A Pilot Study of Mindfulness-Based Cognitive Therapy to Improve Well-Being for Health Professionals Providing Chronic Disease Care

ObjectivePeople with chronic conditions are known to be vulnerable to the COVID-19 pandemic. This study aims to describe patients’ lived experiences, challenges faced by people with chronic conditions, their coping strategies, and the social and economic impacts of the COVID-19 pandemic.Design, setting and participantsWe conducted a qualitative study using a syndemic framework to understand the patients’ experiences of chronic disease care, challenges faced during the lockdown, their coping strategies and mitigators during the COVID-19 pandemic in the context of socioecological and biological factors. A diverse sample of 41 participants with chronic conditions (hypertension, diabetes, stroke and cardiovascular diseases) from four sites (Delhi, Haryana, Vizag and Chennai) in India participated in semistructured interviews. All interviews were audio recorded, transcribed, translated, anonymised and coded using MAXQDA software. We used the framework method to qualitatively analyse the COVID-19 pandemic impacts on health, social and economic well-being.ResultsParticipant experiences during the COVID-19 pandemic were categorised into four themes: challenges faced during the lockdown, experiences of the participants diagnosed with COVID-19, preventive measures taken and lessons learnt during the COVID-19 pandemic. A subgroup of participants faced difficulties in accessing healthcare while a few reported using teleconsultations. Most participants reported adverse economic impact of the pandemic which led to higher reporting of anxiety and stress. Participants who tested COVID-19 positive reported experiencing discrimination and stigma from neighbours. All participants reported taking essential preventive measures.ConclusionPeople with chronic conditions experienced a confluence (reciprocal effect) of COVID-19 pandemic and chronic diseases in the context of difficulty in accessing healthcare, sedentary lifestyle and increased stress and anxiety. Patients’ lived experiences during the pandemic provide important insights to inform effective transition to a mixed realm of online consultations and ‘distanced’ physical clinic visits.

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Dutch Healthcare Professionals Experiences of Assisted Dying: A Constructivist Qualitative Study Conducted in a Chronic Disease Care Centre and Hospice.

10.21203/rs.2.11826/v1 ◽

2019 ◽

Author(s):

Deborah Lewis ◽

Nancy Preston

Keyword(s):

Palliative Care ◽

Chronic Disease ◽

Qualitative Study ◽

Healthcare Professionals ◽

Recovery Period ◽

Well Being ◽

Psychological Support ◽

Assisted Dying ◽

Care Centre ◽

Chronic Disease Care

Abstract Background: Assisted dying is a contemporary issue, but comprehensive consideration of healthcare professionals’ experiences has been lacking. This study sought to gain a deeper understanding of professionals’ experiences of assisted dying to inform the global debate surrounding its implementation. Methods: This constructivist, qualitative study, recruited twenty-one physicians, nurses and therapists from a Dutch chronic disease care centre and a hospice. Data were gathered in semi-structured interviews, conducted in English. Questioning focused on professionals’ experiences along a clinical trajectory from an initial request to beyond the death. Data were subjected to thematic analysis to identify main and subthemes. Results: Analytical procedures generated four broad themes ‘Assessment and its Challenges’, ‘Preparing Staff and Learners’, ‘Assisting a Death’ and ‘Bereavement Care and Beyond’, supported by subthemes. Assessment of requests involved all professional groups and required open dialogue, exploration of fears, palliative care optimisation and psychological evaluation. Such measures resolved the majority of requests. Assisted deaths were challenging, required careful management and were not perceived as normal. Administration of lethal drugs and reporting procedures were stressful for physicians. Structured debriefing and proactive psychological support were valued by all professionals, but resolving their emotions took time. Some physicians required a recovery period creating equity of access issues. Life and care experience aided the preparation of professionals, but resilience was also needed. Support for the provision of assisted dying was overwhelming, but this was unqualified in only a third of participants. Conclusions: Assisted dying creates significant challenges for healthcare professionals who require preparation and support. This is likely to require enhanced levels of palliative care education, legislative advice, and proactive psychological support to ensure professionals’ own well-being. Meeting these needs will have financial implications which should be addressed prior to implementing legislation which permits assisted dying.

