Do Mindfulness and Self-Compassion Predict Burnout in Pediatric Residents?

Kemper, K. J., et al. | 2018| Pediatric Resident Burnout-Resilience Study Consortium| Do Mindfulness and Self-Compassion Predict Burnout in Pediatric Residents?|  Academic Medicine. Published ahead of print

A cohort study that sought to address gaps in the available literature in understanding both the stability of burnout and compassion over time, self-compassion, stress, and mindfulness in pediatric residents, used surveys to assess the participants’  characteristics and standardized measures of mindfulness, self-compassion, stress, burnout, and confidence in providing compassionate care. 

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Abstract

PurposeBurnout symptoms are common among health professionals. Gaps remain in understanding both the stability of burnout and compassion over time and relationships among burnout, self-compassion, stress, and mindfulness in pediatric residents.

MethodThe authors conducted a prospective cohort study of residents at 31 U.S. residency programs affiliated with the Pediatric Resident Burnout – Resilience Study Consortium. Residents completed online cross-sectional surveys in spring 2016 and 2017. The authors assessed demographic characteristics and standardized measures of mindfulness, self-compassion, stress, burnout, and confidence in providing compassionate care.

ResultsOf 1,108 eligible residents, 872 (79%) completed both surveys. Of these, 72% were women. The prevalence of burnout was 58% and the level of mindfulness was 2.8 in both years; levels of stress (16.4 and 16.2), and self-compassion (37.2 and 37.6) were also nearly identical in both years. After controlling for baseline burnout levels in linear mixed model regression analyses, mindfulness in 2016 was protective for levels of stress and confidence in providing compassionate care in 2017. Self-compassion in 2016 was protective for burnout, stress, and confidence in providing compassionate care in 2017; one standard deviation increase in self-compassion score was associated with a decrease in the probability of burnout from 58% to 48%.

ConclusionsBurnout and stress were prevalent and stable over at least 12 months among pediatric residents; mindfulness and self-compassion were longitudinally associated with lower stress and greater confidence in providing compassionate care. Future studies are needed to evaluate the effectiveness of training that promotes mindfulness and self-compassion in pediatric residents.

An unedited article is available ahead of publication from Academic Medicine

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Teaching Wellness Skills: Effect of a Curriculum Designed to Increase Physician Resilience on Obstetrics and Gynecology Intern Burnout, Mindfulness and Self-compassion

An article published in October’s edition of the journal Obstetrics & Gynecology  evaluates the efficacy of a curriculum targeting psychological resilience and its impacts on the burnout, mindfulness and self-compassion of obstetrics and gynecology interns. 

 

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PURPOSE: 
To assess whether a curriculum targeting psychological resilience impacts the burnout, mindfulness and self-compassion of obstetrics and gynecology interns.

BACKGROUND: Physician burnout impacts more than half of obstetrician/gynecologists nationwide. One strategy to reduce burnout is to improve individual physicians’ resiliency through cognitive and behavioral strategies linked to wellness in other populations.

METHODS: A prospective, longitudinal cohort, mixed-methods evaluation of a 12-hour curriculum taught to a residency class of seven obstetrics and gynecology interns was conducted using paired, de-identified, pre- and post-curriculum assessments of Maslach Burnout Inventory (MBI), Five Facets of Mindfulness Questionnaire (FFMQ) and Self-Compassion Scale for Researchers (SCS) scores. Data were analyzed descriptively looking primarily at changes in paired scores. A post-curriculum focus group was conducted to further investigate curriculum acceptance and impact.

RESULTS: Burnout exhaustion and depersonalization scores increased following the curriculum (median difference 3 and 3, respectively). FFMQ and SCS scores also increased (median difference 20 and 7, respectively). Focus group findings suggested interns valued the curriculum, but described an acute increase in distress as they were taken out of their prior “just powering through” coping strategy.

DISCUSSION: A wellness curriculum targeting improved resident resilience was associated with an acute worsening of burnout, but with short-term improvements in mindfulness and self-compassion, both of which have been associated with improved well-being and resilience in other populations. Worsened burnout may have been a result of increased awareness of uncomfortable thoughts and feelings. Extensive further research is needed on how to develop and measure physician resilience, including long-term implications of improved mindfulness and self-compassion.

