Encouraging Mindfulness in Medical House Staff via Smartphone App

Stress and burnout are increasingly recognized as urgent issues among resident physicians, especially given the concerning implications of burnout on physician well-being and patient care outcomes | Academic Psychiatry

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The authors assessed how a mindfulness and meditation practice among residents, supported via a self-guided, smartphone-based mindfulness app, affects wellness as measured by prevalidated surveys.

Study limitations include self-guided app usage, a homogenous study subject population, insufficient study subjects to perform stratified analysis of the impact of specialty on the findings, lack of control group, and possible influence from the Hawthorne effect. This study suggests the feasibility and efficacy of a short mindfulness intervention delivered by a smartphone app to improve mindfulness and associated resident physician wellness parameters.

Full reference: Wen, L. et al. Encouraging Mindfulness in Medical House Staff via Smartphone App: A Pilot Study (2017) Academic Psychiatry. Published online: 09 August 2017

Coping with the stress in the cardiac intensive care unit: Can mindfulness be the answer?

Mothers of infants with complex congenital heart disease are exposed to increased stress which has been associated with numerous adverse health outcomes. The coping mechanisms these mothers use critically effect the familial illness adaptation and most likely infant outcomes | Journal of Pediatric Nursing

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Currently no data-based strategies have been developed for mothers to facilitate their coping, and proactively promote their adaptation in the critical care settings. A potential strategy is mindfulness which is currently used in other clinical settings with stress-reduction effects.

Highlights:

  • Mothers use emotion-regulatory coping mechanisms during the CICU stay.
  • Both active and passive strategies are used by mothers to cope with the stress.
  • Mindfulness is an acceptable and feasible approach to reduce mothers’ stress.
  • Early, tailored interventions can potentially provide long-term stress relief.

Full reference: Golfenshtein, N. et al. (2017) Coping with the stress in the cardiac intensive care unit: Can mindfulness be the answer? Journal of Pediatric Nursing. Published online: August 11, 2017

A systematic review of the impact of mindfulness on the well-being of healthcare professionals

This article is a systematic review of empirical studies pertaining to mindfulness in healthcare professionals | Journal of Clinical Psychology

Databases were reviewed from the start of records to January 2016. Eligibility criteria included empirical analyses of mindfulness and well-being outcomes acquired in relation to practice. 81 papers met the eligibility criteria, comprising a total of 3,805 participants. Studies were principally examined for outcomes such as burnout, distress, anxiety, depression, and stress.

Mindfulness was generally associated with positive outcomes in relation to most measures (although results were more equivocal with respect to some outcomes, most notably burnout).

Overall, mindfulness does appear to improve the well-being of healthcare professionals. However, the quality of the studies was inconsistent, so further research is needed, particularly high-quality randomized controlled trials.

Full reference: Lomas, T. et al. (2017) A systematic review of the impact of mindfulness on the well-being of healthcare professionals. Journal of Clinical Psychology. Published online: 28 July 2017

Mindfulness- and Relaxation-Based eHealth Interventions for Patients

This systematic review aims to summarize eHealth studies with mindfulness- and relaxation-based interventions for medical conditions and to determine whether eHealth interventions have positive effects on health | International Journal of Behavioral Medicine

A comprehensive search of five databases was conducted for all available studies from 1990 to 2015. Studies were included if the intervention was mainly technology delivered and included a mindfulness- or relaxation-based intervention strategy and if patients with a medical condition were treated. Treatment effects were summarized for different outcomes.

A total of 2383 records were identified, of which 17 studies with 1855 patients were included in this systematic review. These studies were conducted in patients with irritable bowel syndrome, chronic fatigue syndrome, cancer, chronic pain, surgery, and hypertension. All but one study were delivered online through a web-based platform; one study delivered the intervention with iPods. The studies indicate that mindfulness- and relaxation-based eHealth interventions can have positive effects on patients’ general health and psychological well-being. No effects were found for stress or mindfulness. Only five studies reported economic analyses of eHealth interventions without any clear conclusion.

There is some evidence that mindfulness- and relaxation-based eHealth interventions for medical conditions can have positive effects on health outcomes. Therefore, such interventions might be a useful addition to standard medical care. No app studies were retrieved, even though a vast number of smartphone apps exist which aim at increasing users’ health. Therefore, more studies investigating those health apps are needed.

