Mindfulness-Based IARA Model® Proves Effective to Reduce Stress and Anxiety in Health Care Professionals. A Six-Month Follow-Up Study

The efficacy of mindfulness-based programs in reducing anxiety among nurses in hospital settings: A systematic review

BACKGROUND

The increasing pressure of their professional duties has led to a notable concern regarding the mounting anxiety levels among nurses. The ongoing discussion revolves around the efficacy of mindfulness as a means to alleviate anxiety in nurses.

AIM

This systematic review evaluated the effectiveness of mindfulness in reducing anxiety among nurses.

METHODS

The evaluation followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. An extensive and comprehensive search was conducted across eight databases to identify studies that utilized randomized controlled trials (RCTs) and were published in English between 2011 and 2022. Independently, two reviewers assessed the validity of the randomized controlled trials using the Consolidated Standards of Reporting Trials criteria. Additionally, two authors independently employed the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-2) method to evaluate the potential bias in the RCTs.

RESULTS

Eight randomized controlled trial studies that were deemed eligible were included in the current analysis. Based on the literature review, it was determined that mindfulness-based training can assist nurses in reducing their anxiety levels. Furthermore, the effectiveness of mindfulness-based programs in enhancing nurses' mindfulness and self-compassion has been firmly established.

LINKING EVIDENCE TO ACTION

Based on existing literature, mindfulness-based interventions have proven to be effective in reducing anxiety levels among nurses. However, in order to enhance the overall quality of research, it is necessary to implement more rigorous controlled designs that include randomization. Additionally, larger sample sizes with a diverse range of participants are needed to establish and validate the effectiveness of mindfulness-based programs in alleviating anxiety among nurses. Implementing mindfulness-based training in healthcare organizations can offer numerous benefits. One such advantage is that it can help nurses in reducing anxiety and enhancing their ability to handle the pressures associated with their profession.

STUDY REGISTRATION

PROSPERO Protocol registration ID: CRD42023475157.

Improving well-being and enhancing awareness in patients undergoing hemodialysis through the person-centered IARA model: an exploratory study

Chronic kidney disease (CKD) globally represents a significant health challenge, particularly among patients undergoing chronic hemodialysis. A careful nutritional and pharmacological prescription plays a key role in the effective management of these patients to optimize serum electrolytes, such as potassium, phosphorus, and protein intake. Furthermore, these patients can suffer psychological distress due to dietary restrictions and tight medication schedules. The present study explores the effectiveness of the person-centered IARA model in improving physiological markers and quality of life in CKD patients undergoing hemodialysis treatment. To demonstrate the effectiveness of the IARA model, 60 patients (M = 40; F = 20; 60.5 ± 9.9 years) undergoing thrice-weekly hemodialysis sessions were enrolled and randomly and blindly assigned to the Control or IARA group. The reduction in abnormal blood potassium, phosphorus, and total protein levels was investigated, alongside the psychological state through the SF-12 questionnaire. Preliminary findings showed a discernible reduction in the frequency of abnormal blood K (> 5.0 mmol/L) and P (> 4.5 mmol/L) levels in the IARA group compared to the Control group. In particular, such reductions were approximately 40% for K (OR = 0.57; 95% CL = 0.23/1.46) and about 15% for P (OR = 0.86; 95% CL = 0.27/2.74). A similar tendency was also observed for patient fluid intake during each hemodialysis session, with the frequency of higher-risk patients in the IARA group being 50% lower (OR = 0.50; 95% CL = 0.07/3.79) than that of the Control group. Although preliminary findings from this study suggest that the IARA model may have a positive effect on CKD patients' subjective wellbeing and quality of life (QoL), further research is needed to understand the long-term impact of the IARA intervention.

Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis

Background

Growing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain.

Aims

To evaluate the evidence for MBIs in improving healthcare workers' psychological well-being.