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The profile and support needs of parents in paediatric palliative care: comparing cancer and non-cancer groups

Palliative Care and Social Practice ◽

10.1177/2632352420958000 ◽

2020 ◽

Vol 14 ◽

pp. 263235242095800

Author(s):

Samar M. Aoun ◽

Fenella J. Gill ◽

Marianne B. Phillips ◽

Suzanne Momber ◽

Lisa Cuddeford ◽

...

Keyword(s):

Palliative Care ◽

Pilot Study ◽

Health Professionals ◽

Assessment Tool ◽

Well Being ◽

Support Needs ◽

Cancer Group ◽

Paediatric Palliative Care ◽

Palliative Care Services ◽

Almost All

Background: Parents of children with life-limiting illnesses experience considerable burden and distress, yet few interventions have targeted their well-being. Objectives: Evaluate the use and feasibility of the Paediatric Carer Support Needs Assessment Tool (pCSNAT) in assessing and addressing parents’ needs caring for cancer and non-cancer conditions. Carer well-being outcomes were also tested. Methods: A non-randomised prospective intervention pilot study. Twenty-eight parents (out of 42 approached) and 5 health professionals working in paediatric palliative care services in Western Australia (2018–2019) completed the pilot study. Results: Two-thirds of eligible parents completed the study. The highest support needs included having time for yourself; practical help in the home; knowing what to expect in the future; financial, legal or work issues; and knowing who to contact if you are concerned. Almost all needs were considerably more pronounced for the non-cancer group. The pCSNAT seemed feasible and outcomes demonstrated a tendency to improve. Conclusion: Using the pCSNAT provided a concise and comprehensive ‘one stop shop’ for health professionals to evaluate difficulties encountered by parents. The disadvantages reported by the non-cancer group warrant increased attention. Paediatric palliative care should adopt routine assessment of parents’ support needs to anticipate early and tailored supports including partnerships with the community.

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Interpersonal Mindfulness Training for Well-Being: A Pilot Study with Psychology Graduate Students

Teachers College Record ◽

10.1177/016146810911101202 ◽

2009 ◽

Vol 111 (12) ◽

pp. 2760-2774

Author(s):

Jeanette Sawyer Cohen ◽

Lisa J. Miller

Keyword(s):

Mental Health ◽

Pilot Study ◽

Graduate Students ◽

Perceived Stress ◽

Mental Health Professionals ◽

Clinical Psychology ◽

Health Professionals ◽

Well Being ◽

Mindfulness Training ◽

Interpersonal Mindfulness

Background/Context Although mindfulness originated in Eastern meditation traditions, notably Buddhism, researchers, clinicians, and, more recently, educators suggest that the cultivation of mindfulness may be beneficial to Westerners uninterested in adopting Buddhist or other Eastern spiritual traditions. Mindfulness is understood as sets of skills that can be developed with practice and taught independently of spiritual origins as a way of being or relating to present-moment experience. Purpose/Objective/Research Question/Focus of Study This pilot study adds to this literature on mindfulness training for nascent mental health professionals, who may be at risk for occupational stress and burnout. This study aims to (1) expand on preliminary research supporting the helpfulness of mindfulness interventions for graduate students in psychology and (2) investigate the feasibility and helpfulness of a novel adaptation of mindfulness-based stress reduction (MBSR) that emphasizes relational awareness. Population/Participants/Subjects This sample consisted of clinicians-in-training (N = 21) within a graduate department of counseling and clinical psychology at an urban university. All students were in their first or second year of graduate school; 20 participants were enrolled in a psychology master's program, and 1 participant was a doctoral student in clinical psychology. Intervention/Program/Practice The authors investigated a novel 6-week interpersonal mindfulness training (IMT) program modeled after the manualized MBSR intervention, with an added emphasis placed on relational awareness. IMT aims to reduce perceived stress and enhance interpersonal well-being and, as such, may be particularly well-suited for psychotherapy trainees. IMT was integrated into a semester-long graduate course in psychology. Research Design A pre-post design was used to examine outcomes associated with participation in IMT. Findings/Results Results suggest that IMT with psychology graduate students is a feasible intervention that positively affects mindfulness, perceived stress, social connectedness, emotional intelligence, and anxiety. Of special interest are changes in interpersonal well-being that suggest potential benefits for future mental health professionals. Conclusions/Recommendations High attendance rate and positive program evaluations suggest that IMT can be successfully taught within a graduate psychology curriculum. We suggest that mindfulness training may be a useful complement to the standard training of future clinicians.

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