Resilience

Improve resilience in Spouses of Schizophrenia Patients with Mindfulness

psyjdc Leave a comment

Improve resilience in Spouses of Schizophrenia Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Most of life’s stressors are subjective and with mindfulness (seeing things as they are in this present moment), we have the ability to respond with wisdom vs. react in a harmful way. When we see our thoughts and feelings clearly and can offer compassion for the hardship we are experiencing, we increase our resilience.” – Carley Hauck

 

Psychological well-being is sometimes thought of as a lack of mental illness. But, it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society. But, stress can interfere with the individual’s ability to achieve these goals.  When highly stressed, resilience is required to cope with the stress and continue on the path to psychological well-being.

 

Schizophrenia is the most common form of psychosis, affecting about 1% of the population worldwide. In many cases it is so debilitating that institutionalization is required. But, the symptoms of psychoses often do not appear until early adulthood. So, many carry on relatively normal lives including marriage prior to the onset of debilitating symptoms. This can result in wives having to cope with the institutionalization of their husbands, having to live alone, replace lost income, and withstand the societal stigma of having a mentally ill spouse. The resultant stress can exacerbate an already difficult situation.

 

Mindfulness has been shown to increase resilience and reduce the psychological and physiological responses to stress. So, it is reasonable to infer that mindfulness training may help increase resilience in the wives of institutionalized individuals with schizophrenia. In today’s Research News article “The Efficacy of Mindfulness-Based Cognitive Therapy on Resilience among the Wives of Patients with Schizophrenia.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449888/,  Solati recruited wives whose husbands were diagnosed with schizophrenia and institutionalized and randomly assigned them to a no-treatment control group or to receive and 8-week, once a week for 90 minutes, program of Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie difficult emotions. The women were measured before and after training for resilience.

 

They found that following the intervention the women who received Mindfulness-Based Cognitive Therapy (MBCT) had a significant, 10%, increase in resilience in comparison to the control group. There is a need to conduct a randomized controlled trial with an active control condition to verify these findings. Nevertheless, mindfulness training appeared to improve resilience. This suggests that MBCT may assist wives whose husbands are diagnosed with schizophrenia and institutionalized to better cope with the resultant stress. This may better equip the women to withstand their difficulties and retain their own well-being.

 

So, improve resilience in spouses of schizophrenia patients with mindfulness.

 

“The emotional soup that follows a stressful event can whip up negative stories about yourself or others that goes on and on, beyond being useful. Mindfulness reduces this rumination and, if practiced regularly, changes your brain so that you’re more resilient to future stressful events.” – Shamash Alidina

 

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

 

Solati, K. (2017). The Efficacy of Mindfulness-Based Cognitive Therapy on Resilience among the Wives of Patients with Schizophrenia. Journal of Clinical and Diagnostic Research : JCDR, 11(4), VC01–VC03. http://doi.org/10.7860/JCDR/2017/23101.9514

 

Abstract

Introduction

The wives of patients with schizophrenia experience high levels of stress due to their spouses’ disease, which leads to certain problems and decreased adaptability and efficiency in them.

Aim

This study investigated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) on resilience in schizophrenia patients.

Materials and Methods

In this quasi-experimental study, 40 wives of patients with schizophrenia (20 assigned to experimental group and 20 to control group) whose husbands were kept in rehabilitation centers for mental disorders were enrolled according to convenience sampling. In the experimental group, the therapeutic protocol of MBCT was conducted. Accordingly, the patients were encouraged to process the experiences in a non-judgmental manner as they have been formed, and to change their relationship with and embrace challenging thoughts and feelings. Meanwhile, the control group underwent no intervention. The research instrument was Connor-Davidson Resilience Scale. Data were analysed by ANCOVA in SPSS 16.

Results

At post-test, mean resilience score of the experimental group (77.95±4.71) was much higher than that of the control group (71.75±5.81). There was a significant difference in the mean resilience score at post-test between the experimental and control groups (p<0.05).

Conclusion

Training MBCT strategies was effective on resilience in the wives of schizophrenia patients. Therefore, this approach can be incorporated into mental health-related interventions for the families of patients with psychiatric disorders such as schizophrenia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449888/

Spring Back from Stress with Mindfulness

psyjdc Leave a comment

Spring Back from Stress with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Among healthcare professionals, mindfulness training can reduce psychological and physiologic stress, emotional distress, and burnout while improving empathy, job satisfaction, and sense of well-being.” – Lois Howland

 

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. 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. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. 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. But, 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 burnout, increasing resilience, and improving sleep.