Full reference: Mikolasek, M. et al. (2017) Effectiveness of Mindfulness- and Relaxation-Based eHealth Interventions for Patients with Medical Conditions: a Systematic Review and Synthesis. International Journal of Behavioral Medicine. Published Online: 27 July 2017

Mindfulness predicts student nurses’ communication self-efficacy

The aim of this study was to compare student nurses’ communication self-efficacy, empathy, and mindfulness across two countries, and to analyse the relationship between these qualities | Patient Education and Counseling

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The study included 156 student nurses, 94 (60%) were Swedish. The mean communication self-efficacy score was 119 (95% CI 116–122), empathy score 115 (95% CI 113–117) and mindfulness score 79 (95% CI 78–81). A Mann-Whitney test showed that Swedish students scored significantly higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. When adjusted for age, gender, and country in a multiple linear regression, mindfulness was the only independent predictor of communication self-efficacy.

The Swedish student nurses in this study scored higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. Student nurses scoring high on mindfulness rated their communication self-efficacy higher.

A mindful learning approach may improve communication self-efficacy and possibly the effect of communication skills training.

Full reference: Sundling, V. et al. (2017) Mindfulness predicts student nurses’ communication self-efficacy: A cross-national comparative study. Patient Education and Counseling. Vol. 100 (Issue 8) pp. 1558–1563.

The role of trait mindfulness in quality of life and asthma control among adolescents with asthma

The current study focused on the role of trait mindfulness in asthma-related quality of life (QoL) and asthma control in adolescent asthma patients | Journal of Psychosomatic Research

In this cross-sectional study, questionnaire data of 94 adolescents with asthma that were prescribed daily asthma medication were included. Two Structural Equation Models (SEMs), a direct model and an indirect model, were tested.

We found that trait mindfulness was directly related to asthma-related QoL, but not to asthma control. The relationship between trait mindfulness and asthma-related QoL was explained by asthma-specific, but not by general stress. Furthermore, an indirect relation from mindfulness to asthma control via asthma-specific stress was found.

Cross-sectional evidence for a relation between mindfulness and asthma-related QoL is found. These findings may point to the possibility that an intervention aimed at increasing mindfulness could be a promising tool to improve asthma-related QoL in adolescents via a decrease in asthma-specific stress.

Full reference: Cillessen, L. et al. (2017) The role of trait mindfulness in quality of life and asthma control among adolescents with asthma. Journal of Psychosomatic Research. Vol. 99 (August) pp. 143–148.

Mindfulness-Based Stress Reduction in Women with Overweight or Obesity

The aim of this study was to evaluate the feasibility and cardiometabolic effects of mindfulness-based stress reduction (MBSR) in women with overweight or obesity | Obesity

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Image source: lazydoll – Flickr // CC BY-NC 2.0

Eighty-six women with BMI less than 25 kg/m2 were randomized to 8 weeks of MBSR or health education and followed for 16 weeks. The primary outcome was the Toronto Mindfulness Scale. Secondary outcomes included the Perceived Stress Scale-10, fasting glucose, and blood pressure.

Compared to health education, the MBSR group demonstrated significantly improved mindfulness at 8 weeks (mean change from baseline, 4.5 vs. −1.0; P = 0.03) and significantly decreased perceived stress at 16 weeks (−3.6 vs. −1.3, P = 0.01). In the MBSR group, there were significant reductions in fasting glucose at 8 weeks (−8.9 mg/dL, P = 0.02) and at 16 weeks (−9.3 mg/dL, P = 0.02) compared to baseline. Fasting glucose did not significantly improve in the health education group. There were no significant changes in blood pressure, weight, or insulin resistance in the MBSR group.

In women with overweight or obesity, MBSR significantly reduces stress and may have beneficial effects on glucose. Future studies demonstrating long-term cardiometabolic benefits of MBSR will be key for establishing MBSR as an effective tool in the management of obesity.

Full reference: Raja-Khan, N. et al. (2017) Mindfulness-Based Stress Reduction in Women with Overweight or Obesity: A Randomized Clinical Trial. Obesity. 
Vol. 25 (no, 8) pp.1349–1359.