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American Journal of Health Promotion :... Nov 2020This systematic review focused on randomized controlled trials (RCTs) with physicians and nurses that tested interventions designed to improve their mental health,... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This systematic review focused on randomized controlled trials (RCTs) with physicians and nurses that tested interventions designed to improve their mental health, well-being, physical health, and lifestyle behaviors.
DATA SOURCE
A systematic search of electronic databases from 2008 to May 2018 included PubMed, CINAHL, PsycINFO, SPORTDiscus, and the Cochrane Library.
STUDY INCLUSION AND EXCLUSION CRITERIA
Inclusion criteria included an RCT design, samples of physicians and/or nurses, and publication year 2008 or later with outcomes targeting mental health, well-being/resiliency, healthy lifestyle behaviors, and/or physical health. Exclusion criteria included studies with a focus on burnout without measures of mood, resiliency, mindfulness, or stress; primary focus on an area other than health promotion; and non-English papers.
DATA EXTRACTION
Quantitative and qualitative data were extracted from each study by 2 independent researchers using a standardized template created in Covidence.
DATA SYNTHESIS
Although meta-analytic pooling across all studies was desired, a wide array of outcome measures made quantitative pooling unsuitable. Therefore, effect sizes were calculated and a mini meta-analysis was completed.
RESULTS
Twenty-nine studies (N = 2708 participants) met the inclusion criteria. Results indicated that mindfulness and cognitive-behavioral therapy-based interventions are effective in reducing stress, anxiety, and depression. Brief interventions that incorporate deep breathing and gratitude may be beneficial. Visual triggers, pedometers, and health coaching with texting increased physical activity.
CONCLUSION
Healthcare systems must promote the health and well-being of physicians and nurses with evidence-based interventions to improve population health and enhance the quality and safety of the care that is delivered.
Topics: Humans; Life Style; Mental Health; Mindfulness; Nurses; Physicians
PubMed: 32338522
DOI: 10.1177/0890117120920451 -
Annals of Behavioral Medicine : a... Apr 2017Chronic pain patients increasingly seek treatment through mindfulness meditation. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic pain patients increasingly seek treatment through mindfulness meditation.
PURPOSE
This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults.
METHOD
We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use.
RESULTS
Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life.
CONCLUSIONS
While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain.
Topics: Chronic Pain; Humans; Meditation; Mindfulness; Pain Management; Quality of Life; Treatment Outcome
PubMed: 27658913
DOI: 10.1007/s12160-016-9844-2 -
Lancet (London, England) Nov 2016Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practising physicians. The consequences are negative... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practising physicians. The consequences are negative effects on patient care, professionalism, physicians' own care and safety, and the viability of health-care systems. A more complete understanding than at present of the quality and outcomes of the literature on approaches to prevent and reduce burnout is necessary.
METHODS
In this systematic review and meta-analysis, we searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, and the Education Resources Information Center from inception to Jan 15, 2016, for studies of interventions to prevent and reduce physician burnout, including single-arm pre-post comparison studies. We required studies to provide physician-specific burnout data using burnout measures with validity support from commonly accepted sources of evidence. We excluded studies of medical students and non-physician health-care providers. We considered potential eligibility of the abstracts and extracted data from eligible studies using a standardised form. Outcomes were changes in overall burnout, emotional exhaustion score (and high emotional exhaustion), and depersonalisation score (and high depersonalisation). We used random-effects models to calculate pooled mean difference estimates for changes in each outcome.
FINDINGS
We identified 2617 articles, of which 15 randomised trials including 716 physicians and 37 cohort studies including 2914 physicians met inclusion criteria. Overall burnout decreased from 54% to 44% (difference 10% [95% CI 5-14]; p<0·0001; I=15%; 14 studies), emotional exhaustion score decreased from 23·82 points to 21·17 points (2·65 points [1·67-3·64]; p<0·0001; I=82%; 40 studies), and depersonalisation score decreased from 9·05 to 8·41 (0·64 points [0·15-1·14]; p=0·01; I=58%; 36 studies). High emotional exhaustion decreased from 38% to 24% (14% [11-18]; p<0·0001; I=0%; 21 studies) and high depersonalisation decreased from 38% to 34% (4% [0-8]; p=0·04; I=0%; 16 studies).
INTERPRETATION
The literature indicates that both individual-focused and structural or organisational strategies can result in clinically meaningful reductions in burnout among physicians. Further research is needed to establish which interventions are most effective in specific populations, as well as how individual and organisational solutions might be combined to deliver even greater improvements in physician wellbeing than those achieved with individual solutions.
FUNDING
Arnold P Gold Foundation Research Institute.
