Exploring the Effect of Mindfulness on Burnout in a Pediatric Emergency Department.

BACKGROUND: Burnout is a common phenomenon among health care providers known to adversely affect their mental health and clinical acumen. As mindfulness has been shown to diminish burnout with large-scale interventions, our aim was to assess whether smaller, on-shift activities aimed at increasing mindfulness could decrease burnout among staff in a pediatric emergency department (PED). METHODS: Prior to the implementation of a series of mindfulness-based activities, a diverse cohort of PED staff including nurses, physicians, nurse practitioners, technicians, and administrative personnel completed electronic preintervention surveys about their demographics, personal mindfulness engagement, and individual baseline burnout level using the Maslach Burnout Inventory (MBI). Trained nurses and physicians served as champions who coordinated on-shift mindfulness activities, and burnout levels were subsequently reassessed using a postintervention survey. FINDINGS: Among 83 eligible staff, 75 completed the preintervention and 69 completed the postintervention survey. For the MBI, the majority of staff had moderate to high burnout levels at baseline. Few staff engaged in personal mindfulness activities outside of work. Although 82% of staff participated in the on-shift interventions, no significant differences were found in scores before and after the intervention for emotional exhaustion (20.1 vs. 20, p = .93), depersonalization (7.6 vs. 7.3, p = .97), and personal accomplishment (36.1 vs. 34.8, p = .11). CONCLUSION/APPLICATION TO PRACTICE: While mindfulness effectively combats burnout, few PED providers regularly practice mindfulness activities. Brief, on-shift mindfulness activities were insufficient to significantly reduce burnout levels. Hospital leadership should consider dedicating resources to more intensive mindfulness activities to combat amplified burnout levels among emergency department staff.

Mobilizing an institutional supportive response for healthcare workers and other staff in the context of COVID-19: The Yale experience.

The burden of the COVID-19 pandemic upon healthcare workers necessitates a systematic effort to support their resilience. This article describes the Yale University and Yale New Haven Health System effort to unite several independent initiatives into a coherent integrated model for institutional support for healthcare workers. Here, we highlight both opportunities and challenges faced in attempting to support healthcare workers during this pandemic.

Running too far ahead? Towards a broader understanding of mindfulness in organisations.

Current workplace mindfulness research and interventions assume that teaching mindfulness will have beneficial effects for people and organizations. While research shows that mindfulness trainings may increase resilience of working adults, assuming that mindfulness will have independent effects on outcomes at different levels of an organization is not well grounded. We assert that mindfulness training would, however, be beneficial for organizations when tailored to that context and shaped by an understanding of organizational theory and practice. We also envisage mindfulness as a beneficial property of teams, organizations and the individuals who constitute them. To close the evidence gap we propose building multi-level models of mindfulness in organizations, broadening training programs, and developing a novel competency framework for teachers in this context.

Building a Grounded Theory of Engagement in Mindfulness-Based Group Therapy for Distressing Voices.

Mindfulness-based group therapy shows promise as a treatment for distressing voice hearing. However, fostering engagement in groups can be challenging, and no theory of engagement in group therapy for distressing voices exists to guide practice or research. This study employed Grounded Theory Method to build a theory of engagement in mindfulness-based groups for distressing voices. Ten service-users and three therapists were interviewed about their experiences of such groups. The model that emerged involves a recursive process of investing in change and continually evaluating its usefulness and safety. Barriers to engagement were often overcome, but sometimes compromised perceived safety, leading to dropout. For others, group participation led to rewards, some of which were integrated beyond group termination. Group engagement can be encouraged by establishing universality around voice hearing early, reducing uncertainty, sharing difficulties with mindfulness practices, and mapping group progress to create a cohering sense of collaboration on therapy tasks.

