Adverse Events

Improve Flow, Communication Skills, and Safety Attitudes of Surgeons with Mindfulness

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Improve Flow, Communication Skills, and Safety Attitudes of Surgeons with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Once you can communicate with yourself, you’ll be able to communicate outwardly with more clarity. The way in is the way out.”― Thích Nhất Hạnh

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Preventing burnout has to be a priority. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Mindfulness has also been shown to improve flow, a state of mind that is characterized by a complete absorption with the task at hand, often resulting in enhanced skilled performance. Thus, there is a need to investigate how mindfulness effects doctors’ well-being, performance, and flow.

 

In today’s Research News article “Focused-Attention Meditation Improves Flow, Communication Skills, and Safety Attitudes of Surgeons.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099589/ ) Chen and colleagues recruited surgeons and randomly assigned them to either a wait-list control condition or to receive 50 minutes of focused meditation practice 3 times per week for 8 weeks. They were measured before and after training for work-related flow, communications skills, safety attitudes, and clinical adverse events.

 

They found that in comparison to baseline and the wait-list control group the surgeons who received mindfulness training had significantly increased levels of work-related flow, communications skills, and safety attitudes. Eight weeks after the training the mindfulness trained surgeons had significantly lower levels of clinical adverse events.

 

Hence, mindfulness training significantly improved surgeons’ flow and medical performance. This further suggests that mindfulness training should be recommended for physicians.

 

“physicians could use mindfulness as a stand-alone technique prior to engaging in bad news delivery to patients.” – AMRA

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Chen H, Liu C, Zhou F, Cao XY, Wu K, Chen YL, Liu CY, Huang DH, Chiou WK. Focused-Attention Meditation Improves Flow, Communication Skills, and Safety Attitudes of Surgeons. Int J Environ Res Public Health. 2022 Apr 27;19(9):5292. doi: 10.3390/ijerph19095292. PMID: 35564687; PMCID: PMC9099589.

 

Abstract

Objective: Patient safety is a worldwide problem and a focus of academic research. Human factors and ergonomics (HFE) is an approach to improving healthcare work systems and processes. From the perspective of the cognitive ergonomics of HFE, the aim of this study is to improve the flow level, communication skills, and safety attitudes of surgeons through focused-attention meditation (FAM) training, thus helping to reduce adverse clinical events. Methods: In total, 140 surgeons were recruited from three hospitals in China and randomly divided into two groups (FAM group and control group). The FAM group received 8 weeks of FAM training, while the control group was on the waiting list and did not receive any interventions. Three scales (WOLF, LCSAS, and SAQ-C) were used to measure the data of three variables (flow, communication skills, and safety attitude), respectively, at two times, before and after the intervention (pre-test and post-test). The incidence of adverse events during the intervention was also collected for both groups. Results: The ANOVA results showed that all three variables had a significant main effect of time and significant interactions between time and group. The independent-sample T-test results showed that the incidence of adverse events during the intervention was significantly lower in the FAM group than in the control group. Conclusions: The intervention of FAM could significantly improve surgeons’ flow levels, communication skills, and safety attitudes, potentially helping to reduce adverse clinical events.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099589/

 

Mindfulness Promotes Grit in College Students with Adverse Childhood Experiences

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Mindfulness Promotes Grit in College Students with Adverse Childhood Experiences

 

By John M. de Castro, Ph.D.

 

“As we introduce Mindfulness and the concept of “whole grit, the focus moves from the outside benchmarks of achievement to the inside benchmarks of achievement. The focus shifts from being a product to the process of learning and happiness. The focus shifts from the tangible grades to the intangible happiness and being in the present moment.” – Shilpi Mahajan

 

Childhood trauma can leave in its wake symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased depression, anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily. Unfortunately, childhood maltreatment can continue to affect mental and physical health throughout the individual’s life. How individuals cope with childhood maltreatment helps determine the effects of the maltreatment on their mental health.

 

It has been found that experiencing the feelings and thoughts produced by trauma completely, allows for better coping. This can be provided by mindfulness. Indeed, mindfulness has been found to be effective for relieving trauma symptoms. But it is not known how mindfulness interacts with adverse childhood experiences to impact psychological well-being later. One possibility is that mindfulness helps to promote grit, perseverance for long-term goals.

 

In today’s Research News article “Adverse Childhood Experiences, Mindfulness, and Grit in College Students in China.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2022.891532/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1885330_a0P58000000G0YfEAK_Psycho_20220614_arts_A ) Cheung and colleagues recruited university students online and had them complete measures of mindfulness, grit, adverse childhood experiences, and socioeconomic status.