 

Working early in healthcare careers to improve resilience could work to prevent burnout. So, it makes sense to investigate how mindfulness training during healthcare education may promote resilience and lower the likelihood of future burnout in healthcare workers. In today’s Research News article “Correlates and Predictors of Resilience among Baccalaureate Nursing Students.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376833/, Mathad and colleagues recruited nursing students who completed measures of mindfulness, resilience, empathy and perseverative thinking.

 

They found that the higher the levels of mindfulness the higher the levels of resilience even in a multiple regression model considering the other measures. They also found that higher levels of resilience were, in turn, associated with higher levels of empathy and lower levels of repeated negative thinking and unproductive negative thinking. This is a correlative study so causation cannot be determined. But, the findings fit with previous research where mindfulness was manipulated through training and caused an increase in resilience. So, it is reasonable to conclude that the current findings were probably due to mindfulness improving resilience.

 

Hence, it appears that mindfulness increases resilience and this in turn reduces negative thinking and improves empathy. This all suggests that mindfulness would tend to protect healthcare providers from the effects of stress, making the individuals more resilient and less likely to experience burnout.

 

So, spring back from stress with mindfulness.

 

“By being in the present moment we help ourselves as health care providers to moderate the challenges of stress, even having the opportunity to transform previously overwhelming situations into ones of challenge and mastery. This presence also helps us to be better clinicians. We are more present, more available, and better able to access empathy, compassion, and caring skills.” – Arnie Kozak

 

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

Mathad, M. D., Pradhan, B., & Rajesh, S. K. (2017). Correlates and Predictors of Resilience among Baccalaureate Nursing Students. Journal of Clinical and Diagnostic Research : JCDR, 11(2), JC05–JC08. http://doi.org/10.7860/JCDR/2017/24442.9352

 

Abstract

Introduction

A growing body of literature recognizes the importance of resilience in the nursing profession. Both mindfulness and resilience aid in handling stress, stress increases the risk of rumination and/or worry especially in females and they are more empathetic than other healthcare students.

Aim

To identify correlates and predictors of the resilience among nursing students.

Materials and Methods

This is a descriptive correlation study and we have recruited 194 participants (1-4th year B.Sc Nursing) from Government College of Nursing and NIMHANS College of Nursing in Bangalore, India. The following instruments were used to collect the data, Freiburg Mindfulness Inventory (FMI), Toronto Empathy Questionnaire (TEQ), Perseverative Thinking Questionnaire (PTQ) and Connor–Davidson Resilience Scale (CD-RISC). Data was analysed using Pearson’s correlation test and multiple regression analysis.

Results

Resilience is significantly correlated with mindfulness, perseverative thinking and empathy in nursing students. Based on regression analysis this model accounted for almost 33% of variance in resilience. This result is of interest as mindfulness alone explained 23% of the variance and unproductive Repeated Negative Thinking (RNT) and RNT consuming mental capacity predicted 8% and 2% respectively.

Conclusion

These results support the importance of resilience and mindfulness in nursing students. Hence, resilience and/or mindfulness enhancing interventions should be inculcated in nursing education.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376833/

Spirituality is Related to Resilience in Older Women

psyjdc 1 Comment

By John M. de Castro, Ph.D.

 

“An improved understanding and respect for individual spiritual practices can help shape personalized medical care for older adults, and improve health outcomes.” – Helen Lavretsky

 

Psychological well-being is sometimes thought of as a lack of mental illness. But, it is more than just a lack of something. It is a positive set of characteristics that lead to happy, well-adjusted life. These include the ability to be aware of and accept one’s strengths and weaknesses, to have goals that give meaning to life, to truly believe that your potential capabilities are going to be realized, to have close and valuable relations with others, the ability to effectively manage life issues especially daily issues, and the ability to follow personal principles even when opposed to society. But, the aging process to some extent interferes with the individual’s ability to achieve these goals as a result of a systematic progressive decline in every system in the body, the brain included, producing declines in mental abilities including impairments in memory, attention, and problem solving ability.

 

Religion and spirituality have been promulgated as solutions to the challenges of life both in a transcendent sense and in a practical sense. What evidence is there that these claims are in fact true? The transcendent claims are untestable with the scientific method. But, the practical claims are amenable to scientific analysis. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Research from this body of work has shown that spirituality and religiosity serve as protective factors against a variety of psychiatric conditions, including depressive disorders, anxiety disorders, suicide, burnout, eating disorders, substance-related disorders and addiction recovery.