Rotherham NHS staff can request this article here 

 

Does the intervention of mindfulness reduce levels of burnout and compassion fatigue and increase resilience in pre-registration students? A pilot study

Clarkson, M., Heads, G.,  Hodgson, D., &  Probst, H.| 2018 | Does the intervention of mindfulness reduce levels of burnout and compassion fatigue and increase resilience in pre-registration students? A pilot study | Radiography |https://doi.org/10.1016/j.radi.2018.08.003

A new study from researchers at Sheffield Hallam University looks at the impact of a mindfulness intervention on pre-registration healthcare workers. The study finds that while no difference between the two arms of the control study were reported, it identified that a third of the workers experienced burnout.
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Highglights: 

  • Development of self-care strategies should start when health care staff begins their training.
  • It is imperative that education institutions address the importance of the potential for burnout in students.
  • Burnout is an issue in student therapeutic radiographers.

Abstract

Introduction

In the current clinical working environment it is important that therapeutic radiographystudents are fully prepared not just clinically but emotionally for a working professional life. Mindfulness has shown promise, as a self-care strategy, in the improvement of burnout, resilience and compassion fatigue in other professions; however, it has not been used with therapeutic radiography students.

Methods

Eight pre-registration therapeutic radiography students were recruited to undergo a five week mindfulness course; six students from the year below were recruited to act as a control arm (no mindfulness). Data was collected using a series of validated tools at baseline, week five, month three and 12 months after the start of the study:

  1. The five-facet mindfulness short form questionnaire (FFMQ-SF)
  2. Maslach Burnout Inventory Student Survey (MBI-SS)
  3. Professional Quality of Life (ProQOL) 5 questionnaire
  4. Connor Davidson Resilience-short form scale (CD-RISC)

Results

The MBI-SS scale demonstrated 29% of the sample experienced emotional exhaustion and 43% increased cynicism. The other tools showed a positive trend with the intervention; however, these were not statistically significant.

Conclusion

Although no statistically significant differences were demonstrated between the study arms, some interesting trends have been noted. The key finding was the identification of burnout experienced by almost a third of the study sample. This suggests that a new area of study is warranted to further investigate the factors contributing to burnout in the student population.

This article can be requested by Rotherham NHS staff here 

Physician burnout: contributors, consequences and solutions

West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: contributors, consequences and solutions. Journal of internal medicine283(6), 516-529.

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Abstract

Physician burnout, a work‐related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the healthcare workforce, costs and physician health exceed 50% in studies of both physicians‐in‐training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients and healthcare organizations and systems. Drivers of this epidemic are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work–home conflicts, lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures and leadership culture. Individual physician‐level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians. Effective solutions align with these drivers. For example, organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout. Individually focused solutions such as mindfulness‐based stress reduction and small‐group programmes to promote community, connectedness and meaning have also been shown to be effective. Regardless of the specific approach taken, the problem of physician burnout is best addressed when viewed as a shared responsibility of both healthcare systems and individual physicians. Although our understanding of physician burnout has advanced considerably in recent years, many gaps in our knowledge remain. Longitudinal studies of burnout’s effects and the impact of interventions on both burnout and its effects are needed, as are studies of effective solutions implemented in combination. For medicine to fulfil its mission for patients and for public health, all stakeholders in healthcare delivery must work together to develop and implement effective remedies for physician burnout.

Rotherham NHS staff can request this article here 

 

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

The effects of mindfulness-based interventions for health and social care undergraduate students

Health and social care undergraduate students experience stress due to high workloads and pressure to perform | Psychology, Health & Medicine

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Consequences include depression and burnout. Mindfulness may be a suitable way to reduce stress in health and social care degree courses. The objective of this systematic review is to identify and critically appraise the literature on the effects of Mindfulness-Based Interventions for health and social care undergraduate students.

PubMed, EMBASE, Psych Info, CINAHL, The Cochrane Library and Academic Search Complete were searched from inception to 21st November 2016. Studies that delivered Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, or an intervention modelled closely on these, to health or social care undergraduate students were included. Eleven studies, representing medicine, nursing and psychology students met the inclusion criteria. The most commonly used measurement tools were; the Five Facet Mindfulness Questionnaire and the General Health Questionnaire.

Short term benefits relating to stress and mood were reported, despite all but one study condensing the curriculum. Gender and personality emerged as factors likely to affect intervention results. Further research with long-term follow-up is required to definitively conclude that mindfulness is an appropriate intervention to mentally prepare health and social care undergraduate students for their future careers.

Full reference: O’Driscoll, M. et al. (2017) The effects of mindfulness-based interventions for health and social care undergraduate students – a systematic review of the literature. Psychology, Health & Medicine. Vol. 22 (Issue 7) pp. 851-865