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      Improving the mental health and well-being of healthcare providers using the transcendental meditation technique during the COVID-19 pandemic: A parallel population study

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      Author(s): 1 , 2 , * , , 1 , 1
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      Publication date (Electronic):
      Journal: PLOS ONE
      Publisher: Public Library of Science

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          Abstract

          Introduction

          Frontline Healthcare provider (HCP) burnout has dramatically increased due to the COVID 19 pandemic. Hospitals are supporting wellness programs and techniques to reduce burnout including the Transcendental Meditation (TM) technique. This study evaluated the use of TM on HCP symptoms of stress, burnout and wellness.

          Methods

          A total of 65 HCPs at three South Florida hospitals were recruited and instructed in the TM technique which they practiced at home for 20 minutes twice a day. A parallel lifestyle as usual control group was enrolled. Validated measurement scales (Brief Symptom Inventory 18 (BSI-18), Insomnia Severity Index (ISI), Maslach Burnout Inventory-Human Services Survey [MBI-HSS (MP)] and the Warwick Edinburgh Mental Well Being Scale (WEMWBS) were administered at baseline, 2 weeks, one and three months.

          Results

          No significant demographic differences were seen between the 2 groups; however, some baseline scales were higher in the TM group. TM average weekly session completion rate was very high at 83%. After 2-weeks, symptoms of somatization, depression, and anxiety in the TM group had all shown near 45% reductions, while insomnia, emotional exhaustion, and well-being had improved by 33%, 16%, and 11% respectively (P = 0.02 for somatization and < .001 for all others); no significant change was noted in the LAU group. At 3-months, in the TM group, the improvement in symptoms showed a mean reduction of in anxiety, 62%, somatization, 58%, depression, 50%, insomnia, 44%, emotional exhaustion 40%, depersonalization, 42%, and improvement of well-being 18% (for all p<0.004). P-values for between-group differences in change from baseline, based upon repeated measures ANCOVA covarying for baseline measurements, showed significance for all scales at 3-months.

          Conclusion

          The study confirmed the reported significant and rapid benefits of the practice of TM and demonstrated its positive psychological impact on healthcare workers in a high stress setting.

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          Most cited references35

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          Physician burnout: contributors, consequences and solutions

          C P West, L Dyrbye, T. D. Shanafelt (2018)
          Physician burnout, a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the healthcare workforce, costs and physician health exceed 50% in studies of both physicians-in-training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients and healthcare organizations and systems. Drivers of this epidemic are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work-home conflicts, lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures and leadership culture. Individual physician-level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians. Effective solutions align with these drivers. For example, organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout. Individually focused solutions such as mindfulness-based stress reduction and small-group programmes to promote community, connectedness and meaning have also been shown to be effective. Regardless of the specific approach taken, the problem of physician burnout is best addressed when viewed as a shared responsibility of both healthcare systems and individual physicians. Although our understanding of physician burnout has advanced considerably in recent years, many gaps in our knowledge remain. Longitudinal studies of burnout's effects and the impact of interventions on both burnout and its effects are needed, as are studies of effective solutions implemented in combination. For medicine to fulfil its mission for patients and for public health, all stakeholders in healthcare delivery must work together to develop and implement effective remedies for physician burnout.
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            Estimating the Attributable Cost of Physician Burnout in the United States

            Shasha Han, Tait Shanafelt, Christine Sinsky … (2019)
            Article 0 comments Cited 205 times – based on 0 reviews     Review now
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              Patient compliance with paper and electronic diaries.