 

They found hat the higher the level of adverse childhood experiences the lower the level of grit while the higher the levels of mindfulness the higher the levels of grit. But considering the levels of mindfulness, the negative association of adverse childhood experiences with grit became nonsignificant. In other words, being mindful prevents adverse childhood experiences from being associated with lower levels of grit.

 

These results are correlative, and causation cannot be determined. Nevertheless, the result suggests that persevering in the pursuit of long-term goals is harmed by having experienced neglect of abuse in childhood, but being mindful prevents this, allowing the student to still pursue long-term goals even though they’ve experienced significant trauma.

 

“the best predictor of success in any situation is “grit”” – Ria Sankar

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Cheung SP, Tu B and Huang C (2022) Adverse Childhood Experiences, Mindfulness, and Grit in College Students in China. Front. Psychol. 13:891532. doi: 10.3389/fpsyg.2022.891532

 

This study investigated the effect of ACEs and COVID-19 on grit and whether this effect is mediated by mindfulness. Although current scholarship has found that adverse childhood experiences (ACEs) have harmful consequences to individuals across the life span, less is known about the relationship between ACEs and grit. Grit is predictive of educational success and subjective wellbeing. A cross-sectional online survey administered to junior and senior students from 12 universities spread across China was conducted from September 20, 2020 to October 5, 2020. The universities were selected from geographically diverse regions of China to ensure a diverse sample. We received 1,871 completed responses from 2,229 invited students. The survey response rate was 83.9%. The results indicated that ACEs had significantly negative effects on grit, while mindfulness had significantly positive effects on grit. Once controlling for level of mindfulness, the effects of ACEs on grit largely reduced and became insignificant. The findings of this research indicate that mindfulness has a significant mediational effect on the relation between ACEs and grit and call for mindfulness-based interventions for enhancing grit for the population at risks.

https://www.frontiersin.org/articles/10.3389/fpsyg.2022.891532/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1885330_a0P58000000G0YfEAK_Psycho_20220614_arts_A

 

Adverse Events are Common with Meditation

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Adverse Events are Common with Meditation

 

By John M. de Castro, Ph.D.

 

“Symptoms such as pain, pressure, involuntary movements, headaches, fatigue, weakness, gastrointestinal problems, and dizziness were all reported in people who were enthusiastic meditators.” – TimesofIndia

 

People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But often the thoughts or memories are overwhelming. At times, professional therapeutic intervention may be needed.

 

states. There are, however, few systematic studies of the extent of negative experiences. In general, the research has reported that unwanted (negative) experiences are quite common with meditators, but for the most part, are short-lived and mild. There is, however, a great need for more research into the nature of the experiences that occur during meditation.

 

In today’s Research News article “Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8693904/ ) and colleagues recruited online adult meditation practitioners and had them compete a measure of previous mental disorders, mindfulness, repetitive negative thinking, neuroticism, and meditation-related adverse events.

 

They found that 22% of the participants reported meditation-related adverse events with 13% of the participants reporting moderate to severe adverse events. Participants with previous mental disorders were more likely to report adverse events and with higher severity. Participants with repetitive negative thinking and neuroticism were also more likely to report adverse events while mindfulness reduced the likelihood of adverse events. Adverse events were more likely to occur during a meditation retreat.

 

So, adverse events are common with meditation especially in meditators who have a history of rumination and prior mental disorders. It is unclear, however, whether these experiences lead to healing or further suffering. Regardless there is a need for care with meditation particularly with people with preexisting mental issues.

 

“The fact that meditation can cause altered states, for example, isn’t news: It’s something that people have been talking about for centuries. What we haven’t been very good about is measuring the impact and significance of these states on individual participants.” – Willoughby  Britton

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Pauly, L., Bergmann, N., Hahne, I., Pux, S., Hahn, E., Ta, T., Rapp, M., & Böge, K. (2021). Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study. BJPsych Open, 8(1), e11. https://doi.org/10.1192/bjo.2021.1066

 

Abstract

Background

Meditation is commonly implemented in psychological therapies since the ‘third wave’ of cognitive–behavioural therapy has increased the focus on mindfulness-based interventions. Although extensive research literature demonstrates its benefits, little is known about potential adverse effects.

Aims

The aim of this study is to report the prevalence, type and severity of particularly unpleasant meditation-related experiences in the largest cross-sectional study on this topic to date, with 1370 regular meditators.

