Mindfulness Workshops Effects on Nurses' Burnout, Stress, and Mindfulness Skills.

Burnout decreases work performance and quality of care and can result in medical errors, lower patient satisfaction, and higher rates of turnover. A study of 68 000 registered nurses showed that 35% of hospital nurses were experiencing symptoms of burnout. A systematic review identified that mindfulness-based interventions for health care professionals reduced stress and burnout and increased self-compassion and general health. However, the authors determined that more high-quality research is needed. This study examined the impact of a 4-hour workshop on burnout syndrome, perceived stress, and mindfulness skills. The objective of this study was to determine whether a 4-hour mindfulness workshop was effective in reducing burnout and perceived levels of stress and increasing mindfulness. Nurses at a Midwest academic medical center were recruited through e-mail to attend a 4-hour mindfulness workshop. Participants completed the Maslach Burnout Inventory-Human Service Survey, Perceived Stress Scale, and Cognitive and Affective Mindfulness Scale-Revised prior to the start of the workshop and 1 and 6 months after the workshop. The study design allowed for comparisons preintervention and postintervention. Of the 52 nurses who completed the baseline questionnaires, 94% were female with an average age of 38 years. Thirty-one percent completed the questionnaires at 1 month and 20 nurses at 6 months. At 1 month, nurses reported statistically significant decreased perceptions of stress (-2.31, P = .01) and emotional exhaustion (-4.78, P = .03). Mindfulness skills, personal accomplishment, and depersonalization improved but were not statistically significant. At 6 months, statistically significant findings included increased perceptions of mindfulness (2.50, P = .04), personal accomplishment (4.43, P = .04), and decreased emotional exhaustion (-6.21, P = .05). Perceptions of stress and depersonalization improved but were not statistically significant. In this study, nurses reported decreases in burnout and perceived stress and increases in mindfulness after attending a 4-hour mindfulness workshop. Further research is needed to determine the long-term impact of mindfulness-based training on nurses' burnout, stress, and mindfulness skills. The results of this study add to the body of literature that supports the benefits of mindfulness-based interventions.

A guide to understanding malignant bowel obstruction.

Malignant bowel obstruction (MBO) is a common occurrence in patients with abdominal and pelvic malignancies. MBO is a complex problem that is a result of a cascade of pathophysiological events. For many patients near the end of life, aggressive medical management of this problem is necessary because patients are not candidates for surgery. An assessment and thoughtful examination of options for intervention is important in aligning treatments with patients' goals of care. The palliative care nurse has an important and privileged role in nursing, educating and advocating for patients with MBO. This article reviews the normal and abnormal physiology of the gastrointestinal tract. Advice is provided for the assessment and management of the physical and psychological symptoms of MBO in patients near the end of life.

HIV-infected inpatients in the HAART era: how do hepatitis C virus coinfected patients differ?

We compared the demographics and clinical characteristics of HIV-infected patients with and without hepatitis C virus (HCV) coinfection hospitalized at Cook County Hospital, Chicago, Illinois, from October 1999 through September 2000. Two hundred three (40%) of the 510 patients were coinfected with HCV. HCV coinfected patients were less likely to be on highly active antiretroviral therapy (HAART) and were frequently hospitalized with higher CD4 counts for non-HIV-related medical problems including complications of liver disease.