The impact of a tailored mindfulness‐based program for resident physicians on distress and the quality of care: A randomised controlled trial

Fendel, Johannes C.; Aeschbach, Vanessa M.; Schmidt, Stefan; Göritz, Anja S.

doi:10.1111/joim.13374

Cited by 26 publications

(13 citation statements)

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“…Several randomized clinical trials have evaluated strategies to reduce stress and burnout, such as the use of psychological or sensory-emotional techniques, [10][11][12][13] group discussions, 14,15 mindfulnessor compassion-based programs, [16][17][18][19] auricular acupressure, 20 and cannabidiol treatment. 21 These studies reported some short-term improvements; however, small cohorts, high attrition rates, lack of sample diversity, or the need for pharmacological therapy has limited their utility, highlighting the need for rigorously tested interventions for burnout.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Transcendental Meditation to Reduce Stress Among Health Care Workers

et al. 2022

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ImportanceHealth care workers (HCWs) have been experiencing substantial stress and burnout, and evidence-based mitigation strategies are needed. Transcendental Meditation (TM) is a mantra meditation practice with potential efficacy in reducing stress.ObjectiveTo assess the efficacy of TM practice in reducing stress among HCWs over a 3-month period.Design, Setting, and ParticipantsThis single-center open-label randomized clinical trial was conducted among HCWs at an academic medical center from November 19, 2020, to August 31, 2021. Inclusion criteria comprised a score of 6 points or greater on the Subjective Units of Distress Scale and an increase of 5% or greater in baseline heart rate or an increase of 33% or greater in galvanic skin response after exposure to a stressful script. Exclusion criteria included the use of antipsychotic or β blocker medications, current suicidal ideation, or previous TM training. Of 213 HCWs who participated in prescreening, 95 attended in-person visits, resulting in 80 eligible participants who were randomized to receive a TM intervention (TM group) or usual treatment (control group).InterventionsThe TM group practiced TM for 20 minutes twice daily over a 3-month period. The control group received usual treatment, which consisted of access to wellness resources.Main Outcomes and MeasuresThe primary outcome was change in acute psychological distress measured by the Global Severity Index. Secondary outcomes included changes in burnout (measured by the Maslach Burnout Inventory), insomnia (measured by the Insomnia Severity Index), and anxiety (measured by the Generalized Anxiety Disorder-7 scale).ResultsAmong 80 participants, 66 (82.5%) were women, with a mean (SD) age of 40 (11) years. One participant (1.3%) was American Indian or Alaska Native, 5 (6.3%) were Asian, 12 (15.0%) were Black, 59 (73.8%) were White, and 3 (3.8%) were of unknown or unreported race; 4 participants (5.0%) were Hispanic, and 76 (95.0%) were non-Hispanic. A total of 41 participants were randomized to the TM group, and 39 were randomized to the control group. Participants in the TM group did not show a statistically significant decrease in psychological distress on the Global Severity Index compared with those in the control group (−5.6 points vs −3.8 points; between-group difference, −1.8 points; 95% CI, −4.2 to 0.6 points; P = .13). Compared with the control group, the TM group had significantly greater reductions in the secondary end points of emotional exhaustion (Maslach Burnout Inventory subscore: −8.0 points vs −2.6 points; between-group difference, −5.4 points; 95% CI, −9.2 to −1.6 points; P = .006), insomnia (Insomnia Severity Scale score: −4.1 points vs −1.9 points; between-group difference, −2.2 points; 95% CI, −4.4 to 0 points; P = .05), and anxiety (Generalized Anxiety Disorder-7 score: −3.1 points vs −0.9 points; between-group difference, −2.2 points; 95% CI, −3.8 to −0.5; P = .01) at 3 months. A total of 38 participants (92.7%) in the TM group adhered to home practice.Conclusions and RelevanceIn this randomized clinical trial, TM practice among HCWs over a 3-month period did not result in a statistically significant reduction in the primary outcome of acute psychological distress compared with usual treatment but significantly improved the secondary outcomes of burnout, anxiety, and insomnia. These findings suggest that TM may be a safe and effective strategy to alleviate chronic stress among HCWs.Trial RegistrationClinicalTrials.gov identifier: NCT04632368

