Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial

IMPORTANCE: Stress among health care professionals is well documented. The use of mindfulness-based interventions to reduce stress has shown promising results; however, the time commitment of typical programs can be a barrier to successful implementation in health care settings. OBJECTIVE: To determ...

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Autores principales: Ameli, Rezvan, Sinaii, Ninet, West, Colin P., Luna, María José, Panahi, Samin, Zoosman, Michael, Rusch, Heather L., Berger, Ann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448827/
https://www.ncbi.nlm.nih.gov/pubmed/32840621
http://dx.doi.org/10.1001/jamanetworkopen.2020.13424
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author Ameli, Rezvan
Sinaii, Ninet
West, Colin P.
Luna, María José
Panahi, Samin
Zoosman, Michael
Rusch, Heather L.
Berger, Ann
author_facet Ameli, Rezvan
Sinaii, Ninet
West, Colin P.
Luna, María José
Panahi, Samin
Zoosman, Michael
Rusch, Heather L.
Berger, Ann
author_sort Ameli, Rezvan
collection PubMed
description IMPORTANCE: Stress among health care professionals is well documented. The use of mindfulness-based interventions to reduce stress has shown promising results; however, the time commitment of typical programs can be a barrier to successful implementation in health care settings. OBJECTIVE: To determine the efficacy and feasibility of a brief mindfulness-based program to reduce stress during work hours among health care professionals. DESIGN, SETTING, AND PARTICIPANTS: This intent-to-treat randomized clinical trial was conducted among full-time health care professionals at the Clinical Center at the National Institutes of Health in Bethesda, Maryland, between September 2017 and May 2018. Participants were randomized to receive mindfulness-based self-care (MBSC) training or life-as-usual control. Data were analyzed from June 2018 to January 2020. INTERVENTIONS: The MBSC intervention included 5 weekly, 1.5-hour in-class mindfulness practice sessions. MAIN OUTCOMES AND MEASURES: Stress level was the primary outcome, assessed with the Perceived Stress Scale 10-Item version. Secondary outcomes included anxiety, burnout, positive and negative affect, mindfulness (trait and state), and self-care. Assessments were taken at baseline and at the end of the intervention (week 5) in the intervention and control groups, and at follow-up (week 13) in the intervention group to test for a maintenance effect. A postprogram evaluation was also obtained. RESULTS: Of 82 randomized participants, 78 who completed the study at week 5 were included in the modified intent-to-treat analysis (median [interquartile range] age, 32 [23-48] years; 65 [83%] women), including 43 participants in the MBSC group and 35 participants in the control group. At the end of the intervention, compared with the control group, the MBSC group had reduced levels of stress (mean [SD] score, 17.29 [5.84] vs 18.54 [6.30]; P = .02) and anxiety (mean [SD] score, 2.58 [1.52] vs 4.23 [1.73]; P < .001), and improved positive affect (mean [SD] score, 35.69 [7.12] vs 31.42 [7.27]; P < .001), state mindfulness (mean [SD] score, 3.74 [1.18] vs 2.78 [1.16]; P < .001), and mindful self-care (mean [SD] score, 7.29 [2.44] vs 5.54 [2.77]; P < .001). Burnout, negative affect, and trait mindfulness levels did not differ between groups. Changes within the MBSC group through follow-up included sustained reductions in stress (change, –6.14; 95% CI, –7.84 to –4.44; P < .001), anxiety (change, –1.46; 95% CI, –1.97 to –0.94; P < .001), trait mindfulness (change, 0.63; 95% CI, 0.36 to 0.90; P < .001), and state mindfulness (change, 1.89; 95% CI, 1.39 to 2.39; P < .001). CONCLUSIONS AND RELEVANCE: This randomized clinical trial found that this brief mindfulness-based intervention was an effective and feasible means to reduce stress in health care professionals. Larger studies are needed to assess the effects on clinical care and patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03781336
