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Lin Y, Jiang C, Pan Y, Xu Z. The impact of mindfulness on nurses' perceived professional benefits: the mediating roles of workplace spirituality and work-life balance. Front Psychol 2024; 15:1346326. [PMID: 38476383 PMCID: PMC10929680 DOI: 10.3389/fpsyg.2024.1346326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
This study delves into the effects of mindfulness on workplace spirituality, work-life balance, and perceived professional benefits among nurses operating in the high-pressure environments of hospitals in Jiangxi Province, China. Utilizing a robust sample of 303 valid questionnaires and employing partial least squares (PLS) analysis, the research uncovers a significant positive relationship between mindfulness and workplace spirituality. Furthermore, it demonstrates how both workplace spirituality and work-life balance serve as crucial mediators in enhancing nurses' perception of their professional benefits. The findings illuminate the potential of mindfulness training in substantially elevating job satisfaction and reducing burnout among nurses. The study not only reinforces the value of mindfulness in the healthcare sector but also advocates for its integration into professional development programs and healthcare policies. By doing so, it aims to bolster the overall wellbeing and professional effectiveness of nurses facing the myriad challenges inherent in demanding healthcare environments. This study contributes to the growing discourse on mindfulness in occupational settings, highlighting its pivotal role in enhancing both the personal wellbeing and professional capabilities of healthcare professionals.
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Affiliation(s)
- Yapeng Lin
- School of Management, Putian University, Putian, China
| | | | - Yujing Pan
- School of Performance and Cultural Industries, University of Leeds, Leeds, United Kingdom
| | - Ziqing Xu
- Business College, Guangdong Ocean University, Yangjiang, China
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2
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Polizzi CP, McDonald CW, Sleight FG, Lynn SJ. Resilience, Coping, and the Covid-19 Pandemic Across the Globe - an Update: What Have we Learned? CLINICAL NEUROPSYCHIATRY 2023; 20:316-326. [PMID: 37791081 PMCID: PMC10544248 DOI: 10.36131/cnfioritieditore20230411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic is a mass traumatic event that has universally and indiscriminately negatively affected the world. The adverse consequences of the pandemic have globally impacted psychological health and well-being via increased stressors, such as uncertainty, health anxieties, and financial instability. During the initial months of the pandemic, we (Polizzi et al., 2020) identified coping strategies that may be well-suited to address the sequelae of the pandemic. These strategies included behavioral activation, acceptance-based coping, mindfulness practice, and loving-kindness meditation. We argued that these coping skills may foster resilience and recovery during the pandemic by generating a sense of social connection, encouraging meaning-making, and enhancing feelings of control amid uncertainty. Three years later, we update our initial suggestions by providing a narrative review that considers empirical evidence collected during the pandemic to support the utility of the previously identified coping strategies as well as additional strategies. We also discuss cross-cultural similarities and differences among these strategies and how research supports their application across diverse countries and groups. Finally, we conclude by synthesizing the literature within a regulatory flexibility framework that emphasizes flexible skill implementation with respect to sensitivity to context, coping repertoires, and feedback from the environment.
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Affiliation(s)
- Craig P. Polizzi
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine
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O'Donnell K, Dunbar M, Speelman D. Effectiveness of Daily Mindfulness Meditation App Usage to Reduce Anxiety and Improve Well-Being During the COVID-19 Pandemic: A Randomized Controlled Trial. Cureus 2023; 15:e42432. [PMID: 37637657 PMCID: PMC10448000 DOI: 10.7759/cureus.42432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction This study examined the effect of 10-minute daily meditation app usage for 30 days on adult anxiety and mental well-being during the first year of the COVID-19 pandemic. Methods Participants were randomized into intervention (10 minutes of daily usage of the Insight Timer app) or control groups. Participants completed surveys to assess anxiety and well-being pre- and post-study. Data were analyzed using t-tests, analysis of variance (ANOVA), or nonparametric equivalents. Results Pre-study results were comparable between groups. The pre- vs. post-study General Anxiety Disorder-7 (GAD-7) scores for anxiety decreased in the intervention group (n=18, median 5.5 vs. 3.0 (pre vs. post), p=0.0233, d=0.50), but not in the control group (n=28). The intervention group had a lower median GAD-7 score than the control group post-study (3.0 vs. 8.0, p=0.0223, d=0.35). Pre- vs. post-study mean 5-item World Health Organization Well-Being Index (WHO-5) scores were improved in both the control (11.6 vs. 12.9 (pre vs. post), p=0.0408, d=0.36) and intervention groups (12.0 vs. 16.3 (pre vs. post), p=0.0001, d=0.77), although it was higher in the intervention group (16.3 vs. 12.9, p=0.0056, d=0.88). Conclusion Ten minutes of daily meditation app usage for 30 days may reduce anxiety and improve well-being in adults during the COVID-19 pandemic.
