Personalised yoga for burnout and traumatic stress in junior doctors

2020 ◽  
Vol 96 (1136) ◽  
pp. 349-357
Author(s):  
Jennifer Taylor ◽  
Loyola McLean ◽  
Bethan Richards ◽  
Nicholas Glozier
Keyword(s):  
Traumatic Stress ◽  
Pilot Trial ◽  
Maslach Burnout Inventory ◽  
Self Report ◽  
Junior Doctors ◽  
Group Format ◽  
Group Fitness ◽  
Quality Of Life Scale ◽  
Trauma Informed ◽  
One To One

ObjectivesJunior doctors are frequently exposed to occupational and traumatic stress, sometimes with tragic consequences. Mindfulness-based and fitness interventions are increasingly used to mitigate this, but have not been compared.We conducted a randomised, controlled pilot trial to assess the feasibility, acceptability and effectiveness of these interventions in junior doctors.MethodsWe randomised participants (n=21) to weekly 1-hour sessions of personalised, trauma-informed yoga (n=10), with a 4-hour workshop, and eHealth homework; or group-format fitness (n=8) in an existing wellness programme, MDOK. Burnout, traumatic stress and suicidality were measured at baseline and 8 weeks.ResultsBoth interventions reduced burnout, and yoga increased compassion satisfaction within group on the Professional Quality of Life scale, without difference between groups on this measure.Personalised yoga significantly reduced depersonalisation (z=−1.99, p=0.05) compared with group fitness on the Maslach Burnout Inventory (MBI-HSS (MP)) and showed greater flexibility changes. Both interventions increased MBI Personal Accomplishment, with no changes in other self-report psychological or physiological metrics, including breath-counting.Participants doing one-to-one yoga rated it more highly overall (p=0.02) than group fitness, and reported it comparatively more beneficial for mental (p=0.01) and physical health (p=0.05). Face-to-face weekly sessions were 100% attended in yoga, but only 45% in fitness.ConclusionIn this pilot trial, both yoga and fitness improved burnout, but trauma-informed yoga reduced depersonalisation in junior doctors more than group-format fitness. One-to-one yoga was better adhered than fitness, but was more resource intensive. Junior doctors need larger-scale comparative research of the effectiveness and implementation of individual, organisational and systemic mental health interventions.Trial registration numberANZCTR 12618001467224.

scholarly journals Pilot Trial of a Noninvasive Closed-Loop Neurotechnology for Stress-Related Symptoms in Law Enforcement: Improvements in Self-Reported Symptoms and Autonomic Function

2020 ◽  
Vol 9 ◽  
pp. 216495612092328
Author(s):  
Catherine L Tegeler ◽  
Hossam A Shaltout ◽  
Sung W Lee ◽  
Sean L Simpson ◽  
Lee Gerdes ◽  
...  
Keyword(s):  
Heart Rate ◽  
Law Enforcement ◽  
Real Time ◽  
Traumatic Stress ◽  
Closed Loop ◽  
Autonomic Function ◽  
Randomized Clinical Trials ◽  
Pilot Trial ◽  
Self Report ◽  
Law Enforcement Personnel

Background Law enforcement officers have decreased life expectancy, attributed to work-related exposure to traumatic stress and circadian disruption. Autonomic dysregulation is reported with traumatic stress and chronic insomnia. Objective We explore potential benefits for reduced symptoms related to stress and insomnia and improved autonomic function associated with open label use of high-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM®), in a cohort of sworn law enforcement personnel. Methods Closed-loop noninvasive therapies utilizing real-time monitoring offer a patient-centric approach for brain-based intervention. HIRREM® is a noninvasive, closed-loop, allostatic, neurotechnology that echoes specific brain frequencies in real time as audible tones to support self-optimization of brain rhythms. Self-report symptom inventories done before and after HIRREM included insomnia (ISI), depression (CES-D), traumatic stress (PCL-C), anxiety (GAD-7), perceived stress (PSS), and quality of life (EQ-5D). Ten-minute recordings of heart rate and blood pressure allowed analysis of baroreflex sensitivity (BRS) and heart rate variability (HRV). Results Fifteen participants (1 female), mean (SD) age 45.7 (5.6), received 12.2 (2.7) HIRREM sessions, over 7.9 in-office days. Data were collected at baseline, and at 22.8 (9.2), and 67.2 (14.1) days after intervention. All symptom inventories improved significantly ( P < .01), with durability for 2 months after completion of the intervention. The use of HIRREM was also associated with significant increases ( P < .001) in HRV measured as rMSSD and BRS measured by high-frequency alpha index. There were no serious adverse events or drop outs. Conclusion These pilot data provide the first report of significant symptom reductions, and associated improvement in measures of autonomic cardiovascular regulation, with the use of HIRREM in a cohort of law enforcement personnel. Randomized clinical trials are warranted.

