Feasibility, Acceptability, and Outcomes of a Yoga-Based Meditation Intervention for Hospice Professionals to Combat Burnout.

(1) Background. This research examined the feasibility, acceptability and outcomes of delivering a 6-week yoga-based meditation intervention to clinical teams of hospice professionals (HPs) at a large non-profit hospice organization. The intervention was designed to increase mind-body integration and combat burnout. This article was written for different audiences, including research scientists who study interoception, burnout, meditation, or yoga, designers of meditation interventions, and hospice organizations looking for ways to mitigate HP burnout. (2) Methods. The intervention was launched within clinical teams, beginning with a half-hour online introduction to the program and exposure to the week 1 meditation at each team's monthly all-staff meeting. Throughout the program, HPs could access the meditations on their own via their workplace computers, tablets, and smartphones. Online pre- and post-intervention surveys were submitted by 151 HPs, 76 of whom were exposed to the intervention and completed both surveys. The surveys assessed burnout using the Professional Fulfillment Index and mind-body integration using the Multidimensional Assessment of Interoceptive Awareness scales. (3) Results. Two-thirds of HPs who were present at a staff meeting where the program was introduced went on to do a meditation on their own at least once. Half of HPs expressed a desire to continue with access to the meditations after the 6-week program ended. Due to COVID-19 work from home restrictions, three-fourth of HPs did a meditation at home, 29% in a car between patient visits (not while driving), and 23% at the office. Higher interoceptive awareness was significantly related to lower burnout, particularly lower work exhaustion. Meditation frequency was significantly related to higher interoceptive awareness but not to burnout. Interpersonal disengagement was rare and temporary. (4) Conclusions. Findings showed that the yoga-based meditation intervention was feasible and acceptable and associated with higher interoceptive awareness. The results point to a role for interoceptive awareness in reducing the risk for burnout.

Hospice Employees' Perceptions of Their Work Environment: A Focus Group Perspective.

Burnout in healthcare professionals can lead to adverse effects on physical and mental health, lower quality of care, and workforce shortages as employees leave the profession. Hospice professionals are thought to be at particularly high risk for burnout. The purpose of the study was to evaluate workplace perceptions of interdisciplinary hospice care workers who provide care to patients at end of life. Six focus groups and one semi-structured interview were conducted with mixed group of social workers, managers, nurses, hospice aides, chaplains, support staff, and a physician (n = 19). Findings from the groups depicted both rewards and challenges of hospice caregiving. Benefits included intrinsic satisfaction from the work, receiving positive patient and family feedback, and teamwork. Challenges reflected issues with workload, technology issues, administrative demands, travel-related problems, communication and interruptions, difficulties with taking time off from work and maintaining work-life integration, and coping with witnessing grief/loss. Hospice workers glean satisfaction from making meaningful differences in the lives of patients with terminal illness and their family members. It is an expected part of the job that certain patients and situations are particularly distressing; team support and targeted grief support is available for those times. Participants indicated that workload and administrative demands rather than dealing with death and dying were the biggest contributors to burnout. Participants reported episodic symptoms of burnout followed by deliberate steps to alleviate these symptoms. Notably, for all except one of the participants, burnout was cyclical. Symptoms would begin, they would take steps to deal with it (e.g., taking a mental health day), and they recovered. At an organizational level, a multipronged approach that includes both personal and occupational strategies is needed to support professional caregivers and help mitigate the stressors associated with hospice work.

Beyond Scientific Mechanisms: Subjective Perceptions with Viniyoga Meditation.

Healthcare professionals and research scientists generally recognize the potential value of mind-body practices grounded in ancient wisdom, but often have limited direct experience with such practices. Meditation participant self-reports provide a window into subjective experiences of three Viniyoga meditations and how and why those meditations could contribute to health and well-being outcomes. Each of the meditations in this analysis had a unique structure and used a different aspect of the ocean as a meditation object. Yoga philosophy and yoga anatomy models of the human system are used to help explain participants' experiences and associated personal benefits and insights. Four aspects of the individual that can influence what happens for them in meditation are illustrated with tangible examples: (1) What is happening in generally in someone's life; (2) the state of their system (mind, body, breath) around the time of the meditation; (3) reactions to the meditation steps and instructions; and (4) their prior experiences with the object of meditation. Summaries of the practices, and why and for whom each meditation might be beneficial are discussed. The authors' perspectives are grounded in Viniyoga and yoga therapy.