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spelling pubmed-74488272020-09-02 Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial Ameli, Rezvan Sinaii, Ninet West, Colin P. Luna, María José Panahi, Samin Zoosman, Michael Rusch, Heather L. Berger, Ann JAMA Netw Open Original Investigation IMPORTANCE: Stress among health care professionals is well documented. The use of mindfulness-based interventions to reduce stress has shown promising results; however, the time commitment of typical programs can be a barrier to successful implementation in health care settings. OBJECTIVE: To determine the efficacy and feasibility of a brief mindfulness-based program to reduce stress during work hours among health care professionals. DESIGN, SETTING, AND PARTICIPANTS: This intent-to-treat randomized clinical trial was conducted among full-time health care professionals at the Clinical Center at the National Institutes of Health in Bethesda, Maryland, between September 2017 and May 2018. Participants were randomized to receive mindfulness-based self-care (MBSC) training or life-as-usual control. Data were analyzed from June 2018 to January 2020. INTERVENTIONS: The MBSC intervention included 5 weekly, 1.5-hour in-class mindfulness practice sessions. MAIN OUTCOMES AND MEASURES: Stress level was the primary outcome, assessed with the Perceived Stress Scale 10-Item version. Secondary outcomes included anxiety, burnout, positive and negative affect, mindfulness (trait and state), and self-care. Assessments were taken at baseline and at the end of the intervention (week 5) in the intervention and control groups, and at follow-up (week 13) in the intervention group to test for a maintenance effect. A postprogram evaluation was also obtained. RESULTS: Of 82 randomized participants, 78 who completed the study at week 5 were included in the modified intent-to-treat analysis (median [interquartile range] age, 32 [23-48] years; 65 [83%] women), including 43 participants in the MBSC group and 35 participants in the control group. At the end of the intervention, compared with the control group, the MBSC group had reduced levels of stress (mean [SD] score, 17.29 [5.84] vs 18.54 [6.30]; P = .02) and anxiety (mean [SD] score, 2.58 [1.52] vs 4.23 [1.73]; P < .001), and improved positive affect (mean [SD] score, 35.69 [7.12] vs 31.42 [7.27]; P < .001), state mindfulness (mean [SD] score, 3.74 [1.18] vs 2.78 [1.16]; P < .001), and mindful self-care (mean [SD] score, 7.29 [2.44] vs 5.54 [2.77]; P < .001). Burnout, negative affect, and trait mindfulness levels did not differ between groups. Changes within the MBSC group through follow-up included sustained reductions in stress (change, –6.14; 95% CI, –7.84 to –4.44; P < .001), anxiety (change, –1.46; 95% CI, –1.97 to –0.94; P < .001), trait mindfulness (change, 0.63; 95% CI, 0.36 to 0.90; P < .001), and state mindfulness (change, 1.89; 95% CI, 1.39 to 2.39; P < .001). CONCLUSIONS AND RELEVANCE: This randomized clinical trial found that this brief mindfulness-based intervention was an effective and feasible means to reduce stress in health care professionals. Larger studies are needed to assess the effects on clinical care and patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03781336 American Medical Association 2020-08-25 /pmc/articles/PMC7448827/ /pubmed/32840621 http://dx.doi.org/10.1001/jamanetworkopen.2020.13424 Text en Copyright 2020 Ameli R et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Ameli, Rezvan
Sinaii, Ninet
West, Colin P.
Luna, María José
Panahi, Samin
Zoosman, Michael
Rusch, Heather L.
Berger, Ann
Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial
title Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial
title_full Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial
title_fullStr Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial
title_full_unstemmed Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial
title_short Effect of a Brief Mindfulness-Based Program on Stress in Health Care Professionals at a US Biomedical Research Hospital: A Randomized Clinical Trial
title_sort effect of a brief mindfulness-based program on stress in health care professionals at a us biomedical research hospital: a randomized clinical trial
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448827/
https://www.ncbi.nlm.nih.gov/pubmed/32840621
http://dx.doi.org/10.1001/jamanetworkopen.2020.13424
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