Effects of mindfulness meditation on mindfulness, mental well-being, and perceived stress.

INTRODUCTION: The purpose of this study was to investigate the effects of mindfulness meditation using the Headspace™ app on mindfulness, mental well-being, and perceived stress in pharmacy students. METHODS: Professional year one (P1), professional year two (P2,) and professional year 3 (P3) pharmacy students were recruited to participate. Students were instructed to meditate using the Headspace™ app for at least 10min per day for four weeks. Students at baseline completed the health promoting lifestyle profile (HPLP). Data was collected from the pre/post surveys using the Five Facet Mindfulness Questionnaire (FFMQ), Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), and Cohen Perceived Stress Scale (PSS). RESULTS: Ninety-two pharmacy students enrolled in the study. Seventy-percent of the participants completed the study. Only one participant was excluded in the post data analysis due to non-adherence with the protocol. The data revealed that for all scales the intervention was associated with enhanced mindfulness and mental well-being and decreased perceived stress. Further analysis indicated that controlling for various health promoting lifestyle behaviors preserves the positive impact of mindfulness meditation as demonstrated. CONCLUSIONS: Mindfulness meditation uniformly and independently improved the participants overall mental health. The data supports a feasible option for minimizing stress and maintaining mental well-being in a demanding professional program. This study encourages students in pharmacy schools to adopt these practices in their curriculum.

Use of mixed-methods approach to assess the impact of a pre-professional health humanities honors course on developing interpersonal skills.

INTRODUCTION: The purpose of this study was to use a mixed-methods approach to provide evidence for growth in empathy, respect for patient autonomy, ability to relate to others, and self-awareness as a result of participating in a health humanities course. METHODS: The mixed-methods approach gathered quantitative data using a quasi-experimental design of a pre/post course survey and qualitative data from reflective writings and student papers. The reflective writings and student papers were evaluated using an adapted rubric to assess the quality of the reflections on measures of empathy, respect for patient autonomy, ability to relate to others, and self-awareness. RESULTS: Twenty-five students were enrolled in the course. Matched pair data was available from 22 students (88% response rate) for the quantitative survey data. Qualitative data was available from all 25 participants. The pre- and post-course surveys revealed a statistically significant increase in empathy (p < 0.001) as a result of completing the health humanities course. The final written report contained the highest quality of reflections compared to all other reflective writing assignments. Evidence for understanding empathy was prominent in the final written report. CONCLUSIONS: The evaluation of development of interpersonal skills through use of health humanities resources may be reproduced by using a mixed-methods assessment approach. The quantitative and qualitative data presented provide some evidence for enhancing awareness and understanding of empathy, particularly by utilizing health humanities resources in an undergraduate interdisciplinary seminar course.

Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice.

AIM: To determine the relationship between chronic kidney disease (CKD) awareness (CKD-A), self-management behaviors (CKD-SMB) knowledge, performance of CKD-SMBs, health literacy (HL) and kidney function. METHODS: Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-management knowledge tool (CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR (eGFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS: One-hundred-fifty patients participated in the study. eGFRs ranged from 17-152 mL/min per 1.73 m2. Majority (83%) of respondents had stage 3 or 4 CKD, low HL (63%), and were CKD aware (88%). Approximately 40% (10/25) of patients in stages 1 and 2 and 6.4% (8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage (P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents (≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure" (P = 0.02), and "keeping healthy body weight" (P = 0.01). Adjusted multivariate analyses between CKD-A and: (1) HL; and (2) CKD-SMB knowledge were non-significant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB (P < 0.05). CONCLUSION: CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower eGFR, suggesting the need for focused patient education in CKD stages 1.

Student Self-Assessment and Faculty Assessment of Performance in an Interprofessional Error Disclosure Simulation Training Program.