Topics: Burnout, Professional; Efficiency; Humans; Mindfulness; Physicians; Quality of Health Care; Stress, Psychological
PubMed: 27692469
DOI: 10.1016/S0140-6736(16)31279-X -
International Journal of Environmental... May 2021Emotional intelligence is an essential trait and skill for healthcare professionals. Mindfulness meditation has proved to be effective in increasing the wellbeing of... (Review)
Review
Emotional intelligence is an essential trait and skill for healthcare professionals. Mindfulness meditation has proved to be effective in increasing the wellbeing of those who practice it, leading to better mental health, self-care and job satisfaction. This paper aims to identify the recent evidence on the relationship between mindfulness and emotional intelligence among healthcare professionals and students. A systematic review was conducted including the databases PubMed, Cinhal, PsycINFO and Web of Science. The main variables were emotional intelligence skills and mindfulness practice. Data were extracted according to the following outcomes: authors, year of publication, country, study design, participants, mindfulness training intervention, tools used in data collection and main results. The following inclusion criteria were applied: peer-reviewed articles; published in English or Spanish; published between 2010 and 2020; quantitative methodology; a study population of healthcare professionals or students; the relationship with the aim of the study. The Joanna Briggs Institute criteria were followed for assessing the methodological quality of the selected studies. Three researchers were involved in the review. After the selection process, 10 studies were selected out of the 197 references initially identified. These studies revealed a positive relationship between mindfulness and emotional intelligence, particularly the capacity to regulate emotions. Furthermore, mindfulness is negatively related to emotional exhaustion. Training interventions based on mindfulness have proved to be useful in promoting emotional balance, emotional awareness, emotional acceptance, emotion recognition, expressive suppression and a reduction in emotional exhaustion. This study could serve as a basis for further research on the benefits of emotional intelligence and practicing mindfulness for the bio-psycho-social welfare of healthcare professionals.
Topics: Delivery of Health Care; Emotional Intelligence; Health Personnel; Humans; Mindfulness; Protective Factors
PubMed: 34065519
DOI: 10.3390/ijerph18105491 -
Clinical Psychology Review Feb 2018Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. We sought to... (Meta-Analysis)
Meta-Analysis
Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. We sought to examine the efficacy of mindfulness-based interventions for clinical populations on disorder-specific symptoms. To address the question of relative efficacy, we coded the strength of the comparison group into five categories: no treatment, minimal treatment, non-specific active control, specific active control, and evidence-based treatment. A total of 142 non-overlapping samples and 12,005 participants were included. At post-treatment, mindfulness-based interventions were superior to no treatment (d=0.55), minimal treatment (d=0.37), non-specific active controls (d=0.35), and specific active controls (d=0.23). Mindfulness conditions did not differ from evidence-based treatments (d=-0.004). At follow-up, mindfulness-based interventions were superior to no treatment conditions (d=0.50), non-specific active controls (d=0.52), and specific active controls (d=0.29). Mindfulness conditions did not differ from minimal treatment conditions (d=0.38) and evidence-based treatments (d=0.09). Effects on specific disorder subgroups showed the most consistent evidence in support of mindfulness for depression, pain conditions, smoking, and addictive disorders. Results support the notion that mindfulness-based interventions hold promise as evidence-based treatments.
Topics: Evidence-Based Practice; Humans; Meditation; Mental Disorders; Mindfulness; Treatment Outcome
PubMed: 29126747
DOI: 10.1016/j.cpr.2017.10.011 -
International Journal of Environmental... Nov 2022(1) Objectives: Mindfulness-based interventions have been receiving more attention in research for children with attention deficit hyperactivity disorder (ADHD). This... (Meta-Analysis)
Meta-Analysis Review
(1) Objectives: Mindfulness-based interventions have been receiving more attention in research for children with attention deficit hyperactivity disorder (ADHD). This systematic review and meta-analysis was conducted to synthesize the findings of randomized controlled trials of mindfulness-based interventions for children with ADHD. (2) Methods: A systematic review and meta-analysis of studies published in PsycINFO, PubMed, and Google Scholar was completed from the earliest available date until August 2022. (3) Results: The systematic review included 12 studies that met the inclusion criteria, and the meta-analysis included 11 studies. The overall effect sizes were = 0.77 for ADHD symptoms, = 0.03 for externalizing behavior problem, = 0.13 for internalizing behavior problem, = 0.43 for mindfulness, and = 0.40 for parental stress for children with ADHD. (4) Conclusion: The results of this systematic review highlight the possible benefits of mindfulness-based interventions for children with ADHD.
Topics: Child; Humans; Adolescent; Attention Deficit Disorder with Hyperactivity; Mindfulness; Randomized Controlled Trials as Topic; Problem Behavior
PubMed: 36429915
DOI: 10.3390/ijerph192215198 -
Journal of Psychosomatic Research Jun 2015An increasing number of mindfulness-based stress reduction (MBSR) studies are being conducted with nonclinical populations, but very little is known about their... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
An increasing number of mindfulness-based stress reduction (MBSR) studies are being conducted with nonclinical populations, but very little is known about their effectiveness.
OBJECTIVE
To evaluate the efficacy, mechanisms of actions, and moderators of MBSR for nonclinical populations.
DATA SOURCES
A systematic review of studies published in English journals in Medline, CINAHL or Alt HealthWatch from the first available date until September 19, 2014.