The Evaluation of a Narrative Intervention for Health-Care Professionals in an Urban Oncology Inpatient Unit

2018 ◽  
Vol 2 (2) ◽  
pp. 176-190
Author(s):  
Nicole M. Saint-Louis ◽  
Evan Senreich
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Secondary Traumatic Stress ◽  
Maslach Burnout Inventory ◽  
Care Providers ◽  
Urban Hospitals ◽  
Narrative Intervention ◽  
Quality Of Life Scale

Background:Oncology professionals in fast-paced urban hospitals are at risk for burnout and secondary traumatic stress.Objective:This exploratory study evaluated the effectiveness of a workplace narrative intervention for oncology professionals in regard to reducing burnout and secondary traumatic stress.Methods:Thirty-five oncology health-care providers from three inpatient oncology units within an urban medical center completed the Professional Quality of Life Scale and the Maslach Burnout Inventory-Human Services Survey before and after four monthly group narrative oncology interventions during the work day.Findings:Findings lend tentative support to the effectiveness of this intervention in reducing different aspects of burnout and secondary traumatic stress.Conclusions:Oncology social workers are in a prime position to take a leadership role in instituting such interventions in urban hospitals.

The Traumatic Stress Institute Belief Scale as a Measure of Vicarious Trauma in a National Sample of Clinical Social Workers

2001 ◽  
Vol 82 (4) ◽  
pp. 363-371 ◽  
Author(s):  
Kathryn Betts Adams ◽  
Holly C. Matto ◽  
Donna Harrington
Keyword(s):  
Social Workers ◽  
Traumatic Stress ◽  
Vicarious Trauma ◽  
Discriminant Validity ◽  
Maslach Burnout Inventory ◽  
National Sample ◽  
Self Report ◽  
Traumatic Experience ◽  
Clinical Social Workers ◽  
Belief Scale

This article reports on a study of convergent and discriminant validity of the Traumatic Stress Institute Belief Scale (TSI)–Revision L (Traumatic Stress Institute, 1994) as a measure of vicarious trauma in a random sample of master's level clinical social workers. Forty-nine items from six subscales of the TSI were used. The scale purports to measure disturbed beliefs that may be caused by direct traumatic experience or repeated exposure to details of clients' traumatic stories. Results of correlational analyses of the TSI score with study variables and exploratory multiple regression analysis on the TSI score indicate its association with younger age, more reported somatic symptoms, lower annual salaries, lower scores on the Perceived Social Support (PSS)–Friends subscale (Procidano & Heller, 1983) and greater burnout as measured by the Maslach Burnout Inventory (Maslach & Jackson, 1986). TSI scores were not associated with social workers' personal trauma history, their reported weekly amount of face-to-face client contact, or a self-report of the level of intrusiveness of client material into the social workers' lives. TSI scores appear to be measuring perceptions about self and work that, like burnout, may relate to social workers' general outlook, not necessarily to the effects of traumatic stress, vicarious or otherwise. Significant overlap of the TSI with burnout scores in this social work sample suggests a lack of clear distinction between burnout and vicarious trauma.

