The Effectiveness of a Neurofeedback-Assisted Mindfulness Training Program Using a Mobile App on Stress Reduction in Employees: Randomized Controlled Trial.

BACKGROUND: Mindfulness-based training programs have consistently shown efficacy in stress reduction. However, questions regarding the optimal duration and most effective delivery methods remain. OBJECTIVE: This research explores a 4-week neurofeedback-assisted mindfulness training for employees via a mobile app. The study's core query is whether incorporating neurofeedback can amplify the benefits on stress reduction and related metrics compared with conventional mindfulness training. METHODS: A total of 92 full-time employees were randomized into 3 groups: group 1 received mobile mindfulness training with neurofeedback assistance (n=29, mean age 39.72 years); group 2 received mobile mindfulness training without neurofeedback (n=32, mean age 37.66 years); and group 3 were given self-learning paper materials on stress management during their first visit (n=31, mean age 38.65 years). The primary outcomes were perceived stress and resilience scales. The secondary outcomes were mindfulness awareness, emotional labor, occupational stress, insomnia, and depression. Heart rate variability and electroencephalography were measured for physiological outcomes. These measurements were collected at 3 different times, namely, at baseline, immediately after training, and at a 4-week follow-up. The generalized estimating equation model was used for data analysis. RESULTS: The 4-week program showed significant stress reduction (Wald χ22=107.167, P<.001) and improvements in psychological indices including resilience, emotional labor, insomnia, and depression. A significant interaction was observed in resilience (time × group, Wald χ42=10.846, P=.02). The post hoc analysis showed a statistically significant difference between groups 1 (least squares mean [LSM] 21.62, SE 0.55) and 3 (LSM 19.90, SE 0.61) at the posttraining assessment (P=.008). Group 1 showed a significant improvement (P<.001) at the posttraining assessment, with continued improvements through the 1-month follow-up assessment period (LSM 21.55, SE 0.61). Physiological indices were analyzed only for data of 67 participants (22 in group 1, 22 in group 2, and 23 in group 3) due to the data quality. The relaxation index (ratio of alpha to high beta power) from the right electroencephalography channel showed a significant interaction (time × group, Wald χ22=6.947, P=.03), with group 1 revealing the highest improvement (LSM 0.43, SE 0.15) compared with groups 2 (LSM -0.11, SE 0.10) and 3 (LSM 0.12, SE 0.10) at the 1-month follow-up assessment. CONCLUSIONS: The study demonstrated that the neurofeedback-assisted group achieved superior outcomes in resilience and relaxation during the 4-week mobile mindfulness program. Further research with larger samples and long-term follow-up is warranted. TRIAL REGISTRATION: ClinicalTrials.gov NCT03787407; https://clinicaltrials.gov/ct2/show/NCT03787407.

Relationship between Different Dimensions of Workplace Spirituality and Psychological Well-Being: Measuring Mediation Analysis through Conditional Process Modeling.

The present study aims to identify the relationship between workplace spirituality, compassion, relationship with others at work, spiritual orientation, organizational value and alignment of personal values, and psychological well-being among universities' teachers. Further, the mediating effect of job stress was also identified between workplace spirituality and psychological well-being. Similarly, the mediation of environmental mastery between organizational values and alignment of personal values and psychological well-being was examined. Finally, we examined the mediation of personal growth between spiritual orientation and psychological well-being. The data were collected through a structured and adapted five-point Likert scale using a purposive sampling technique, with a total sample of 873 male and female university teachers working in the private and government universities. We employed structural equation modeling to check the relationship among the considered variables for analysis purposes. The results show a strong positive relationship between the independent and dependent variables. The findings further demonstrated that the mediation analysis confirms that job stress mediates the relationship between workplace spirituality and psychological well-being, and environmental mastery mediates between organizational values and alignment of personal values and psychological well-being. Finally, personal growth mediates between spiritual orientation and psychological well-being. To maintain the excellent quality of education, educational institutes need to identify and imply the practice of workplace spirituality that will help to reduce job stress and improve the psychological well-being of universities' teachers, thus resulting in better educational output.

Managing job stress among teachers of children with autism spectrum disorders: A randomized controlled trial of cognitive behavioral therapy with yoga.

