Effects of a brief interpersonal mindfulness program embedded in a psychiatric nursing practicum: A controlled pilot study.

BACKGROUND: Nursing school is a stressful environment that demands high performance both professionally and academically. Interpersonal mindfulness training has shown promise for its stress-reducing capacity in other contexts; however, few descriptions or tests of this method in nursing training settings exist in the literature. PURPOSE: This pilot study examined effects of a brief interpersonal mindfulness program embedded in a 4-week psychiatric nursing practicum in Thailand. METHODS: Mixed methods were used with 31 fourth-year nursing students to measure changes in mindfulness and assess their experiences of the program's impact. The control and experimental groups received the same clinical training, but the experimental group was also trained to practice interpersonal mindfulness throughout the course. FINDINGS: The experimental group reported statistically significantly greater increases in Observing, Describing, and Non-reacting subscale scores, and in scores for the overall Five-Facet Mindfulness questionnaire, Thai version, than the control group (p < .05, Cohen's d = 0.83-0.95, large effect sizes). Group interviews revealed themes: initial challenges to mindfulness practice, experiences of becoming more mindful, intrapersonal benefits, and consequences of mindfulness on interpersonal skills. CONCLUSION: Overall, an interpersonal mindfulness program embedded in a psychiatric nursing practicum was effective. Further studies are required to address limitations of the present study.

Depressive disorders in Thai medical students: an exploratory study of institutional, cultural, and individual factors.

OBJECTIVES: This exploratory qualitative study conducted among Thai medical students aimed to investigate factors related to the development of medical students' depression and how these factors interact in contributing to depressive disorders. METHODS: Forty-three undergraduate medical students of the six-year Doctor of Medicine program were identified as having moderate to severe depression on an annual depression screening. From these, eighteen students agreed to participate in individual in-depth interviews. Transcriptions of the interviews were analyzed by independent reviewers using a thematic analysis approach. RESULTS: Among 43 participants screened as having moderate-to-severe depression, major depressive disorder and adjustment disorder were 9.3% and 14.0%, respectively. Reported factors related to medical students' disorders were personal vulnerabilities, medical educational administration, academic achievement, learning environment, intrinsic motivation, self-care and self-management, relationship, and community. In particular, lack of social support and relationship problems were mentioned among those with more severe and persistent symptoms. Protective factors were social support, positive relationships, a growth mindset, spiritual and mindfulness practices, and an adequate mentoring program. CONCLUSIONS: Medical students' depression and suicidal ideations are significant concerns in Thai medical education. Besides personal vulnerabilities, high expectations, the value placed on academic achievement, and relationship problems can precipitate the onset of depressive disorders, if not being properly addressed. The 4P framework of predisposing, precipitating, perpetuating, and protective factors are suggested to understand the onset and development of students' depressive disorders and to identify targets for institutional and educational intervention.