Methods

A systematic literature search was conducted on Medline, Embase, Cumulative Index for Nursing and Allied Health Literature, PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords 'healthcare worker', 'doctor', 'nurse', 'allied health', 'mindfulness', 'wellness', 'workshop' and 'program'. Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion. R V.4.0.3 was used for data analysis, with the standardised mean difference as the primary outcome, employing DerSimonian and Laird's random effects model. Grading of Recommendations, Assessment, Development and Evaluation framework was used to evaluate the quality of evidence. Cochrane's Risk of Bias 2 tool was used to assess the risk of bias in the included studies.

Results

A total of 27 studies with 2506 participants were included, mostly from the USA, involving various healthcare professions. MBIs such as stress reduction programmes, apps, meditation and training showed small to large effects on anxiety, burnout, stress, depression, psychological distress and job strain outcomes of the participants. Positive effects were also seen in self-compassion, empathy, mindfulness and well-being. However, long-term outcomes (1 month or longer postintervention) varied, and the effects were not consistently sustained.

Conclusions

MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers. The review also highlights limitations such as intervention heterogeneity, reduced power in specific subgroup analyses and variable study quality.

PROSPERO registration number

CRD42022353340.

The Impact of Psychological Interventions with Elements of Mindfulness on Burnout and Well-Being in Healthcare Professionals: A Systematic Review

Background

Healthcare professionals are highly likely to experience various causes of work-related stress, which often leads to burnout. This became even more obvious during the Covid-19 pandemic. This systematic review aimed to analyze articles where psychological interventions with elements of mindfulness (PIM) were used to support healthcare professionals to foster well-being and reduce burnout levels. Compared to other recently published reviews, it is unique, due to its focus on a wide group of healthcare professionals, a broader selection of psychological interventions, and the evaluation of any sustained effects.

Methods

Systematic searches were carried out in February 2021 with different combinations of Boolean operators within six electronic databases: PubMed, EBSCOhost, MEDLINE, PsycArticles, Cochrane Library, JSTOR and Cobiss. We included articles that had been published in the last ten years (2011 to 2021) and which reported on original research focused on evaluating the influence of PIM on healthcare professionals. MERSQI was used to assess the quality of the included studies.

Results

Of 1315 identified studies, 15 were included in this systematic review. Regardless of the specific type, duration and setting (individual vs group) of PIM applied, the results demonstrated a positive impact on well-being and burnout in participating healthcare professionals. The most studied interventions involved MBSR (mindfulness-based stress reduction) and other mindfulness training programmes, in online as well as in-person versions.

Conclusion

Given the new reality with the presence of the SARS-Cov-2 virus, it is of the utmost importance to offer feasible, effective interventions for burnout reduction to vulnerable groups of healthcare professionals. By focusing on their needs, several key aspects of burnout and mindfulness could be efficiently improved; this review demonstrates that short, online interventions could be as effective as longer, in-person ones.

Individual-level interventions for reducing occupational stress in healthcare workers

BACKGROUND

Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions.  OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms.  SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022.

SELECTION CRITERIA

We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms.  DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour);  2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise);  3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above.  The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended).  MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised.  The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants.  Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention  Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention.  A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type  Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar.

AUTHORS' CONCLUSIONS

Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.

Evaluation of Cardiovascular Activity and Emotional Experience in Healthcare Workers (HCWs) Operating in COVID-19 Wards

The new 2019 coronavirus or SARS-CoV-2 has been the first biological agent to generate, in this millennium, such a global health emergency as to determine the adoption of public health measures. During this sanitary emergency, the emotional experience of healthcare workers (HCWs) has been hugely tested by several factors. In fact, HCWs have been exposed to greatly tiring physical, psychological and social conditions. The authors investigated the cardiocirculatory activity of a group of HCWs as well as how they perceived stress while working in COVID-19 wards. In particular, every HCW underwent a medical check, an electrocardiographic base exam, systolic and diastolic pressure measurement, and cardio frequency measurement. Furthermore, each HCW was provided with a cardiac Holter device (HoC) and a pressure Holter (Hop). Some psychological factors were considered in order to quantify the stress perceived by each HCW while at work through the administration of two questionnaires: the "Social Stigma towards Patients due to COVID Scale (SSPCS)" and the "Professional Quality of Life Scale (ProQOL)". The HoC and HoP analysis results for HCWs working in COVID-19 OU wards showed significant variations in cardiocirculatory activity. From the analysis of the SSPCS questionnaire answers, it is clear that all of them showed a sense of duty towards their patients. The analysis of the ProQOL questionnaire answers showed that the prevailing attitude is fear; however, HCWs did not absolutely discriminate against those who had COVID-19 nor did they refuse to help those in need. Continuous monitoring of these employees, also carried out through occupational medicine surveillance, allows for the detection of critical conditions and the implementation of actions aimed at preventing chronic processes.