 

Perhaps spirituality counteracts the challenges to well-being produced by aging. In today’s Research News article “Correlates of Spirituality in Older Women.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017739/

Vahia and colleagues examine the relationships between religiosity/spirituality and well-being in aging women. They examined measures obtained in 2005 from the “Women’s Health Initiative (WHI), a large NIH-funded multi-center study of the predictors of morbidity and mortality among post-menopausal women.” These included measures of successful aging, religiosity/spirituality, resilience, stressful life events, optimism, attitude toward aging, depression, and physical and mental functioning. They analyzed these measures with bivariate and multivariate regression analyses.

 

They found that high levels of religiosity/spirituality were directly associated with high levels of morale toward aging, resilience, and optimism and low levels of stressful life events. Applying a multiple regression, however, they found that religiosity/spirituality was only significantly associated with higher resilience, and demographic issues of lower income, lower education, and lower likelihood of being in a committed relationship. Hence, in these postmenopausal women, spirituality appeared to be associated with resilience and negative life circumstances. It should be emphasized, though, the results are correlational and therefore do not demonstrate causal connections.

 

The association with resilience is particularly interesting. It suggests that aging women who have high levels of spirituality are also highly resilient and are therefore better able to cope with problematic life circumstances. It remains for future research to investigate whether being spiritual promotes resilience, the other way around, or some third factor may be responsible for the covariation.

 

“Seniors are always somewhere in the grief process. For most, their experience is dominated by losses such as the deaths of loved ones, decreases in physical functioning, and reductions in income. The accumulation of such losses – and the increasing awareness of their own deaths – can lead seniors to an exploration of spiritual issues.” – NAP411

 

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

Vahia, I. V., Depp, C. A., Palmer, B. W., Fellows, I., Golshan, S., Thompson, W., … Jeste, D. V. (2011). Correlates of Spirituality in Older Women. Aging & Mental Health, 15(1), 97–102. http://doi.org/10.1080/13607863.2010.501069

 

Abstract

Introduction

The role of spirituality in the context of mental health and successful aging is not well understood. In a sample of community-dwelling older women enrolled at the San Diego site of the Women’s Health Initiative study, we examined the association between spirituality and a range of variables associated with successful cognitive and emotional aging, including optimism, resilience, depression, and health-related quality of life (HRQoL).

Methods

A detailed cross-sectional survey questionnaire on successful aging was completed by 1,973 older women. It included multiple self-reported measures of positive psychological functioning (e.g., resilience, optimism,), as well as depression and HRQoL. Spirituality was measured using a 5-item self report scale constructed using two items from the Brief Multidimensional Measure of Religiosity/Spirituality and three items from Hoge’s Intrinsic Religious Motivation Scale

Results

Overall, 40% women reported regular attendance in organized religious practice, and 53% reported engaging in private spiritual practices. Several variables were significantly related to spirituality in bivariate associations; however, using model testing, spirituality was significantly associated only with higher resilience, lower income, lower education, and lower likelihood of being in a marital or committed relationship.

Conclusions

Our findings point to a role for spirituality in promoting resilience to stressors, possibly to a greater degree in persons with lower income and education level. Future longitudinal studies are needed to confirm these associations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017739/

Improve Resilience with Mindfulness

psyjdc Leave a comment

 

By John M. de Castro, Ph.D.

 

“The emotional soup that follows a stressful event can whip up negative stories about yourself or others that goes on and on, beyond being useful. Mindfulness reduces this rumination and, if practiced regularly, changes your brain so that you’re more resilient to future stressful events.” – Richard Davidson

 

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. 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. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity.

 

Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Sleep disruption is an important consequence of the stress. “Poor or inadequate sleep can contribute to poor personal health and burnout and adversely affect the quality of care” (Kemper et al. 2016).

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. But, 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 including yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep.

 

So, it makes sense to investigate how mindfulness training during healthcare education may promote resilience and lower the likelihood of future burnout in healthcare workers. In today’s Research News article “Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1398515100172412/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050545/

Chamberlain and colleagues recruited third-year nursing students and had them complete measures of mindfulness, resilience, compassion, and burnout. They found that for these nursing students the single best predictor of resilience was mindfulness, particularly acceptance; accepting without judging things just as they are. The next most powerful predictor was expectancy for a successful next career step. High levels of mindfulness were also associated with increased compassion and reduced fatigue in compassion.

 

The results are encouraging, but must be interpreted with caution. The study was correlational and nothing was manipulated, so causation cannot be determined. But the results suggest that mindfulness is very important for resilience. In particular the ability to take what comes and accept it without judgement helps to maintain the individual’s resilience. Since resilience is important for being able to cope with and bounce back from the stress of the occupation, mindfulness may be important for preventing burnout. In addition, the results suggest that mindfulness is associated with persistence of compassion, an important capacity for nurses.

