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JAMA Network Open Aug 2020Stress among health care professionals is well documented. The use of mindfulness-based interventions to reduce stress has shown promising results; however, the time... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Stress among health care professionals is well documented. The use of mindfulness-based interventions to reduce stress has shown promising results; however, the time commitment of typical programs can be a barrier to successful implementation in health care settings.
OBJECTIVE
To determine the efficacy and feasibility of a brief mindfulness-based program to reduce stress during work hours among health care professionals.
DESIGN, SETTING, AND PARTICIPANTS
This intent-to-treat randomized clinical trial was conducted among full-time health care professionals at the Clinical Center at the National Institutes of Health in Bethesda, Maryland, between September 2017 and May 2018. Participants were randomized to receive mindfulness-based self-care (MBSC) training or life-as-usual control. Data were analyzed from June 2018 to January 2020.
INTERVENTIONS
The MBSC intervention included 5 weekly, 1.5-hour in-class mindfulness practice sessions.
MAIN OUTCOMES AND MEASURES
Stress level was the primary outcome, assessed with the Perceived Stress Scale 10-Item version. Secondary outcomes included anxiety, burnout, positive and negative affect, mindfulness (trait and state), and self-care. Assessments were taken at baseline and at the end of the intervention (week 5) in the intervention and control groups, and at follow-up (week 13) in the intervention group to test for a maintenance effect. A postprogram evaluation was also obtained.
RESULTS
Of 82 randomized participants, 78 who completed the study at week 5 were included in the modified intent-to-treat analysis (median [interquartile range] age, 32 [23-48] years; 65 [83%] women), including 43 participants in the MBSC group and 35 participants in the control group. At the end of the intervention, compared with the control group, the MBSC group had reduced levels of stress (mean [SD] score, 17.29 [5.84] vs 18.54 [6.30]; P = .02) and anxiety (mean [SD] score, 2.58 [1.52] vs 4.23 [1.73]; P < .001), and improved positive affect (mean [SD] score, 35.69 [7.12] vs 31.42 [7.27]; P < .001), state mindfulness (mean [SD] score, 3.74 [1.18] vs 2.78 [1.16]; P < .001), and mindful self-care (mean [SD] score, 7.29 [2.44] vs 5.54 [2.77]; P < .001). Burnout, negative affect, and trait mindfulness levels did not differ between groups. Changes within the MBSC group through follow-up included sustained reductions in stress (change, -6.14; 95% CI, -7.84 to -4.44; P < .001), anxiety (change, -1.46; 95% CI, -1.97 to -0.94; P < .001), trait mindfulness (change, 0.63; 95% CI, 0.36 to 0.90; P < .001), and state mindfulness (change, 1.89; 95% CI, 1.39 to 2.39; P < .001).
CONCLUSIONS AND RELEVANCE
This randomized clinical trial found that this brief mindfulness-based intervention was an effective and feasible means to reduce stress in health care professionals. Larger studies are needed to assess the effects on clinical care and patient outcomes.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03781336.
Topics: Academies and Institutes; Adult; Anxiety; Feasibility Studies; Female; Health Personnel; Hospitals; Humans; Male; Maryland; Middle Aged; Mindfulness; Occupational Stress; Research Personnel; Young Adult
PubMed: 32840621
DOI: 10.1001/jamanetworkopen.2020.13424 -
Journal of Pediatric Health Care :... 2022Mindfulness, defined as focusing on the present moment without judgment, has shown clinical efficacy in pediatric research. Mindfulness-based interventions reduce...
Mindfulness, defined as focusing on the present moment without judgment, has shown clinical efficacy in pediatric research. Mindfulness-based interventions reduce anxiety, depression, and burnout in pediatric nurses and health care providers, and improve asthmatic symptoms, eating disorders, and stress in pediatric patients. We provide an overview of mindfulness-based interventions in pediatric research, a summary of the techniques and exercises that comprise mindfulness, and a list of mindfulness measures that can be used for evaluating mindful practices in research. We aimed to provide an educational overview of how mindfulness can be incorporated into research methods, including interventions in pediatric health care.
