Effect of leader mindfulness on hindrance stress in nurses: The social mindfulness information processing path

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J Adv Nurs. 2021 Jul 6.

Abstract

Aim: This study aimed to explore the influence of leader mindfulness on hindrance stress in nurses. Based on the social mindfulness framework, the mediating effects of nurses’ perceptions of their leaders’ perspective taking and empathic concern and how they are moderated by mindfulness of nurses were investigated.

Design: A time-lagged cross-sectional survey was conducted.

Methods: The convenience sampling method was adopted. Data were collected at three time points from January to September 2020. A total of 393 paired datasets of nurses and their leaders were collected from 28 Chinese 3A grade hospitals. SPSS 23.0 and AMOS 23.0 were used for data analysis and hypotheses testing.

Results: (1) Leader mindfulness significantly reduced nurse hindrance stress. (2) Both nurses’ perceptions of their leaders’ perspective taking and empathic concern mediated the relationship between leader mindfulness and nurse hindrance stress. Empathic concern was more effective than perspective taking in the process of leader mindfulness for reducing nurse hindrance stress. Nurses’ perceptions of their leaders’ perspective taking completely mediated the relationship between empathic concern and nurse hindrance stress. (3) Nurse mindfulness moderated the relationship between leader mindfulness and nurses’ perceptions of their leaders’ empathic concern but had no significant effect on the relationship between leader mindfulness and nurses’ perceptions of their leaders’ perspective taking.

Conclusion: Leader mindfulness was an important interpersonal factor for reducing nurse hindrance stress. Nurses’ perceptions of their leaders’ perspective taking and empathic concern were pivotal mechanisms underlying the effectiveness of leader mindfulness. Nurse mindfulness is a situational factor that contributes to the effectiveness of leader mindfulness.

Impact: Hospitals can benefit from mindfulness interventions by improving the mindfulness of leaders and nurses. Nurse managers are encouraged to promote social mindfulness, which will enable perspective taking and empathic concern by nurses and thus reduce hindrance stress on nurses during the pandemic.

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Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial

BMJ Support Palliat Care. 2021 Jul 8;bmjspcare-2021-003068.

Abstract

Context: Numerous studies have shown that gratitude can reduce stress and improve quality of life.

Objective: Our study aimed to examine the effect of mindful gratitude journaling on suffering, psychological distress and quality of life of patients with advanced cancer.

Methods: We conducted a parallel-group, blinded, randomised controlled trial at the University of Malaya Medical Centre, Malaysia. Ninety-two adult patients with advanced cancer, and an overall suffering score ≥4/10 based on the Suffering Pictogram were recruited and randomly assigned to either a mindful gratitude journaling group (N=49) or a routine journaling group (N=43).

Results: After 1 week, there were significant reductions in the overall suffering score from the baseline in both the intervention group (mean difference in overall suffering score=-2.0, 95% CI=-2.7 to -1.4, t=-6.125, p=0.000) and the control group (mean difference in overall suffering score=-1.6, 95% CI=-2.3 to -0.8, t=-4.106, p=0.037). There were also significant improvements in the total Hospital Anxiety and Depression Scale score (mean difference=-3.4, 95% CI=-5.3 to -1.5, t=-3.525, p=0.000) and the total Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being score (mean difference=7.3, 95% CI=1.5 to 13.1, t=2.460, p=0.014) in the intervention group after 7 days, but not in the control group.

Conclusion: The results provide evidence that 7 days of mindful gratitude journaling could positively affect the state of suffering, psychological distress and quality of life of patients with advanced cancer.

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Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: A randomized controlled trial comparing mindfulness-based childbirth and parenting with enhanced care as usual

Birth. 2021 Jul 11.

Abstract

Objective: To investigate whether mindfulness-based childbirth and parenting (MBCP) or enhanced care as usual (ECAU) for expectant couples decreases fear of childbirth (FOC) and nonurgent obstetric interventions during labor and improves newborn outcomes.

Design: Randomized controlled trial.

Setting: Midwifery settings, the Netherlands, April 2014-July 2017.

Population: Pregnant women with high FOC (n = 141) and partners.