Method

The participants were asked whether they ever encountered particularly unpleasant experiences as a result of their meditation experience. For the first time, the type and severity of those experiences were assessed and the association with several predictors, such as pre-existing mental disorders, were explored via logistic and linear regression.

Results

Similar to previous studies, 22% of participants (95% CI 20–24) reported having encountered unpleasant meditation-related experiences, and 13% of participants (95% CI 3–5) reported experiences that were categorised as adverse. Those were mostly of affective, somatic and cognitive nature. Unpleasant meditation-related experiences were more likely to occur in participants with pre-existing mental illnesses (P = 0.000, 95% CI 1.25–2.12).

Conclusions

This study demonstrates that unpleasant meditation-related experiences are prevalent among meditators and, to a relevant extent, severe enough to warrant further scientific inquiry. Longitudinal studies are needed to examine whether the unpleasant meditation-related experiences are merely negative and thus should be avoided, or are an inherent part of the contemplative path.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8693904/

 

Mindfulness Training Produces no Harm

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Mindfulness Training Produces no Harm

 

By John M. de Castro, Ph.D.

 

“the occurrence of AEs during or after meditation practices is not uncommon, and may occur in individuals with no previous history of mental health problems.” – M. Farias

 

People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But often the thoughts or memories are overwhelming. At times, professional therapeutic intervention may be needed.

 

Many practitioners never experience these negative experiences or only experience very mild states. There are, however, few systematic studies of the extent of negative experiences. In general, the research has reported that unwanted (negative) experiences are quite common with meditators, but for the most part, are short-lived and mild. There is, however, a great need for more research into the nature of the experiences that occur during meditation.

 

In today’s Research News article “). Prevalence of harm in mindfulness-based stress reduction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889774/ ) Hirshberg and colleagues compared patients who had received treatment with Mindfulness-Based Stress Reduction (MBSR) program to those on a wait-list. MBSR was either delivered in community settings or was part of a formal randomized clinical trial and consisted of 8 weekly 2.5-hour sessions involving meditation, yoga, body scan, and group discussion with daily homework. They were measured before and after treatment for global psychological symptom severity and bothersome physical symptoms. They were also measured for anxiety, depression, interpersonal sensitivity, paranoid ideation, and psychoticism.

 

They found that Mindfulness-Based Stress Reduction (MBSR) significantly improved psychological and physical symptoms and only a small number of patients experienced increases in symptoms at a much lower proportion than control participants. There was not a single comparison in which MBSR led to greater harm than occurred in controls.

 

Hence, no evidence was found that mindfulness training led to harm greater than with no treatment while there was clear evidence for mindfulness training producing significantly lower levels of psychological and physical symptoms.

Mindfulness-Based Stress Reduction (MBSR) was clearly a safe and effective treatment to improve mental and physical well-being,

 

 

“Meditation isn’t magic. Like any other treatment for stress or mood disorders, it comes with side effects.” – Simon Spichak

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Hirshberg, M. J., Goldberg, S. B., Rosenkranz, M., & Davidson, R. J. (2020). Prevalence of harm in mindfulness-based stress reduction. Psychological medicine, 1–9. Advance online publication. https://doi.org/10.1017/S0033291720002834

 

Abstract

Background

Mindfulness meditation has become a common method for reducing stress, stress-related psychopathology and some physical symptoms. As mindfulness programs become ubiquitous, concerns have been raised about their unknown potential for harm. We estimate multiple indices of harm following Mindfulness-based Stress Reduction (MBSR) on two primary outcomes: global psychological and physical symptoms. In secondary analyses we estimate multiple indices of harm on anxiety and depressive symptoms, discomfort in interpersonal relations, paranoid ideation and psychoticism.

Methods

Intent-to-treat analyses with multiple imputation for missing data were used on pre- and post-test data from a large, observational dataset (n = 2155) of community health clinic MBSR classes and from MBSR (n = 156) and waitlist control (n = 118) participants from three randomized controlled trials conducted contemporaneous to community classes in the same city by the same health clinic MBSR teachers. We estimate change in symptoms, proportion of participants with increased symptoms, proportion of participants reporting greater than a 35% increase in symptoms, and for global psychological symptoms, clinically significant harm.

Results

We find no evidence that MBSR leads to higher rates of harm relative to waitlist control on any primary or secondary outcome. On many indices of harm across multiple outcomes, community MBSR was significantly preventative of harm.

Conclusions

Engagement in MBSR is not predictive of increased rates of harm relative to no treatment. Rather, MBSR may be protective against multiple indices of harm. Research characterizing the relatively small proportion of MBSR participants that experience harm remains important.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889774/