Abbreviated Mindfulness Intervention for Job Satisfaction, Quality of Life, and Compassion in Primary Care Clinicians: A Pilot Study
01 Sep 2013-Annals of Family Medicine (American Academy of Family Physicians)-Vol. 11, Iss: 5, pp 412-420
TL;DR: Participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress.
Abstract: PURPOSE Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interven - tions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and com- passion among primary care clinicians. METHODS A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months postintervention), participants completed a set of online measures assessing burnout, anxiety, stress, resil- ience, and compassion. We used a linear mixed-effects model analysis to assess changes in outcome measures. RESULTS Participants had improvements compared with baseline at all 3 follow-up time points. At 9 months postintervention, they had significantly bet - ter scores (1) on all Maslach Burnout Inventory burnout subscales—Emotional Exhaustion (P = .009), Depersonalization (P = .005), and Personal Accomplish- ment (P <.001); (2) on the Depression (P = .001), Anxiety (P = .006), and Stress (P = .002) subscales of the Depression Anxiety Stress Scales-21; and (3) for perceived stress (P = .002) assessed with the Perceived Stress Scale. There were no significant changes on the 14-item Resilience Scale and the Santa Clara Brief Compassion Scale. CONCLUSIONS In this uncontrolled pilot study, participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clini - cian health and well-being, which may have implications for patient care.
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01 Dec 2015
TL;DR: Burnout and satisfaction with work-life balance in US physicians worsened from 2011 to 2014, resulting in an increasing disparity in burn out and satisfaction in physicians relative to the general US working population.
Abstract: Objective To evaluate the prevalence of burnout and satisfaction with work-life balance in physicians and US workers in 2014 relative to 2011. Patients and Methods From August 28, 2014, to October 6, 2014, we surveyed both US physicians and a probability-based sample of the general US population using the methods and measures used in our 2011 study. Burnout was measured using validated metrics, and satisfaction with work-life balance was assessed using standard tools. Results Of the 35,922 physicians who received an invitation to participate, 6880 (19.2%) completed surveys. When assessed using the Maslach Burnout Inventory, 54.4% (n=3680) of the physicians reported at least 1 symptom of burnout in 2014 compared with 45.5% (n=3310) in 2011 ( P P P P Conclusion Burnout and satisfaction with work-life balance in US physicians worsened from 2011 to 2014. More than half of US physicians are now experiencing professional burnout.
2,150 citations
TL;DR: This review identifies the limited empirical understanding of compassion in healthcare, highlighting the lack of patient and family voices in compassion research.
Abstract: Recent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care is expected by patients and is a professional obligation of clinicians; however, little is known about the state of research on clinical compassion. The purpose of this scoping review was to map the literature on compassion in clinical healthcare. Searches of eight electronic databases and the grey literature were conducted to identify empirical studies published over the last 25 years. Eligible studies explored perceptions or interventions of compassionate care in clinical populations, healthcare professionals, and healthcare students. Following the title and abstract review, two reviewers independently screened full-texts articles, and extracted study data. A narrative approach to synthesizing and mapping the literature was used. Of 36,637 records, 648 studies were retrieved and 44 studies were included in the review. Less than one third of studies included patients. Six themes emerged from studies that explored perceptions of compassionate care: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. Intervention studies included two compassionate care trials with patients and eight educational programs that aimed to improve compassionate care in clinicians and students. This review identifies the limited empirical understanding of compassion in healthcare, highlighting the lack of patient and family voices in compassion research. A deeper understanding of the key behaviors and attitudes that lead to improved patient-reported outcomes through compassionate care is necessary.
285 citations
TL;DR: This article conducted a meta-analysis of existing primary evidence on the effectiveness of resilience-building programs in the workplace and found that the overall effect of such programs was small (d = 0.21) and that program effects diminish over time (dproximal = 0.,26 vs. ddistal = 0,07).
Abstract: Organizations have increasingly sought to adopt resilience-building programmes to prevent absenteeism, counterproductive work behaviour, and other stress-related issues. However, the effectiveness of these programmes remains unclear as a comprehensive review of existing primary evidence has not been undertaken. Using 42 independent samples across 37 studies, the present meta-analysis sought to address this limitation in the literature by summarizing the effectiveness of resilience-building programmes implemented in organizational contexts. Results demonstrated that the overall effect of such programmes was small (d = 0.21) and that programme effects diminish over time (dproximal = 0.26 vs. ddistal = 0.07). Alternatively, moderator analyses revealed that programmes targeting individuals thought to be at greater risk of experiencing stress and lacking core protective factors showed the opposite effect over time. Programmes employing a one-on-one delivery format (e.g., coaching) were most effective, followed by the classroom-based group delivery format. Programmes using train-the-trainer and computer-based delivery formats were least effective. Finally, substantially stronger effects were observed among studies employing single-group within-participant designs, in comparison with studies utilizing between-participant designs. Taken together, these findings provide important theoretical and practical implications for advancing the study and use of resilience-building in the workplace.
