Reduce Physician Burnout with Mindfulness

Reduce Physician Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For me, the program has been worth everything. It has enabled me to emerge from my depression, change my toxic work situation, improve my home and family life, and allow myself to be happy and realize that I deserve to be happy.” ~ Anonymous MD

 

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. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Medical residency is an extremely stressful period and many express burnout symptoms. This would seem to be an ideal time to intervene.

 

In today’s Research News article “Mind-Body Skills Training for Resident Wellness: A Pilot Study of a Brief Mindfulness Intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954313/ ), Romcevich and colleagues conducted a small pilot study of the effectiveness of a Mind-Body Skills Training (MBST) program to reduce burnout in hospital residents. They recruited 2nd through 4th year residents and had them complete 4 weekly 90-minute training sessions and 12 on-line modules including relaxation, breath following meditation, and loving kindness meditation. They were measured before and after training and 6 months later for burnout, perceived stress, resilience, mindfulness, self-compassion, and burnout subscales of emotional exhaustion, depersonalization, and personal achievement.

 

They found that after training there were significant improvements in personal achievement, perceived stress, resilience, and mindfulness and an unexpected decrease in self-compassion. At the 6-month follow-up there were significant improvements in self-compassion, depersonalization and mindfulness. Hence, the pilot results suggest that Mind-Body Skills Training (MBST) may be effective in improving well-being and decreasing symptoms of burnout in medical residents.

 

It will be necessary to replicate these results in a larger controlled randomized trial. But the pilot results are encouraging. They suggest that this form of mindfulness training may be a safe and effective method to improve well-being and intervene early in the career to prevent future burnout in medical professionals.

 

So, reduce physician burnout with mindfulness.

 

“these tools can help us be the best we can be in our “inner space” while we struggle to eliminate the challenges and burdens that occupy the “outer space” of our practice of medicine. After all, if we can’t take care of ourselves, we won’t have anything left to care for others.” – Lynne Lillie

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Romcevich, L. E., Reed, S., Flowers, S. R., Kemper, K. J., & Mahan, J. D. (2018). Mind-Body Skills Training for Resident Wellness: A Pilot Study of a Brief Mindfulness Intervention. Journal of Medical Education and Curricular Development, 5, 2382120518773061. http://doi.org/10.1177/2382120518773061

 

Abstract

Background:

Interventions to address burnout include mind-body skills training (MBST), but few studies have evaluated the feasibility of MBST for busy pediatric residents.

Objective:

In this pilot study, we tested the feasibility of a brief MBST intervention, using in-person peer-led training supported by online modules, to decrease stress and burnout in pediatric resident physicians.

Methods:

Of 99 (10%) residents, 10 residents at Nationwide Children’s Hospital in Ohio participated in up to four 90-minute MBST sessions more than 1 month, led by a co-resident with 5 years of informal training in mind-body skills. Participants were offered 8 assigned online modules through OSU Center for Integrative Health and Wellness. Measures including Maslach Burnout Inventory (MBI), Cohen’s Perceived Stress, Smith’s Brief Resilience, Cognitive and Affective Mindfulness Scale-Revised, and Neff’s Self-Compassion Scale (NSS) were administered before (T1) and after (T2) the course. Participants were offered optional monthly “maintenance” sessions for 6 months and completed a third set of measures at this follow-up (T3).

Results:

The residents completed an average of 4.3/8 online modules and attended an average of 2.8/4 in-person sessions. There was significant improvement in positive attitude, perceived stress, and resilience post intervention (T2). Follow-up evaluation (T3) also demonstrated significant improvement in burnout (depersonalization) and mindfulness. More than 75% of participants found the course worthwhile.

Conclusions:

A short mixed-method mindfulness-based skills course may be a practical way to offer resilience and stress management training to busy resident physicians.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954313/

 

Reduce Anxiety and Depression with Mindfulness

Reduce Anxiety and Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“If you have unproductive worries, you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Depression can be difficult to treat. Fortunately, Mindfulness training is also effective for treating depression.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is based upon Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety and to be effective for depression. ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, ACT helps people strengthen aspects of cognition such as in committing to valued living. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

In today’s Research News article “Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839459/ ), Heydari and colleagues recruited adult volunteers with moderate symptoms of burnout and randomly assigned them to either receiving a program of Acceptance and Commitment Therapy (ACT) or to a no-treatment control condition. The ACT program was delivered over 8 weeks in once a week, 90-minute sessions. The participants were measured before and after training and 2 months later for anxiety and depression.

 

They found that after treatment and 2 months later the group that received Acceptance and Commitment Therapy (ACT) had large and significant decreases in both anxiety (35% reduction) and depression (20% reduction) while there were no significant changes in the no-treatment control participants. It is interesting that the participants were suffering from moderate burnout in their jobs. This indicates that ACT may be effective in treating career burnout.

 

It is important to note that these effects were still present 2 months after the completion of the therapy program. They thus appear to have lasting beneficial effects. It should be noted that since the there was no treatment in the control condition that a placebo effect may still be present and may potentially account for at least some of the improvements. Nevertheless the results are in line with previous studies that demonstrate that mindfulness training is effective in relieving anxiety and depression.

 

So, Reduce Anxiety and Depression with Mindfulness

 

Anxiety softens when we can create a space between ourselves and what we’re experiencing. . .