Development of the Shift Smartphone App to Support the Emotional Wellbeing of Junior Doctors: Design of a Prototype and Results of Usability and Acceptability Testing (Preprint)

2020 ◽  
Author(s):  
Isabelle Counson ◽  
Alexandra Bartholomew ◽  
Joanna Crawford ◽  
Katherine Petrie ◽  
Geetanjali Basarkod ◽  
...  
Keyword(s):  
Mental Health ◽  
User Experience ◽  
Help Seeking ◽  
Pilot Trial ◽  
User Involvement ◽  
Health Behaviours ◽  
Junior Doctors ◽  
User Centered Design ◽  
Emotional Wellbeing ◽  
Prototype Development

BACKGROUND Junior doctors report higher levels of psychological distress than more senior doctors and report several barriers to seeking professional mental health support, including concerns about confidentiality and career progression. Mobile health applications (mHealth apps) may be utilised to help overcome these barriers to assist the emotional wellbeing of this population and encourage help-seeking. OBJECTIVE We describe the development and pilot trial of the Shift mHealth app to provide an unobtrusive avenue for junior doctors to seek information about, and help for, wellbeing and mental health concerns that is sensitive to workplace settings. METHODS A 4-phase iterative development process was undertaken to create the content and features of Shift involving junior doctors, using principles of user-centered design. These four phases were: I) Needs assessment, based on interviews with 12 junior doctors; II) Prototype development with user experience feedback from two junior doctors; III) Evaluation, consisting of a pilot trial with 22 junior doctors to assess usability and acceptability of the initial prototype; and IV) Redesign, including user experience workshops with 51 junior doctors. RESULTS Qualitative results informed the content and design of Shift to ensure the app was tailored to junior doctors’ needs. The Shift app prototype contained cognitive-behavioural, mindfulness, value-based actions, and psychoeducational modules, as well as a tracking function visualising patterns of daily variations in mood and health behaviours. Pilot testing revealed possible issues with the organisation of the app content, which were addressed in a thorough restructuring and redesign of Shift with the help of junior doctors across three user experience workshops. CONCLUSIONS The current research demonstrates the importance of ongoing end-user involvement in the creation of a specialised mHealth app for a unique working population experiencing profession-specific stressors and barriers to help-seeking. The development and pilot trial of this novel Shift mHealth app are first steps in addressing the mental health and support-seeking needs of junior doctors, although further research is required to validate its effectiveness and appropriateness on a larger scale.

scholarly journals Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students’ Burnout and Mental Health

2021 ◽  
Vol 18 (1) ◽  
pp. 349
Author(s):  
Panagiotis Zis ◽  
Artemios Artemiadis ◽  
Panagiotis Bargiotas ◽  
Antonios Nteveros ◽  
Georgios M. Hadjigeorgiou
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Emotional Exhaustion ◽  
Short Form ◽  
Maslach Burnout Inventory ◽  
Junior Doctors ◽  
Digital Learning ◽  
Student Survey ◽  
Medical Studies ◽  
The Impact

Objectives: The aim of this ecological study was to investigate what the impact of digital learning due to the COVID-19 pandemic was on the burnout and overall mental health (MH) of medical students. Background: During the unprecedented era of the COVID-19 pandemic, the majority of countries worldwide adopted very strong measures. Universities closed their doors, and education continued through digital learning lectures. Methods: An anonymous questionnaire was administered to all 189 eligible candidates before and during the COVID-19 pandemic. Mental health was assessed via the MH domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory—Student Survey (MBI-SS). Results: The overall response rate was 81.5%. The overall burnout prevalence did not differ significantly between the two periods (pre-COVID-19 18.1% vs. COVID-19 18.2%). However, the burnout prevalence dropped significantly in year 4 (pre-COVID-19 40.7% vs. COVID-19 16.7%, p = 0.011), whereas it increased significantly in year 6 (pre-COVID-19 27.6% vs. COVID-19 50%, p = 0.01). When looking at each MBI-SS dimension separately, we found that emotional exhaustion decreased significantly in year 4 but increased in year 6, and cynicism increased in all years. The overall MH deteriorated significantly between the two periods (pre-COVID-19 58.8 ± 21.6 vs. COVID-19 48.3 ± 23, p < 0.001). Conclusions: Digital learning in medical studies carries significant risks. Not only does the MH deteriorate, but cynicism levels also increase. Emotional exhaustion was found to increase particularly in final year students, who struggle with the lack of clinical experience just before they start working as qualified junior doctors.