The Role of the Person Focused IARA Model in Reducing Anxiety and Improving Body Awareness and Illness Management in Diabetics with Acquired Lipodystrophy: A Mixed-Method Study

Background: Lipodystrophy is one of the most frequent complications in people with diabetes following subcutaneous insulin therapy, and poor management can lead to several problems, such as impaired glycemic control and adherence to therapy, anxiety, and depression. Poor injection technique represents the main risk factor for lipodystrophies. In order to enhance the patient’s insulin injection technique to heal lipodystrophy, improve psychological indices, and promote involvement in their health and care, the efficacy of emerging person-centered care called the IARA model was tested. Methods: A total of 49 patients were randomly allocated to the IARA group (Experimental; n = 25) or standard education (Control; n = 24). The following questionnaires were used in a mixed-method design: (i) State Anxiety Scale; (ii) Beck Depression Inventory; (iii) Italian Summary of Diabetes Self-Care Activities. An ad hoc open-ended questionnaire was structured for the qualitative analysis. Finally, photos were taken in order to verify if injection sites were changed until the follow-up at 12 months. The number of patients who participated until the completion of the study was 17 in the IARA and 11 in the Control group. Results: State anxiety was significantly reduced in people who followed IARA to follow-up at 3 and 6 months (p < 0.05). The IARA group also demonstrated better compliance in blood glucose monitoring and foot-care compared to Control at follow-up at 12 months. The management of insulin injections dramatically improved in participants who received IARA intervention. Conclusions: IARA could be considered an effective strategy to improve well-being and compliance in people affected with diabetes mellitus and lipodystrophy complications.

Work Ability after Breast Cancer: Study of Healthcare Personnel Operating in a Hospital of South Italy

Breast cancer (BrC) treatment can produce disabilities that often impact the quality of daily life and impact the social and working relationships of the patient. This paper looked into the remaining work ability in a group of female healthcare personnel (HCPs) with BrC in Southern Italy. Each HCP was subjected to a medical check, routine blood tests, and a questionnaire on the work ability index (WAI). Of 980 (100%) HCWs undergoing health control, 6% (n = 54) had experienced BRC, and only 66.6% (n = 36) agreed to take part in the study. A total of 28 (78%) were on night shifts. The WAI score was quite low in 5 (13.8%) cases, moderate in 10 (27.7%) cases, good in 14 (38.8%) cases, and excellent in 7 (19.5%) HCWs. Among all health figures, in nurses as well as technical staff, lower WAI scores were observed. HCWs reported various comorbidities, which affected WAI score, such as limited mobility in the upper limbs, arm/shoulder pain, numbness, and lymphoedema. The main complication that negatively affects any work activity is the morbidity in the upper limbs. This seems to affect the ability to perform tasks, and the re-entry to work is highlighted on sick leave days.

Validity and Psychometric Properties of the ILO-WHO Workplace Stress Scale: A Study with Workers from the Canary Islands

Occupational stress, as a negative facet, is a pervasive problem with significant implications for organizations, employees, welfare systems and health. The implementation of measurement tools that can capture the different organizational dimensions that determine stress in workers is part of the stress management and troubleshooting strategy that every company must manage daily. The aim of the present study was to adapt and validate the 25-item version of the ILO-WHO stress scale by Ivancevich and Matteson in the context of the Canary Islands of Spain. The tool assesses specific organizational dimensions of work-related stress determinants: organizational climate and structure, leader influence, cohesion, territory, technology and group support. An exploratory factor analysis (EFA) on a sample of 1510 Canary Islands workers was carried out. The results indicate that the job stress scale revealed adequate psychometric properties, construct validity and internal consistency (Cronbach’s alpha = 0.972), and it can be profitably used to measure stress. At the end of the paper, theoretical and practical implications are discussed.