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Affiliation(s)
- Katie O'Donnell
- Obstetrics and Gynecology, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Melanie Dunbar
- Behavioral Health, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Diana Speelman
- Biochemistry and Medical Genetics, Lake Erie College of Osteopathic Medicine, Erie, USA
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Bursky M, Kosuri M, Walsh Carson K, Babad S, Iskhakova A, Nikulina V. The Utility of Meditation and Mindfulness-Based Interventions in the Time of COVID-19: A Theoretical Proposition and Systematic Review of the Relevant Prison, Quarantine and Lockdown Literature. Psychol Rep 2023; 126:557-600. [PMID: 34889700 PMCID: PMC10037136 DOI: 10.1177/00332941211048734] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As of July 20, 2021, Covid-19 has killed 4,086,000 people, infected at least 190,169,833 others, and devastated the world's economy. To slow the spread of the virus, numerous governments instituted "lockdown" policies and quarantines, limiting social interactions to the immediate household. The experience of isolation and uncertainty have contributed to increased fear, anxiety, and loneliness; with limited options of research-supported interventions. Although different in nature, the experiences of quarantine and lockdown have been likened to incarceration. Past research has found meditation and mindfulness-based interventions (MBIs) to be effective psychological treatments for prisoners and may therefore translate well into effective methods for the maintenance of psychological well-being for individuals quarantined during the pandemic. More recently, research investigating the effects of meditation and MBIs during the pandemic have demonstrated preliminary evidence for beneficial psychological improvements. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), the current narrative review paper: 1) examines the parallels and differences between the experience of quarantine and imprisonment, 2) investigates the mechanisms through which meditation and mindfulness enact their effects, and 3) systematically reviews literature on the benefits of various types of meditation and MBIs for inmates and individuals in lockdown or quarantine. With this knowledge, the public can garner applicable insight into the potential use of meditation and MBIs for individuals forced to cope with pandemic lockdowns and quarantines. Two hundred and twenty one (221) articles were identified through Pubmed and Google Scholar, and 24 articles were ultimately included in the manuscript.
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Affiliation(s)
- Mikell Bursky
- Psychology Department, The Graduate Center, City University
of New York, New York, NY, USA
- Psychology Department, Queens College, City University of
New York, Queens, NY, USA
| | - Mahathi Kosuri
- Psychology Department, The Graduate Center, City University
of New York, New York, NY, USA
- Psychology Department, Queens College, City University of
New York, Queens, NY, USA
- Psychology Department, John Jay College of Criminal Justice,
City University of New York, New York, NY, USA
| | - Kaitlin Walsh Carson
- Psychology Department, The Graduate Center, City University
of New York, New York, NY, USA
- Psychology Department, Queens College, City University of
New York, Queens, NY, USA
| | - Sara Babad
- Psychology Department, The Graduate Center, City University
of New York, New York, NY, USA
- Psychology Department, Queens College, City University of
New York, Queens, NY, USA
| | - Alexandra Iskhakova
- Psychology Department, Queens College, City University of
New York, Queens, NY, USA
| | - Valentina Nikulina
- Psychology Department, The Graduate Center, City University
of New York, New York, NY, USA
- Psychology Department, Queens College, City University of
New York, Queens, NY, USA
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5
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Adanaqué-Bravo I, Escobar-Segovia K, Gómez-Salgado J, García-Iglesias JJ, Fagundo-Rivera J, Ruiz-Frutos C. Relationship Between Psychological Distress, Burnout and Work Engagement in Workers During the COVID-19 Pandemic: A Systematic Review. Int J Public Health 2023; 67:1605605. [PMID: 36686389 PMCID: PMC9849247 DOI: 10.3389/ijph.2022.1605605] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023] Open
Abstract
Objective: The psychological distress that the COVID-19 pandemic has produced has generated negative effects on workers, and in one way or another this has affected their work engagement within companies. The aim of this research was to assess the relationship between psychological distress, burnout and work engagement in workers during the COVID-19 pandemic. Methods: A systematic review was carried out following the PRISMA methodology, taking articles from the Scopus, Pubmed, and Web of Science databases from the beginning of the pandemic until November 2022. The methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for non-randomised studies. Results: 24 articles were selected. All the articles found an association between psychological distress, burnout or other factors and work engagement. Conclusion: The COVID-19 pandemic has had an impact on work engagement and a negative relationship with psychological distress and burnout, hence the importance of companies taking measures to minimise levels of psychological distress and burnout.