              Joan Broderick, Roslyn Stone, Saul Shiffman … (2003)
              Paper diaries are commonly used in health care and clinical research to assess patient experiences. There is concern that patients do not comply with diary protocols, possibly invalidating the benefit of diary data. Compliance with paper diaries was examined with a paper diary and with an electronic diary that incorporated compliance-enhancing features. Participants were chronic pain patients and they were assigned to use either a paper diary instrumented to track diary use or an electronic diary that time-stamped entries. Participants were instructed to make three pain entries per day at predetermined times for 21 consecutive days. Primary outcome measures were reported vs actual compliance with paper diaries and actual compliance with paper diaries (defined by comparing the written times and the electronically-recorded times of diary use). Actual compliance was recorded by the electronic diary. Participants submitted diary cards corresponding to 90% of assigned times (+/-15 min). However, electronic records indicated that actual compliance was only 11%, indicating a high level of faked compliance. On 32% of all study days the paper diary binder was not opened, yet reported compliance for these days exceeded 90%. For the electronic diary, the actual compliance rate was 94%. In summary, participants with chronic pain enrolled in a study for research were not compliant with paper diaries but were compliant with an electronic diary with enhanced compliance features. The findings call into question the use of paper diaries and suggest that electronic diaries with compliance-enhancing features are a more effective way of collecting diary information.
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                Author and article information

                Contributors
                Mark S. Nestor:
                ORCID: https://orcid.org/0000-0002-8978-7932
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Alec Lawson: Role: Data curationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Daniel Fischer: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Vanessa Carels: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS One
                Journal ID (publisher-id): plos
                Title: PLOS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 3 March 2023
                Publication date Collection: 2023
                Publication date PMC-release: 3 March 2023
                Volume: 18
                Issue: 3
                Electronic Location Identifier: e0265046
                Affiliations
                [1 ] Center for Clinical and Cosmetic Research, Aventura, Florida, United States of America
                [2 ] Department of Dermatology and Cutaneous Surgery, Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
                PLoS ONE, UNITED STATES
                Author notes

                Competing Interests: The authors have read the journal’s policy and have the following competing interests: MSN, AL, and DF are paid employees of the Center for Clinical and Cosmetic Research. There are no patents, products in development or marketed products associated with this research to declare.

                Author information
                https://orcid.org/0000-0002-8978-7932
                Article
                Publisher ID: PONE-D-22-04543
                DOI: 10.1371/journal.pone.0265046
                PMC ID: 9983866
                PubMed ID: 36867626
                SO-VID: d84930e9-4a29-451b-8c13-8b00d850dc9c
                Copyright © © 2023 Nestor et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 21 February 2022
                Date accepted : 14 February 2023
                Page count
                Figures: 1, Tables: 5, Pages: 14
                Funding
                Funded by: David Lynch Foundation
                This study was conducted by the authors and the Center for Clinical and Cosmetic Research Pro Bono for the Heal the Healers initiative from the nonprofit David Lynch Foundation. Funding sources included local donations and a grant from the David Lynch Foundation which specifically funded instruction in the Transcendental Meditation Technique and the statistician. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Psychological Stress
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Psychological Stress
                Subject: Social Sciences
                Subject: Psychology
                Subject: Psychological Stress
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Medicine and Health Sciences
                Subject: Medical Conditions
                Subject: Sleep Disorders
                Subject: Dyssomnias
                Subject: Insomnia
                Subject: Medicine and Health Sciences
                Subject: Neurology
                Subject: Sleep Disorders
                Subject: Dyssomnias
                Subject: Insomnia
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Mood Disorders
                Subject: Depression
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Emotions
                Subject: Anxiety
                Subject: Social Sciences
                Subject: Psychology
                Subject: Emotions
                Subject: Anxiety
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Emotions
                Subject: Social Sciences
                Subject: Psychology
                Subject: Emotions
                Subject: People and Places
                Subject: Population Groupings
                Subject: Professions
                Subject: Medical Personnel
                Subject: Medicine and Health Sciences
                Subject: Medical Conditions
                Subject: Infectious Diseases
                Subject: Viral Diseases
                Subject: Covid 19
                Custom metadata
                Data Availability All relevant data are within the manuscript and its Supporting Information files.
                Outbreaks COVID-19

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

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