BACKGROUND: Job-related stress undermines occupational, personal, and organizational outcomes. Stress symptoms are common among teachers of children with autism spectrum disorders and affect the academic progress of the children. This study investigated the effectiveness of yoga-based cognitive behavioral therapy in reducing occupational stress among teachers of children with autism in Lagos states, Nigeria. METHODS: The current study adopted a group-randomized waitlist control (WLC) trial design with pre-test, posttest, and follow-up assessments. Participants included 58 teachers of children with autism in public and private special schools in Lagos state. Participants were randomly assigned to combined cognitive behavioral therapy and yoga (Y-CBT) (N = 29) and WLC (N = 29) groups. The Y-CBT group participated in a 2 hours Y-CBT program weekly for 12 weeks. Three instruments - Demographic Questionnaire, Single-Item Stress Questionnaire, and Teachers' Stress Inventory (TSI) were used to collect data. Data were collected at baseline; posttest and follow-up evaluations. Data were analyzed using means, standard deviations, t test statistics, repeated measures analysis of variance, and bar charts. RESULTS: Results revealed that all dimensions of job stress (perception of stress sources, stress manifestation, and total TSI scores) reduced significantly at posttest and follow up assessments among the Y-CBT group, compared to the WLC. CONCLUSION: It was concluded that Y-CBT modalities could help to minimize the perception of stress sources and stress manifestation as well as total TSI scores among teachers of children with autism spectrum disorders.

Brief Mindfulness Practice Course for Healthcare Providers.

OBJECTIVE: The aim of this study was to examine the short-term and sustained effect on well-being, burnout, and mindful awareness of an abbreviated mindfulness practice course designed for nurses and other healthcare professionals. BACKGROUND: Most mindfulness programs are impractical for frontline healthcare providers because of the intensive, off-site initial training and prolonged practice commitment. A psychiatric nurse educator developed a brief training program tailored for healthcare providers. METHODS: Two institutional review board-approved studies examined the abbreviated mindfulness practice course for healthcare providers: the first, a single-group pretest-posttest design with 25 nursing employees in an academic medical center, and the second, a randomized controlled trial with 83 healthcare professionals. RESULTS: Significant improvement in mindful awareness and at least 1 indicator of burnout were demonstrated. Improvements in quality of life were noted with nurses. CONCLUSIONS: Findings support the short-term and sustained impact of this brief mindfulness curriculum on mindful awareness, quality of life, and aspects of burnout for healthcare professionals.

Physical relaxation for occupational stress in healthcare workers: A systematic review and network meta-analysis of randomized controlled trials.

OBJECTIVES: Work related stress is a major occupational health problem that is associated with adverse effects on physical and mental health. Healthcare workers are particularly vulnerable in the era of COVID-19. Physical methods of stress relief such as yoga and massage therapy may reduce occupational stress. The objective of this systematic review and network meta-analysis is to determine the effects of yoga, massage therapy, progressive muscle relaxation, and stretching on alleviating stress and improving physical and mental health in healthcare workers. METHODS: Databases were searched for randomized controlled trials on the use of physical relaxation methods for occupational stress in healthcare workers with any duration of follow-up. Meta-analysis was performed for standard mean differences in stress measures from baseline between subjects undergoing relaxation vs non-intervention controls. Network meta-analysis was conducted to determine the best relaxation method. RESULTS: Fifteen trials representing 688 healthcare workers were identified. Random-effects meta-analysis shows that physical relaxation methods overall reduced measures of occupational stress at the longest duration of follow-up vs baseline compared to non-intervention controls (SMD -0.53; 95% CI [-0.74 to -0.33]; p < .00001). On network meta-analysis, only yoga alone (SMD -0.71; 95% CI [-1.01 to -0.41]) and massage therapy alone (SMD -0.43; 95% CI [-0.72 to -0.14]) were more effective than control, with yoga identified as the best method (p-score = .89). CONCLUSION: Physical relaxation may help reduce occupational stress in healthcare workers. Yoga is particularly effective and offers the convenience of online delivery. Employers should consider implementing these methods into workplace wellness programs.

Do challenge and hindrance job demands prepare employees to demonstrate resilience?