Mindfulness-based interventions for the treatment of depressive rumination: Systematic review and meta-analysis / Intervenciones basadas en Mindfulness para el tratamiento de rumiaciones en depresión: revisión sistemática y metaanálisis

Background/Objective: This systematic review aims to evaluate the effect of interventions based on the mindfulness and/or acceptance process on ruminative thoughts, in patients with depression. Method: Electronic searches in Medline, Embase, Cochrane Central, PsycInfo, and Cinahl until December 2016, in addition to hand-searches of relevant studies, identified eleven studies that fulfilling inclusion criteria. Results: A meta-analysis of the effect of the intervention compared to usual care showed a significant and moderate reduction of ruminative thoughts (g=-0.59, 95% CI: -0.77, -0.41; I2=0%). Furthermore, findings suggest that mindfulness/acceptance processes might mediate changes in rumination, and that they in turn mediate in the clinical effects of interventions. A meta-analysis of three studies that compared the intervention to other active treatments (medication, behavioral activation and cognitive-behavioral therapy, respectively) showed no significant differences. Conclusions: Mindfulness-based cognitive therapy compared to usual care, produces a significant and moderate reduction in rumination. This effect seems independent of the treatment phase (acute or maintenance) or the number of past depressive episodes, and it was maintained one month after the end of treatment. However, further controlled studies with real patients that compare the most commonly used cognitive-behavioral techniques to treat ruminative thoughts to the acceptance and mindfulness techniques are needed (AU)

Antecedentes/Objetivo: Revisión sistemática para evaluar el efecto de las intervenciones basadas en la atención plena y/o en el proceso de aceptación de pensamientos rumiativos en la depresión. Método: Búsquedas sistemáticas en Medline, Embase, Cochrane Central, PsycInfo y Cinahl hasta diciembre 2016 y búsquedas manuales identificaron once estudios. Resultados: Un metanálisis que comparó el efecto de la intervención basada en Mindfulness con la atención habitual mostró una reducción significativa y moderada de pensamientos rumiativos. Los hallazgos sugieren que los procesos de atención/aceptación producen cambios en las rumiaciones e influyen en el efecto clínico de las intervenciones. Otro metanálisis con estudios que compararon la intervención basada en Mindfulness con otros tratamientos activos (medicación, activación conductual y terapia cognitivo-conductual, respectivamente) no mostraron diferencias significativas (g=-0,02, 95% CI: -0,39, 0,35; I2=0%). Conclusiones: Mindfulness en comparación con la atención habitual, produce una reducción significativa y moderada en la rumia. Este efecto parece independiente de la fase de tratamiento o del número de episodios depresivos pasados, y se mantuvo un mes después del final del tratamiento. Sin embargo, se necesitan más estudios controlados con pacientes reales que comparen las técnicas cognitivo-conductuales más utilizadas para tratar los pensamientos rumiativos con técnicas de aceptación y atención plena (AU)

Relationships between early maladaptive schemas, mindfulness, self-compassion, and psychological distress

Early maladaptive schemas (EMSs) are maladaptive beliefs about oneself and one’s relationships with others that originate from adverse childhood experiences and lead to psychological distress when activated. Schema therapy (ST) was developed to treat EMSs and maladaptive coping responses to the triggering of EMSs. Mindfulness-based interventions are increasingly used in ST. The purpose of the present study was to explore the relationships between EMSs, mindfulness, self-compassion, and psychological distress. The Young Schema Questionnaire (YSQ-S3), the Five Facet Mindfulness Questionnaire (FFMQ-SF), the Self-Compassion Scale (SCS-SF), and the Brief Symptom Inventory (BSI) were administered to 212 undergraduate psychology students (mean age= 21.8 years, SD= 4.4). The results showed negative associations between EMSs and mindfulness and self-compassion. Mindfulness and self-compassion mediated, but did not moderate, the associations between EMSs and psychological distress. It is concluded that low mindfulness and low self-compassion are mechanisms through which EMSs exert their effect on psychological distress. These findings support the use of techniques aimed at enhancing mindfulness and self-compassion in the treatment of EMSs (AU)

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Mindfulness for neuropathic pain: a case study