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Affiliation(s)
- Ingrid Adanaqué-Bravo
- Faculty of Engineering in Mechanics and Production Sciences, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Kenny Escobar-Segovia
- Faculty of Engineering in Earth Sciences, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Juan Jesús García-Iglesias
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
| | - Javier Fagundo-Rivera
- Centro Universitario de Enfermería Cruz Roja, Universidad de Sevilla, Sevilla, Spain
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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Aşkun D, Çetin F. Understanding possible personal correlates of organizational citizenship behavior: Mindfulness and oneness behaviors. JOURNAL OF GENERAL MANAGEMENT 2022. [DOI: 10.1177/03063070221104587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The current study aims to understand the mechanisms underlying the predictive relationship between mindfulness and organizational citizenship behaviors especially targeted for other individuals inside the organizations. As part of this relationship model, oneness behaviors were suggested as an actor of mediation. A sample of 281 blue collar employees participated for the study with employing a multi-source data gathering method. In line with the self-regulation and Buddhist based conceptualizations, and previous related research, statistical analyses revealed significant effects of mindfulness on organizational citizenship behavior towards individuals (OCBI) after controlling demographic variables, and showed fully mediated roles of one and other sub dimensions in mindfulness-OCBI interaction. The current study brings a novel approach to mindfulness and organizational citizenship relationship by including oneness behaviors inside the research model while stressing the importance of interconnectedness and how it could be practiced inside the organizations.
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Affiliation(s)
| | - Fatih Çetin
- Department of Business Administration, Niğde Ömer Halisdemir University, Niğde, Turkey
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Treves IN, Li CE, Wang KL, Ozernov-Palchik O, Olson HA, Gabrieli JDE. Mindfulness supports emotional resilience in children during the COVID-19 Pandemic. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.11.18.22282510. [PMID: 36415463 PMCID: PMC9681054 DOI: 10.1101/2022.11.18.22282510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
An important aspect of mental health in children is emotional resilience, the capacity to adapt to, and recover from, stressors and emotional challenges. Variation in trait mindfulness, one’s disposition to attend to experiences with an open and nonjudgmental attitude, may be an important individual difference in children that supports emotional resilience. In this study, we investigated whether trait mindfulness was related to emotional resilience in response to stressful changes in education and home-life during the COVID-19 pandemic in the United States. We conducted a correlational study examining self-report data from July 2020 to February 2021, from 163 eight-to-ten-year-old children living in the US. Higher trait mindfulness scores correlated with less stress, anxiety, depression, and negative affect in children, and lower ratings of COVID-19 impact on their lives. Mindfulness moderated the relationship between COVID-19 child impact and negative affect. Children scoring high on mindfulness showed no correlation between rated COVID-19 impact and negative affect, whereas those who scored low on mindfulness showed a positive correlation between child COVID-19 impact and negative affect. Higher levels of trait mindfulness may have helped children to better cope with a wide range of COVID-19 stressors. Future studies should investigate the mechanisms by which trait mindfulness supports emotional resilience in children.
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Figueiredo S, João R, Alho L, Hipólito J. Psychological Research on Sleep Problems and Adjustment of Working Hours during Teleworking in the COVID-19 Pandemic: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14305. [PMID: 36361185 PMCID: PMC9656353 DOI: 10.3390/ijerph192114305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Mandatory home isolation caused by COVID-19 in professional contexts led to a situation that required work activities to be converted into a remote modality. The literature on this topic is very recent, given the pandemic and the uncertainty of virtual and face-to-face work modalities. This study aimed to examine the effects of adults' prolonged exposure to screens on sleep quality, the type of devices used according to age and gender, periods of access to such devices and the impact on performance in the context of telework due to COVID-19. Specifically, the study analyzed the differences in the use of devices and in the time spent using them during and after teleworking between genders and age groups. A total of 127 Portuguese participants answered the Pittsburgh Sleep Quality Index and a questionnaire that we specifically developed to characterize teleworking habits. The results showed differences between men and women regarding the use of devices and its impact on sleep quality, as well as differences in terms of age. These results are discussed in terms of how the current work context may affect performance, sleep, gender differences and the adverse effects of exposure to screens during and after work hours.