Hospice and Palliative Care Provider Experiences With Meditation Using Mobile Applications.

PURPOSE: Healthcare providers who are involved in the care of patients at the end of life are at risk of developing compassion fatigue, a condition characterized by emotional exhaustion and reduced professional engagement. Research has shown that development of a meditation practice can modify stress perceptions and promote quality of life. This study aimed to evaluate perceived benefits, challenges, and recommendations following participation in a workplace mobile application- and email-based meditation research program. PARTICIPANTS & SETTING: 11 healthcare providers who participated in the feasibility pilot were recruited from Sparrow Health System in Lansing, Michigan. METHODOLOGIC APPROACH: Three focus groups and one in-depth interview were conducted. Data were analyzed using qualitative methodology. FINDINGS: Major themes included program advantages and limitations, challenges that affected adherence, and support for caregivers. IMPLICATIONS FOR NURSING: Findings support further evaluation of a technology-mediated meditation program for professional caregivers to reduce perceived stress associated with the work environment.

Effects of a computer-based cognitive exercise program on age-related cognitive decline.

We developed a 'senior friendly' suite of online 'games for learning' with interactive calibration for increasing difficulty, and evaluated the feasibility of a randomized clinical trial to test the hypothesis that seniors aged 60-80 can improve key aspects of cognitive ability with the aid of such games. Sixty community-dwelling senior volunteers were randomized to either an online game suite designed to train multiple cognitive abilities, or to a control arm with online activities that simulated the look and feel of the games but with low level interactivity and no calibration of difficulty. Study assessment included measures of recruitment, retention and play-time. Cognitive change was measured with a computerized assessment battery administered just before and within two weeks after completion of the six-week intervention. Impediments to feasibility included: limited access to in-home high-speed internet, large variations in the amount of time devoted to game play, and a reluctance to pursue more challenging levels. Overall analysis was negative for assessed performance (transference effects) even though subjects improved on the games themselves. Post hoc analyses suggest that some types of games may have more value than others, but these effects would need to be replicated in a study designed for that purpose. We conclude that a six-week, moderate-intensity computer game-based cognitive intervention can be implemented with high-functioning seniors, but the effect size is relatively small. Our findings are consistent with Owen et al. (2010), but there are open questions about whether more structured, longer duration or more intensive 'games for learning' interventions might yield more substantial cognitive improvement in seniors.

Gaming mindsets: implicit theories in serious game learning.

Individuals' beliefs about the malleability of their abilities may predict their response and outcome in learning from serious games. Individuals with growth mindsets believe their abilities can develop with practice and effort, whereas individuals with fixed mindsets believe their abilities are static and cannot improve. This study uses survey and gameplay server data to examine the implicit theory of intelligence in the context of serious game learning. The findings show that growth mindset players performed better than fixed mindset players, their mistakes did not affect their attention to the game, and they read more learning feedback than fixed mindset players. In addition, growth mindset players were more likely to actively seek difficult challenges, which is often essential to self-directed learning. General mindset measurements and domain-specific measurements were also compared. These findings suggest that players' psychological attributes should be considered when designing and applying serious games.

Mind your errors: evidence for a neural mechanism linking growth mind-set to adaptive posterror adjustments.

How well people bounce back from mistakes depends on their beliefs about learning and intelligence. For individuals with a growth mind-set, who believe intelligence develops through effort, mistakes are seen as opportunities to learn and improve. For individuals with a fixed mind-set, who believe intelligence is a stable characteristic, mistakes indicate lack of ability. We examined performance-monitoring event-related potentials (ERPs) to probe the neural mechanisms underlying these different reactions to mistakes. Findings revealed that a growth mind-set was associated with enhancement of the error positivity component (Pe), which reflects awareness of and allocation of attention to mistakes. More growth-minded individuals also showed superior accuracy after mistakes compared with individuals endorsing a more fixed mind-set. It is critical to note that Pe amplitude mediated the relationship between mind-set and posterror accuracy. These results suggest that neural mechanisms indexing on-line awareness of and attention to mistakes are intimately involved in growth-minded individuals' ability to rebound from mistakes.