When you become aware of the present moment, you gain access to resources you may not have had before. You may not be able to change a situation, but you can mindfully change your response to it.” – Mindful

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Heydari, M., Masafi, S., Jafari, M., Saadat, S. H., & Shahyad, S. (2018). Effectiveness of Acceptance and Commitment Therapy on Anxiety and Depression of Razi Psychiatric Center Staff. Open Access Macedonian Journal of Medical Sciences, 6(2), 410–415. http://doi.org/10.3889/oamjms.2018.064

 

Abstract

AIM:

Considering the key role of human resources as the main operator of organisations, the present research aimed to determine the effectiveness of acceptance and commitment therapy for anxiety and depression of Razi Psychiatric Center staff.

MATERIALS AND METHODS:

This research follows a quasi-experimental type with pre-test, post-test plans, and control group. Accordingly, 30 people were selected through volunteered sampling among Razi Psychiatric Center staff. Then, they were randomly placed into two groups of 15 (experimental and control) and evaluated using research tools. Research tools consisted of Beck Anxiety and Depression Inventories whose reliability and validity have been confirmed in several studies. Research data were analysed using the analysis of covariance (ANCOVA).

Results:

The statistical analysis confirmed the difference in the components of anxiety and depression in the experimental group, which had received acceptance and commitment therapy compared to the group that had not received any therapy in this regard (control group) (p < 0.05).

CONCLUSION:

Acceptance and commitment therapy reduces anxiety and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839459/

 

Improve PTSD and Academic Burnout in Adolescents with Mindfulness and Parental Attachment

Improve PTSD and Academic Burnout in Adolescents with Mindfulness and Parental Attachment

 

By John M. de Castro, Ph.D.

 

“Mindfulness can help people train themselves to get unstuck from a vicious cycle of negative thinking, often a cornerstone of trauma.” – Jennifer Wolkin

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Only a fraction will develop Post-Traumatic Stress Disorder (PTSD); about 7%-8%. PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, avoiding situations that remind them of the event memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.

 

Mindfulness training has been found to be particularly effective in treating the symptoms of PTSD. So, it would seem reasonable to examine the relationship of individual mindfulness with the ability to cope with the aftermath of traumatic events. Adolescents have been found to be particularly vulnerable to the psychological impact of traumatic events. But, might be buffered by their positive attachment to their parents.

 

In today’s Research News article “Dispositional mindfulness mediates the relationships of parental attachment to posttraumatic stress disorder and academic burnout in adolescents following the Yancheng tornado.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965031/ ), An and colleagues examine the impact of mindfulness and parental support on the ability of adolescents to deal with trauma. In particular they examine youths about a year after a traumatic tornado in their community in China. The tornado killed 99 people, injured approximately 800 and affected more than 1.6 million people. They recruited junior High School students from the affected area and measured them for mindfulness, PTSD symptoms, academic burnout, and parental attachment.

 

They found that the higher the level of student’s mindfulness and parental attachment the lower the level of PTSD symptoms and academic burnout. In addition, the higher the level mindfulness the higher the level of parental attachment. Employing statistical modelling, they found that parental attachment being associated with to lower PTSD symptoms and academic burnout was partially mediated by the student’s level of mindfulness. Hence, higher parental attachment was associated with lower PTSD symptoms and academic burnout directly and also indirectly by being associated with higher levels of mindfulness which, in turn, were associated with lower levels of PTSD symptoms and academic burnout.

 

These are interesting results but they must be interpreted cautiously as the study was correlational. As a result, causation cannot be determined. Nevertheless, the results suggest that having a positive attachment to parents helps to buffer the adolescent from the effects of trauma and it does so, in part, by improving the youths’ ability to be present in the moment; mindfulness. It can be speculated that positive attachment makes the youth more secure and thereby more able to perceive reality just as it is and not be overly affected by previous negative events. This, in turn, allows them to be more effective in relation to their schooling, reducing burnout.

 

Since, trauma occurs in such a large proportion of the population, producing tremendous suffering, it is important to find ways to lessen its impact. The results suggest that being a good parent and attaching in a positive way with your child promotes mindfulness and my buffer the child from the effects of experiencing a traumatic event.

 

So, improve PTSD and academic burnout in adolescents with mindfulness and parental attachment.

 

“The memories are so painful that many live their life trying to avoid triggers. The problem is that the triggers are everywhere.” But the development of better mindfulness skills “might allow patients to be fully present and lean into these scary or avoided situations.” – Tony King

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

An, Y., Yuan, G., Liu, Z., Zhou, Y., & Xu, W. (2018). Dispositional mindfulness mediates the relationships of parental attachment to posttraumatic stress disorder and academic burnout in adolescents following the Yancheng tornado. European Journal of Psychotraumatology, 9(1), 1472989. http://doi.org/10.1080/20008198.2018.1472989

 

HIGHLIGHTS

  • We found that parental attachment and dispositional mindfulness are both negatively correlated with PTSD and academic burnout.
  • We found that parental attachment and dispositional mindfulness are both negatively correlated with academic burnout.
  • We found that dispositional mindfulness mediates the relationships between parental attachment and PTSD and academic burnout

ABSTRACT

Background: Previous studies have shown that parental attachment is associated with low severity of posttraumatic stress disorder (PTSD) and low academic burnout in individuals who have experienced traumatic events.

Objective: The present study investigated the ways in which parental attachment is related to PTSD symptoms and academic burnout in Chinese traumatized adolescents by considering the role of dispositional mindfulness.

