | - J Kevin Dorsey
- c Department of Medical Education , Southern Illinois University School of Medicine , Springfield , Illinois , USA
| | - Giancarlo Lucchetti
- a Department of Medical Education , School of Medicine, Federal University of Juiz de Fora , Brazil
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Regis JMO, Ramos-Cerqueira ATA, Lima MCP, Torres AR. Social anxiety symptoms and body image dissatisfaction in medical students: prevalence and correlates. JORNAL BRASILEIRO DE PSIQUIATRIA 2018. [DOI: 10.1590/0047-2085000000187] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective Social anxiety disorder (SAD) and body image dissatisfaction (BID) are common problems among college students, but few studies focused on medical students. We aimed to estimate the prevalence, severity and correlates of SAD symptoms and BID among medical students of a Brazilian public university. Methods A cross-sectional study with 479 students, using structured instruments: Social Phobia Inventory (SPIN), Body Shape Questionnaire (BSQ), and Beck Depression Inventory (BDI). Bivariate analyses were followed by logistic regression models to obtain independent predictors of SAD symptoms, BID and both outcomes combined. Results Most students were single (99%) and female (58.7%). The prevalence rates of SAD symptoms (SPIN ≥ 19) and BID (BSQ ≥ 81) were 36.3% and 34.7%, respectively. Depressive symptoms (BDI ≥ 19) occurred in 8.8% of the sample. SAD symptoms were independently associated with: BID, thoughts of abandoning the course, difficulty making friends, depressive symptoms, and mental health treatment prior to university. Besides SAD symptoms, BID was associated with female sex, difficulty making friends, depressive symptoms, and body mass index (BMI). Seventy-eight students (16.3%) presented SAD symptoms and BID, which was associated with female sex, difficulty making friends, dissatisfaction with the course, depressive symptoms and BMI. Conclusion SAD symptoms and BID are common and related problems that should be screened for among medical students. The identification of specific correlates could contribute to the elaboration of preventive measures, minimizing the distress and negative impact of these mental health problems on relationships and academic performance.
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Freire IV, Casotti CA, Ribeiro ÍJS, Silva JRD, Barbosa AAL, Pereira R. Daily sodium intake influences the relationship between angiotensin-converting enzyme gene insertion/deletion polymorphism and hypertension in older adults. J Clin Hypertens (Greenwich) 2018; 20:541-550. [PMID: 29521003 PMCID: PMC8031090 DOI: 10.1111/jch.13224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/28/2017] [Accepted: 12/08/2017] [Indexed: 01/02/2023]
Abstract
The angiotensin-converting enzyme insertion/deletion (I/D) gene polymorphism has been widely reported as being associated with hypertension; however, most studies do not consider environmental/behavioral factors. This study aimed to investigate the relationship among angiotensin-converting enzyme insertion/deletion gene polymorphism, environmental/behavioral factors, and hypertension in community-dwelling elderly individuals. All community-dwelling older adults from Aiquara, Bahia, Brazil, were invited to take part in this study. After exclusions, 234 elderly participants were submitted to a data collection, which included sociodemographics, lifestyle and health status questionnaires, clinical assessment, and blood withdrawal. From the blood samples, the gene polymorphism was identified through polymerase chain reaction and patients grouped as II or D allele carriers (ID and DD genotypes). Hypertension was defined by self-report of the condition and confirmed by antihypertensive drug treatment. Chi-square test was used to identify differences in the proportions distributed between groups of each dependent variable (ie, genotype, diagnosis of hypertension, and blood pressure state from medicated patients with hypertension). The prevalence of hypertension was 59.3% and was associated with diabetes mellitus and obesity, but not with angiotensin-converting enzyme insertion/deletion gene polymorphism. However, carriers of the II genotype, a salt-sensitivity genotype, exhibited a significantly greater estimated sodium intake. In addition, among medicated elderly patients with hypertension, II genotype carriers exhibited poor blood pressure control, despite similar antihypertensive drug treatment in D allele carriers, while exhibiting a greater estimated sodium intake. Our results provide new evidence regarding the interaction of genetic and environmental/behavioral factors in the genesis of hypertension among elderly patients, as well as in blood pressure control in medicated elderly patients with hypertension.
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Affiliation(s)
- Ivna V. Freire
- Postgraduate Program in Nursing & HealthState University of Southwest Bahia (UESB)JequieBABrazil
- Department of Biological SciencesIntegrative Physiology Research CenterState University of Southwest Bahia (UESB)JequieBABrazil
- Human Genetics LaboratoryDepartment of Biological SciencesState University of Southwest Bahia (UESB)JequieBABrazil
| | - Cezar A. Casotti
- Postgraduate Program in Nursing & HealthState University of Southwest Bahia (UESB)JequieBABrazil
| | - Ícaro J. S. Ribeiro
- Postgraduate Program in Nursing & HealthState University of Southwest Bahia (UESB)JequieBABrazil
- Department of Biological SciencesIntegrative Physiology Research CenterState University of Southwest Bahia (UESB)JequieBABrazil
| | - Jonas R. D. Silva
- Department of Biological SciencesIntegrative Physiology Research CenterState University of Southwest Bahia (UESB)JequieBABrazil
| | - Ana A. L. Barbosa
- Human Genetics LaboratoryDepartment of Biological SciencesState University of Southwest Bahia (UESB)JequieBABrazil
| | - Rafael Pereira
- Postgraduate Program in Nursing & HealthState University of Southwest Bahia (UESB)JequieBABrazil
- Department of Biological SciencesIntegrative Physiology Research CenterState University of Southwest Bahia (UESB)JequieBABrazil
- Human Genetics LaboratoryDepartment of Biological SciencesState University of Southwest Bahia (UESB)JequieBABrazil
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Bolsoni-Silva AT, Loureiro SR. O Impacto das Habilidades Sociais para a Depressão em Estudantes Universitários. PSICOLOGIA: TEORIA E PESQUISA 2016. [DOI: 10.1590/0102.3772e324212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO A depressão é prevalente em universitários, embora se verifique escassez de estudos sobre habilidades sociais associadas à depressão. Objetivou-se comparar as habilidades sociais e as percepções de consequências nas interações de universitários com depressão (n=64) em relação a um grupo não clínico (n=64); e verificar o valor preditivo das habilidades sociais. Habilidades sociais e saúde mental foram mensuradas por instrumentos aferidos. Constatou-se diferenças significativas em comunicação, afeto, expressar sentimentos negativos, lidar com críticas e falar em público. O grupo com depressão relatou mais consequências e sentimentos negativos nas interações sociais. Na análise de regressão identificou-se que um repertório deficitário de habilidades sociais foi preditor de depressão, o que sugere a relevância de programas de prevenção e intervenção para essa população.
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