Topics: Anxiety; Burnout, Professional; Child; Health Personnel; Humans; Mindfulness; Treatment Outcome
PubMed: 35168819
DOI: 10.1016/j.pedhc.2022.01.004 -
Neonatal Network : NN May 2019Stress in parents who have an infant in the NICU is well documented in literature. Prematurity and related comorbid conditions, high-tech NICU environments, presence of... (Review)
Review
Stress in parents who have an infant in the NICU is well documented in literature. Prematurity and related comorbid conditions, high-tech NICU environments, presence of multidisciplinary health care professionals, altered parenting roles, and concerns of health outcomes in the infant are common stress factors. Further, inadequate management of stress can result in poor parent-infant bonding, poor infant outcome, and postpartum depression in parents. Effective stress management strategies may help parents adapt to their parental role thereby improving infant outcomes. Research has shown mindfulness-based strategies help reduce stress in the general population. Can this strategy be applied in the context of parents of infants in the NICU? Literature is scant on the impact of mindfulness-based strategies on parents of infants in the NICU and on the infant's health outcomes. This article explores the application of mindfulness-based strategies to reduce stress in parents of infants in the NICU.
Topics: Adult; Female; Humans; Infant; Infant, Newborn; Intensive Care, Neonatal; Male; Mindfulness; Parents; Stress, Psychological
PubMed: 31470380
DOI: 10.1891/0730-0832.38.3.135 -
Current Opinion in Psychology Aug 2019Research on Mindfulness-Based Interventions (MBI) is hampered by semantic ambiguity surrounding the term 'mindfulness'. Understanding the core quality involved in such... (Review)
Review
Research on Mindfulness-Based Interventions (MBI) is hampered by semantic ambiguity surrounding the term 'mindfulness'. Understanding the core quality involved in such research could be improved by adding historical depth to definitions of mindfulness, based on more detailed information on mindfulness from text-historical and doctrinal sources in the Buddhist traditions. Particular applications of mindfulness in current clinical usage could be compared to related approaches or doctrinal teachings in Buddhist traditions as part of an ongoing cross-disciplinary dialogue between academics in Buddhist studies and in psychology under the shared aim of deepening our understanding of what mindfulness involves and how it operates.
Topics: Awareness; Buddhism; History, Ancient; Humans; Mind-Body Therapies; Mindfulness
PubMed: 30359935
DOI: 10.1016/j.copsyc.2018.09.013 -
Annual Review of Psychology Jan 2023Self-compassion refers to being supportive toward oneself when experiencing suffering or pain-be it caused by personal mistakes and inadequacies or external life... (Review)
Review
Self-compassion refers to being supportive toward oneself when experiencing suffering or pain-be it caused by personal mistakes and inadequacies or external life challenges. This review presents my theoretical model of self-compassion as comprised of six different elements: increased self-kindness, common humanity, and mindfulness as well as reduced self-judgment, isolation, and overidentification. It discusses the methodology of self-compassion research and reviews the increasingly large number of empirical studies that indicate self-compassion is a productive way of approaching distressing thoughts and emotions that engenders mental and physical well-being. It also reviews research that dispels common myths about self-compassion (e.g., that it is weak, selfish, self-indulgent or undermines motivation). Interventions designed to increase self-compassion, such as compassion-focused therapy and mindful self-compassion, are discussed. Finally, the review considers problematic issues in the field, such as the differential effects fallacy, and considers limitations and future research directions in the field of self-compassion research.