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Section: Introductionmentioning

confidence: 99%

Efficacy of Transcendental Meditation to Reduce Stress Among Health Care Workers

et al. 2022

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“…There might be three combined factors for the increased RAS in doctor/nurse population. First, recent researches indicate the doctor and nurse as one of the population with greatest professional pressure suffers from more distress [ 26 ] and RAS is associated with psychological factors [ 2 , 3 , 6 ]. Long-term follow up study from university to career also found the RAS prevalence rate is relatively high in the doctor/nurse and dental profession [ 2 , 7 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of recurrent aphthous stomatitis, oral submucosal fibrosis and oral leukoplakia in doctor/nurse and police officer population

Liu

Yin³

et al. 2022

BMC Oral Health

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Background The doctor/nurse and police officer population have some common typical characteristics of great professional pressure and night shift and past studies indicated oral mucosa lesions were closely associated with psychological factors and health-risking behaviors, however the prevalence of recurrent aphthous stomatitis (RAS) and the two commonly seen oral potentially malignant disorders of oral submucosal fibrosis (OSF) and oral leukoplakia in doctor/nurse and police officer in the Betel quid chewing city of Mainland China is unknown The cross-sectional study was to determine the prevalence differences of RAS, oral leukoplakia and OSF among doctor/nurse, police officer and non-doctor/nurse and non-police officer population aged 20–59 years. Methods RAS, OSF and oral leukoplakia were examined in doctor/nurse group (male: 659, female: 2439), police officer group (male: 839, female: 262) and non-doctor/nurse and non-police officer group (male: 7576, female: 8129) from 2020-11-01 to 2021-08-31 in Health Management Center, Xiangya Hospital in Changsha city, Hunan province. Results The prevalence rates of RAS, OSF, oral leukoplakia and oral leukoplakia combined with OSF in male and female non-doctor/nurse and non-police officer group are 8.32‰ and 10.83‰, 58.08‰ and 1.23‰, 11.75‰ and 0.25‰, 7.66‰ and 0.12‰ respectively. Compared with the non-doctor/nurse and non-police officer population, prevalence rates of RAS in male (24.27‰) and female (20.50‰) doctor/nurse population were significantly higher. Prevalence rates of OSF (21.24‰) and oral leukoplakia (3.03‰) in male doctor/nurse population were significantly less but prevalence rates of OSF (93.71‰), oral leukoplakia (20.17‰) and oral leukoplakia combined with OSF (15.42‰) for male police officer were significantly greater in comparison with male non-doctor/nurse and non-police officer group. OSF and oral leukoplakia prevalence rates were obvious lower for the female than the counterpart male group, but there were no significant differences of OSF and oral leukoplakia prevalence rates between the female non-doctor/nurse and non-police officer and female doctor/nurse group. Oral leukoplakia was not found in the female police officers. Conclusions Doctor/nurse population have higher prevalence of RAS. Male doctors/nurses have lower prevalence of OSF and oral leukoplakia, while male police officers have higher prevalence of OSF, oral leukoplakia and oral leukoplakia combined with OSF.

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“…In Lin et al's study, 39 the mindfulness-based stress reduction intervention for nurses resulted in a large reduction in stress outcomes (SMD=−1.44, 95% CI: −1.91 to 0.97). However, in Fendel et al's study, 33 where the programme was conducted for doctors, a similar mindfulness-based stress reduction intervention yielded a much smaller effect size (SMD=−0.23, 95% CI: −0.55 to 0.10).…”

Section: Main Findingsmentioning

confidence: 91%

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

Ong,

Teo,

et al. 2024

Gen Psych

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BackgroundGrowing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain.AimsTo evaluate the evidence for MBIs in improving healthcare workers’ psychological well-being.MethodsA 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.ResultsA 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.ConclusionsMBIs 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 numberCRD42022353340.

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The impact of a tailored mindfulness‐based program for resident physicians on distress and the quality of care: A randomised controlled trial

Abstract: Fendel JC, Aeschbach VM, Schmidt S, Göritz AS. The impact of a tailored mindfulnessbased program for resident physicians on distress and the quality of care: A randomised controlled trial.

Cited by 26 publications

References 80 publications

Efficacy of Transcendental Meditation to Reduce Stress Among Health Care Workers

Efficacy of Transcendental Meditation to Reduce Stress Among Health Care Workers

Prevalence of recurrent aphthous stomatitis, oral submucosal fibrosis and oral leukoplakia in doctor/nurse and police officer population

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

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