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Affiliation(s)
- Sandra Figueiredo
- Department of Psychology, Psychology Research Centre (CIP), Universidade Autónoma de Lisboa, Foundation for Science and Technology (FCT), 1169-023 Lisbon, Portugal
| | - Raquel João
- Department of Psychology, Universidade Autónoma de Lisboa, 1169-023 Lisbon, Portugal
| | - Laura Alho
- Think Wise, 3810-133 Aveiro, Portugal
- Mind—Clinical and Forensic Institute, 1990-019 Lisbon, Portugal
| | - João Hipólito
- Department of Psychology, Psychology Research Centre (CIP), Universidade Autónoma de Lisboa, 1169-023 Lisbon, Portugal
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9
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Beshai S, Salimuddin S, Refaie N, Maierhoffer J. Dispositional Mindfulness and Self-Compassion Buffer the Effects of COVID-19 Stress on Depression and Anxiety Symptoms. Mindfulness (N Y) 2022; 13:3028-3042. [PMID: 36312006 PMCID: PMC9589785 DOI: 10.1007/s12671-022-02008-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
Objectives The COVID-19 pandemic has been associated with a dramatic rise in symptoms of depression and anxiety. Dispositional mindfulness (DM) and self-compassion (SC) have consistently been associated with psychological disorder symptoms and appear to buffer the effects of stress on depression and anxiety. Methods Across two studies (n = 888), we examined direct and indirect (moderation) relationships of DM, SC, COVID-19-related stress, and symptoms of depression and anxiety. We also examined the differential effects of several DM measures (FFMQ-15; FFMQ-39; MAAS) in the relationships of COVID-19 stress and psychological disorder symptoms. We recruited participants (Study 1 n = 350; 42.2% cis women; Study 2 n = 538; 44.3% cis women) online (MTurk) and examined associations of DM, SC, and COVID-19 stress, and emotional impact, and the moderating effect of DM and SC in the relationships of COVID-19-related fears, stress, emotional impacts, and psychological disorder symptoms. Results DM and SC were moderately and negatively correlated with COVID-19 fears and stress (correlations ranging r = − .14 to r = − .42) across studies. Study 1 moderation analyses demonstrated SC, but not DM (FFMQ-15), significantly moderated relationships of COVID-19 fears and emotional impacts with symptoms. Study 2 analyses demonstrated the FFMQ-39, but not the MAAS, significantly moderated relationships of COVID-19 stress and psychological disorder symptoms. Conclusions These results support the potential protective roles of DM and SC in disrupting pathological trajectories related to naturally elevated pandemic stress. Results also demonstrate the differential associations of several DM measures with COVID-19 stress. Future research should replicate such findings with more diverse samples and using various measures of self-compassion and risk metrics. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-022-02008-0.
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10
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Ozmen S, Arslan Yurumezoglu H. Nurse managers' challenges and opportunities in the COVID-19 pandemic crisis: A qualitative descriptive study. J Nurs Manag 2022; 30:2609-2619. [PMID: 36189859 PMCID: PMC9874453 DOI: 10.1111/jonm.13817] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/16/2022] [Accepted: 09/25/2022] [Indexed: 01/27/2023]
Abstract
AIM The study was conducted to understand the experiences of nurse managers with regard to the difficulties and opportunities they encountered during the pandemic. BACKGROUND Although many studies have been carried out to understand how nurses were affected in the COVID-19 pandemic, there are few studies that treat the experiences of nurse managers. METHODS In this qualitative descriptive study with 19 nurse managers working in pandemic management at a university hospital in Turkey during the first three waves of the pandemic, data were collected between April and July 2021 using the semi-structured interview method. Content analysis was performed to analyse the data. RESULTS Six themes were identified with respect to the experiences of nurse managers during the pandemic. These themes were initial reactions to the crisis, ineffective crisis management, excessive workload, the moral burden in decision-making, support of colleagues and other multidisciplinary team and nurse manager empowerment. CONCLUSIONS The nurse managers had difficulties in their managerial roles during the pandemic. However, they also viewed the crisis as an opportunity because they were able to note the deficiencies in management at all levels of the hospital and their leadership and decision-making roles took on more importance. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers may use the results of this study to be prepared for the continuing COVID-19 pandemic and any other emergency circumstances that they may have to face in the future.
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Affiliation(s)
- Sinem Ozmen
- Institute of Health ScienceDokuz Eylul UniversityİzmirTurkey
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11
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Lan Y, Han C, Liu X, Cao Q, Chen S, Xia Y. How and when perceived COVID-19 crisis strength impacts individuals' life satisfaction and sleep quality: A moderated mediation model. Front Public Health 2022; 10:944942. [PMID: 36117609 PMCID: PMC9470827 DOI: 10.3389/fpubh.2022.944942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/05/2022] [Indexed: 01/21/2023] Open
Abstract
The COVID-19 pandemic has caused millions of deaths, seriously hampering people's lives and their productivity. Drawing on social information processing theory, this research developed a moderated mediation model to investigate the influence of perceived COVID-19 crisis strength on individuals' well-being. The results from a sample of 441 suggest that individuals' perceived COVID-19 crisis strength indirectly affects their life satisfaction and sleep quality via their perceived risk of being infected. Moreover, both individuals' trust in local government and mindfulness trait can buffer the positive effect of perceived COVID-19 crisis strength on their perceived risk of being infected. At the same time, they also buffer the indirect impact of individuals' perceived COVID-19 crisis strength on life satisfaction and sleep quality through perceived risk of being infected. This research provides several practical implications for governments and individuals to mitigate the negative influences of the COVID-19 pandemic and help individuals boost life satisfaction and sleep quality.