Method: A total of 443 Chinese adolescents who had experienced a severe tornado one year prior to this study completed measures of parental attachment, dispositional mindfulness, PTSD and academic burnout.

Results: The results showed that our model fitted the data well [χ2/df = 2.968, CFI = 0.971, TLI = 0.955, RMSEA (90% CI) = 0.067 (0.052–0.082)] and revealed that dispositional mindfulness partially mediates the relationship between parental attachment, PTSD severity and academic burnout.

Conclusions: The findings suggested that dispositional mindfulness and parental attachment may be two critical resources in dealing with traumatization and academic burnout.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965031/

Improve Mental Health in Medical Residents with Mindfulness

Improve Mental Health in Medical Residents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“increasing physician resilience, or the ability to “bounce back” from experiences such as burnout, has been shown to have a significant positive impact on patient care and physician wellbeing. . . benefits include improved quality of care, reduced errors and minimized attrition . . . mindfulness-influenced wellness programs for residents can improve self-compassion, empathy, burnout and stress reactions. Mindfulness meditation introduces a way of cultivating awareness of one’s relationship with the present moment. With practice, it may lead to healthier ways of working with stressful life experiences, including those inherent to residency training.” – Vincent Minichiello

 

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. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Medical residency is an extremely stressful period and many express burnout symptoms. This would seem to be an ideal time to intervene.

 

In today’s Research News article “Mindfulness-Based Stress Reduction for Residents: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880763/ ), Verweij and colleagues examined the ability of a Mindfulness-Based Stress Reduction (MBSR) program to treat the symptoms of burnout in medical residents. They recruited medical residents and randomly assigned them to either receive an 8-week, once a week, 2,5 hour session of Mindfulness-Based Stress Reduction (MBSR) or be assigned to a wait-list control condition. MBSR consists of a combination of meditation, yoga, and body scan practice in combination with discussion and home practice. The residents were measured before the program and 3 weeks later for emotional exhaustion, worry, home-work interference, mindfulness, self-compassion, positive mental health, physician empathy, and medical errors.

 

They found that in comparison to baseline and to the wait-list control condition, the residents who received MBSR training had significantly higher mindfulness, self-compassion, personal accomplishment, and perspective taking empathy, and significantly lower worry. These outcomes were all of moderate effect sizes. There were no significant effects on the primary measure of burnout, emotional exhaustion. But, the residents who had the highest levels of emotional exhaustion did show a significant improvements in emotional exhaustion after treatment.

 

These results suggest that Mindfulness-Based Stress Reduction (MBSR) maybe an effective treatment to improve the mental health of medical residents and perhaps reduce the tendency toward burnout. It should be noted, however, that medical residents are very restricted for time and MBSR training requires a considerable investment of time both in the training sessions and in home practice, making participation difficult. Future research should include an active control condition such as aerobic exercise to help control for potential sources of confounding and bias.

 

So, improve mental health in medical residents with mindfulness.

 

“I experienced burnout as a resident, and meditation was a key aspect to my recovery. My mother advised me to meditate, and afterwards, I felt like my brain had been rebooted.” – Louise Wen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Verweij, H., van Ravesteijn, H., van Hooff, M. L. M., Lagro-Janssen, A. L. M., & Speckens, A. E. M. (2018). Mindfulness-Based Stress Reduction for Residents: A Randomized Controlled Trial. Journal of General Internal Medicine, 33(4), 429–436. http://doi.org/10.1007/s11606-017-4249-x

 

Abstract

Background

Burnout is highly prevalent in residents. No randomized controlled trials have been conducted measuring the effects of Mindfulness-Based Stress Reduction (MBSR) on burnout in residents.

Objective

To determine the effectiveness of MBSR in reducing burnout in residents.

Design

A randomized controlled trial comparing MBSR with a waitlist control group.

Participants

Residents from all medical, surgical and primary care disciplines were eligible to participate. Participants were self-referred.

Intervention

The MBSR consisted of eight weekly 2.5-h sessions and one 6-h silent day.

Main Measures

The primary outcome was the emotional exhaustion subscale of the Dutch version of the Maslach Burnout Inventory–Human Service Survey. Secondary outcomes included the depersonalization and reduced personal accomplishment subscales of burnout, worry, work–home interference, mindfulness skills, self-compassion, positive mental health, empathy and medical errors. Assessment took place at baseline and post-intervention approximately 3 months later.

Key Results

Of the 148 residents participating, 138 (93%) completed the post-intervention assessment. No significant difference in emotional exhaustion was found between the two groups. However, the MBSR group reported significantly greater improvements than the control group in personal accomplishment (p = 0.028, d = 0.24), worry (p = 0.036, d = 0.23), mindfulness skills (p = 0.010, d = 0.33), self-compassion (p = 0.010, d = 0.35) and perspective-taking (empathy) (p = 0.025, d = 0.33). No effects were found for the other measures. Exploratory moderation analysis showed that the intervention outcome was moderated by baseline severity of emotional exhaustion; those with greater emotional exhaustion did seem to benefit.

Conclusions

The results of our primary outcome analysis did not support the effectiveness of MBSR for reducing emotional exhaustion in residents. However, residents with high baseline levels of emotional exhaustion did appear to benefit from MBSR. Furthermore, they demonstrated modest improvements in personal accomplishment, worry, mindfulness skills, self-compassion and perspective-taking. More research is needed to confirm these results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880763/

 

Reduce Health Symptoms of Burnout with Yoga and Mindfulness

Reduce Health Symptoms of Burnout with Yoga and Mindfulness

 

By John M. de Castro, Ph.D.