Topics: Humans; Self-Compassion; Empathy; Emotions; Mindfulness; Judgment
PubMed: 35961039
DOI: 10.1146/annurev-psych-032420-031047 -
Psychological Reports Apr 2023Emerging adulthood is often recognized as a time of uncertainty, confusion, pressure, and stress. This time period also coincides in the Western world with attending... (Review)
Review
Emerging adulthood is often recognized as a time of uncertainty, confusion, pressure, and stress. This time period also coincides in the Western world with attending college. Many emerging adults arrive at this developmental stage feeling the pressure and obligation for success, but lack the interpersonal resources needed to make required choices. The purpose of this study was to provide insight into the psychological and mental state of this particular group by focusing on mechanisms of self-awareness and its connection to psychological health. The present study examines whether an indirect path could explain the relationships between mindfulness, positive thinking, and positive affect. Path analysis was used to test whether decentering fosters positive thinking and positive affect. Participants were surveyed for dispositional mindfulness, frequency of positive and negative feelings, positive thinking, and rumination. Results show decentering mediates between mindfulness and positive affect but does not mediate between mindfulness and positive thinking. Rumination counteracts the effects of mindfulness and predicts negative affect.
Topics: Adult; Humans; Mindfulness; Emotions; Personality; Surveys and Questionnaires; Students
PubMed: 34970935
DOI: 10.1177/00332941211061705 -
Translational Psychiatry Nov 2023Mindfulness-based interventions are showing increasing promise as a treatment for psychological disorders, with improvements in cognition and emotion regulation after...
Mindfulness-based interventions are showing increasing promise as a treatment for psychological disorders, with improvements in cognition and emotion regulation after intervention. Understanding the changes in functional brain activity and neural plasticity that underlie these benefits from mindfulness interventions is thus of interest in current neuroimaging research. Previous studies have found functional brain changes during resting and task states to be associated with mindfulness both cross-sectionally and longitudinally, particularly in the executive control, default mode and salience networks. However, limited research has combined information from rest and task to study mindfulness-related functional changes in the brain, particularly in the context of intervention studies with active controls. Recent work has found that the reconfiguration efficiency of brain activity patterns between rest and task states is behaviorally relevant in healthy young adults. Thus, we applied this measure to investigate how mindfulness intervention changed functional reconfiguration between rest and a breath-counting task in elderly participants with self-reported sleep difficulties. Improving on previous longitudinal designs, we compared the intervention effects of a mindfulness-based therapy to an active control (sleep hygiene) intervention. We found that mindfulness intervention improved self-reported mindfulness measures and brain functional reconfiguration efficiency in the executive control, default mode and salience networks, though the brain and behavioral changes were not associated with each other. Our findings suggest that neuroplasticity may be induced through regular mindfulness practice, thus bringing the intrinsic functional configuration in participants' brains closer to a state required for mindful awareness.
Topics: Young Adult; Humans; Aged; Mindfulness; Brain; Cognition; Executive Function; Brain Mapping; Magnetic Resonance Imaging
PubMed: 37951943
DOI: 10.1038/s41398-023-02642-9 -
Consciousness and Cognition Aug 2014Mindfulness training has proven to be an efficacious therapeutic tool for a variety of clinical and nonclinical health problems and a booster of well-being. In this... (Review)
Review
Mindfulness training has proven to be an efficacious therapeutic tool for a variety of clinical and nonclinical health problems and a booster of well-being. In this paper we propose a multi-level metacognitive model of mindfulness. We postulate and discuss following hypothesis: (1) mindfulness is related to the highest level of metacognition; (2) mindfulness depends on dynamic cooperation of three main components of the metacognition (metacognitive knowledge, metacognitive experiences and metacognitive skills); (3) a mindful meta-level is always conscious while the other meta-cognitive processes can occur implicitly; (4) intentionally practiced mindfulness decreases dissociations between awareness and meta-awareness; (5) components of mindful meta-level develop and change during continuous practice. The current model is discussed in the light of empirical data and other theoretical approaches to mindfulness concept. We believe that presented model provides some helpful avenues for future research and theoretical investigations into mindfulness and the mechanisms of its actions.