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Affiliation(s)
- Yuanyuan Lan
- School of Business, Qingdao University, Qingdao, China
| | - Changlin Han
- School of Business, Qingdao University, Qingdao, China
| | - Xiaotong Liu
- School of Business, Qingdao University, Qingdao, China
| | - Qinqin Cao
- School of Business, Qingdao University, Qingdao, China
| | - Siyuan Chen
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Yuhuan Xia
- School of Innovation and Entrepreneurship, Shandong University, Qingdao, China
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12
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Impact of the COVID-19 Pandemic on the Work Engagement of UK Active Employees. Healthcare (Basel) 2022; 10:healthcare10071226. [PMID: 35885753 PMCID: PMC9318238 DOI: 10.3390/healthcare10071226] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 12/27/2022] Open
Abstract
The objective of this investigation was to describe the work engagement perceived by UK workers during the COVID-19 pandemic. A descriptive cross-sectional study was conducted. The sample included 1085 participants, aged 18 years and older, living in the UK during the COVID-19 pandemic, who were active workers. Data were collected using an online questionnaire and the UWES-9. They were analysed using descriptive statistics, a t-test for equality of means or ANOVA, and the Chi-squared Automatic Interaction Detection method. The mean value in the UWES-9 was 3.46 (SD = 1.11). Participants with lower satisfaction (21.8%) gave significantly low or very low UWES-9 scores in 58.5% of the cases. Greater work engagement was obtained with more resources and less conflict, risk, and stress. In cases where there had been contact with COVID-19, this was associated with slightly lower levels of work engagement. These results could motivate and guide companies to adopt risk prevention measures and protocols to return to normal working conditions after the initial crisis phase of the pandemic.
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Did Mindful People Do Better during the COVID-19 Pandemic? Mindfulness Is Associated with Well-Being and Compliance with Prophylactic Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095051. [PMID: 35564450 PMCID: PMC9105751 DOI: 10.3390/ijerph19095051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/19/2022]
Abstract
This paper investigates the relationship between mindfulness and well-being within the context of compliance with prophylactic measures in the time of COVID-19. We conducted a large-scale survey among a representative sample of the French population. We measured mindfulness, using the Mindful Attention Awareness Scale, and the extent to which respondents were impacted by COVID-19 in terms of their mood and quality of sleep, as well as how they complied with prophylactic measures. Our results suggest that more mindful individuals were less negatively impacted by COVID-19 with regard to their sleep and mood. Concerning the prophylactic measures, we obtained mixed results: more mindful participants were more likely to respect lockdowns, physical distancing and to cough in their sleeves, but did not wash their hands, wear masks or avoid touching their face more often than less mindful individuals.
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14
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Bossi F, Zaninotto F, D'Arcangelo S, Lattanzi N, Malizia AP, Ricciardi E. Mindfulness-based online intervention increases well-being and decreases stress after Covid-19 lockdown. Sci Rep 2022; 12:6483. [PMID: 35444198 PMCID: PMC9019542 DOI: 10.1038/s41598-022-10361-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/01/2022] [Indexed: 12/31/2022] Open
Abstract
Mindfulness interventions were shown to be effective in improving well-being and reducing perceived stress in several conditions. These effects were also found in online mindfulness-based training, especially in employees in organizational environments. The aim of this study was to test the effectiveness of an online mindfulness intervention on healthy employees, especially after the first Italian Covid-19 lockdown. Participants in the intervention group underwent an 8-week mindfulness online training program based on the Mindfulness-Based Stress Reduction (MBSR) protocol compared to a control (no-intervention) group. All participants filled in weekly surveys for the whole intervention duration via online questionnaires to measure their habits, mindfulness (FFMQ-15), emotion regulation (ERQ), positive and negative affect (PANAS), depression, anxiety and stress (DASS-21), resilience (RSA) and insomnia (ISI). 69 participants in the intervention group and 63 in the no-treatment control group were considered in the longitudinal analyses. We found significant differences between the intervention and control groups over time in the measures of mindfulness (in particular the nonreactivity subscale), positive affect, depression, and insomnia. Moreover, we found that the frequency of practice and ease perceived in practicing were positively correlated to several indices of well-being (mindfulness, positive affect, cognitive reappraisal) and negatively correlated to several indices of stress (negative affect, depression, anxiety, stress, insomnia, expressive suppression). These results show the importance and effectiveness of online mindfulness training programs to cope with stress among employees, especially after the Covid-19 lockdown.
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Affiliation(s)
- Francesco Bossi
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy.