Neuropathic pain (NP) is a debilitating chronic pain state that affects approximately 6-8% of the general population. Limited success in pharmacological treatments has led to the rise of psychological therapy in attempts to reduce pain intensity. One such therapy is Mindfulness: a meditative practice concerned with purposeful and non-judgemental awareness of the present moment. Whilst Mindfulness has demonstrated its effectiveness in alleviating symptoms of a number of psychological disorders and symptoms of chronic pain, little evidence is available to determine whether its practice is associated with improvements in pain intensity in individuals suffering from NP. The following is a case study of a 62-year-old female (LU), who for the past 18 years has experienced chronic Neuropathic Pain (NP) as a result of a stroke. The current study examined the relationship between 12 weeks of daily Mindfulness practice and immediate, short-term and long-term self-reported pain levels. An additional goal was to explore the impact of Mindfulness on psychological functioning and well-being following the 12-week period of Mindfulness practice. LU showed a clinically meaningful reduction in pain immediately following Mindfulness practice. An overall reduction in ‘Continuous’, ‘Neuropathic’ and ‘Affective’ type pain was observed at post intervention but was not maintained at follow up. The results of the psychological functioning and well-being measures were mixed, with a notable reduction in in the domains of emotional reactivity, depression and stress. These results provide preliminary support for the use of Mindfulness in managing chronic pain of a neuropathic nature. The results are discussed in relation to practice factors (AU)

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Impact of the mindful emotional intelligence program on emotional regulationm in college students

The present study tests the effectiveness of the Mindful Emotional Intelligence Program (PINEP) that appeared from the fusion of two concepts; emotional intelligence and mindfulness. The program was given as training to 136 college students during a two-month period. The purpose of the study was to determine the impact of (PINEP) and to know how students regulate their emotions. Student emotional behavior was evaluated before and after the PINEP program was carried out using self-report measures selected for their reliability. These were, burnout, engagement, neuroticism, extroversion, emotional regulation, and empathy. The results showed moderate significant differences (Cohen’s d) in the dimension of extroversion, burnout, engagement, refocus on planning, positive reappraisal, putting into perspective and empathy. The outcome pointed toward favorable changes in relation with the program PINEP as the students showed significant changes in the way they regulated their emotions after the training (AU)

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Mindfulness, personalidad y sugestionalibilidad: estudio correlacional exploratorio / Mindfulness, personality and suggestibility: a correlational study

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The present paper aims to explore the relationship between mindfulness (measured by the Spanish version of the Five Facet Mindfulness Questionnaire -FFMQ), personality 'Big Five' (measured by the Spanish version of the NEO Five Factor Inventory) and suggestibility (measured by the Inventory of Suggestibility) in normal university population (N= 80). Main results revealed negative and significant correlations between Neuroticism and all FFMQ facets, except for the 'observe' subscale. Very low and mainly non-significant correlations were obtained regarding Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. Regarding suggestibility, there were positive and significant correlations between the Absorption subscale and the FFMQ total score, 'describe' and 'act with awareness' facets; and negative and significant correlations between the Influencing by others subscale and the FFMQ total score, 'act with awareness' and 'nonjudgment' facets. Taking into account FFMQ y IS total scores, mindfulness and suggestibility constructs appear to be relatively independent. Results are discussed regarding previous literature (AU)

Intervención breve basada en ACT y mindfulness: estudio piloto con profesionales de enfermería en UCI y Urgencias / Brief intervention based on ACT and mindfulness: pilot study with nursing staff in intensive care unit and emergency services

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Nurses develop their work in a highly stressful context, where their emotional, attentional and well-being resources are frequently impaired. Because the health care work context is a dynamic and changing context, it is necessary to continue implementing and evaluating the efficacy of brief interventions that consider the organizational needs. The aim of the current paper is showing the result of a pilot study, which implemented and assessed the efficacy of a brief intervention based on Acceptance and Commitment Therapy and Mindfulness to improve nurses levels of psychological flexibility, mindfulness and well-being. Intervention was conducted in a public and tertiary-level hospital in Madrid, specifically in their Intensive Care Units and Emergency Room. For this pilot study, 50 nurses were randomly selected of a total professional population of 164. They were assigned to two groups: the experimental and the waiting-list group. Between-group comparison showed that the intervention had significant benefits in terms of vitality and purpose of life among participants when compared with controls. Intra-group comparisons also showed significant benefits on nurses’ psychological flexibility and negative affect when both groups received the intervention. The intervention also significantly changed nurses’ vitality at follow-up. These results were discussed in terms of strengths and limitations that a brief intervention of these characteristics could have in the work context (AU)

A Systematic Review and Meta-Analysis of Yoga and Mindfulness Meditation in Prison.