 

“Teachers who practice yoga say it has given them an outlet for the daily stresses and frustrations of teaching. It also equips them with strategies to stay calm during chaotic moments and helps them understand and reflect on both their mindset and that of their students.” – Madeline Will

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. It frequently results from emotional exhaustion. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. Sleep disruption is an important consequence of the stress.  This exhaustion produces a loss of enthusiasm, empathy, and compassion. Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the workplace. From a business standpoint, it reduces employee efficiency and productivity and increases costs. From the worker perspective, it makes the workplace a stressful, unhappy place, promoting physical and psychological problems that can become so severe as to result in sick leave. Hence, preventing burnout in the workplace is important.

 

Mindfulness techniques, including meditation, yoga, and Mindfulness-Based Cognitive Therapy (MBCT) are gaining increasing attention for the treatment of the symptoms of stress and burnout. They have been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout in a number of work environments. It is not known, however, which of the myriad of mindfulness training techniques is best for the treatment of burnout.

 

In today’s Research News article “Effect of traditional yoga, mindfulness–based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839058/ ), Grensman and colleagues recruited workers who were on sick leave for work-related burnout. They were randomly assigned to receive either traditional yoga (Ashtanga Yoga), Mindfulness-Based Cognitive Therapy (MBCT), or Cognitive Behavioral Therapy (CBT). Therapy included three hours of supervised group training per week and the participants practiced on their own for 1–1½ hours, 3–4 times a week, including homework. They were measured before and after treatment for health-related quality of life.

 

They found that all three interventions produced significant improvements in 12 of the 13 subscales of health-related quality of life; including physical well-being, emotional well-being, sleep, cognitive function, general health perceptions, satisfaction with family and with partner, and sexual function. The outcomes produced by the interventions containing mindfulness training (yoga and Mindfulness-Based Cognitive Therapy (MBCT)) were slightly, albeit significantly better than those produced by Cognitive Behavioral Therapy (CBT).

 

The study implies that the physical and psychological state of workers on sick leave for work-related burnout can be significantly improved by all of the three therapies tested. It is unfortunate that a no-treatment control or a non-effective treatment was included as without such comparison conditions it is impossible to tell if the treatment was effective or that the patients improved due to healing over time, spontaneous recovery, or participant expectancy effects.

 

But the fact that yoga and Mindfulness-Based Cognitive Therapy (MBCT) were slightly better than those produced by Cognitive Behavioral Therapy (CBT) suggests that the effects of these treatments that contained mindfulness training were not due to these potential confounding variables. This further suggests that mindfulness-based treatments are effective in reducing the symptoms of severe burnout. It appears that training in mindfulness is a very important component of any treatment for the symptoms of burnout.

 

So, reduce health symptoms of burnout with yoga and mindfulness.

 

“meditation helps in a number of ways. When you are forever on the go, you can easily disconnect from the fact that you’re ready to drop, your neck is crippled with tension or you haven’t breathed deeper than your upper chest for over 24 hours. Meditation provides an opportunity for you to check in with your body. It also provides a framework within which you can practice observing your thoughts and emotions rather than trying to tackle them. This gives you a new perspective on a very busy mind and far more space to make more rational decisions and reduce procrastination.” – Shona Mitchell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Grensman, A., Acharya, B. D., Wändell, P., Nilsson, G. H., Falkenberg, T., Sundin, Ö., & Werner, S. (2018). Effect of traditional yoga, mindfulness–based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout. BMC Complementary and Alternative Medicine, 18, 80. http://doi.org/10.1186/s12906-018-2141-9

 

Abstract

Background

To explore if health related quality of life(HRQoL) increased after traditional yoga(TY), mindfulness based cognitive therapy(MBCT), or cognitive behavioral therapy(CBT), in patients on sick leave because of burnout.

Methods

Randomized controlled trial, blinded, in ninety-four primary health care patients, block randomized to TY, MBCT or CBT (active control) between September 2007 and November 2009. Patients were living in the Stockholm metropolitan area, Sweden, were aged 18–65 years and were on 50%–100% sick leave. A group treatment for 20 weeks, three hours per week, with homework four hours per week. HRQoL was measured by the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, each with a separate index, and scores from 0 (worse) to 100 (best). SWED-QUAL covers aspects of physical and emotional well-being, cognitive function, sleep, general health and social and sexual functioning. Statistics: Wilcoxon’s rank sum and Wilcoxon’s sign rank tests, Bonett-Price for medians and confidence intervals, and Cohen’s D.

Results

Twenty-six patients in the TY (21 women), and 27 patients in both the MBCT (24 women) and in the CBT (25 women), were analyzed. Ten subscales in TY and seven subscales in MBCT and CBT showed improvements, p < 0.05, in several of the main domains affected in burnout, e.g. emotional well-being, physical well-being, cognitive function and sleep. The median improvement ranged from 0 to 27 points in TY, from 4 to 25 points in CBT and from 0 to 25 points in MBCT. The effect size was mainly medium or large. Comparison of treatments showed no statistical differences, but better effect (small) of both TY and MBCT compared to CBT. When comparing the effect of TY and MBCT, both showed a better effect (small) in two subscales each.