| | - Francesca Zaninotto
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
- Department of Psychology, School of Social and Behavioural Sciences, Kingston University, London, UK
| | - Sonia D'Arcangelo
- Intesa Sanpaolo Innovation Center SpA Neuroscience Lab, Turin, Italy
| | - Nicola Lattanzi
- Axes Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Andrea P Malizia
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Emiliano Ricciardi
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
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Mamede A, Merkelbach I, Noordzij G, Denktas S. Mindfulness as a Protective Factor Against Depression, Anxiety and Psychological Distress During the COVID-19 Pandemic: Emotion Regulation and Insomnia Symptoms as Mediators. Front Psychol 2022; 13:820959. [PMID: 35432084 PMCID: PMC9010863 DOI: 10.3389/fpsyg.2022.820959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesResearch has linked mindfulness to improved mental health, yet the mechanisms underlying this relationship are not well understood. This study explored the mediating role of emotion regulation strategies and sleep in the relationship between mindfulness and symptoms of depression, anxiety and psychological distress during the COVID-19 pandemic.MethodsAs detailed in this study’s pre-registration (osf.io/k9qtw), a cross-sectional research design was used to investigate the impact of mindfulness on mental health and the mediating role of emotion regulation strategies (i.e., cognitive reappraisal, rumination and suppression) and insomnia. A total of 493 participants from the general population answered an online survey and were included in the final analysis. The online survey consisted of the short form of the Five-Facets Mindfulness Questionnaire (FFMQ-SF), the Impact of Event Scale-revised (IES-R), the Generalised Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-8), the Emotion Regulation Questionnaire (ERQ), the short form of the Rumination Response Scale (RSS-SF), and the Insomnia Severity Index (ISI).ResultsStructural equation modelling revealed that mindfulness was related to lower symptoms of depression, anxiety and psychological distress, both directly and indirectly. Mindfulness was negatively associated with rumination and insomnia. As hypothesised, models revealed that the associations between mindfulness and depression, anxiety and psychological distress were significantly mediated by its negative associations with rumination and insomnia. Our findings also demonstrated that rumination was related to increased insomnia symptoms, which in turn was associated with increased mental health problems, indicating a mediated mediation. Mindfulness was also positively associated with cognitive reappraisal and negatively associated with suppression, which were, respectively, negatively and positively associated with depressive symptoms, and thus functioned as specific mediators of the association between mindfulness and depression.ConclusionOur findings suggest that rumination and insomnia operate transdiagnostically as interrelated mediators of the effects of mindfulness on mental health, whereas cognitive reappraisal and suppression function as specific mediators for depression. These insights emphasise the importance of targeting emotion regulation and sleep in mindfulness interventions for improving mental health. Limitations and implications for practice are discussed.
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Affiliation(s)
- André Mamede
- Department of Psychology, Education and Child Development, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- *Correspondence: André Mamede,
| | - Inge Merkelbach
- Department of Psychology, Education and Child Development, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Gera Noordzij
- Department of Psychology, Education and Child Development, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- Erasmus University College, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Semiha Denktas
- Department of Psychology, Education and Child Development, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
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Does Mindfulness Moderate the Link of Worry About COVID-19 With Adjustment? An Actor-Partner Interdependence Model Approach. Mindfulness (N Y) 2022; 13:627-636. [PMID: 35126766 PMCID: PMC8799446 DOI: 10.1007/s12671-021-01818-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 12/03/2022]
Abstract
Objectives COVID-19 constitutes an unprecedented mental health challenge to the world. At this critical time, it is important to identify factors that may boost individuals’ well-being or render individuals more resistant to the negative impact of COVID-19-related stressors. The goals of this study were to examine whether individuals’ and their partners’ worry about COVID-19 were linked to individuals’ psychological, social, and cognitive adjustment and test individuals’ and their partners’ mindfulness as possible moderators. Methods Cross-sectional, dyadic data were collected from 211 Chinese couples with kindergarten-aged children living in Hong Kong, China, during its fourth major outbreak of COVID-19 (between December 2020 and January 2021). Using paper-and-pencil questionnaires, fathers and mothers independently reported their worry about COVID-19, mindfulness, depressive symptoms, social difficulties, and cognitive problems. Results Actor-Partner-Interdependence Models revealed that, controlling for individuals’ gender and education levels, individuals’ worry about COVID-19 and mindfulness were positively and negatively associated with their own depressive symptoms, social difficulties, and cognitive problems, respectively. The worry of individuals’ partners was also positively associated with individuals’ depressive symptoms and social difficulties. These associations, however, were only significant when the partners had low but not high levels of mindfulness. Conclusions Our study highlighted the importance of studying the potential benefits of mindfulness at not only the individual but also the dyadic level.
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Accept Anxiety to Improve Sleep: The Impact of the COVID-19 Lockdown on the Relationships between Mindfulness, Distress, and Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413149. [PMID: 34948759 PMCID: PMC8701850 DOI: 10.3390/ijerph182413149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/04/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022]
Abstract
It has been recently proposed that mindfulness can improve sleep quality through the mediating role on psychological distress and that acceptance may play a pivotal role in mindfulness beneficial effects. The aim of the present work was to understand the effects of the COVID-19 lockdown on dispositional mindfulness, sleep, and distress, and on their relationships. In particular, we wanted to test the hypothesis that the detrimental effects of lockdown on sleep depended on mindfulness and distress (including anxiety and depression) and that the acceptance facet of mindfulness played the leading role. A longitudinal study based on self-report questionnaires was conducted on 39 Italian adults (M age = 35.03, SD = 14.02; 21 men) assessing mindfulness, distress, and sleep quality before (23 December 2019–8 March 2020) and during (27 April 2020–10 May 2020) the first Italian COVID-19 lockdown. Lockdown decreased mindfulness while increasing distress and sleep problems. Path analysis showed that the effects of lockdown on sleep were fully mediated by mindfulness and distress. Furthermore, a more detailed analysis showed that these effects were mainly dependent on the acceptance component of mindfulness working through anxiety. The present study confirms, in the context of the COVID-19 lockdown, a model according to which mindfulness, and specifically acceptance, influences sleep through the mediating role of distress.