Methods: Allocation to MBCP or ECAU. Hierarchical multilevel and intention-to-treat (ITT) and per-protocol (PP) analyses.

Main outcome measures: Primary: pre-/postintervention FOC, labor anxiety disorder, labor pain (catastrophizing and acceptance), and preferences for nonurgent obstetric interventions. Secondary: rates of epidural analgesia (EA), self-requested cesarean birth (sCB), unmedicated childbirth, and 1- and 5-minute newborn’s Apgar scores.

Results: MBCP was significantly superior to ECAU in decreasing FOC, catastrophizing of labor pain, preference for nonurgent obstetric interventions, and increasing acceptance of labor pain. MBCP participants were 36% less likely to undergo EA (RR 0.64, 95% CI [0.43-0.96]), 51% less likely to undergo sCB (RR 0.49, 95% CI [0.36-0.67]), and twice as likely to have unmedicated childbirth relative to ECAU (RR 2.00, 95% CI [1.23-3.20]). Newborn’s 1-minute Apgar scores were higher in MBCP (DM -0.39, 95% CI [-0.74 to -0.03]). After correction for multiple testing, results remained significant in ITT and PP analyses, except EA in ITT analyses and 1-minute Apgar.

Conclusions: MBCP for pregnant couples reduces mothers’ fear of childbirth, nonurgent obstetric interventions during childbirth and may improve childbirth outcomes. MBCP adapted for pregnant women with high FOC and their partners appears an acceptable and effective intervention for midwifery care.

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A mindfulness-based mobile health (mHealth) intervention among psychologically distressed university students in quarantine during the COVID-19 pandemic: A randomized controlled trial

J Couns Psychol. 2021 Jul 15.

Abstract

This randomized controlled trial evaluated the effect of a mindfulness-based mobile health (mHealth) intervention, tailored to the pandemic context, among young adult students (N = 114) with elevated anxiety and/or depressive symptoms during quarantine in China, compared to a time- and attention-matched social support-based mHealth control. At baseline, postintervention (1 month), and 2-month follow-up, participants completed self-reports of primary outcomes (anxiety and depression), secondary outcomes (mindfulness and social support), and emotional suppression as a culturally relevant mechanism of change. Feasibility and acceptability were also evaluated. Using intent-to-treat (ITT) analysis, linear mixed effects models showed that compared to social support mHealth, mindfulness mHealth had a superior effect on anxiety (p = .024, between-group d = 0.72). Both conditions improved on depression (baseline-to-FU ds > 1.10, between-group difference not significant, d = 0.36 favoring mindfulness). There was an interaction of Emotional suppression reduction × Condition in the improvement of anxiety and depression. Further, mindfulness mHealth was demonstrated to be more feasible and acceptable in program engagement, evaluation, skills improvement, and perceived benefit. Retention was high in both conditions (>80%). The difference in self-reported adverse effect was nonsignificant (3.9% in mindfulness and 8.7% in social support). Results of this pilot trial suggest that both mindfulness and social support, delivered via mHealth, show promise in reducing distress among young adults in quarantine, with mindfulness being particularly effective in addressing anxiety. Successful implementation and dissemination of this mHealth intervention approach have the potential for addressing the psychological consequences of the pandemic. 

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Prenatal stress self-help mindfulness intervention via social media: a randomized controlled trial

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J Ment Health. 2021 Jul 15;1-10.

Abstract

Background: Prenatal stress is a pressing issue. However, there is a lack of robust evidence for psychosocial interventions to manage this problem.

Aims: This study aimed to examine the effectiveness of a mindfulness-based intervention on reducing prenatal stress compared to participation in health education groups.

Methods: A randomized controlled trial was conducted in a prenatal clinic of comprehensive tertiary care from April to October 2017. A total of 108 pregnant women were randomly assigned to an intervention or a control group. Participants completed self-report measures of depression, anxiety, perceived stress, fatigue, positive and negative affect, and mindfulness before, immediately after, and 15weeks after the 4-week intervention period. Generalized estimating equations were used to analyze the intervention outcomes.