Conclusions

A 20 week group treatment with TY, CBT or MBCT had equal effects on HRQoL, and particularly on main domains affected in burnout. This indicates that TY, MBCT and CBT can be used as both treatment and prevention, to improve HRQoL in patients on sick leave because of burnout, reducing the risk of future morbidity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839058/

 

Improve Psychological Well-Being and Productivity with Work-Place Mindfulness

Improve Psychological Well-Being and Productivity with Work-Place Mindfulness

 

“Toxic emotions disrupt the workplace, and mindfulness increases your awareness of these destructive patterns, helping you recognize them before they run rampant. It’s a way of reprogramming your mind to think in healthier, less stressful, ways.” – Drew Hansen

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological and physical health. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the work environment. But, more than half of employees in the U.S. and nearly 2/3 worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired physical and mental health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnoutmindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. There is a need, however, to better document the benefits of these programs.

 

In today’s Research News article “A Workplace Mindfulness Intervention May Be Associated With Improved Psychological Well-Being and Productivity. A Preliminary Field Study in a Company Setting.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00195/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_568639_69_Psycho_20180313_arts_A ), Kersemaekers and colleagues recruited employees in major European corporations and provided them with a workplace mindfulness program that consisted of 2 day-long training days plus eight 2.5 h-long sessions implemented in a group setting and included trainings in mindfulness meditation, walking meditation, pausing meditation, body scan and compassion meditation. They were also encouraged to practice at home. Participants were measured one month before, just before, and after the program for burnout, perceived stress, mindfulness, well-being, team environment; including organizational climate, team climate and personal performance, and program feasibility and satisfaction.

 

They compared the changes during the one-month baseline period to those occurring during the mindfulness training period and found that after training there were significantly greater reductions in burnout, perceived stress, particularly tension and worry, and organizational stress, and significantly greater improvements in psychological well-being and mindfulness, including presence and acceptance. There were also significant improvements in the participants perceptions of the organizational culture, including team decision making and cooperation, of the organizational climate, including atmosphere and respect, and of personal performance and productivity. There were high compliance and participation rates in the program. Hence, the workplace mindfulness program appeared to be feasible, safe, and effective.

 

The results have to be interpreted with caution as there wasn’t a control group. But, the fact that there was a one-month baseline where reactivity, bias, and time-based changes could be assessed, the conclusion would appear to be guardedly valid. Workplace mindfulness training improved the psychological well-being and mindfulness of the workers, the organizational climate, and the workers productivity. This suggests that workplace mindfulness programs can be of substantial benefit to the workers and the organization.

 

So, Improve Psychological Well-Being and Productivity with work-Place mindfulness.

 

“By letting it go it all gets done. The world is won by those who let it go. But when you try and try, the world is beyond winning.” – Lao Tzu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Kersemaekers W, Rupprecht S, Wittmann M, Tamdjidi C, Falke P, Donders R, Speckens A and Kohls N (2018) A Workplace Mindfulness Intervention May Be Associated With Improved Psychological Well-Being and Productivity. A Preliminary Field Study in a Company Setting. Front. Psychol. 9:195. doi: 10.3389/fpsyg.2018.00195

 

Background: Mindfulness trainings are increasingly offered in workplace environments in order to improve health and productivity. Whilst promising, there is limited research on the effectiveness of mindfulness interventions in workplace settings.

Objective: To examine the feasibility and effectiveness of a Workplace Mindfulness Training (WMT) in terms of burnout, psychological well-being, organizational and team climate, and performance.

Methods: This is a preliminary field study in four companies. Self-report questionnaires were administered up to a month before, at start of, and right at the end of the WMT, resulting in a pre-intervention and an intervention period. There was no separate control group. A total of 425 participants completed the surveys on the different time points. Linear mixed model analyses were used to analyze the data.

Results: When comparing the intervention period with the pre-intervention period, significantly greater improvements were found in measures of burnout (mean difference = 0.3, p < 0.001), perceived stress (mean difference = -0.2, p < 0.001), mindfulness [mean difference = 1.0 for the Freiburg Mindfulness Inventory (FMI) and 0.8 for the Mindfulness Attention Awareness Scale (MAAS), both p < 0.001], and well-being (mean difference = 0.4, p < 0.001). Additionally, greater increases in team climate, organizational climate and personal performance were reported during the intervention compared to the pre-intervention period with largest improvements in team cooperation (mean difference = 0.3, p < 0.001), productivity (mean difference = 0.5, p < 0.001), and stress (mean difference = -0.4, p < 0.001). Effect sizes were large for mindfulness (d > 0.8), moderate for well-being, burnout and perceived stress (d = 0.5–0.8), and ranged from low to moderate for organizational and team climate and personal performance (d = 0.2–0.8).

Conclusion: These preliminary data suggest that compared to the pre-intervention period, the intervention period was associated with greater reductions in burnout and perceived stress, improvements in mindfulness, well-being, and increases in team and organizational climate and personal performance. Due to design limitations, no conclusions can be drawn on the extent to which the WMT or non-specific factors such as time have contributed to the findings. Further studies, preferably using randomized controlled designs with longer follow up periods are needed to evaluate whether the associations found can be attributed to the WMT and whether these sustain after the training.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00195/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_568639_69_Psycho_20180313_arts_A

 

Improve Dementia Caregiver Psychological Health and Stress with Mindfulness

Improve Dementia Caregiver Psychological Health and Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“people who care for family members with Alzheimer’s disease and other dementias in the home experienced a decrease in perceived stress and mood disturbance when practicing Mindfulness-based Stress Reduction (MBSR).” – Heather Stang

 

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Alzheimer’s disease is the most common type of dementia and accounts for 50 to 70 percent of dementia cases. For Alzheimer’s disease, there are an estimated 10 million caregivers providing 9 billion hours of care at a value of over $100 Billion dollars.

