Impact of short term yoga intervention on mental well being of medical students posted in community medicine: a pilot study

The psychosomatic impact of Yoga in medical education: a systematic review and meta-analysis

Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve the physical and mental well-being of learners. This study aimed to evaluate the effectiveness of yoga intervention in improving cardiopulmonary parameters such as blood pressure, heart rate, pulmonary function tests and psychosomatic symptoms such as depression, anxiety and stress in medical and dental students. Using the PRISMA protocol, a search from databases such as PubMed, Scopus, and Embase resulted in 304 relevant articles. After screening the title and abstracts, 47 papers were analyzed thoroughly and included in the qualitative analysis. 18 articles with homogenous statistical data on physiology and psychological parameters were included for meta-analysis. In comparison to the control group, the study showed a significant reduction of systolic blood pressure (SBP: 6.82 mmHg, z = -3.06, p = 0.002), diastolic blood pressure (DBP: 2.92 mmHg, z = -2.22, p = 0.03), and heart rate (HR: 2.55 beats/min, z = -2.77, p = 0.006). Additionally, data from 4 studies yielded a significant overall effect of a stress reduction of 0.77 on standardized assessments due to the yoga intervention (z = 5.29, p < 0.0001). Lastly, the results also showed a significant (z = -2.52, p = 0.01) reduction of 1.2 in standardized anxiety tests in intervention group compared to the control. The findings offer promising prospects for medical educators globally, encouraging them to consider reformation and policymaking in medical curricula to enhance academic success and improve the overall quality of life for medical students worldwide.

An Intervention to Improve Mental and Physical Health of Undergraduate Nursing Students

BACKGROUND

Nursing students experience poorer mental and physical health relative to students in other health-related disciplines and young adults of similar age outside post-secondary school. Compromised mental and physical health has numerous negative impacts on nursing students and can result in burnout and development of chronic diseases.

PURPOSE

To determine whether an asynchronous online yoga intervention would improve mental and physical health of students.

METHODS

An asynchronous online 6-week yoga intervention was carried out between January and December 2021, using a pre/post design. Participants' symptoms of depression, anxiety, stress, and self-compassion were assessed using the Depression, Anxiety, and Stress Scale and Self-Compassion Scale and core endurance was assessed using the Mackenzie Core Endurance Test prior to commencement and at the conclusion of the program.

RESULTS

Of 114 participants, 68 completed the online program and pre and post measures showed that the mean depression, anxiety, stress, self-compassion and core endurance scores improved significantly (p<0.001) between baseline and study completion.

CONCLUSION

A six-week virtual yoga program significantly improved mental and physical health of undergraduate nursing students. Targeted modifications to the yoga program might enhance participant retention.

Yoga as a Contemplative Practice and Its Contribution to Participatory Self-Knowledge and Student Retention: A Scoping Review of the First-Year Undergraduate Student Transition

BACKGROUND

Contemplative pedagogy, specifically yoga, introduced into the higher education curriculum has the potential to develop and entrain intellectual, emotional, and social development in relation to mental health among university students studying for medical and nursing degrees. The objective of the study is to determine the extent of the current literature on the prevalence of yoga as a contemplative practice that contributes to student well-being and self-knowledge in the first-year transition from high school to university.

METHODS

As part of the scoping review, CINAHL, EBSCO, Medline, Emerald, Eric, and PsycINFO were searched to identify the prevalence and connection of mind-body courses to student well-being between 2011 and 2022. Screening and selection of studies were based on eligibility criteria and methodological quality assessment. Colaizzi's method of data analysis enabled the phenomena of interest to be examined and follows the PRISMA for Scoping Reviews (PRISMA-ScR) checklist.

RESULTS

Seventeen studies were included with two themes emerging, which include physical practices and training and barriers to success.

CONCLUSION

Yoga is a practice that supports undergraduate students in managing their stressful lives. Due to the experiential nature of yoga the participatory reflective processes established within the physicality of the students provided a framework to cope with the stress and challenges of higher education.

Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints

PURPOSE

Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary.

METHODS

Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed.

RESULTS

221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once.

CONCLUSIONS

Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.

The effect of mindfulness interventions on stress in medical students: A systematic review and meta-analysis

BACKGROUND

Medical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students.

PURPOSE

The purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included.

METHODS

A comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics.

RESULTS

Mindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239-0.501, p < .001) and one-arm pre-post studies (d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127-0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress.

CONCLUSIONS

This study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.

Divulging the Impetus of Yoga on Cardiorespiratory Fitness and Its Persona in Alleviating Anxiety Experienced by Youth: A Cohort Interventional Study

BACKGROUND

 Globalization endangers youngsters worldwide with new standards and possibilities. Hereat of being exposed to greater demands and expectations, when it comes to performance review, their life may become more distressed. Yoga with revolutionary methods may assist youngsters in bettering their physical health regarding their maximal oxygen uptake, and also help manage their anxiety. This study ascertains the effect of yoga on youth's anxiety levels and cardio-respiratory fitness.

METHODS

 It was a longitudinal interventional study recruiting 99 medical students wherein VO₂ max (maximal oxygen uptake) on the treadmill/ergometer exercise and anxiety scores through Spielberger's anxiety scale was assessed at baseline and evaluated after 6 months of a regular yogic regime. The VO₂ max was recorded by the metabolic module of Labchart software (Bella Vista, New South Wales, Australia).

FINDINGS

 The VO₂ max evaluated by incremental exercise to volitional fatigue was found to be 2.64 ± 0.49 L/min in males and 1.51 ± 0.44 L/min in females pre-yoga and 2.81 ± 0.52 L/min in males and 1.69 ± 0.47 L/min in females post yoga. The difference in the endline and baseline VO₂ max values of yoga-performing males (t=6.595, p<0.001) and females (t = 2.478, p = 0.017) was found to be significantly higher than non-yoga performers. The METS value obtained in males was 11.96 and in females was 7.68 before yoga. Post-yoga values were 13.44 and 8.37, respectively. The difference in total anxiety scores post-intervention was 34.6 which was statistically significant (t= 4.959, p <0.001).

CONCLUSION

 From the viewpoint of a physiologist, higher VO₂ max in young adults links to better physical fitness which is the potential outcome of regular yogic practice. As a result of regular yogic practice, initial soaring anxiety levels of subjects culminated in a drastic observable reduction in anxiety, which helped inculcate a judicious acumen in youngsters.

Stress Reduction by Yoga versus Mindfulness Training in Adults Suffering from Distress: A Three-Armed Randomized Controlled Trial including Qualitative Interviews (RELAX Study)

Distress is a growing public health concern. In this three-armed randomized controlled trial, n = 102 adults with elevated stress levels and stress-related symptoms were randomly assigned to (1) “integrative” yoga classes which combined physical exercises, mindfulness training, and ethical/philosophical aspects of traditional yoga; to (2) Iyengar yoga classes which entailed primarily physical exercises; or to (3) mindfulness training without physical training. We hypothesized the synergistic effects of physical yoga exercises, mindfulness, and ethical/philosophical aspects. The primary outcome was the group difference on Cohen’s Perceived Stress Scale (PSS) after 12 weeks. Secondary outcomes included burnout, quality of life, physical complaints, depression, anxiety, mindfulness, interoceptive awareness, self-regulation, spirituality, mysticism, and posttraumatic stress. All outcomes were evaluated at baseline (V0), after 12 weeks (V1), and after 24 weeks (V2). A subset of participants took part in qualitative interviews. A lasting and clinically relevant stress reduction was observed within all groups (PSS ΔV0−V1Integrative Yoga = −6.69 ± 6.19; ΔV0−V1Iyengar Yoga = −6.00 ± 7.37; ΔV0−V1Mindfulness = −9.74 ± 7.80; all p < 0.00). Effect sizes were also statistically large at the end of the follow-up period (Cohen’s d Integrative Yoga = 1.41; d Iyengar Yoga = 1.37; d Mindfulness = 1.23). There were no significant group differences or evidence of relevant synergistic effects from combining mindfulness and physical yoga exercises. All three interventions were found to be equally effective methods of stress reduction. Their use in practice should be based on availability and patient preference.

