Exploring the Effect of Mindfulness on Burnout in a Pediatric Emergency Department.

BACKGROUND: Burnout is a common phenomenon among health care providers known to adversely affect their mental health and clinical acumen. As mindfulness has been shown to diminish burnout with large-scale interventions, our aim was to assess whether smaller, on-shift activities aimed at increasing mindfulness could decrease burnout among staff in a pediatric emergency department (PED). METHODS: Prior to the implementation of a series of mindfulness-based activities, a diverse cohort of PED staff including nurses, physicians, nurse practitioners, technicians, and administrative personnel completed electronic preintervention surveys about their demographics, personal mindfulness engagement, and individual baseline burnout level using the Maslach Burnout Inventory (MBI). Trained nurses and physicians served as champions who coordinated on-shift mindfulness activities, and burnout levels were subsequently reassessed using a postintervention survey. FINDINGS: Among 83 eligible staff, 75 completed the preintervention and 69 completed the postintervention survey. For the MBI, the majority of staff had moderate to high burnout levels at baseline. Few staff engaged in personal mindfulness activities outside of work. Although 82% of staff participated in the on-shift interventions, no significant differences were found in scores before and after the intervention for emotional exhaustion (20.1 vs. 20, p = .93), depersonalization (7.6 vs. 7.3, p = .97), and personal accomplishment (36.1 vs. 34.8, p = .11). CONCLUSION/APPLICATION TO PRACTICE: While mindfulness effectively combats burnout, few PED providers regularly practice mindfulness activities. Brief, on-shift mindfulness activities were insufficient to significantly reduce burnout levels. Hospital leadership should consider dedicating resources to more intensive mindfulness activities to combat amplified burnout levels among emergency department staff.

Mobilizing an institutional supportive response for healthcare workers and other staff in the context of COVID-19: The Yale experience.

The burden of the COVID-19 pandemic upon healthcare workers necessitates a systematic effort to support their resilience. This article describes the Yale University and Yale New Haven Health System effort to unite several independent initiatives into a coherent integrated model for institutional support for healthcare workers. Here, we highlight both opportunities and challenges faced in attempting to support healthcare workers during this pandemic.

Running too far ahead? Towards a broader understanding of mindfulness in organisations.

Current workplace mindfulness research and interventions assume that teaching mindfulness will have beneficial effects for people and organizations. While research shows that mindfulness trainings may increase resilience of working adults, assuming that mindfulness will have independent effects on outcomes at different levels of an organization is not well grounded. We assert that mindfulness training would, however, be beneficial for organizations when tailored to that context and shaped by an understanding of organizational theory and practice. We also envisage mindfulness as a beneficial property of teams, organizations and the individuals who constitute them. To close the evidence gap we propose building multi-level models of mindfulness in organizations, broadening training programs, and developing a novel competency framework for teachers in this context.

Building a Grounded Theory of Engagement in Mindfulness-Based Group Therapy for Distressing Voices.

Mindfulness-based group therapy shows promise as a treatment for distressing voice hearing. However, fostering engagement in groups can be challenging, and no theory of engagement in group therapy for distressing voices exists to guide practice or research. This study employed Grounded Theory Method to build a theory of engagement in mindfulness-based groups for distressing voices. Ten service-users and three therapists were interviewed about their experiences of such groups. The model that emerged involves a recursive process of investing in change and continually evaluating its usefulness and safety. Barriers to engagement were often overcome, but sometimes compromised perceived safety, leading to dropout. For others, group participation led to rewards, some of which were integrated beyond group termination. Group engagement can be encouraged by establishing universality around voice hearing early, reducing uncertainty, sharing difficulties with mindfulness practices, and mapping group progress to create a cohering sense of collaboration on therapy tasks.

A Systematic Review and Meta-Analysis of Yoga and Mindfulness Meditation in Prison.

This article presents results from a systematic review and two meta-analyses that examine whether prison yoga and meditation programs are significantly related to increased psychological well-being and improvements in the behavioural functioning of prisoners. Comprehensive searches of the empirical literature were conducted up to December 2014. Participants who completed yoga or meditation program in prison experienced a small increase in their psychological well-being (Cohen's d = 0.46, 95% confidence interval [CI] = [0.39, 0.54]) and a small improvement in their behavioural functioning (Cohen's d = 0.30, 95% CI = [0.20, 0.40]). Moderator analyses suggested that there was a significant difference in effect sizes for programs of longer duration and less intensity, compared with those that were shorter and more intensive, for psychological well-being. Programs of longer duration had a slightly larger positive effect on behavioural functioning ( d = 0.424), compared with more intensive programs ( d = 0.418). Overall, the evidence suggests that yoga and meditation have favourable effects on prisoners.