Job demands may affect employee resilience in future stress events. However, not all job demands are equal. Drawing on the challenge-hindrance framework, we argue that challenge and hindrance demands differentially relate to psychological and physiological resilience. Further, based on the concept of habituation, we propose that it is essential to factor in temporal issues, that is job demands' variance. By including job demands' type, level, and variance we add to a more holistic understanding of the job demands-resilience relationship. To test our assumptions, we combined field and experimental data. Specifically, over the course of 1 month 63 employees repeatedly provided information on their experience of job challenge and hindrance demands. Following, using the paradigm of the Trier Social Stress Test (TSST) we exposed participants to an acute stress situation within a laboratory setting. Piecewise growth curve modeling revealed that moderate levels of challenge demands may enhance employees' ability to demonstrate psychological resilience. Further, moderate levels of challenge demands related to a stronger cortisol reactivity and marginally enhanced cortisol recovery. Hindrance demands as well as demands' variance did not affect employee resilience. Overall, our results suggest that moderate levels of challenge demands may train employees' resilience, particularly psychological resilience, in future stress events. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A qualitative exploration of a mindful resiliency program for community healthcare providers.

Despite the important contribution of nongovernmental organizations (NGOs) to the community healthcare sector, the building and maintenance of occupational resilience in community health workers has received little attention. However, it is recognized that employees in this sector are exposed to significant stressors from the high demand work environment which negatively impacts on their well-being. Therefore, this research examined the acceptability, feasibility, and sustainability of a mindful resiliency program by employing a qualitative analysis of participant subjective experience of the program in this cohort. This was the first study to be conducted with senior managers and frontline healthcare providers in the nongovernmental organizations community sector. A 1-month post-delivery qualitative review of the program identified four major themes: applicability, changes to participant's skills, social support, and coping with COVID-19. A major finding was the ability of the participants to immediately recognize their stress levels and then manage them. Additionally, lessons from the program were shown to be usefully applied with colleagues and clients within the work environment, and with family members.

Heartfulness meditation improves loneliness and sleep in physicians and advance practice providers during COVID-19 pandemic.

Objective: Unprecedented work pressures and social isolation during the COVID-19 pandemic may worsen loneliness and sleep problems in health-care professionals. Heartfulness meditation has been shown to improve burnout and sleep. In the current study, the effects of remote Heartfulness meditation in improving loneliness and sleep quality were measured. Methods: Physicians and advance practice providers were randomly assigned to receive either daily Heartfulness Meditation program or no intervention (control group) in a prospective four-week randomized control study design. UCLA loneliness and PSQI scores were collected at baseline and after the program duration of 4 weeks. The study was retrospectively registered with trial Number, ISRCTN85787008 (8 January 2021). Results: Of the 155 subjects enrolled in the study, 50% were lonely and 97% had sleep problems. Attrition rate was 36%. Among those who completed the study, the mean UCLA loneliness scores decreased from 42.1 to 39.4 in the Heartfulness group (N = 40, p = 0.009) and 42.2 to 41.15 in the control group (N = 57, p = 0.254). The mean PSQI scores decreased from 10.75 to 9.14 in the Heartfulness group (N = 41, p = 0.001) and 9.41 to 8.87 in the control group (N = 58, p = 0.122). Younger participants aged 30 and under had higher loneliness and sleep problems. Conclusions: The current study is one of the first attempts to assess loneliness and sleep problems among physicians and advance practice providers during COVID-19 pandemic in the US. A significant burden of loneliness and sleep problems was identified. An improvement of sleep and loneliness was noted with the practice of Heartfulness meditation. This remote intervention might be a useful tool to be explored in larger studies.

Impact of Citrus Essential Oil Diffusion on Health Care Staff's Stress Levels: An Evidence-Based Practice Project.

Essential oil diffusion can decrease stress. In one hospital, citrus essential oils were diffused over 6 weeks. Staff completed surveys of their stress levels before and after diffusion. Staff did not report a significant reduction in stress; however, there was an increase in feeling "relaxed."

Examining Associations With Mental, Well-Being and Faith in Nurses (LIFT).

OBJECTIVE: The aim of this study was to explore the association between religion/spirituality (r/s) and mental health outcomes in hospital-based nursing staff. BACKGROUND: The relationship between r/s and health has been studied extensively. Most frequently, r/s has been studied in association with mental health outcomes, including depression, anxiety, and distress among patients. However, hospital-based nurses suffer from the mental health effects of working in high-stress work environments. To date, little research has focused on the relationship between r/s and mental health outcomes in nurses. METHODS: A cross-sectional online survey was completed by 207 nurses from 6 community hospitals. RESULTS: Approximately half of the nurses sampled identified as religious, whereas nearly 75% identified as spiritual. There were significant associations between measures of r/s and mental health outcomes such as depression, anxiety, and mental well-being. CONCLUSIONS: This whole-person assessment of nurses may inform future retention and engagement strategies focused on faith-based interventions.