Current Approaches to Yoga in U.S. Medical Schools: Scoping Review of the Literature

Background: Yoga is described as a system of physical and mental practices originating from India that connects mind, body, and spirit with techniques such as physical exercises, breathing, and meditation to promote health and well-being. Medical students experience an immense amount of stress that unfortunately continues throughout their residency and careers. Yoga represents a tool to reduce stress and support medical student resilience. Objective: This study aims to evaluate the current approaches to yoga in U.S. medical schools. Methods: A scoping literature review was conducted using search terms such as "medical school," "medical student," "medical education," "yoga," "asana," "pranayama," and "mindfulness." The primary aim of the review was to examine if U.S. medical schools offer accessible yoga to medical students and the characteristics of those yoga programs. Results: The search yielded 1313 primary articles. All titles and abstracts were screened for eligibility. Duplicate articles were removed, and 156 articles were reviewed independently by two authors. A total of eight articles met all the criteria. Yoga is offered in medical schools through three main models: recreational, research, and educational. All of the studies indicated various positive effects on medical students from these yoga programs, including in psychological states, perceived stress, and scores on medical knowledge assessments. Conclusions: Yoga aligns well with the objectives of medical education by combining physician resiliency, mindfulness, and education that can ultimately serve patients. Greater opportunities should be created to engage medical students in yoga through the length of their entire undergraduate and graduate medical training.

Effectivity of Psychotherapy Interventions for Anxiety in Medical Students: A Systematic Review

BACKGROUND: The mental health of medical students has long been a topic of concern in many countries. Much research in Europe reported that around 30% of medical students suffered from anxiety. Anxiety disorders have significant physical and emotional consequences. Various studies show that excessive, unmanaged stress related to poor academic performance in medical students leads to cynical personalities, lack of empathy, and suicidal ideas. AIM: This study aimed to identify studies for psychotherapy interventions carried out in medical students and analyze each impact on anxiety level in medical students. METHODS: This systematic review was conducted with evidence sourced from 2000 to 2020. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was registered with the Prospective Registering of Systematic Reviews database (Protocol ID: CRD42020180650). RESULTS: Twenty-three studies meet the inclusion criteria, and there are various psychotherapy interventions to deal with anxiety. Most studies reported that students who received mindfulness-based interventions reported lower anxiety, depression, and stress. CONCLUSION: There are various interventions carried out to decrease stress levels, depression, and anxiety in medical students. The most effective psychotherapy was found in cognitive and behavior intervention and mindfulness intervention.

A systematic review of yoga interventions for helping health professionals and students

Helping Health Professionals (HHP) and HHP students are among the highest risk occupational groups for compromised mental and physical health. There is a paucity of information regarding preventive interventions for mental and physical health in this group of healthcare providers.

OBJECTIVE

The objective of this review was to examine the effectiveness of yoga interventions for the prevention and reduction of mental and physical disorders among HHPs and HHP students.

DESIGN

An exhaustive systematic search was conducted in May 2020. Databases searched in the OVID interface included: MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Embase, and PsycINFO. EbscoHost databases searched included: CINAHL Plus with Full Text, SPORTDiscus with Full Text, Alt HealthWatch, Education Research Complete, SocINDEX with Full Text, ERIC, and Academic Search Complete. Scopus was also searched.

RESULTS

The search yielded 4,973 records, and after removal of duplicates 3197 records remained. Using inclusion and exclusion criteria, titles and abstracts were screened and full text articles (n = 82) were retrieved and screened. Twenty-five studies were identified for inclusion in this review. Most frequently reported findings of yoga interventions in this population included a reduction in stress, anxiety, depression, and musculoskeletal pain.