Trauma-Informed Spiritual Care: Lifelines for a Healing Journey

2021 ◽  
Vol 77 (4) ◽  
pp. 359-371
Author(s):  
Deborah van Deusen Hunsinger
Keyword(s):  
Lived Experience ◽  
Traumatic Stress ◽  
Spiritual Care ◽  
Collective Trauma ◽  
Severe Stress ◽  
Healing Journey ◽  
Trauma Informed ◽  
The Church

The article describes how primary, secondary, intergenerational and collective trauma are intertwined in our lived experience, especially in times of severe stress, such as the current coronavirus pandemic. An argument is made for personal and collective mourning, and for developing an attitude of curiosity, openness, acceptance, and love toward oneself and others who suffer traumatic stress. The foundational lifeline of trust in God is nurtured by the faith and practice of the church through the witness of Scripture, worship, prayer, song, and mutual caring.

Post-traumatic Stress and Subthreshold Autism Spectrum Among Divers of the Italian Navy Employed in Search and Rescue Activities

2017 ◽  
Vol 41 (S1) ◽  
pp. S722-S722
Author(s):  
C. Carmassi ◽  
P. Isabella ◽  
C.A. Bertelloni ◽  
M. Corsi ◽  
G. Massimetti ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Traumatic Stress ◽  
Autism Spectrum ◽  
Social Impairment ◽  
Self Report ◽  
Risk And Resilience ◽  
Post Traumatic Stress ◽  
Rescue Operation ◽  
Autism Symptomatology ◽  
Post Traumatic

IntroductionRescue emergency personnel is at high risk to develop PTSD due to possible extreme and repetitive exposition to “cruel details of traumatic events”.ObjectiveThis study aimed to explore posttraumatic stress and subthreshold autism symptomatology and their impact on social and working functioning level among sub mariner of Italian Navy, who were employed in the Costa Concordia and Genova tower rescue operation.MethodsEighty-five subjects were enrolled and investigated by the following instruments: Trauma and Loss Spectrum Self-Report (TALS-SR), Adult Autism Subthreshold Spectrum (AdAS Spectrum) and Work and Social Adjustment Scale (WSAS).ResultsThe response rate was about 50%. Ninety-five percent of the subjects were employed in recovering corpses and 80% reported at least one rescue operation in the last three years. Full and partial DSM-5 PTSD rates were 8% and 27.5%, respectively. A strong correlation emerged between several TALS-SR and ADAS domain. Furthermore, TALS-SR domain scores were related to WSAS domain.ConclusionThis data showed rescue personnel to be at risk for post-traumatic stress spectrum and related work and social impairment. Further studies are needed to better investigate possible risk and resilience factors associated to PTSD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Investigating Race-related Stress, Burnout, and Secondary Traumatic Stress for Black Mental Health Therapists

2021 ◽  
pp. 009579842110339
Author(s):  
E Mackenzie Shell ◽  
Daniel Teodorescu ◽  
Lauren D. Williams
Keyword(s):  
Mental Health ◽  
Traumatic Stress ◽  
Secondary Traumatic Stress ◽  
Demographic Variables ◽  
Future Research ◽  
Mental Health Therapists ◽  
Quality Of Life Scale ◽  
Related Stress ◽  
Race Related Stress ◽  
Black Mental Health

The present study examines the relationships among burnout, secondary traumatic stress (STS), and race-related stress among a national sample of 250 Black mental health therapists (counselors, social workers, psychologists, and marriage and family therapists). We investigated the predictive nature of the three subscales (Individual Racism, Cultural Racism, and Institutional Racism) of the Index of Race-Related Stress–Brief Version (IRRS-B) and selected demographic variables on therapists’ reports of burnout and STS assessed on the Professional Quality of Life Scale–Version 5 (ProQOL-5). All three forms of race-related stress significantly predicted both burnout and STS for Black mental health therapists. Of the demographic variables, hours worked per week significantly predicted burnout and STS. Additionally, highest degree obtained significantly predicted STS for Black mental health therapists. The utility of these findings in understanding the connections among race-related stress, burnout, and STS are discussed as well as directions for future research.

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