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Singla H, Mehta MD, Mehta P. Manifesting hope in despair: Exploring prosocial behavioural outcomes of COVID-19. INTERNATIONAL SOCIAL SCIENCE JOURNAL 2021; 71:51-67. [PMID: 34898717 PMCID: PMC8652769 DOI: 10.1111/issj.12290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 02/17/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Abstract
The novel coronavirus (COVID-19) outbreak has resulted into global devastation. This study attempts to explore the positive phenomenal impact of perceived pandemic anxiety resulting in prosocial behaviour (PB) through the mechanisms of self-awareness and spiritual transformation using terror management theory (TMT). The study also examines the moderating impact of conscious state expansion (CSE) on the self-awareness and spiritual transformation relationship, and the impact of this moderation effect is further tested separately on two gender groups. The data (N = 573) for the study were collected from the Punjab state of India during the ascending phase of outbreak. The results of PLS-SEM analysis reveal the significant influence of variables under study on prosocial behavioural outcomes. Taking insights from the findings of the study it becomes clear that during dreadful situations, when people experience the possibility of loss of life, their self-awareness level increases, which in turn results in their spiritual transformation. Such mechanism is observed more in the people possessing higher spiritual consciousness. The study concludes by recognising the positive role played by spiritual transformation (ST) in the evolution of the attributes of care and compassion for others, resulting in positive social consequences. The discussion, implications, limitations, and future directions are presented and discussed.
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Affiliation(s)
| | - Minakshi Duggal Mehta
- Assistant ProfessorPost Graduate Department of CommerceHans Raj Mahila MahavidyalayaJalandharPunjabIndia
| | - Pooja Mehta
- Assistant ProfessorSri Aurobindo College of Commerce and ManagementLudhianaPunjabIndia
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Self-Compassion and Rumination Type Mediate the Relation between Mindfulness and Parental Burnout. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168811. [PMID: 34444555 PMCID: PMC8393602 DOI: 10.3390/ijerph18168811] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 lockdown increased the day-to-day challenges faced by parents, and thereby may have increased parental burnout risk. Therefore, identifying parental burnout protection factors is essential. This study aimed to assess the protective role of the following factors which can be increased through mindfulness practice: trait mindfulness, self-compassion, and concrete vs. abstract ruminations. A total of 459 parents (Mage = 40; 98.7% female) completed self-reported questionnaires at two-time points to assess the predictive role of mindfulness on parental burnout, self-compassion and rumination type, and the mediating role of self-compassion and rumination type in the relation between mindfulness and parental burnout. Results showed that trait mindfulness, self-compassion, and rumination type at Time 1 predicted levels of parental burnout at Time 2. Self-compassion (indirect effects: b = − 22, 95% CI = [−38, −05], p < 0.01), concrete ruminations (indirect effects: b = −20, 95% CI = [−32, −09], p < 0.001), and abstract ruminations (indirect effects: b = −0.54, 95% CI = [−71, −37], p < 0.001) partially mediated the relation between trait-mindfulness and parental burnout. These findings showed that trait mindfulness, self-compassion, and concrete (vs. abstract) ruminations may help prevent parental burnout in the context of the COVID-19 pandemic. These results contribute to the field of research on parental burnout prevention and will allow for the development of effective approaches to mental health promotion in parents.
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A Qualitative Study Comparing Mindfulness and Shinrin-Yoku (Forest Bathing): Practitioners’ Perspectives. SUSTAINABILITY 2021. [DOI: 10.3390/su13126761] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The boundary between mindfulness and forest bathing, two conceptually related therapies, is unclear. Accordingly, this study reports the strengths and challenges, similarities and differences, and barriers and facilitators for both. Semi-structured interviews were conducted with seven trained and experienced practitioners of both mindfulness and forest bathing. Reflexive thematic analysis revealed four main themes: (i) differences between the approaches; (ii) the benefits of forest bathing; (iii) biophilia through forest bathing; and (iv) inward versus outward attentional focus as a distinction between the approaches. Both practices were found to benefit well-being, but practitioners revealed key barriers to mindfulness. For vulnerable groups experiencing mental health challenges or difficulties achieving a meditative state, mindfulness may introduce well-being risks. By offering a gentler, more intuitive approach that encourages outward attentional focus, forest bathing was found to overcome this barrier. Forest bathing is suitable for all groups, but adaptations are recommended for those expressing fear or discomfort in forested environments. The findings inform how to position both approaches in practice, as a first step towards social prescribing recommendations. Wider implications concern forest bathing’s potential to impact environmental well-being. Future research must garner comparative data, involve young people, and explore the feasibility of a forest bathing social prescription.
