Abstract
Hospital employees may experience occupational stress and burnout, which negatively impact quality of life and job performance. Evidence-based interventions implemented within the hospital setting are needed to promote employees’ well-being. We offered a 4-week mindfulness-based cognitive therapy (MBCT) group program for hospital employees and used a mixed-methods practice-based research approach to explore feasibility, acceptability, and effects on stress and burnout. Participants were 65 hospital employees (M age = 44.06; 85% white) who participated between September 2015 and January 2016. Participants completed validated measures of stress and burnout before and after the program and answered open-ended satisfaction questions after the program. Groups consistently enrolled at least ten participants, but attendance rates declined across sessions (76% at session 2 vs. 54% at session 4) due primarily to work-related scheduling conflicts. The program content was acceptable as evidenced by high perceived value (M = 9.18 out of 10), homework compliance (51% practicing at least three times/week), and qualitative requests for program expansion. There were large, statistically significant decreases in stress (ΔM = 2.1, p < .001, d = 0.85) and medium decreases in burnout (ΔM = 0.46, p = .01, d = 0.57), which were supported by qualitative themes of improved self-regulation and mindfulness skills, stress reduction, emotional well-being, and improved work productivity and patient care skills. Findings suggest that 4-week MBCT is acceptable and useful for hospital employees, though research is needed to identify alternate delivery methods or strategies to enhance session attendance.
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Bazarko, D., Cate, R. A., Azocar, F., & Kreitzer, M. J. (2013). The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. Journal of Workplace Behavioral Health, 28(2), 107–133.
Bourbonnais, R., Comeau, M., & Vézina, M. (1999). Job strain and evolution of mental health among nurses. Journal of Occupational Health Psychology, 4(2), 95.
Carmody, J., & Baer, R. A. (2009). How long does a mindfulness-based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress. Journal of Clinical Psychology, 65(6), 627–638.
Cohen, J. (1988a). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: L. Erlbaum.
Cohen, S. (1988b). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The Claremont symposium on applied social psychology, The social psychology of health (pp. 31–67). Thousand Oaks: Sage Publications.
Cohen-Katz, J., Wiley, S. D., Capuano, T., Baker, D. M., & Shapiro, S. (2004). The effects of mindfulness-based stress reduction on nurse stress and burnout: a quantitative and qualitative study. Holistic Nursing Practice, 18(6), 302–308.
Cohen-Katz, J., Wiley, S. D., Capuano, T., Baker, D. M., & Shapiro, S. (2005). The effects of mindfulness-based stress reduction on nurse stress and burnout, part II: a quantitative and qualitative study. Holistic Nursing Practice, 19(1), 26–35.
Crane, R. S., & Kuyken, W. (2013). The implementation of mindfulness-based cognitive therapy: learning from the UK health service experience. Mindfulness, 4(3), 246–254.
Day, P. O. H., & Horton-Deutsch, S. (2004a). Using mindfulness-based therapeutic interventions in psychiatric nursing practice-part I: description and empirical support for mindfulness-based interventions. Archives of Psychiatric Nursing, 18(5), 164–169.
Day, P. O. H., & Horton-Deutsch, S. (2004b). Using mindfulness-based therapeutic interventions in psychiatric nursing practice-part II: mindfulness-based approaches for all phases of psychotherapy-clinical case study. Archives of Psychiatric Nursing, 18(5), 170–177.
Demarzo, M., Cebolla, A., & Garcia-Campayo, J. (2015). The implementation of mindfulness in healthcare systems: a theoretical analysis. General Hospital Psychiatry, 37(2), 166–171.
Dunlap, W. P., Cortina, J. M., Vaslow, J. B., & Burke, M. J. (1996). Meta-analysis of experiments with matched groups or repeated measures designs. Psychological Methods, 1(2), 170–177.
Galantino, M. L., Baime, M., Maguire, M., Szapary, P. O., & Farrar, J. T. (2005). Association of psychological and physiological measures of stress in health-care professionals during an 8-week mindfulness meditation program: mindfulness in practice. Stress and Health, 21(4), 255–261.
Goodman, M. J., & Schorling, J. B. (2012). A mindfulness course decreases burnout and improves well-being among healthcare providers. The International Journal of Psychiatry in Medicine, 43(2), 119–128.
Hansen, V., & Girgis, A. F. (2010). Can a single question effectively screen for burnout in Australian cancer care workers? BMC Health Services Research, 10, 341.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169.