Effects of Incontro, Alleanza, Responsabilita, Autonomia Intervention Model Combined with Orem Self-Care Model and the Use of Smart Wearable Devices on Perceived Stress and Self-Efficacy in Patients after Total Hip Arthroplasty

Objective

To explore the effects of Incontro, Alleanza, Responsabilita, Autonomia (IARA) combined with Orem self-care model and the use of smart wearable devices on perceived stress and self-efficacy in patients after total hip arthroplasty (THA).

Methods

A total of 60 patients after THA in our hospital were enrolled. Patients were randomly divided into control group (IARA intervention model combined with Orem self-care model) and study group (intelligent wearable device combined conference-IARA and Orem self-care model). Harris hip function score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, functional independence measure (FIM) score, social support level, perceived stress, and self-efficacy were compared between the two groups.

Results

Harris hip function score, WOMAC score, FIM score, and the level of social support of the study group were higher compared with the control group after operation (P < 0.05). Additionally, the perceptual pressure in the study group was lower compared with the control group after intervention (P < 0.05). The self-efficacy of the two groups was compared, and the self-efficacy of the study group was higher than that of the control group at 4, 6, 8, and 12 weeks after the intervention, and the difference was statistically significant (P < 0.05).

Conclusion

Patients after THA utilize an intelligent wearable device combined with IARA model and Orem self-care model, which can effectively reduce awareness pressure, improve self-efficacy, and facilitate the improvement of the hip fracture.

An Integrative Review on the Research Progress of Mindfulness and Its Implications at the Workplace

Mindfulness has rapidly become a significant subject area in many disciplines. Most of the work on mindfulness has focused on the perspective of health and healthcare professionals, but relatively less research is focused on the organizational outcomes at the workplace. This review presents a theoretical and practical trajectory of mindfulness by sequential integration of recent fragmented scholarly work on mindfulness at the workplace. The review showcases that most contemporary practical challenges in organizations, such as anxiety, stress, depression, creativity, motivation, leadership, relationships, teamwork, burnout, engagement, performance, well-being, and physical and psychological health, could be addressed successfully with the budding concept of mindfulness. The causative processes due to higher mindfulness that generate positive cognitive, emotional, physiological, and behavioral outcomes include focused attention, present moment awareness, non-judgmental acceptance, self-regulatory functions, lower mind wandering, lower habit automaticity, and self-determination. Employee mindfulness could be developed through various mindfulness interventions in order to improve different organizational requirements, such as psychological capital, emotional intelligence, prosocial behavior, in-role and extra-role performance, financial and economic performance, green performance, and well-being. Accordingly, this review would be beneficial to inspire academia and practitioners on the transformative potential of mindfulness in organizations for higher performance, well-being, and sustainability. Future research opportunities and directions to be addressed are also discussed.

Global Psychological Implications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Coronavirus Disease-2019 (COVID-19). What Can Be Learned From Italy. Reflections, Perspectives, Opportunities

On December 31, 2019, the Chinese authorities announced that in the city of Wuhan, Hubei Province, central-eastern China, a cluster of pneumonia cases of unknown etiology had developed. A new coronavirus (SARS-CoV-2) that causes serious problems like pneumonia and even death, has been discovered. This new disease (COVID-19) has spread also in Italy starting from the first recognized case on February 20. Beyond its biological implications, this coronavirus allows us many psychological reflections. A new virus is indeed a potentially serious problem for mankind, but it can also be an opportunity to bring the focus back to us, to observe what is happening, who we are and how we are reacting both as individuals and as a population. Even positive implication of this pandemic was discussed.