 

Caregiving for dementia patients is a daunting and all too frequent task. It is an intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. In the last year, 59% of caregivers report that they are effectively on duty 24/7. Over time dementia will lead to loss of memory, loss of reasoning and judgment, personality and behavioral changes, physical decline, and death. The memory and personality changes in the patient may take away all those characteristics that make the loved one identifiable, unique, and endearing, producing psychological stress in the caregiver.

 

The feelings of hopelessness can be overwhelming regarding the future of a patient with an irreversible terminal degenerative illness. In addition, caregivers often experience an anticipatory grief associated with a feeling of impending loss of their loved one. If this isn’t bad enough, a little appreciated consequence is that few insurance programs cover dementia care outside of the hospital. So, medical expenses can produce extra financial strain on top of the loss of income for the caregiver. It is sad that 72% of caregivers report relief when their loved one passes away. Obviously, there is a need to care for the caregivers of dementia patients. They play an essential and often irreplaceable role. So, finding ways to ease the burden is extremely important. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving.

 

In today’s Research News article “A Pilot Randomized Controlled Trial of Mindfulness-Based Stress Reduction for Caregivers of Family Members with Dementia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070659/ ), Brown and colleagues recruited adult family members providing caregiving for patients with Alzheimer’s Disease. They were randomly assigned to receive either an 8-week, once a week for 2 hours, Mindfulness-Based Stress Reduction (MBSR) program or a Social Support program. Participants were measured before and after the programs and 3 months later for perceived stress, experiential avoidance, mood states, physical and mental health, caregiver burden, and quality of relationship between the caregiver and care recipient. They also provided saliva samples to measure cortisol levels.

 

They found that both MBSR and Social Support produced significant improvements in experiential avoidance, depression, vitality, fatigue, confusion, and physical and mental health. They also found that MBSR also produced significant improvements in perceived stress, tension, and anger while Social Support produced significant improvement in caregiver burden. Unfortunately, these effects were not sustained at the 3-month follow-up.

 

Hence, it appears that both MBSR and Social Support are effective in improving caregivers’ psychological well-being, but only temporarily. MBSR appears to be superior to Social Support in providing these benefits. The stress of caring for patients with Alzheimer’s Disease is immense and the importance of the relief provided by these programs cannot be overemphasized. But, the study clearly demonstrates a need for future research to investigate means to prolong the effectiveness of these programs.

 

So, improve dementia caregiver psychological health and stress with mindfulness.

 

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities. The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past. It is a good way to address stress.” – Marla Paul

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Brown, K. W., Coogle, C. L., & Wegelin, J. (2016). A Pilot Randomized Controlled Trial of Mindfulness-Based Stress Reduction for Caregivers of Family Members with Dementia. Aging & Mental Health, 20(11), 1157–1166. http://doi.org/10.1080/13607863.2015.1065790

 

Abstract

Objectives

The majority of care for those with Alzheimer’s Disease and other age-related dementias is provided in the home by family members. To date there is no consistently effective intervention for reducing the significant stress burden of many family caregivers. The present pilot randomized controlled trial tested the efficacy of an adapted, 8-week Mindfulness-based Stress Reduction (MBSR) program, relative to a near structurally equivalent, standard Social Support (SS) control condition for reducing caregiver stress and enhancing the care giver-recipient relationship.

Method

Thirty-eight family caregivers were randomized to MBSR or SS, with measures of diurnal salivary cortisol, and perceived stress, mental health, experiential avoidance, caregiver burden, and relationship quality collected pre- and post-intervention and at 3-month follow-up.

Results

MBSR participants reported significantly lower levels of perceived stress and mood disturbance at post-intervention relative to SS participants. At 3-month follow-up, participants in both treatments conditions reported improvements on several psychosocial outcomes. At follow-up there were no condition differences on these outcomes, nor did MBSR and SS participants differ in diurnal cortisol response change over the course of the study.

Conclusion

Both MBSR and SS showed stress reduction effects, and MBSR showed no sustained neuroendocrine and psychosocial advantages over SS. The lack of treatment condition differences could be attributable to active ingredients in both interventions, and to population-specific and design factors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070659/

 

Improve Employee’s Mental Health with Mindfulness

Improve Employee’s Mental Health with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Toxic emotions disrupt the workplace, and mindfulness increases your awareness of these destructive patterns, helping you recognize them before they run rampant. It’s a way of reprogramming your mind to think in healthier, less stressful, ways.” – Drew Hansen

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. How we spend that time is immensely important for our psychological and physical health. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the people we work with. But, more than half of employees in the U.S. and nearly 2/3 worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnoutmindfulness practices have been implemented in the workplace. Indeed, mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity. For example, Google offers “Search Inside Yourself” classes to teach mindfulness at work. But, although there is a lot of anecdotal evidence of meditation improving well-being and work performance, there is actually very little systematic research on its effectiveness.

 

In today’s Research News article “Effects of Mindfulness-Based Stress Reduction on employees’ mental health: A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783379/ ), Janssen and colleagues review and summarize the published research literature on the effectiveness of mindfulness programs to improve the mental health of workers. They identify 23 studies, most of which employed Mindfulness-Based Stress Reduction (MBSR) programs.