This article presents results from a systematic review and two meta-analyses that examine whether prison yoga and meditation programs are significantly related to increased psychological well-being and improvements in the behavioural functioning of prisoners. Comprehensive searches of the empirical literature were conducted up to December 2014. Participants who completed yoga or meditation program in prison experienced a small increase in their psychological well-being (Cohen's d = 0.46, 95% confidence interval [CI] = [0.39, 0.54]) and a small improvement in their behavioural functioning (Cohen's d = 0.30, 95% CI = [0.20, 0.40]). Moderator analyses suggested that there was a significant difference in effect sizes for programs of longer duration and less intensity, compared with those that were shorter and more intensive, for psychological well-being. Programs of longer duration had a slightly larger positive effect on behavioural functioning ( d = 0.424), compared with more intensive programs ( d = 0.418). Overall, the evidence suggests that yoga and meditation have favourable effects on prisoners.

Un método para la comparación de correlaciones basado en intervalos de confianza: aportes a Tejedor et al / A method for comparing correlations based on confidence intervals: contributions to Tejedor et al

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Intervenciones psicológicas basadas en mindfulness y sus beneficios: estado actual de la cuestión / Mindfulness-based psychological interventions and benefits: State of the art

Las intervenciones basadas en mindfulness (IBM) se fundamentan en antiguas prácticas del budismo, actualizadas y adaptadas al contexto occidental. En la presente revisión se describirán las técnicas más usadas, para a continuación analizar los mecanismos de acción que el mindfulness (i.e., atención plena) parece activar como intervención psicológica. En la segunda parte se revisarán los estudios de tipo aplicado. Se comenzará analizando los ensayos clínicos y metaanálisis relativos a las intervenciones sobre problemas mentales. En un segundo momento se analizarán los estudios de eficacia y metaanálisis relativos a los problemas de salud física. En la parte final se tratan algunos temas importantes, como los posibles efectos adversos o los perfiles más adecuados a este tipo de intervención, y se revisan los temas que requieren de más investigación, como la eficacia comparada con otras técnicas de intervención ya validadas. La conclusión global en función de la investigación revisada es que las IBM son técnicas de gran versatilidad, ideales para contextos de atención primaria o similares y que logran sus mayores tasas de eficacia en pacientes con sintomatología de estrés, ansiedad o depresión

Mindfulness-based interventions, rooted in old Buddhist practices, have been updated and adapted to the western context. In the present review, the most frequently used mindfulness interventions will be described as well as the psychological mechanisms activated by them. Afterwards, applied studies will be reviewed. First, clinical trials and meta-analytic studies focused on interventions for psychological disorders will be analyzed. Second, clinical trials and meta-analytic studies focused on interventions for health conditions will be analyzed. In the last section some important issues are addressed, such as, for instance, potential adverse effects, personality profiles that fit better with this type of interventions, and topics that need more attention, such as the analysis of efficacy compared with other well-validated interventions, are reviewed. The overall conclusion after the literature review is that mindfulness-based interventions show high versatility, being very suitable for primary health care or similar settings, and have demonstrated their best results in patients with symptoms of stress, anxiety, or depression

Revisión sistemática de la eficacia de los tratamientos basados en mindfulness para los trastornos de ansiedad / Systematic review of the efficacy of mindfulness-based therapy for anxiety disorders

En los últimos 20 años ha crecido el interés por los tratamientos basados en mindfulness. El objetivo de este trabajo fue hacer una revisión sistemática de la bibliografía científica actual que mostrara la evidencia disponible respecto a la eficacia de los tratamientos psicológicos basados en mindfulness cuando son aplicados específicamente en trastornos de ansiedad. De diversas bases de datos se obtuvieron 269 artículos potencialmente relevantes, de los cuales se seleccionaron 8 que cumplían los criterios de inclusión. El análisis de estos estudios sugiere que las intervenciones psicológicas basadas en mindfulness son un tratamiento eficaz para los trastornos de ansiedad generalizada, angustia, fobia social y estrés postraumático, cuando son usadas como coadyuvantes del tratamiento farmacológico. Aun así se plantea la necesidad de realizar estudios que, mediante un control metodológico riguroso, permitan el establecimiento de conclusiones sólidas respecto de la eficacia de este de tipo intervenciones para el tratamiento de trastornos de ansiedad