STUDY SELECTION
Any quantitative study that used MBSR as an intervention, that was conducted with healthy adults, and that investigated stress or anxiety.
RESULTS
A total of 29 studies (n=2668) were included. Effect-size estimates suggested that MBSR is moderately effective in pre-post analyses (n=26; Hedge's g=.55; 95% CI [.44, .66], p<.00001) and in between group analyses (n=18; Hedge's g=.53; 95% CI [.41, .64], p<.00001). The obtained results were maintained at an average of 19 weeks of follow-up. Results suggested large effects on stress, moderate effects on anxiety, depression, distress, and quality of life, and small effects on burnout. When combined, changes in mindfulness and compassion measures correlated with changes in clinical measures at post-treatment and at follow-up. However, heterogeneity was high, probably due to differences in the study design, the implemented protocol, and the assessed outcomes.
CONCLUSIONS
MBSR is moderately effective in reducing stress, depression, anxiety and distress and in ameliorating the quality of life of healthy individuals; however, more research is warranted to identify the most effective elements of MBSR.
Topics: Anxiety; Depression; Empathy; Humans; Mindfulness; Quality of Life; Stress, Psychological; Treatment Outcome
PubMed: 25818837
DOI: 10.1016/j.jpsychores.2015.03.009 -
International Journal of Environmental... Nov 2019The prevalence of mental health problems within students due to high academic demands and learning difficulties is a current challenge the field of education. The aim of... (Meta-Analysis)
Meta-Analysis
The prevalence of mental health problems within students due to high academic demands and learning difficulties is a current challenge the field of education. The aim of this study is to review the scientific literature in order to analyze the effect produced by cognitive-behavioral programs and meditation strategies on stress, anxiety, and depression in students. A further aim is to identify the determinants of treatment success. The bibliographic search was carried out using Web of Science, specifically in the categories of "Education and Educational Research" and "Psychology", obtaining a sample of 122 articles published between 2007 and 2018. Studies were included which had a pre-experimental or quasi-experimental design and included pre-test and post-test phases. Following application of inclusion criteria, 34 articles were selected for inclusion in a meta-analysis of the random effects of each variable. This obtained an average effect size of -0.41 for stress, -0.37 for anxiety, and -0.30 for depression. Three moderating variables were analyzed, with significant correlations being found for the type of treatment relating to stress (Q = 11.01, df = 2, = 0.004, R = 0.294) and depression (Q = 6.14, df = 2, = 0.048; R = 0.436). The stage of education of the individuals was also found to impact upon anxiety intervention success (Q = 13.093 df = 2, = 0.0009, R = 0.196). Interventions mainly addressed the importance of meditation strategies, mindfulness programs, and cognitive-behavioral therapy to reduce stress, anxiety, and depression in students. This supports the need to increase research at an early age, considering the treatment of mental health as a key factor influencing academic performance and quality of life.
Topics: Adolescent; Anxiety; Child; Cognitive Behavioral Therapy; Depression; Female; Humans; Male; Meditation; Mental Health; Mindfulness; Quality of Life; Stress, Psychological; Students; Treatment Outcome; Young Adult
PubMed: 31717682
DOI: 10.3390/ijerph16224394 -
Annals of the New York Academy of... Jun 2016Mindfulness meditation represents a mental training framework for cultivating the state of mindful awareness in daily life. Recently, there has been a surge of interest... (Review)
Review
Mindfulness meditation represents a mental training framework for cultivating the state of mindful awareness in daily life. Recently, there has been a surge of interest in how mindfulness meditation improves human health and well-being. Although studies have shown that mindfulness meditation can improve self-reported measures of disease symptomatology, the effect that mindfulness meditation has on biological mechanisms underlying human aging and disease is less clear. To address this issue, we conducted the first comprehensive review of randomized controlled trials examining the effects of mindfulness meditation on immune system parameters, with a specific focus on five outcomes: (1) circulating and stimulated inflammatory proteins, (2) cellular transcription factors and gene expression, (3) immune cell count, (4) immune cell aging, and (5) antibody response. This analysis revealed substantial heterogeneity across studies with respect to patient population, study design, and assay procedures. The findings suggest possible effects of mindfulness meditation on specific markers of inflammation, cell-mediated immunity, and biological aging, but these results are tentative and require further replication. On the basis of this analysis, we describe the limitations of existing work and suggest possible avenues for future research. Mindfulness meditation may be salutogenic for immune system dynamics, but additional work is needed to examine these effects.
Topics: Awareness; Humans; Immune System; Immunity, Cellular; Meditation; Mindfulness; Randomized Controlled Trials as Topic; Stress, Psychological
PubMed: 26799456
DOI: 10.1111/nyas.12998 -
PloS One 2018The purpose of this exploratory study was to obtain greater insight into the effects of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy... (Review)
Review
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.
Topics: Humans; Mental Health; Mindfulness; Stress, Psychological
PubMed: 29364935
DOI: 10.1371/journal.pone.0191332