 

These results need to be followed up with a randomized controlled trial in which these nursing students are trained in mindfulness, to determine if mindfulness is causally responsible for these important benefits. If this was confirmed it would strongly suggest that mindfulness training be included in the nursing curriculum; improving resilience and compassion, making them better nurses who are less likely to burn out.

 

So, improve resilience with mindfulness.

 

“The findings provide support for universities to develop strategies that promote mindfulness. Mindfulness training could provide a practical means of enhancing resilience, and personality characteristics like optimism, zest, and patience.” – Badri Bajaj

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Chamberlain, D., Williams, A., Stanley, D., Mellor, P., Cross, W., & Siegloff, L. (2016). Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study. Nursing Open,3(4), 212–221. http://doi.org/10.1002/nop2.56

 

Abstract

Background: Nursing students will graduate into stressful workplace environments and resilience is an essential acquired ability for surviving the workplace. Few studies have explored the relationship between resilience and the degree of innate dispositional mindfulness, compassion, compassion fatigue and burnout in nursing students, including those who find themselves in the position of needing to work in addition to their academic responsibilities.

Aim: This paper investigates the predictors of resilience, including dispositional mindfulness and employment status of third year nursing students from three Australian universities.

Design: Participants were 240 undergraduate, third year, nursing students. Participants completed a resilience measure (Connor–Davidson Resilience Scale, CD‐RISC), measures of dispositional mindfulness (Cognitive and Affective Mindfulness Scale Revised, CAMS‐R) and professional quality of life (The Professional Quality of Life Scale version 5, PROQOL5), such as compassion satisfaction, compassion fatigue and burnout.

Method: An observational quantitative successive independent samples survey design was employed. A stepwise linear regression was used to evaluate the extent to which predictive variables were related each to resilience.

Results: The predictive model explained 57% of the variance in resilience. Dispositional mindfulness subset acceptance made the strongest contribution, followed by the expectation of a graduate nurse transition programme acceptance, with dispositional mindfulness total score and employment greater than 20 hours per week making the smallest contribution. This was a resilient group of nursing students who rated high with dispositional mindfulness and exhibited hopeful and positive aspirations for obtaining a position in a competitive graduate nurse transition programme after graduation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050545/

 

Improve Employee Well-being with Mindfulness

psyjdc Leave a comment

 

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 Hanson

 

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 health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. In fact, it has become very trendy for business to incorporate meditation into the workday to help improve 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 work performance, there is actually very little systematic research on its effectiveness.

 

In today’s Research News article “Systematic review: complementary therapies and employee well-being.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1305498966140693/?type=3&theater

or see summary below. Ravalier and colleagues reviewed the published research literature on the effects of mindfulness practices implemented in the work environment. They included only full-length peer-reviewed journal articles published since 2000. They found that mindfulness practices produced significant reductions in perceived stress and improvements in vigor, psychological health, and resilience in the employees. In other words, they found very promising research findings, suggesting marked improvements in employee psychological well-being produced by mindfulness practices. They point out, however, that there is a need for longer-term follow-up studies to ascertain whether mindfulness practices have lasting effects in the workplace.

 

These results complement the research findings of mindfulness effects in many other contexts. It has been shown in general to reduce the psychological and physical responses to stress and to improve mental and physical health. This suggests that mindfulness practices may improve health and productivity and reduce burnout in modern workers. Beyond overcoming the negative effects of the work environment, the workplace has been postulated to be an excellent environment to practice the Buddha’s Eightfold Path for spiritual development and the relief of suffering.

 

So, improve employee well-being with mindfulness.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“By improving the way people relate to one another, ideally it can change corporate culture for the better, creating a more supportive, friendlier workplace with better relationships. In many organizations, there are bigger, systemic changes that need to be made, but I don’t think that instituting a mindfulness program will prevent those changes from happening. At the least, a mindfulness program provides workers with some relief from stress and anxiety while they campaign for systemic changes; at best, it helps to catalyze those bigger systemic changes.” – Jason Marsh

 

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

 

Study Summary

  1. M. Ravalier, P. Wegrzynek and S. Lawton Systematic review: complementary therapies and employee well-being. Occup Med (Lond) April 4, 2016, doi: 10.1093/occmed/kqw047

 

Abstract

Background A variety of workplace-based interventions exist to reduce stress and increase productivity. However, the efficacy of these interventions is sometimes unclear.

Aims To determine whether complementary therapies offered in the workplace improve employee well-being.