Study Protocol of Brief Daily Body-Mind-Spirit Practice for Sustainable Emotional Capacity and Work Engagement for Community Mental Health Workers: A Multi-Site Randomized Controlled Trial

Background

Given the emotional demanding nature of social services, we developed a brief daily body-mind-spirit (BMS) program and successfully piloted it with workers at elderly services. The proposed study focuses on community mental health workers who are often under chronic stress and vulnerable to burnout.

Methods

The study aims to evaluate the program for fostering sustainable emotional capacity and work engagement for community mental health workers. A multi-site randomized controlled trial design is adopted. All the 24 the Integrated Community Centre for Mental Wellness (ICCMW of Hong Kong will be approached to join this program. Assuming conservatively, 60% ICCWM (14 centers) will respond and participate. At each site, a pair of intervention and control groups will be run. The targeted total sample size is 224. To investigate the course of changes in burnout and engagement, each group will last 6 months, including 3-month intervention and 3-month follow-up. Measures will be taken at monthly intervals.

Discussion

In light of literature and the pilot trial’s findings, participants in the Brief Daily BMS intervention group are expected to have a reduced burnout level and a narrowing of range in work engagement during the 3 months intervention. And within the 3 months post-intervention period, a rebound of burnout level and a widening of range in work engagement are expected to be observed in the same group of participants. Hopefully, this study will contribute to the deeper understanding of burnout and work engagement, and shed light on sustainable intervention for emotionally demanding workplaces.

Clinical Trial Registration

The trial has been registered in the Clinical Trials Centre of the University of Hong Kong. HKUCTR-2763 Registered 27 December 2019 – Retrospectively registered, http://www.hkuctr.com/Study/Show/eb930d24e2c647afb7a922055163f24b.

Mindfulness as a Protective Factor for Dissatisfaction in HCWs: The Moderating Role of Mindful Attention between Climate Stress and Job Satisfaction

With the aim of investigating the possible moderating effect of job control and dispositional mindfulness between different sources of organizational stress and job satisfaction, a correlational study was designed involving health care workers (HCWs). The following questionnaires were administered and completed by 237 HCWs: (1) Occupational Stress Indicator (OSI), to measure the sources of stress at work (managerial role, climate power, climate structure, internal relationships), and job satisfaction; (2) Mindfulness Attention Awareness Scale (MAAS) to assess the individual’s level of attention to what is taking place in the present; (3) Job Control Scale (JCS) to assess the perceived control at work. Hierarchical regression analyses were used to test the hypothesized relationships between variables; the results showed that, between the different sources of stress, the organizational climate dimension was negatively associated with job satisfaction; moreover, mindfulness attention moderated the relationship between climate stress and job satisfaction; unexpectedly, the interaction between job control and the organizational climate dimension was not significant in affecting job satisfaction. This study can provide useful information for Human Resources Management (HRM) practices regarding job and mental control interventions and empowerment, and possibly offer a new interpretation of the role of attention to what is happening in the present moment and autonomy between climate stressors and occupational satisfaction.

Social Stigma during COVID-19 and its Impact on HCWs Outcomes

The COVID-19 emergency has significantly transformed the working environment and job demands. Providing care was emotionally difficult for healthcare workers. Uncertainty, stigmatisation, and potentially exposing their families to infection were prominent themes for healthcare workers (HCWs) during the crisis, which first broke out in China at the end of 2019, and then in Italy in early 2020. This study examined the effects of stigma, job demands, and self-esteem, and the consequences of working as a “frontline care provider” with patients infected with the coronavirus (COVID-19). A correlational design study involved 260 healthcare workers (HCWs) working in a large hospital in southern Italy. The following questionnaires were administered: (1) the Job Content Questionnaire (JCQ), for assessing psychological and physical demands; (2) the Professional Quality of Life Scale (ProQOL) to measure the quality individuals feel in relation to their work as “frontline care providers”, through three dimensions: compassion fatigue (CF), burnout (BO), and compassion satisfaction (CS); (3) the Rosenberg Self-Esteem Scale, for evaluating individual self-esteem; (4) a self-administered multiple-choice questionnaire developed by See et al. about attitudes of discrimination, acceptance, and fear towards HCWs exposed to COVID-19. The findings suggest that stigma has a high impact on workers’ outcomes. Stigma may influence worker compliance and can guide management communication strategies relating to pandemic risk for HCWs.

