Self-care

What can I do?

Impact
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Quality
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  1. Encourage students to engage  in mindfulness strategies to reduce their stress, anxiety and the potential for burnout [1, 3]
  2. Mindfulness retreats may be particularly effective for improving self-compassion [2]

What is this about?

Mindfulness has been defined as:

“the awareness that emerges through paying attention on purpose, in the present moments, and nonjudgmentally, to things as they are” (1, p. 1916)

Mindfulness and meditation strategies are where:

“participants learn to be purposively alert and attentive to the present moment and to self-observe in an objective and detached manner” (2, p. 29)

What's the evidence say?

Mindfulness-based interventions for health care professionals and trainees have a moderate effect on anxiety, depression, psychological distress and stress ➕➕➕➕ [1]. Other evidence has shown that mindfulness-based interventions have a moderate effect on self-compassion ➕➕➕ [2] where interventions with a retreat component have a larger effect. Mindfulness-based interventions have also been shown to be moderately effective at reducing subjective stress in healthcare students, both in the short-term and long-term (6 months) ➕➕➕ [3].

What's the underlying theory?

Relational Frame Theory (RFT) suggests that mindfulness can be useful for students when on placement in stressful healthcare settings because it can help them to develop more flexible and adaptive responses to challenging situations. According to RFT, mindfulness involves a shift in perspective from an evaluative or reactive mode to a more open and accepting mode. This shift can help students to more effectively process and respond to challenging situations, and to avoid getting stuck in unhelpful or rigid patterns of thought and behaviour. For example, mindfulness can help students to more effectively regulate their emotions and reactions, to be more present and aware in their interactions with patients and colleagues, and to be more open and receptive to new ideas and perspectives.

Where does the evidence come from?

This evidence summary is based on three meta-analyses. The first [1] explored the effect of mindfulness training for healthcare professionals and trainees on a range of wellbeing outcomes. All 38 studies included in this paper were randomised controlled trials and represented healthcare professionals and trainees from a range of professions. The risk of publication bias was low (732 studies with contrary findings would be needed to overturn their conclusions). The only issue was the significant heterogeneity statistic in relation to the effect on stress and anxiety ➕➕➕➕. The second study [2] explored the effect of mindfulness-based interventions on self-compassion in healthcare professionals. Only one-third of the included 27 studies were randomised controlled trials yet included a broad range of professions. There was very little risk of publication bias influencing the results and the heterogeneity score was low (I2 = 28.3%)  ➕➕➕➕. The third study [3] focused on the effect of mindfulness-based interventions in reducing stress in medical students. Six studies were included, all randomised controlled trials, representing a range of healthcare students. The authors reported concerns relating to publication bias due to no blinding of the interventions or outcomes assessed yet the heterogeneity score was moderate (I2 = 45%) ➕➕➕.

References

  1. Spinelli, C., Wisener, M., & Khoury, B. (2019). Mindfulness training for healthcare professionals and trainees: A meta-analysis of randomized controlled trials. Journal of Psychosomatic Research, 120, 29-38. https://doi.org/https://doi.org/10.1016/j.jpsychores.2019.03.003
  2. Wasson, R. S., Barratt, C., & O’Brien, W. H. (2020). Effects of mindfulness-based interventions on self-compassion in health care professionals: a meta-analysis. Mindfulness, 11(8), 1914-1934. https://doi.org/10.1007/s12671-020-01342-5
  3. Hathaisaard, C., Wannarit, K., & Pattanaseri, K. (2022). Mindfulness-based interventions reducing and preventing stress and burnout in medical students: A systematic review and meta-analysis. Asian Journal of Psychiatry, 69, 102997. https://doi.org/https://doi.org/10.1016/j.ajp.2021.102997

Additional Resources

Here’s a LINK to a free mindfulness app specifically designed by busy healthcare professionals for busy healthcare professionals