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.

Mindfulness in healthcare professionals and medical education.

Healthcare professionals are exposed not only to the ubiquitous stress, but also to the culture of perfectionism. Therefore, they need tools to achieve a balance between work and rest in order to effectively help their patients. The study objective is a review of the literature on the implementation of mindfulness in healthcare professionals and medical students. The authors searched the literature in PubMed and Google Scholar databases for publications about "mindfulness" in "healthcare professionals" and "medical students." The search included manuscripts published to July 31, 2019. Mindfulness is a process of intentional paying attention to experiencing the present moment with curiosity, openness and acceptance of each experience without judgment. Mindfulness training leads to a better mood perception, lower stress perception, and responding to stimuli more effectively. All these features can have a potentially positive effect on healthcare service. The paper describes methods of intervention as well as their effects, which may be useful both in maintaining the well-being of healthcare professionals and in patient care. Mindfulness meditation has a beneficial effect on stress, depression, burnout, well-being and empathy among doctors, nurses and other healthcare workers. However, the method has a number of limitations, including a small number of participants, a high dropout rate in the intervention group and, above all, ceasing to practice mindfulness in the longer term after the course termination. Mindfulness can be widely implemented by healthcare professionals, thus improving their well-being and the quality of care they provide. Further standard scientific research is needed to confirm this impact. Int J Occup Med Environ Health. 2021;34(1):1-14.

Effects of Mindfulness-Based Stress Reduction Training on Healthcare Professionals' Mental Health: Results from a Pilot Study Testing Its Predictive Validity in a Specialized Hospital Setting.

This pilot study aimed to evaluate the feasibility and acceptability of a Mindfulness-Based Stress Reduction (MBSR) training and to examine positive and negative symptom-focused mental health variables. The mental health variables were used to test the predictive validity of the training among healthcare professionals. Thirty healthcare professionals participated in this non-randomized pre-post intervention pilot study. The questionnaire on mental health was filled in twice. Baseline and post-intervention differences were tested with paired samples t-tests and Wilcoxon signed-rank tests. The participants' evaluation of the training was assessed with a five-item questionnaire. The recruitment and retention were successful, and participants' evaluation of the training itself was positive but the influence on daily life was rated only moderately positive. In comparison with baseline at post-intervention participants showed significant improvements in general mindfulness, the burnout dimension personal accomplishment, quality of sleep, positive emotions, and self-efficacy. A significant decrease was found in the burnout dimension emotional exhaustion, stress level, negative emotions at work, and worrying. No significant changes were found for the burnout dimension mental distance, and work engagement. The measures showed ample within-person differences and low, medium, or high effect sizes. The current trial approach of the MBSR training seems feasible and acceptable. Our results suggest that mindfulness, burnout, stress level, quality of sleep, positive emotions at work, negative emotions at work, self-efficacy, and worrying are meaningful mental health variables for inclusion in a larger-scale Randomized Controlled Trial on the effects of MBSR.

Work situation and professional role for midwives at a labour ward pre and post implementation of a midwifery model of care - A mixed method study.

Purpose: To explore and analyse the experience of work situation and professional role for midwives at a labour ward pre and post the implementation of a midwifery model of care (MiMo). Methods: A simultaneous mixed method was used. The qualitative core component departed from three focus group interviews (n = 16 midwives). Secondary inductive and deductive content analysis was performed using an unconstrained matrix to make a corresponding comparison of the different time points. The supplemental component was a quantitative survey about the work situation (n = 58). Results: The qualitative results pre the implementation showed three categories: Balance between Women and Organization, Midwives-Diverse as both Profession and Person, and Strained Work Situation. Post the intervention they transformed to Balance between Midwifery and Organization, Midwives-An Adaptable Profession, Strained Work Situation, and a new category Ability to concretize midwifery was found. There were no significant differences in the measures of work situation in the quantitative analyses. Conclusions: The synthesized findings based on the qualitative part show that MiMo has a potential to strengthen the professional role and midwifery practice. As such, MiMo has the capability to offer benefits to the labour wards with additional considerations.