Practitioner points
Resilience-building programmes have had a modest effect in the workplace. The effect is weaker than that associated with secondary prevention techniques, but similar to those shown for other primary prevention techniques.
Across primary studies, programme effects diminished substantially from proximal (≤1 month post-intervention) to distal time points (>1 month). However, among those at greater risk of experiencing stress or who lack protective resources, weak proximal effects became stronger when measured distally. To optimize the effectiveness of resilience-building programmes, developers should carefully conduct needs assessments, identifying individuals at elevated risk.
Methodological decisions (i.e., the use of within- vs. between-participant designs) may have a substantial impact on the conclusions researchers draw regarding the effectiveness of resilience-building programmes. When evaluating the effectiveness of resilience-building programmes, researchers and practitioners should compare observed effects to estimates of mean effects across studies using similar evaluative designs.
282 citations
TL;DR: Results of the meta-analysis suggest that MBIs have the potential to significantly improve stress among HCPs; however, there was evidence of a file drawer problem and more high-quality research is needed before this finding can be confirmed.
Abstract: Workplace stress is high among healthcare professionals (HCPs) and is associated with reduced psychological health, quality of care and patient satisfaction. This systematic review and meta-analysis reviews evidence on the effectiveness of mindfulness-based interventions (MBIs) for reducing stress in HCPs. A systematic literature search was conducted. Papers were screened for suitability using inclusion criteria and nine papers were subjected to review and quality assessment. Seven papers, for which full statistical findings could be obtained, were also subjected to meta-analysis. Results of the meta-analysis suggest that MBIs have the potential to significantly improve stress among HCPs; however, there was evidence of a file drawer problem. The quality of the studies was high in relation to the clarity of aims, data collection and analysis, but weaker in terms of sample size and the use of theoretical frameworks. MBIs have the potential to reduce stress among HCPs; however, more high-quality research is needed before this finding can be confirmed. Future studies would benefit from long-term follow-up measures to determine any continuing effects of mindfulness training on stress outcomes. Copyright © 2016 John Wiley & Sons, Ltd.
249 citations
References
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01 Jan 1988
4,196 citations
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...50 50% 6 (20) 4 (22) 2 (17) 51%-99% 19 (63) 10 (56) 9 (75) 100% 5 (17) 4 (22) 1 (8) Percentage of work time in activities other than clinical practice (eg, teaching/research), No....
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TL;DR: Burnout is more common among physicians than among other US workers, and Physicians in specialties at the front line of care access seem to be at greatest risk.
Abstract: Methods: We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored. Results: Of 27276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8%ofphysiciansreportedatleast1symptomofburnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internalmedicine,andemergencymedicine).Comparedwith a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with worklife balance (40.2% vs 23.2%) (P.001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Comparedwithhighschoolgraduates,individualswithanMD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P.001), whereas individuals with a bachelor’sdegree(OR,0.80;P=.048),master’sdegree(OR, 0.71;P=.01),orprofessionalordoctoraldegreeotherthan an MD or DO degree (OR, 0.64; P=.04) were at lower risk for burnout. Conclusions: Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.
2,546 citations
"Abbreviated Mindfulness Interventio..." refers background or methods in this paper
...At 9 months postintervention, they had significantly better scores (1) on all Maslach Burnout Inventory burnout subscales—Emotional Exhaustion (P = ....
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...The time dependencies were modeled with an AR(1) autoregressive error structure....
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...Inclusion criteria were (1) employment as a primary care medical doctor or doctor of osteopathy, nurse practitioner, or physician assistant; (2) working at least 50% time in direct patient care; (3) availability to attend all or most intervention sessions; (4) willingness to do 10 to 20 minutes of mindfulness-related activity daily, and (5) agreement to complete a 15- to 30-minute online survey 4 times....
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TL;DR: In this paper, the Maslach Burnout Inventory is used to measure and evaluate mental health in counseling and development, and the results show that the majority of participants report burnout.
Abstract: (1984). Maslach Burnout Inventory. Measurement and Evaluation in Counseling and Development: Vol. 17, No. 2, pp. 100-102.
1,878 citations