Topics: Cognition; Humans; Mindfulness; Models, Theoretical
PubMed: 25038535
DOI: 10.1016/j.concog.2014.06.005 -
Current Opinion in Psychology Aug 2019The development and implementation of psychometrically sound behavioral measures of mindfulness are important to advancing the science of mindfulness. To help organize,... (Review)
Review
The development and implementation of psychometrically sound behavioral measures of mindfulness are important to advancing the science of mindfulness. To help organize, conceptualize, and guide the development of behavioral measures of mindfulness, we propose defining features, and a four-domain framework, of the behavioral assessment of mindfulness. The framework domains include measurement of (I) objects of mindful awareness, (II) time-course of mindful awareness, (III) sensitivity of mindful awareness, and (IV) attitudes toward present moment experience. We describe mindfulness processes in each domain, and review extant behavioral method(s) and specific behavioral measure(s) of mindfulness processes per domain. Four of the 12 reviewed measures demonstrate acceptable reliabilities and preliminary evidence of construct validity as measures of mindfulness processes.
Topics: Awareness; Humans; Mindfulness; Psychometrics
PubMed: 30959378
DOI: 10.1016/j.copsyc.2019.01.008 -
L'Encephale Feb 2018Mindfulness based interventions (MBI) have recently gained much interest in western medicine. MBSR paradigm is based on teaching participants to pay complete attention... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Mindfulness based interventions (MBI) have recently gained much interest in western medicine. MBSR paradigm is based on teaching participants to pay complete attention to the present experience and act nonjudgmentally towards stressful events. During this mental practice the meditator focuses his or her attention on the sensations of the body. While the distractions (mental images, thoughts, emotional or somatic states) arise the participant is taught to acknowledge discursive thoughts and cultivate the state of awareness without immediate reaction. The effectiveness of these programs is well documented in the field of emotional response regulation in depression (relapse prevention), anxiety disorders, obsessive-compulsive disorder or eating disorders. Furthermore, converging lines of evidence support the hypothesis that mindfulness practice improves cognition, especially the ability to sustain attention and think in a more flexible manner. Nevertheless, formal rehabilitation programs targeting cognitive disturbances resulting from psychiatric (depression, disorder bipolar, schizophrenia) or neurologic conditions (brain injury, dementia) seldom rely on MBI principles. This review of literature aims at discussing possible links between MBI and clinical neuropsychology.
METHODS
We conducted a review of literature using electronic databases up to December 2016, screening studies with variants of the keywords ("Mindfulness", "MBI", "MBSR", "Meditation") OR/AND ("Cognition", "Attention", "Executive function", "Memory", "Learning") RESULTS: In the first part, we describe key concepts of the neuropsychology of attention in the light of Posner's model of attention control. We also underline the potential scope of different therapeutic contexts where disturbances of attention may be clinically relevant. Second, we review the efficacy of MBI in the field of cognition (thinking disturbances, attention biases, memory and executive processes impairment or low metacognitive abilities), mood (emotional dysregulation, anxiety, depression, mood shifts) and somatic preoccupations (stress induced immune dysregulation, chronic pain, body representation, eating disorders, sleep quality, fatigue). In psychiatry, these three components closely coexist and interact which explains the complexity of patient assessment and care. Numerous studies show that meditation inspired interventions offer a promising solution in the prevention and rehabilitation of cognitive impairment. In the last part, we discuss the benefits and risks of integrating meditation practice into broader programs of cognitive remediation and therapeutic education in patients suffering from cognitive disorders. We propose a number of possible guidelines for developing mindfulness inspired cognitive remediation tools. Along with Jon Kabatt Zinn (Kabatt-Zinn & Maskens, 2012), we suggest that the construction of neuropsychological tools relies on seven attitudinal foundations of mindfulness practice.
CONCLUSIONS
This paper highlights the importance of referring to holistic approaches such as MBI when dealing with patients with neuropsychological impairment, especially in the field of psychiatry. We advocate introducing mindfulness principles in order to help patients stabilize their attention and improve cognitive flexibility. We believe this transition in neuropsychological care may offer an interesting paradigm shift promoting a more efficient approach towards cognition and its links to emotion, body, and environment.
Topics: Cognitive Remediation; Humans; Mental Disorders; Mindfulness; Recurrence
PubMed: 28483271
DOI: 10.1016/j.encep.2017.03.006