Pediatric end-of-life care (EOL care) entails challenging tasks for health care professionals (HCPs). Little is known about HCPs’ experiences and needs when providing pediatric EOL care in Switzerland. This study aimed to describe the experiences and needs of HCPs in pediatric EOL care in Switzerland and to develop recommendations for the health ministry. The key aspect in EOL care provision was identified as the capacity to establish a relationship with the dying child and the family. Barriers to this interaction were ethical dilemmas, problems in collaboration with the interprofessional team, and structural problems on the level of organizations. A major need was the expansion of vocational training and support by specialized palliative care teams. We recommend the development of a national concept for the provision of EOL care in children, accompanied by training programs and supported by specialized pediatric palliative care teams located in tertiary children’s hospitals.

ClinicalTrials.gov Identifier: NCT01983852.

No abstract

Objective: Exposure to intimate partner violence (IPV) is a significant public health issue associated with deleterious mental and medical health comorbidities, including posttraumatic stress disorder (PTSD). The hallmark symptoms of posttraumatic stress (PTS), even when not meeting the threshold for a diagnosis of PTSD, appear to be underpinned by poor self-regulation in multiple domains, including emotion, cognitive control, and physiological stress. Mindfulness-based stress reduction (MBSR) holds promise for treating PTS symptoms because evidence suggests it targets these domains. The current study was a pilot randomized clinical trial designed to examine changes in emotion regulation, attentional function, and physiological stress dysregulation among women IPV survivors with elevated PTS symptoms after participation in a group-based, 8-week MBSR program. Method: In total, 29 participants were randomized to receive MBSR (n = 19) or an active control (n = 10). Assessments were conducted at study entry, as well as 8 and 12 weeks later. Results: Between-group differences on primary outcomes were nonsignificant; however, when exploring within groups, statistically significant decreases in PTS symptoms, F(1.37, 16.53) = 5.19, p < .05, and emotion dysregulation, F(1.31, 14.46) = 9.36, p < .01, were observed after MBSR but not after the control intervention. Further, decreases in PTSD and emotion dysregulation were clinically significant for MBSR participants but not control participants. Conclusions: These preliminary data signal that MBSR may improve PTS symptoms and emotion regulation and suggest further study of the effectiveness of PTSD interventions guided by integrative models of MBSR mechanisms and psychophysiological models of stress regulation.

Since Jon Kabat-Zinn first introduced a contemporary, secularized application of mindfulness for the relief of pain and stress in physical health-care settings, there has been a significant and rapid expansion of the range of mindfulness-based programs (MBPs) designed for various health care, education, workplace, and other settings. As is common with developing programs, these often run ahead of carefully considered and researched effectiveness evaluations. This raises questions of how to best train mindfulness teachers to skillfully facilitate such interventions while minimizing the potential for harm. In this article, we describe the work of an international group of senior teacher trainers who met to develop guidelines on the ethics and standards for teacher trainers and their training pathways. In this article, we will define MBPs; describe the process by which these international guidelines were developed; and share details of the collaborative team who made up the international network that worked on them. We offer these guidelines as “living documents” that specifically set out: (1) ethical standards for mindfulness teachers and trainers; (2) criteria and standards for teacher trainers; and (3) criteria and standards for training pathways. As “living documents,” these will continue to be commented on and refined over time. Given that MBPs offered within secular settings in most countries currently have limited oversight or accreditation processes, we hope these guidelines will provide support and clarity to the teachers of all established and emerging MBPs, and their trainers and supervisors.