 

They report that the published research demonstrates that mindfulness programs produced significant increases in workers’ mindfulness, personal accomplishment, self-compassion, sleep quality, relaxation, life satisfaction, emotion regulation, self-efficacy, and work engagement, and significant decreases in stress levels, psychological distress, depression, anxiety, burnout, emotional exhaustion, depersonalization, mood disturbance, They also found that the mindfulness programs did not produce any harmful side-effects. But, the studies were in general of only moderate research quality and there is a need for more high-quality studies.

 

The summary of the research provides extensive evidence that mindfulness programs produce significant improvements in workers’ mental health and well-being. It is striking how widespread the benefits are for otherwise healthy employees. These effects are important in not only preventing burnout and mental illness, but the stress reduction will tend to prevent illness and promote physical health. This may, in turn, improve employee retention and productiveness and decrease employee absences and health-care costs.

 

So, improve employee’s mental health with mindfulness.

 

“Many corporations and employees are realizing that the benefits of mindfulness practices can be dramatic. In addition to supporting overall health and well-being, mindfulness has been linked to improved cognitive functioning and lower stress levels.” – Carolyn Gregoire

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Math Janssen, Yvonne Heerkens, Wietske Kuijer, Beatrice van der Heijden, Josephine Engels. Effects of Mindfulness-Based Stress Reduction on employees’ mental health: A systematic review. PLoS One. 2018; 13(1): e0191332. Published online 2018 Jan 24. doi: 10.1371/journal.pone.0191332

 

Abstract

Objectives

The purpose of this exploratory study was to obtain greater insight into the effects of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) on the mental health of employees.

Methods

Using PsycINFO, PubMed, and CINAHL, we performed a systematic review in October 2015 of studies investigating the effects of MBSR and MBCT on various aspects of employees’ mental health. Studies with a pre-post design (i.e. without a control group) were excluded.

Results

24 articles were identified, describing 23 studies: 22 on the effects of MBSR and 1 on the effects of MBSR in combination with some aspects of MBCT. Since no study focused exclusively on MBCT, its effects are not described in this systematic review. Of the 23 studies, 2 were of high methodological quality, 15 were of medium quality and 6 were of low quality. A meta-analysis was not performed due to the emergent and relatively uncharted nature of the topic of investigation, the exploratory character of this study, and the diversity of outcomes in the studies reviewed. Based on our analysis, the strongest outcomes were reduced levels of emotional exhaustion (a dimension of burnout), stress, psychological distress, depression, anxiety, and occupational stress. Improvements were found in terms of mindfulness, personal accomplishment (a dimension of burnout), (occupational) self-compassion, quality of sleep, and relaxation.

Conclusion

The results of this systematic review suggest that MBSR may help to improve psychological functioning in employees.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783379/

 

Reduce Medical Resident Burnout with Mindfulness

Reduce Medical Resident Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation introduces a way of cultivating awareness of one’s relationship with the present moment. With practice, it may lead to healthier ways of working with stressful life experiences, including those inherent to residency training.” – Vincent Minichiello

 

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. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout it is a threat to the healthcare providers and their patients. In fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout, so it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnoutincreasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Medical residency is an extremely stressful period and many express burnout symptoms. This would seem to be an ideal time to intervene.

 

In today’s Research News article “Mindfulness, burnout, and effects on performance evaluations in internal medicine residents.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565254/, Braun and colleagues recruited medical residents and had them complete measures of mindfulness, burnout, depression, and stress. They were also rated by the staff for their level of professional development.

 

They found that 71% of the residents met the criterion for burnout and this was associated with poor performance in their residency. Importantly, dispositional mindfulness, particularly “acting with awareness,” was significantly, negatively associated with meeting the burnout criterion, such that low mindfulness predicted a high likelihood of burnout. Burned-out residents tended to be low in mindfulness while resilient residents tended to be high in mindfulness.

 

These are interesting results, but were correlational, so causal relationships cannot be determined. Nevertheless, previous studies have demonstrated that mindfulness training can reduce burnout. This combined with the present results suggest that being mindful and acting with awareness are helpful for preventing burnout.  It remains for future research to demonstrate if mindfulness training can prevent burnout in medical residents.

 

So, reduce medical resident burnout with mindfulness.

 

“Having a greater ability to recognize what’s going on inside allows you to set aside distractions and really attend to the moment. Paradoxically, what you learn in meditation is that turning toward the distress and becoming curious about it rather than being swept away by it is a way to detoxify it. The more we try to escape the stress, the worse it becomes.” – Ron Epstein

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Braun, S. E., Auerbach, S. M., Rybarczyk, B., Lee, B., & Call, S. (2017). Mindfulness, burnout, and effects on performance evaluations in internal medicine residents. Advances in Medical Education and Practice, 8, 591–597. http://doi.org/10.2147/AMEP.S140554

 

Abstract

Purpose

Burnout has been documented at high levels in medical residents with negative effects on performance. Some dispositional qualities, like mindfulness, may protect against burnout. The purpose of the present study was to assess burnout prevalence among internal medicine residents at a single institution, examine the relationship between mindfulness and burnout, and provide preliminary findings on the relation between burnout and performance evaluations in internal medicine residents.