Irving, J. A., Dobkin, P. L., & Park, J. (2009). Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR). Complementary Therapies in Clinical Practice, 15(2), 61–66.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33–47.
Keng, S.-L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: a review of empirical studies. Clinical Psychology Review, 31(6), 1041–1056.
Klatt, M., Steinberg, B., & Duchemin, A.-M. (2015). Mindfulness in motion (MIM): an onsite mindfulness based intervention (MBI) for chronically high stress work environments to increase resiliency and work engagement. Journal of Visualized Experiments: JoVE(101).
Leiter, M. P., Harvie, P., & Frizzell, C. (1998). The correspondence of patient satisfaction and nurse burnout. Social Science & Medicine, 47(10), 1611–1617.
Mackenzie, C. S., Poulin, P. A., & Seidman-Carlson, R. (2006). A brief mindfulness-based stress reduction intervention for nurses and nurse aides. Applied Nursing Research, 19(2), 105–109.
Magidson, J. F., Seitz-Brown, C., Safren, S. A., & Daughters, S. B. (2014). Implementing behavioral activation and life-steps for depression and HIV medication adherence in a community health center. Cognitive and Behavioral Practice, 21(4), 386–403.
McVicar, A. (2003). Workplace stress in nursing: a literature review. Journal of Advanced Nursing, 44(6), 633–642.
Ree, M. J., & Craigie, M. A. (2007). Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients. Behaviour Change, 24(02), 70–86.
Ruscio, A. C., Muench, C., Brede, E., & Waters, A. J. (2016). Effect of brief mindfulness practice on self-reported affect, craving, and smoking: a pilot randomized controlled trial using ecological momentary assessment. Nicotine & Tobacco Research, 18(1), 64–73.
Schmoldt, R., Freeborn, D., & Klevit, H. (1994). Physician burnout: recommendations for HMO managers. HMO practice/HMO Group, 8(2), 58–63.
Sears, R. W., Tirch, D. D., & Denton, R. B. (2011). Mindfulness in clinical practice. New York: Professional Resource Exchange
Segal, Z., Williams, J., & Teasdale, J. (2002). Mindfulness-based cognitive therapy for depression: a new approach to relapse prevention. New York: Guilford Press.
Segal, Z., Williams, J., & Teasdale, J. (2013). Mindfulness-based cognitive therapy for depression (2nd ed.). New York: Guilford Press.
Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: results from a randomized trial. International Journal of Stress Management, 12(2), 164.
Sorenson, S., Duberstein, P., Gill, D., & Pinquart, M. (2006). Dementia care: mental health effects, intervention strategies, and clinical implications. Lancet Neurology, 5, 961–973.
Vettese, L. C., Toneatto, T., Stea, J. N., Nguyen, L., & Wang, J. J. (2009). Do mindfulness meditation participants do their homework? And does it make a difference? A review of the empirical evidence. Journal of Cognitive Psychotherapy: An International Quarterly, 23, 198–225.
Wahbeh, H., Zwickey, H., & Oken, B. (2011). One method for objective adherence measurement in mind-body medicine. The Journal of Alternative and Complementary Medicine, 17, 175–177.
Westfall, J. M., Mold, J., & Fagnan, L. (2007). Practice-based research—“blue highways” on the NIH roadmap. JAMA, 297(4), 403–406.
Williams, E. S., Manwell, L. B., Konrad, T. R., & Linzer, M. (2007). The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health Care Management Review, 32(3), 203–212.
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CML completed the data analyses and wrote the paper. RSW assisted with the execution of the study and assisted with data analysis. KMK assisted with data analysis and contributed to writing the introduction of the paper. RWS delivered the intervention, assisted with the execution of the study, and contributed to writing the discussion of the paper. CH assisted with the execution of the study and contributed to writing the paper. SC designed and executed the study and contributed to writing and editing the paper.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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This study was supported in part by funds from the University of Cincinnati Medical Center and National Center for Complementary and Integrative Health (NCCIH 2T32AT000051-6; Dr. Luberto).
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Luberto, C.M., Wasson, R.S., Kraemer, K.M. et al. Feasibility, Acceptability, and Preliminary Effectiveness of a 4-Week Mindfulness-Based Cognitive Therapy Protocol for Hospital Employees. Mindfulness 8, 1522–1531 (2017). https://doi.org/10.1007/s12671-017-0718-x
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DOI: https://doi.org/10.1007/s12671-017-0718-x