Estratégias de enfrentamento e coping do estresse ocupacional utilizadas por profissionais de enfermagem no ambiente hospitalar: scoping review / Estrategias de afrontamiento y coping del estrés ocupacional utilizadas por los profesionales de enfermería en el ámbito hospitalario: scoping review / Coping strategies for occupational stress used by nursing professionals in the hospital environment: scoping review

OBEJTIVO: Identificar e mapear as estratégias de enfrentamento e coping do estresse ocupacional utilizadas por profissionais de enfermagem no ambiente hospitalar. MÉTODO: Trata-se de uma scoping review baseada nas recomendações do Joanna Briggs Institute. A coleta de dados ocorreu em junho de 2020, em bancos de dados que indexam artigos científicos, dissertações e teses. Os dados foram analisados pela estatística descritiva simples. RESULTADOS: A amostra final foi constituída de 63 estudos, dos quais 49 (77,8%) correspondiam a artigos. As estratégias de enfrentamento do estresse ocupacional apresentadas nos estudos foram: coping ativo; autocuidado; Práticas Integrativas e Complementares; suporte social; capacitações; suporte organizacional; e estratégia negativa. Essas devem abarcar os níveis de prevenção primária, prevenção secundária e terciária. CONCLUSÃO: As estratégias de enfrentamento elencadas nos estudos contemplaram medidas que asseguram a redução de sobrecarga de trabalho; auxiliam o desenvolvimento de habilidades para lidar com o estresse; e elaborem programas de assistência especial.

OBJETIVO: Identificar y mapear las estrategias de afrontamiento y coping del estrés laboral utilizadas por los profesionales de enfermería en el ámbito hospitalario. MÉTODO: Es una scoping review basada en las recomendaciones del Joanna Briggs Institute. La recolección de datos tuvo lugar en junio de 2020, en bases de datos que indexan artículos científicos, disertaciones y tesis. Los datos se analizaron mediante estadística descriptiva simple. RESULTADOS: La muestra final estuvo constituida por 63 estudios, de los cuales 49 (77,8%) correspondieron a artículos. Las estrategias para afrontar el estrés ocupacional presentadas en los estudios fueron: coping activo; cuidados personales; Prácticas integradoras y complementarias; apoyo social; formación; apoyo organizacional; y estrategia negativa. Estos deben abarcar los niveles de prevención primaria, prevención secundaria y terciaria. CONCLUSIÓN: Las estrategias de afrontamiento enumeradas en los estudios incluían medidas que aseguran la reducción de la sobrecarga de trabajo; ayudar en el desarrollo de habilidades para lidiar con el estrés; y diseñar programas de asistencia especial.

OBJECTIVE: To identify and map the coping strategies related to occupational stress used by nursing professionals in the hospital environment. METHOD: This is a scoping review based on the recommendations of the Joanna Briggs Institute. Data collection occurred in June 2020, in databases indexing scientific articles, dissertations and theses. The data were analyzed by simple descriptive statistics. RESULTS: The final sample consisted of 63 studies, of which 49 (77.8%) corresponded to articles. The coping strategies with occupational stress presented in the studies were: Active coping; Self-care; Integrative and Complementary Practices; Social support; Training; Organizational support; and Negative strategy. These should include levels of primary prevention, secondary and tertiary prevention. CONCLUSION: The coping strategies that were included in the studies included measures that ensure the reduction of work overload; help the development of skills to deal with stress; and develop special care programs.

The Psychological Experience of Obstetric Patients and Health Care Workers after Implementation of Universal SARS-CoV-2 Testing.