Methods

Residents (n = 38) completed validated measures of burnout at three time points separated by 2 months and a validated measure of dispositional mindfulness at baseline. Program director end-of-year performance evaluations were also obtained on 22 milestones used to evaluate internal medicine resident performance; notably, these milestones have not yet been validated for research purposes; therefore, the investigation here is exploratory.

Results

Overall, 71.1% (n = 27) of the residents met criteria for burnout during the study. Lower scores on the “acting with awareness” facet of dispositional mindfulness significantly predicted meeting burnout criteria χ2(5) = 11.88, p = 0.04. Lastly, meeting burnout criteria significantly predicted performance on three of the performance milestones, with positive effects on milestones from the “system-based practices” and “professionalism” domains and negative effects on a milestone from the “patient care” domain.

Conclusion

Burnout rates were high in this sample of internal medicine residents and rates were consistent with other reports of burnout during medical residency. Dispositional mindfulness was supported as a protective factor against burnout. Importantly, results from the exploratory investigation of the relationship between burnout and resident evaluations suggested that burnout may improve performance on some domains of resident evaluations while compromising performance on other domains. Implications and directions for future research are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565254/

Improve Dementia Patient Caregiver Mental Health and Reduce Stress with Mindfulness

Improve Dementia Patient Caregiver Mental Health and Reduce Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“To my mother, I owe the experience of being with her since the beginning of her dementia, and the ability to notice what a difference mindfulness practice made in our relationship. From feeling only grief, to a growing acceptance of her in the moment, even appreciating new aspects of her personality that became freed as a result of her condition.” – Marguerite Manteau-Rao

 

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. Dementia patients require caregiving particularly in the later stages of the disease. Alzheimer’s disease is the most common type of dementia and accounts for 50 to 70 percent of dementia cases. Other types of dementia include vascular dementia, mixed dementia, dementia with Lewy bodies and frontotemporal dementia. For Alzheimer’s disease alone, there are an estimated 10 million caregivers providing 9 billion hours of care at a value of over $100 Billion dollars.

 

Caregiving for dementia patients is a daunting and all too frequent task. It is an intense experience that can go on for four to eight years with increasing responsibilities as the loved one deteriorates. In the last year, 59% of caregivers report that they are effectively on duty 24/7. Over time dementia will lead to loss of memory, loss of reasoning and judgment, personality and behavioral changes, physical decline, and death. The memory and personality changes in the patient may take away all those characteristics that make the loved one identifiable, unique, and endearing, producing psychological stress in the caregiver.

 

The feelings of hopelessness can be overwhelming regarding the future of a patient with an irreversible terminal degenerative illness. In addition, caregivers often experience an anticipatory grief associated with a feeling of impending loss of their loved one. If this isn’t bad enough, a little appreciated consequence is that few insurance programs cover dementia care outside of the hospital. So, medical expenses can produce extra financial strain on top of the loss of income for the caregiver. It is sad that 72% of caregivers report relief when their loved one passes away.

 

Obviously, there is a need to care for the caregivers of dementia patients. They play an essential and often irreplaceable role. So, finding ways to ease the burden is extremely important. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving. In today’s Research News article “Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626236/, Liu and colleagues review and summarize the published Randomized Controlled Trials (RCTs) on the effectiveness of mindfulness training on the psychological state of caregivers for dementia patients.

 

They identified 7 published Randomized Controlled Trials (RCTs). The studies employed a variety of different mindfulness training techniques; including Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), and meditation practice. They report that the published studies find that mindfulness training produces a significant decrease in depression and perceived stress, a trend toward decreased anxiety, and significant improvement in mental health quality of life. The importance of these findings is underscored by the fact that these were all well controlled scientific studies of high quality. Hence, mindfulness training appears to be of significant help to caregivers of dementia patients improving their mental health and quality of life.

 

It has been demonstrated that mindfulness training improves anxiety, depression, and quality of life, and reduces stress in a wide variety of populations. So, it is not surprising that it has similar effectiveness for these caregivers. The magnitude of the burden on these caregivers, however, is such that the improvements produced by mindfulness training are a blessing. Hence, mindfulness training should be incorporated into routing support and treatment programs for caregivers of dementia patients.

 

So, improve dementia patient caregiver mental health and reduce stress with mindfulness.

 

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities. The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past.” – Sandra Weintraub

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Liu, Z., Chen, Q., & Sun, Y. (2017). Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials. Clinical Interventions in Aging, 12, 1521–1529. http://doi.org/10.2147/CIA.S146213

 

Abstract

Caring for a relative with dementia is extremely challenging; conventional interventions may not be highly effective or easily available on some occasions. This study aimed to explore the efficacy of mindfulness training in improving stress-related outcomes in family caregivers of people with dementia using a meta-analytic review. We searched randomized controlled trials (RCT) through April 2017 from five electronic databases, and assessed the risk of bias using the Cochrane Collaboration tool. Seven RCTs were included in our review. Mindfulness interventions showed significant effects of improvement in depression (standardized mean difference: −0.58, [95% CI: −0.79 to −0.37]), perceived stress (−0.33, [−0.57 to −0.10]), and mental health-related quality of life (0.38 [0.14 to 0.63]) at 8 weeks post-treatment. Pooled evidence did not show a significant advantage of mindfulness training compared with control conditions in the alleviation of caregiver burden or anxiety. Future large-scale and rigorously designed trials are needed to confirm our findings. Clinicians may consider the mindfulness program as a promising alternative to conventional interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626236/