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21
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COVID-19 is a moderating variable with its own moderating factors. INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY-PERSPECTIVES ON SCIENCE AND PRACTICE 2021. [DOI: 10.1017/iop.2021.38] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lu Y, Remond J, Bunting M, Ilies R, Tripathi N, Narayanan J. An App-Based Workplace Mindfulness Intervention, and Its Effects Over Time. Front Psychol 2021; 12:615137. [PMID: 33967887 PMCID: PMC8101632 DOI: 10.3389/fpsyg.2021.615137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/22/2021] [Indexed: 11/27/2022] Open
Abstract
We investigated the week-to-week effects of a mindfulness intervention on emotional exhaustion, work engagement, and job satisfaction in a field study involving 218 participants who participated and reported their weekly outcomes during the 8-week program. To examine how mindfulness impacted work outcomes, we used intraindividual modeling of the 8-week data. Mindfulness increased over time, and time also had indirect effects on emotional exhaustion, work engagement, and job satisfaction, through mindfulness. Supplementary growth curve analyses on the improvement of mindfulness over time showed a slight decrease in the positive effect of time on mindfulness.
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Affiliation(s)
- Yizhen Lu
- Department of Management and Organization, National University of Singapore, Singapore, Singapore
| | | | | | - Remus Ilies
- Department of Management and Organization, National University of Singapore, Singapore, Singapore
| | - Neha Tripathi
- Department of Management and Organization, National University of Singapore, Singapore, Singapore
| | - Jayanth Narayanan
- Department of Management and Organization, National University of Singapore, Singapore, Singapore
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Bäuerle A, Jahre L, Teufel M, Jansen C, Musche V, Schweda A, Fink M, Dinse H, Weismüller B, Dörrie N, Junne F, Graf J, Skoda EM. Evaluation of the E-Mental Health Mindfulness-Based and Skills-Based "CoPE It" Intervention to Reduce Psychological Distress in Times of COVID-19: Results of a Bicentre Longitudinal Study. Front Psychiatry 2021; 12:768132. [PMID: 34803775 PMCID: PMC8599585 DOI: 10.3389/fpsyt.2021.768132] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/11/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The SARS-CoV-2 pandemic poses immense challenges for health care systems and population-wide mental health. The e-mental health intervention "CoPE It" has been developed to offer standardized and manualized support to overcome psychological distress caused by the pandemic. The aim of this study was to assess the effectiveness of "CoPE It" in terms of reducing distress (primary outcome), depression and anxiety symptoms, and improving self-efficacy, and mindfulness (secondary outcomes). Furthermore, the intervention's usability, feasibility, and participants' satisfaction with "CoPE It" was evaluated (tertiary outcome). The study protocol has been published previously. Methods: A bicentre longitudinal study was conducted from April 27th 2020 to May 3rd 2021. N = 110 participants were included in the analyses. The intervention consisted of four modules featuring different media promoting evidence-based methods of cognitive behavioral therapy and mindfulness-based stress reduction. Difference in psychological distress between baseline (T0) and post-intervention (T1) were analyzed by repeated measure analysis of covariance. Mixed linear models were applied to assess moderating effects. Depressive symptoms, generalized anxiety symptoms, self-efficacy, and mindfulness were compared between baseline (T0) and post-intervention (T1) via t-tests. Usability of the "CoPE It" intervention and participants' satisfaction was evaluated by calculation means and frequencies. Results: Primary outcome: A significant effect of time on psychological distress at post-intervention (T1) after controlling for age, gender, education, mental illness and attitudes toward online interventions was found. Depressive and anxiety symptoms, and mindfulness were a significant moderators of the relationship between time and psychological distress for consistent wording. Secondary outcomes: There was a significant decrease in depressive symptoms and generalized anxiety, and a significant increase in self-efficacy and mindfulness between baseline (T0) and post-intervention (T1). Tertiary outcomes: 95.83% of the participants thought the "CoPE It" intervention was easy to use and 87.50% were satisfied with the "CoPE It" intervention in an overall, general sense. Conclusion: The e-mental health "CoPE It" intervention seems to be an effective approach in reducing psychological distress, anxiety and depressive symptoms, and in enhancing self-efficacy and mindfulness during the COVID-19 pandemic. Participants' satisfaction and the program's feasibility, and usability were proven to be high. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: DRKS00021301.
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Affiliation(s)
- Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lisa Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Venja Musche
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adam Schweda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Madeleine Fink
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hannah Dinse
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Benjamin Weismüller
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nora Dörrie
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.,Department for Psychosomatic Medicine and Psychotherapy, Otto Von Guericke University Magdeburg, Magdeburg, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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