CONCLUSION

It is our conclusion that mental and physical benefits can be obtained through implementation of yoga interventions for HHPs and HHP students across a variety of settings and backgrounds. However, researchers would benefit from following recommended guidelines for the design and reporting of yoga interventions to improve study quality and rigour.

Effect of yoga-based physical activity on perceived stress, anxiety, and quality of life in young adults

PURPOSE

This study, conducted at a public university in Turkey, sought to determine the effects of yoga-based physical activity on perceived stress, anxiety, and quality of life in young adults.

DESIGN AND METHODS

This study was planned as a semiexperimental nonrandomized study with a control group.

FINDINGS

Yoga-based physical activity decreased the perceived stress and state anxiety levels, but had no effect on trait anxiety levels and quality of life.

PRACTICAL IMPLICATIONS

It is recommended that yoga-based treatment can be included in nursing interventions for reducing stress and anxiety levels in young adults.

Effect of Moola Bandha (Perineum Contraction), A Yogic Lock on Cognitive Functions of College Students: An Exploratory Study

Academic performance and excellence of college students are mainly depending on their cognitive functions. The purpose of this study was to examine the effectiveness of a yogic lock or hold, Moola bandha (perineum contraction) on cognitive functions of teacher training college students. Twenty-three healthy volunteers with the mean ± standard deviation age of 21.96 ± 1.64 years were recruited from a district institute of education and training (DIET) college, North India. All the subjects were asked to perform Moola bandha for the duration of 30 min a day (15 min in the morning and 15 min in the evening) for a period of 30 days. Assessments were taken before and after the intervention period. Results of this study showed a significant increase in the scores of d2 attention total number, digits span forward and backward test, Stroop tasks (neutral total and correct, congruent total and correct, and incongruent correct), and self-control scale along with a significant reduction in d2 attention (omission, commission, and timings), trail making text A and B duration, and positive and negative affective schedule's negative affect scores compared with its respective baseline. These results suggest that 30 min of daily practice of Moola bandha for 30 days is effective in improving the cognitive functions of teacher training college students.

Mental Well-being of the First and Final-Year Medical and Dental Students of Kermanshah University of Medical Sciences

Background and Aim:

Medical and dental students are predisposed to developing psychiatric disorders owing to heavy physical, intellectual, and emotional activities. This study was conducted to evaluate the mental health status of medical and dental students.

Materials and Methods:

This cross-sectional study was conducted on the first- and final-year medical and dental students at Kermanshah University of Medical Sciences in 2016. The mental health status was measured by the General Health Questionnaire-28 (GHQ-28) involving somatic, social, anxiety, and depression domains. Scores > 6 (out of 28) and > 2 (out of 7) were considered to show psychiatric disorder for each domain, respectively. Data were analyzed by SPSS-18 using Kruskal-Wallis and Chi-square tests (P< 0.05).

Results:

The participants consisted of 246 students (39.4% first- and 37.8% last-year medical students; 8.1% first- and 14.6% last-year dental students) aged 18-37 years (22.6 ± 3.3). Psychiatric disorder, somatic symptoms, social dysfunction, anxiety, and depression were experienced by 44.7, 42.7, 46.3, 49.6, and 28.5% of the students, respectively. The prevalence of psychiatric disorder was comparable between the first- and final-year medical students (40.2% and 48.4%, respectively;P= 0.258). The final-year dental students significantly underwent more psychiatric disorder than the first-year dental students (61.1% and 20%, respectively;P= 0.003). There were no significant differences between the medical and dental students in the first (P= 0.089) and final (P= 0.196) years. There was also no significant association between the occurrence of psychiatric disorder and gender and age group (P> 0.05).

Conclusion:

Psychiatric disorder was common among dental and medical students. Hence, preventive and control measures are suggested to improve their mental health.

