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The Impact of Psychological Interventions with Elements of Mindfulness (PIM) on Empathy, Well-Being, and Reduction of Burnout in Physicians: A Systematic Review.

ABSTRACT: Introduction: Physician's burnout has been recognized as an increasing and significant work-related syndrome, described by the combination of emotional exhaustion (EE) and depersonalization (D), together with low personal accomplishment (PA). It has many negative consequences on personal, organizational, and patient care levels. This systematic review aimed to analyze research articles where psychological interventions with elements of mindfulness (PIMs) were used to support physicians in order to reduce burnout and foster empathy and well-being. Methods: Systematic searches were conducted in May 2019, within six electronic databases PubMed, EBSCOhost MEDLINE, PsycArticles, Cochrane Library, JSTOR, and Slovenian national library information system. Different combinations of boolean operators were used-mindfulness, empathy, medicine/family medicine/general practice/primary care, burnout, doctors/physicians, intervention, and support group. Additional articles were manually searched from the reference list of the included articles. Studies with other healthcare professionals (not physicians and residents) and/or medical students, and those where PIMs were applied for educational or patient's treatment purposes were excluded. Results: Of 1194 studies identified, 786 screened and 139 assessed for eligibility, there were 18 studies included in this review. Regardless of a specific type of PIMs applied, results, in general, demonstrate a positive impact on empathy, well-being, and reduction in burnout in participating physicians. Compared with other recent systematic reviews, this is unique due to a broader selection of psychological interventions and emphasis on a sustained effect measurement. Conclusions: Given the pandemic of COVID-19, it is of utmost importance that this review includes also interventions based on modern information technologies (mobile apps) and can be used as an awareness-raising material for physicians providing information about feasible and easily accessible interventions for effective burnout prevention and/or reduction. Future research should upgrade self-reported data with objective psychological measures and address the question of which intervention offers more benefits to physicians.

SUBMITTER: Tement S

PROVIDER: S-EPMC8582910 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Conflicting perspectives on whether mixed emotions are adaptive states which promote integrative processes or uncomfortable states which are agonizing make divergent predictions on whether mixed emotions in daily life are conducive towards psychological well-being. We examined this across three studies. Study 1 (N = 335, 135 males; M age = 41.31) examined associations between state mixed emotions and psychological well-being. Study 2 (N = 389; 160 males; M age = 40.86) examined associations between workplace-specific mixed emotions and workplace ill-being assessed based on burnout. Both direct measures and indirect measures were examined in Study 1 and 2, allowing some comparison of methodological issues related to their predictive validity. Study 3 (N = 3444; 1587 males; M age = 55.34) examined bidirectional relationships between an index of emotional ambivalence and psychological well-being about ten years later, controlling for baselines. Demographic covariates, positive emotions, and negative emotions were controlled for in all studies. Analyses were performed using latent variable structural equation modelling. After adjusting for all covariates, the direct measures of mixed emotions predicted poorer psychological well-being (Study 1) and greater burnout (Study 2). However, indirect measures were found to suffer from relatively greater multicollinearity and poorer predictive validity upon controlling for positive and negative emotions. In Study 3, emotional ambivalence predicted poorer long-term psychological well-being, while psychological well-being also predicted lower emotional ambivalence, supporting bidrectionality. The findings provide preliminary evidence that naturalistically experienced mixed emotions may be conflicting and unpleasant, with potentially negative implications for psychological well-being over and above positive and negative emotions.Supplementary informationThe online version contains supplementary material available at 10.1007/s10902-021-00493-z.

Project description:The benefits of mindfulness meditation among clinical and non-clinical populations have been largely reported in literature. Existing mindfulness-based programs are particularly useful in targeting specific populations while researchers have pointed out the possibility of developing programs adapted to the audience and the context. In this two-groups pre-post experimental design we developed a mindfulness-based social intervention program to target individuals from the general population. Here we present a two-groups pre-post experimental design to investigate its effectiveness on participants' psychological functioning assessed by eight self-reported questionnaires (CORE-OM, FFMQ, SWLS, PANAS, PSS, SCS, WEMWBS, SHS) which encompass different domains of well-being, mindfulness and emotional functioning. Participants, recruited on voluntary basis, were randomly allocated to treated or passive control groups and were aware of group allocation. The intervention comprises a 12-week meditation training in a big group that represents the social aspect of meditation. Data were analysed via a linear mixed effect model and intention to treat. Statistically significant results were obtained for global score of CORE-OM (? = -0.20 [-0.30; -0.10], p = 0.0002), FFMQ (? = 0.20 [0.12; -0.28], p < 0.0001), SWLS (? = 1.43 [0.42; 2.45], p = 0.006), positive PANAS (? = 1.99 [0.95; 3.04], p = 0.0002), negative PANAS (? = -1.67 [-2.92; -0.43], p = 0.009), PSS (? = -2.98 [-4.25; -1.71], p < 0.0001), WEMWBS (? = 4.38 [2.93; 5.83], p < 0.0001) and SHS (? = 1.43 [0.42; 2.45], p = 0.006). Our intervention is causally associated with an improvement of the psychological functioning and hence can be considered as a preventive measure that may potentially reduce the risk of developing psychological problems and improve the subject's general well-being. Given the voluntary recruitment, our inference only applies to those individuals who have decided to experience meditation as a way to well-being and not to a random person from the general population.

Project description:BackgroundNationally over 50% of physicians report symptoms of burnout.ObjectiveTo understand the perspectives of health system leaders and frontline physicians on contributors to physician burnout and strategies to improve well-being.DesignWe conducted in-depth interviews with health system leaders and frontline physicians at a large, predominantly fee-for-service, multispecialty group practice with approximately 1300 physicians.ParticipantsThe 17 participants included 15 physicians, (12 Internal Medicine and Family Medicine physicians and 3 from other specialties), 11 individuals in leadership roles, and 11 women.ApproachInterviews included a review of factors associated with burnout at the organization, asking participants which factors they believed contributed to burnout, questions about experiences of burnout, and what specific changes would improve well-being.Key resultsAll 17 participants agreed that organizational factors were key contributors to burnout, while only 9 mentioned the salience of individual factors: "It does not matter how resilient or positive you are, the work environment, especially in primary care will eventually be a problem." An increasing workload associated with the electronic health record (EHR) and a culture focused on productivity were cited as contributing to burnout, especially among physicians in Internal Medicine and Family Medicine (primary care) departments. Physicians in primary care, women, and leaders described multiple barriers to well-being. Participants described responding to increased workloads by reducing clinical work hours. Participants suggested reducing and compensating EHR work, expanding care teams/support staff, reducing use of metrics, providing more support to leaders, changing the business model, and increasing positivity and collegiality, as essential to improving well-being.ConclusionInterviews reveal a variety of interacting factors contributing to physician burnout. Reducing clinical work hours has become a coping strategy. Changes recommended to improve physician well-being include increasing support staff, reducing EHR workload, changing revenue generation and compensation approaches, and shifting organizational culture to place more value on physician wellness.

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The Impact of Psychological Interventions with Elements of Mindfulness (PIM) on Empathy, Well-Being, and Reduction of Burnout in Physicians: A Systematic Review.

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