Burnout and Self-Perceived Instructional Competence: An Exploratory Study of a Group of Italian Female Elementary School Teachers

Since the first half of the 1980s, burnout in teachers has been the object of particular attention by many international authors. Teachers are subject, more than other professions, to numerous and heavy pressures, covering the peculiarity of the profession. The objectives of the present research are to measure the predictive role of emotional exhaustion, depersonalization, and personal accomplishment on the quality of teaching in a group of elementary school teachers. We carried out a cross-sectional study involving 324 Sicilian female teachers, who worked in three school orders: Kindergarten, primary school, and the first year of middle school. Participants completed a socio-demographic questionnaire, the assessment teaching scale for primary school teachers (ECAD-EP), and the Maslach Burnout Inventory (MBI). In reference to the level of burnout, the correlation analysis underlined the presence of a positive correlation between: Emotional exhaustion and depersonalization; and a negative correlation between exhaustion and depersonalization. Furthermore, a predictive role of emotional exhaustion, depersonalization, and personal accomplishment on the quality of teaching in a group of primary school teachers was found.

Straining at Work and Its Relationship with Personality Profiles and Individual Consequences in Healthcare Workers (HCWs)

Straining is an attenuated form of mobbing, in which the continuity of vexatious actions is not driven by a discriminatory intent. With the objective of testing the possible moderating role of personality in the relationship between perceptions about straining at work and individual consequences, a correlational design research involved 374 healthcare workers (HCWs) from two Italian hospitals. The following questionnaires were administered: (1) Short Negative Acts Questionnaire (S-NAQ), to assess discriminative actions at work); (2) the Italian version of the Big Five Inventory (BFI-10 scale), to assess personality factors; (3) Occupational Stress Indicator (OSI), to measure psychological and physical health. Regression analysis and Structural Equation Models (SEM) were computed in order to test the relationships between variables. Perceived straining showed significant correlations with both psychological and physical health. Conscientiousness was inversely proportional to work-related bullying (WB), as agreeableness was to personal bullying (PB). Emotional stability was negatively correlated with all the three component scales of S-NAQ: WB, PB, and social bullying. The results seem to confirm that straining perceptions especially elicit, through emotional stability, psychological consequences. As regards the role of emotional stability in risk perceptions, it seems management has to pay thorough attention to personal factors in organizational perceptions and to straining actions.

Implementation of a Mindfulness-Based Crisis Intervention for Frontline Healthcare Workers During the COVID-19 Outbreak in a Public General Hospital in Madrid, Spain

Introduction: The COVID-19 outbreak is having an impact on the well-being of healthcare workers. Mindfulness-based interventions have shown effectiveness in reducing stress and fostering resilience and recovery in healthcare workers. There are no studies examining the feasibility of brief mindfulness-based interventions during the COVID-19 outbreak. Materials and Methods: This is an exploratory study with a post intervention assessment. We describe an on-site brief mindfulness intervention and evaluate its helpfulness, safety, and feasibility. Results: One thousand out of 7,000 (14%) healthcare workers from La Paz University Hospital in Madrid (Spain) participated in at least one session. One hundred and fifty out of 1,000 (15%) participants filled out a self-report questionnaire evaluating the helpfulness of the intervention for on-site stress reduction. Ninety two subjects (61%) participated in more than one session. Most of the participants were women (80%) with a mean age of 38.6 years. Almost half of the sample were nurses (46%). Sessions were perceived as being helpful with a mean rating of 8.4 on a scale from 0 to 10. Only 3 people (2%) reported a minor adverse effect (increased anxiety or dizziness). Discussion: Our data supports the utility, safety and feasibility of an on-site, brief mindfulness-based intervention designed to reduce stress for frontline health workers during a crisis. There is a need to continue testing this type of interventions, and to integrate emotion regulation strategies as an essential part of health workers' general training. Clinical Trial Registration number: NCT04555005.