Small group activities within academic communities improve the connectedness of students and faculty

BACKGROUND

The University of California, San Diego, School of Medicine implemented a curriculum change that included reduction of lectures, incorporation of problem-based learning and other small group activities. Six academic communities were introduced for teaching longitudinal curricular content and organizing extracurricular activities.

METHODS

Surveys were collected from 904 first- and second-year medical students over 6 years. Student satisfaction data with their sense of connectedness and community support were collected before and after the implementation of the new curriculum. In a follow-up survey, medical students rated factors that contributed to their sense of connectedness with faculty and students (n = 134).

RESULTS

Students' perception of connectedness to faculty significantly increased following implementation of a curriculum change that included academic communities. Students ranked small group clinical skills activities within academic communities significantly higher than other activities concerning their sense of connectedness with faculty. Students' perception of connectedness among each other was high at baseline and did not significantly change. Small group activities scored higher than extracurricular activities regarding students' connectedness among themselves.

CONCLUSIONS

The implementation of a new curriculum with more small group educational activities including academic communities enhanced connectedness between students and faculty and resulted in an increased sense of community.

Evaluation of a Web-Based Holistic Stress Reduction Pilot Program Among Nurse-Midwives

Purpose: Work-related stress among midwives results in secondary traumatic stress, posttraumatic stress disorder, and job attrition. The purpose of this pilot project was to evaluate the effectiveness of a holistic, web-based program using holistic modalities for stress reduction and improved coping among certified nurse-midwives. Design and Method: A convenience sample of 10 midwives participated in a web-based holistic stress reduction intervention using yoga, mindfulness-based stress reduction, and meditation for four days each week over 4 weeks. Participants completed pre- and postintervention questionnaires (Perceived Stress Scale [PSS] and the Coping Self-Efficacy Scale [CSES]) for evaluation of effectiveness. Findings: The PSS means showed improvement in midwives’ stress (16.4-12.3). The CSES means showed improvement in coping (174.8-214.5). Improvement was shown in each subscale of the CSES (“uses problem-focused coping”: 19.2%; “stops unpleasant thoughts and emotions”: 20.3%; and “gets support from family and friends”: 16.6%). Conclusion: Findings suggest the potential for stress reduction and improved coping skills after using holistic techniques in a web-based format within a cohort of nurse-midwives. Further research of web-based, holistic intervention for stress reduction among midwives is warranted.

Effect of a Single Session of a Yogic Meditation Technique on Cognitive Performance in Medical Students: A Randomized Crossover Trial

Medical students confront enormous academic, psychosocial, and existential stress throughout their training, leading to a cascade of consequences both physically and psychologically. The declined cognitive function of these students interferes in their academic performance and excellence. The purpose of this study was to examine the effectiveness of a yogic meditation technique, mind sound resonance technique (MSRT), on cognitive functions of University Medical students in a randomized, two-way crossover study. In total, 42 healthy volunteers of both genders (5 males and 37 females) with mean age of 19.44 ± 1.31 years were recruited from a medical college in South India, based on the inclusion and exclusion criteria. A 10-day orientation in the technique of MSRT was given to all the recruited subjects after which each subject underwent both MSRT and supine rest (SR) sessions. All participants were randomized in a 1:1 ratio to receive a session of either MSRT or SR. After a day of washout, participants crossed over to receive the alternative intervention. The cognitive functions were assessed using 2 paper-pencil tasks called Digit Letter Substitution Test (DLST) and Six-Letter Cancelation Task (SLCT), before and immediately after both sessions. Both the groups showed significant improvement in net attempt of both DLST and SLCT, but the magnitude of change was more in the MSRT group than in the SR group. The MSRT group demonstrated significantly enhanced net scores in both SLCT (p < 0.001) and DLST (p < 0.001). The result of the present study suggests that a single session of MSRT, a Mind-Body Practice, may positively impact the performance in cognitive tasks by the University Medical Students.