OBJECTIVE: This study was aimed to describe the hospitalization and early postpartum psychological experience for asymptomatic obstetric patients tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) as part of a universal testing program and report the impact of this program on labor and delivery health care workers' job satisfaction and workplace anxiety. STUDY DESIGN: This is a cohort study of asymptomatic pregnant women who underwent SARS-CoV-2 testing between April 13, 2020 and April 26, 2020. Semistructured interviews were conducted via telephone at 1 and 2 weeks posthospitalization to assess maternal mental health. Depression screening was conducted using the patient health questionnaire-2 (PHQ-2). An online survey of labor and delivery health care workers assessed job satisfaction and job-related anxiety before and during the novel coronavirus disease 2019 (COVID-19) pandemic, as well as employees' subjective experience with universal testing. Patient and employee responses were analyzed for recurring themes. RESULTS: A total of 318 asymptomatic women underwent SARS-CoV-2 testing during this 2-week period. Six of the eight women (75%) who tested positive reported negative in-hospital experiences secondary to perceived lack of provider and partner support and neonatal separation after birth. Among the 310 women who tested negative, 34.4% of multiparous women reported increased postpartum anxiety compared with their prior deliveries due to concerns about infectious exposure in the hospital and lack of social support. Only 27.6% of women, tested negative, found their test result to be reassuring. Job satisfaction and job-related anxiety among health care workers were negatively affected. Universal testing was viewed favorably by the majority of health care workers despite concerns about delays or alterations in patient care and maternal and neonatal separation. CONCLUSION: Universal testing for SARS-CoV-2 in obstetric units has mixed effects on maternal mental health but is viewed favorably by labor and delivery employees. Ongoing evaluation of new testing protocols is paramount to balance staff and patient safety with quality and equality of care. KEY POINTS: · Women with SARS-CoV-2 had a negative hospital experience.. · A negative SARS-CoV-2 test was not reassuring for patients.. · COVID-19 negatively impacts healthcare workers' well-being..

Comparing Effectiveness of HRV-Biofeedback and Mindfulness for Workplace Stress Reduction: A Randomized Controlled Trial.

Psychophysiological disorders due to work-related stress continue to be highly costly for health systems and approaches for cost-effective and easily accessible interventions are much needed. Both heart rate variability-biofeedback (HRV-Bfb) and mindfulness-based interventions (MBI) have been empirically shown to reduce stress. This study compares these two interventions in the work context to a wait-list-control-group (WLC). In this three-armed randomized controlled trial (RCT), 69 healthy adults employed in the same organization were randomized to participate in HRV-Bfb, MBI or the WLC. Participants were assessed for psychophysiological parameters of stress (stress perception, coping, HRV parameters and cortisol) and stress related symptoms (depressive symptoms, psychological wellbeing, mindfulness and self-compassion). Participants trained using either HRV-Bfb or MBI for 6 weeks on a daily basis. Outcomes were assessed at baseline, after the intervention and at follow-up 12 weeks later. Results did not show any statistically significant differences between HRV-Bfb and MBI groups, and neither of the intervention groups (IGs) differed from the WLC. Findings suggest an overall reduction in stress for all groups, including the WLC, with mostly small to medium effect sizes. However, it is important to note that participants with higher baseline stress levels might benefit more from mindfulness and biofeedback-based stress reduction interventions. The results have to be interpreted with caution due to the relatively small sample size. MBI might have a slightly stronger effect on stress reduction in comparison to HRV-Bfb, as suggested by the effect sizes. This study highlights issues and challenges of the implementation of such interventions in corporate health management.

Mindful2Work the next steps: Effectiveness of a program combining physical exercise, yoga and mindfulness, adding a wait-list period, measurements up to one year later and qualitative interviews.

BACKGROUND: Mindful2Work is a 6-week program combining physical activity, yoga and mindfulness meditations, targeting (work-related) stress complaints from a body-mind perspective. MATERIALS AND METHODS: We combined a top-down approach (researcher-driven outcome measures) with a bottom-up approach (personal goals and interview data) to investigate the effects on 98 employees with at least moderate (work-related) stress. Effects on personal goals, well-being (stress, anxiety, depression, sleep, affect, happiness), functioning at work (dropout, mental and physical workability, work satisfaction), and training-specific aspects (mindful awareness, self-compassion, emotion regulation strategies) were assessed. RESULTS: Nearly all measures showed no change during the wait-list period, with only negative affect and physical workability showing small statistically significant improvements. Medium to large effect size improvements directly after training and at all follow-ups were found on primary outcomes stress (0.62-1.17), and risk for dropout from work (0.55-1.00), and largest effects occurred on personal goals (0.98-1.46). Improvements in well-being and functioning at work were medium directly after training, and at follow-up 1 (six weeks later) and 2 (six months later), and large at follow-up 3 (one year later). The training-specific measures showed small to medium effects after training and at follow-up 1. Further, from the interviews (n = 9), two main categories of effects emerged: well-being and acquired insights. CONCLUSION: Mindful2Work showed substantial and long-lasting improvements according to researcher-driven measures as well as participants' own reports.