Objectives. To conduct a prospective evaluation for effectiveness of an error disclosure assessment tool and video recordings to enhance student learning and metacognitive skills while assessing the IPEC competencies. Design. The instruments for assessing performance (planning, communication, process, and team dynamics) in interprofessional error disclosure were developed. Student self-assessment of performance before and after viewing the recordings of their encounters were obtained. Faculty used a similar instrument to conduct real-time assessments. An instrument to assess achievement of the Interprofessional Education Collaborative (IPEC) core competencies was developed. Qualitative data was reviewed to determine student and faculty perceptions of the simulation. Assessment. The interprofessional simulation training involved a total of 233 students (50 dental, 109 nursing and 74 pharmacy). Use of video recordings made a significant difference in student self-assessment for communication and process categories of error disclosure. No differences in student self-assessments were noted among the different professions. There were differences among the family member affects for planning and communication for both pre-video and post-video data. There were significant differences between student self-assessment and faculty assessment for all paired comparisons, except communication in student post-video self-assessment. Students' perceptions of achievement of the IPEC core competencies were positive. Conclusion. The use of assessment instruments and video recordings may have enhanced students' metacognitive skills for assessing performance in interprofessional error disclosure. The simulation training was effective in enhancing perceptions on achievement of IPEC core competencies. This enhanced assessment process appeared to enhance learning about the skills needed for interprofessional error disclosure.

Design and evaluation of interprofessional cross-cultural communication sessions.

The 2013 National Standards for Culturally and Linguistically Appropriate Services (CLAS) call for healthcare professionals to provide quality care and services that are responsive to diverse cultural health beliefs and practices. Accreditation organizations for health professional programs require their curriculum to adequately prepare future practitioners for serving culturally and linguistically diverse populations. Another common curricular need of health professional programs is interprofessional education (IPE). This study presents data that evaluates two IPE culturally competent communication sessions designed for pharmacy and nursing students. Teams of nursing and pharmacy students (n = 160) engaged in case studies focused on developing cross-cultural communication skills, using the LEARN model. Quantitative survey data collected pre-test and post-test measured cultural competency (including subscales of perceived skills, perceived knowledge, confidence in encounter, and attitude) and knowledge related to culturally competent communication. Univariate ANOVA results indicate that actual knowledge as measured by the test and all four Clinical Cultural Competency Questionnaire (CCCQ) subscales significantly increased after the IPE sessions. Pharmacy students scored higher than nursing students on the knowledge pre-test, and nursing students had a more positive attitude at pre-test. The IPE sessions effectively addressed all learning outcomes and will continue in future course offerings. Using cross-cultural communication as a thematic area for IPE program development resulted in educational benefits for the students. To further strengthen nursing and pharmacy students' interprofessional practice, additional IPE opportunities are to be explored.

Relationship between Health Literacy and Kidney Function.

AIM: Low health literacy (HL) may contribute to poor self-management of chronic kidney disease (CKD) and poor kidney function. This study aimed to assess the relationship between HL and estimated glomerular filtration rate (eGFR). METHODS: A cross-sectional observational study was conducted among consecutive eligible adult patients with CKD stages 1-4 attending an outpatient nephrology clinic. HL was assessed using Newest Vital Sign (NVS). eGFR was estimated using the Modification of Diet in Renal Disease equation. CKD self-management behaviour knowledge was assessed using a study instrument (CKD self-management knowledge (SMKT)). RESULTS: One hundred fifty patients participated in the study (83% participation rate). The prevalence of high likelihood of limited HL was 32.7%. Participants' eGFRs ranged from 17 to 152 mL/min / 1.73 m(2) , with over 80% of the eGFRs below 60 mL/min / 1.73 m(2) . HL was associated with eGFR after controlling for all demographics except age, race and gender (which are included in eGFR equation) (P = 0.05). Every unit increase in NVS score was associated with a 1.9% increase (95% confidence interval = 0 to 3.86%) in eGFR (model R square = 0.23, P = 0.002), which remained significant after controlling for CKD-SMKT (P = 0.05; model R square = 0.28, P < 0.001). The relationship was non-significant after controlling for age, although it remained significant after controlling for other demographics including gender and race. CONCLUSIONS: There is a small but significant association between HL and eGFR. Providers should use HL-tailored communication strategies in CKD patients. Larger multicentre studies are needed to substantiate this relationship.