During the last 20 years, interest in mindfulness-based therapy has grown. The objective of this study was to systematically review the current scientific literature that shows evidence concerning the efficacy of mindfulness-based psychological therapy when applied specifically to the treatment of anxiety disorders. A total of 269 potentially relevant articles were gathered from various databases. Of these, 8 articles fulfilled the inclusion criteria. The analysis of these studies suggests that mindfulness-based psychological therapy is efficacious in the treatment of general anxiety disorder, panic disorder, social anxiety disorder and post-traumatic stress disorder when they are used in conjunction with pharmacological treatments. Nevertheless, the authors suggest the need for further studies that, following rigorous methodological review, would allow firm conclusions to be reached concerning the efficacy of this type of treatment for anxiety disorders

Intervenciones basadas en Mindfulness (Atención Plena) en Psicología del Deporte / Mildfulness-based interventions in sports psychology / Intervenções baseadas nomindfulness (atenção plena) em psicologia do desporto

En este estudio se pretende analizar los trabajos aplicados de mindfulness (atención plena) en publicaciones de psicología del deporte. Para ello se realiza una revisión sistemática a partir de criterios de inclusión y exclusión de trabajos publicados. Se realiza el análisis de referencias a partir de bases de datos bibliográficos como Medline, Psychinfo, Web of Science, Cochrane, Ebscohost o Isi Web of Knowledge durante el periodo entre 1985 y diciembre 2014. Las palabras claves de búsqueda fueron: psicología del deporte, mindfulness, deporte, estrés y entrenamiento. Inicialmente se partió de 22 artículos, de los que se cribaron 11 por motivos varios (deficiencias metodológicas, conclusiones poco claras, tesis o artículos no publicados). Los 11 artículos analizados realizan intervenciones basadas en mindfulness en el ámbito de la psicología del deporte. Los resultados indican que, aunque se observan deficiencias metodológicas en los diseños de investigación, la mayoría de trabajos muestran mejoras en el rendimiento deportivo, y en variables como ansiedad, burn-out, niveles de flow y niveles de mindfulness. Se recomiendan más estudios y con una mejor metodología para confirmar esta tendencia y continuar profundizando en el conocimiento de la efectividad de la conciencia plena en psicología del deporte

The aim of this article is to identify work on the mindfulness concept in sports psychology research. Research into published works was undertaken using the Medline, Psychinfo, Web of Science, Cochrane, Ebscohost and Isi Web of Knowledge databases and references to articles retrieved from 1985 to December 2014, using inclusion and exclusion criteria. The main search terms were sports psychology, mindfulness, sport, stress and training. From the initial 22 articles we excluded 11 for various reasons (methodological problems, vague conclusions, theses or unpublished articles). The 11 final articles set out different mindfulness-based interventions in the field of sports psychology. Despite methodological limitations in the research design, the results show some improvements in sports performance and variables such as anxiety levels, burn-out, flow and mindfulness levels. To confirm these preliminary results, and to continue to enhance knowledge about the effectiveness of mindfulness in sports psychology, further research, with improved methodology, is recommended

Neste estudo pretendeu-se analisar os trabalhos aplicados de mindfulness(atenção plena) em publicações de psicologia do desporto. Paratal, realizou-se uma revisão sistemática a partir de critérios de inclusão e exclusão de trabalhos publicados. Foi realizada uma análise de referências apartir de bases de dados bibliográficos como Medline, Psychinfo, Web of Science, Cochrane, Ebscohost ou Isi Web of Knowledge durante o períodoentre 1985 e Dezembro de 2014. As palavras-chave de busca foram: psicologia do desporto, mindfulness, desporto, stress e treino. Inicialmente partiu-se de 22 artigos, dos quais foram eliminados 11 por motivos vários (deficiências metodológicas, conclusões pouco claras, teses ou artigos não publicados).Os 11 artigos analisados versam sobre intervenções realizadas com base no mindfulnessno âmbito da psicologia do desporto. Os resultados indicamque, embora se observem deficiências metodológicas nos delineamentos de investigação, a maioria dos trabalhos revelam melhorias no rendimento des-portivo, e em variáveis como a ansiedade, burnout, níveis de flowe níveis de mindfulness. São recomendados estudos adicionais e com uma melhor me-todologia para confirmar esta tendência e continuar a aprofundar o conhecimento da efectividade da consciência plena em psicologia do desporto