ABSTRACT
Purpose of Study Burnout is experienced by over 60% of physicians in the US with a 10% increase in the past year, and leads to degradation of patient care, low professional satisfaction, increased physician turnover, and increased healthcare costs. The COVID-19 pandemic has magnified and exacerbated these challenges. Pediatric mental impact from this healthcare crisis has been referred to as the second pandemic, and dealing with it requires health professionals to be centered and resilient. Physicians experiencing burnout can suffer from denial at first, preventing early intervention. One proposed solution is incorporating mindfulness-based meditation into the residency wellness curriculum. This study compared a pilot study in 2019 with a subsequent study in 2021 incorporating changes reflecting lessons learned from the pilot study, to measure burnout in pediatric residents before and after the implementation of a 3 month mindfulness-based meditation curriculum. Methods Used Comparison was made between a pilot study in mindfulness conducted in the department of pediatrics in 2019, and a Phase II in the departments of pediatrics and pastoral care in 2021. The outcome measures were: number of participants attending the sessions and the percentage compliance in filling the initial survey, final survey and post-meditation short surveys. The changes implemented included interdepartmental participation, increase in the number of 'mindfulness ambassadors', making attendance possible virtually (online) as well as physical presence, and making the surveys accessible online instead of paper-only (see table 2). Summary of Results There was a 20% increase in compliance filling the initial and final surveys between the pilot study and phase II (see figure 1). There was also a 30% increase in compliance with post-meditation surveys in 2021 as compared to the pilot study in 2019. It's noteworthy that phase II occurred during the first peak of the COVID pandemic, when residents were stretched thin. It was difficult ensuring consistent participation secondary to this, but phase II showed increased compliance in spite of these challenges. Conclusions Survey participation with consequent increase in the power of the study is critical in making survey-based research studies relevant. The integrity of such studies is often compromised by attenuation in the numbers of participants, as well as incomplete survey filling as a result of 'survey fatigue'. Valuable lessons were learned during the pilot study and when changes were implemented in the subsequent study, statistical power increased, proving higher relevance and effectiveness. (Table Presented).
ABSTRACT
Purpose of Study Language exposure is essential for speech and language development in newborns. NICU infants by virtue of their prolonged hospitalizations or multiple complications are more likely exposed to less language. Based on a low rate of reading measured in our NICU, this initiative was designed to target this deficiency. Methods Used A family reading survey used for two-week old infants at home (modified from Before and After Books and Reading Survey and the Stony Brook Family Reading Survey) was adapted for inpatients. The survey, consisting of 22 questions, was given to caretakers of infants in the NICU at >7 days to 2 months' time period. The R.E.A.D. (Read to, Enjoy, And Develop) Your Baby program was developed to promote shared reading and educate parents about the importance of language. The campaign consists of giving baby books to families with an infant in the NICU >7 days and bi-weekly for chronically hospitalized infants. Books were made available by the Reach Out and Read Program and by acquisition using a regional grant fund. Using historical cohorts, the survey was given to parents before and after instituting the R.E.A.D. Your Baby program. Comparisons of proportions of parents reporting reading or verbalizing activity was analyzed using N-1 two proportion test. Summary of Results The initial survey was conducted with 50 families in 2019;the post-intervention survey collection is still ongoing and currently 12 families have participated. Demographic data of caretakers are included in Table 1. One item asked parents to name three favorite activities to do with your baby in the NICU by free text-25.2% (37/150) responses centered about language (talking, singing, or reading) in the pre-phase;41.7% (15/36) provided language responses (p=0.024) in the post-intervention phase. Reading represented 5.3% (8/150) of responses in the pre-phase, whereas it represented 13.9% (5/36) of the responses in the post-phase, p=0.00001. A multiple-choice question later asked do you read to your baby in the NICU? in which 22% (11/50) of parents answered yes in the pre-phase;91.7% (11/12) respondents answered yes in the post-phase, p=0.00000. Conclusions Shared reading was occurring for a minority of infants in our urban-setting NICU before the R.E.A.D. Your Baby campaign. Initially we had aimed to improve the reading rate to 50%. Already in the early stages of surveying postintervention, a remarkable increase has been observed. One confounding factor may be a long interval of time between pre- and post-intervention (which was mostly due to the Covid-19 pandemic);another factor may be higher number of parents with education beyond high school in the post-phase. Beyond exposing infants to language in the NICU, additional benefits of reading together likely include promoting parentinfant bonding, providing parental stress coping techniques, and priming for continued reading at home. (Table Presented).