Methods We performed a systematic literature review which involved an electronic search of articles published between January 2000 and July 2015 from the databases Cochrane Central Register of Controlled Trials, PsycINFO, MEDLINE, AMED, CINAHL Plus, EMBASE and PubMed. We also undertook a manual search of all applicable article reference lists to ensure that no relevant studies were missed. We only selected published, full-length, English-language, peer-reviewed journal articles. Articles had to address the research objective using valid and reliable measures. We excluded articles concerning return to work or whose populations had been adversely affected by work resulting in the development of health issues.

Results We included 10 articles in the review from 131 identified. Mindfulness and meditation-based interventions were most effective in improving workplace health and work performance; the latter demonstrating some evidence of maintaining gains up to 3 months later. The evidence for relaxation interventions was inconclusive.

Conclusions Mindfulness and meditation interventions may be helpful in improving both psychosocial workplace health and work performance, but long-term efficacy has yet to be fully determined.

 

Burnout Doctor Burnout with Mindfulness

psyjdc Leave a comment

“Something very alarming is going on in the American healthcare system nowadays. Doctors aren’t happy, and neither are patients. The proverbial admonition, “Happy doctors make for happy patients” comes to mind with the caveat that the reverse is also true.” Thomas Murphy

 

With the advent of managed care and the Affordable Healthcare Act in the U.S., primary healthcare providers have become a critical component of the healthcare system. Unfortunately, there is a marked shortage of these providers. It is estimated that in the U.S. there are over 9,000 fewer primary care physicians than needed. The shortages are not just due to training insufficient numbers of healthcare providers but also due to high turnover rates. In part because of the shortage and high patient loads, primary healthcare providers experience high stress and burnout. They experience a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.

 

In a recent survey 46% of all physicians responded that they had burnout. Currently, over a third of healthcare workers report that they are looking for a new job. Nearly half plan to look for a new job over the next two years and 80% expressed interest in a new position if they came across the right opportunity. Since there is such a great need to retain primary healthcare providers, it is imperative that strategies be identified to decrease stress and burnout.

 

Burnout is not a unitary phenomenon. In fact, there appear to be a number of subtypes of burnout. The overload subtype is characterized by the perception of jeopardizing one’s health to pursue worthwhile results, and is highly associated with exhaustion. The lack of development subtype is characterized by the perception of a lack of personal growth, together with the desire for a more rewarding occupation that better corresponds to one’s abilities. The neglect subtype is characterized by an inattentive and careless response to responsibilities, and is closely associated with inefficacy.

 

Doctors appear to vary in resilience, in their ability to withstand the stress of practice and not burnout. They also vary in mindfulness which has been shown to be effective in preventing and treating healthcare professional burnout (see http://contemplative-studies.org/wp/index.php/category/research-news/burnout/). In today’s Research News article “Mindfulness, Resilience, and Burnout Subtypes in Primary Care Physicians: The Possible Mediating Role of Positive and Negative Affect”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1166142213409703/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681844/

Montero-Marin and colleagues investigate the relationship of resilience, mindfulness, and emotions to burnout in 622 Spanish primary care physicians. Using sophisticated statistical techniques, they found that the three types of burnout were highly positively associated, with high levels of each associated with high levels of all the other types. They also found that mindfulness and resilience were highly related, with higher levels of mindfulness associated with higher levels of resilience.

 

The overload type of burnout was directly associated with both negative emotions and mindfulness. In addition, both mindfulness and resilience appeared to affect overload indirectly by reducing negative emotions and thereby reducing overload burnout. The lack of development type of burnout was negatively associated with positive emotions and resilience was positively associated with positive emotions. So, resilience appeared to affect lack of development burnout by increasing positive emotions which in turn decrease lack of development burnout. Thereby, high levels of resilience were associated with low levels of lack of development. Finally, they found that resilience was negatively related to neglect burnout such that the higher the levels of resilience, the lower the neglect burnout.

 

These are complex interrelationships. But in general they suggest that the mindfulness and the resilience of the physicians were highly related and worked in consort to reduce all types of primary care physician burnout and they do so, at least in part, by affecting the positive and negative emotions of the physicians. They may do so by different mechanisms, mindfulness by reducing the psychological and physical responses to stress and resilience by increasing the ability to withstand the stress.

 

Regardless, burnout doctor burnout with mindfulness.

 

“The benefits of mindful practice extend beyond the practitioner to his or her patients. It is not only that mindful practitioners can listen attentively, but that their patients are empowered to make their voice heard in areas that matter to them.” – Mary Catherine Beach
CMCS – Center for Mindfulness and Contemplative Studies