Results: The results supported greater improvement in terms of perceived stress (Wald χ²=26.94, p<0.001), fatigue (Wald χ²=17.61, p<0.001), positive affect (Wald χ²=9.03, p = 0.011), negative affect (Wald χ²=11.37, p = 0.003), and mindfulness (Wald χ²=24.97, p<0.001) in the intervention group than in the control group.

Conclusions: The self-help mindfulness intervention decreased prenatal stress and negative affect and improved positive affect and mindfulness.

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An ongoing process of reconnection: A qualitative exploration of mindfulness-based cognitive therapy for adults in remission from depression

Psychol Psychother. 2021 Jul 17.

Abstract

Objectives: Mindfulness-based cognitive therapy (MBCT) is an 8-week relapse-prevention intervention designed for people who have experienced multiple episodes of depression and remain vulnerable to relapse. Previous qualitative explorations of the effects of MBCT for people in remission from depression have suggested a number of themes regarding changes arising from participating in MBCT ranging from awareness, agency, perspective, group processes, self-related change, and new ways of understanding depression. We aimed to qualitatively explore how participants in remission from depression experienced MBCT both post-MBCT and during a follow-up period.

Methods: In a preference-choice trial design, 35 participants took part in qualitative interviews and assessments post-MBCT and at three time points during a 12-month follow-up. Data were analysed using reflexive thematic analysis.

Results: Two overarching themes were developed as follows: (1) ‘reconnection with experience, self, and others’ and (2) ‘acknowledging an ongoing process of change’. In theme one, sub-themes captured participants’ experiences of increasing levels of awareness of their experience (e.g., thoughts, emotions, sensations, and present moment) from which they described changes in their relationship with experience describing increases in control, choice, acceptance, and calm. Participants described shifts towards reconnection with aspects of the self and relationships with others. In theme two, sub-themes reflected participants’ conflict between avoidance and engagement in mindfulness practices, and the recognition of the gradual change following MBCT and long-term investment needed in mindfulness practices.

Conclusions: Our findings have clinical implications in terms of facilitating MBCT and point to important themes around recognizing the ongoing process of reconnection with experiences, self, and others.

Practitioner points: Participants with histories of depression may have experienced disconnection and isolation from internal experiences (e.g., thoughts and emotions), self, and others; MBCT encourages a deliberate shift towards reconnection with these experiences. Practitioners could encourage more psychoeducation and discussions around depression during MBCT to encourage reflections on the process of reconnection. Practitioners should maintain an awareness of the ongoing, gradual processes of change and potential for conflict experienced during MBCT Practitioners could provide a stronger emphasis on building awareness of body sensations during MBCT, with suggestions provided in the discussion section.

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Stroke survivors’ expectations and post-intervention perceptions of mindfulness training: A qualitative study

Neuropsychol Rehabil. 2021 Jul 19;1-23.

Abstract

Depression and anxiety are common sequelae of stroke, occurring in at least one-third of patients. This study evaluated the acceptability and feasibility of providing mindfulness training (MT) to stroke survivors with the aim of reducing depression and anxiety. Following a six-week one-on-one MT course, 17 participants were interviewed. The median age of participants was 71, and 10 participants were male. This paper focuses on participants’ expectations of the MT and their views about its impact on their everyday lives. Conventional content analysis was used for coding and analysis. A single theme, Seizing rehabilitation opportunities, was captured in relation to expectations of MT, and four themes provided information relating to participants’ perceived impact of the course: Calming the mind, Reduced reactivity, Remedying physical symptoms, and Not quite there yet.Most participants knew little about mindfulness before the MT and did not have specific goals in mind when volunteering to take part. The findings suggest that most participants considered MT beneficial through reducing stress and giving them additional skills to cope with their everyday lives. A tailored mindfulness intervention may be a useful adjunct to other rehabilitation therapies for stroke survivors.

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New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-analysis of Randomized Controlled Trials

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JMIR Ment Health. 2021 Jul 19;8(7):e28168.

Abstract

Background: There is a need to regularly update the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing.

Objective: This study presents an updated meta-analysis of randomized controlled trials assessing the effects of online MBIs on mental health and the potential moderators of these effects.

Methods: We conducted a systematic literature search in PsycINFO, PubMed, and Web of Science up to December 4, 2020, and included 97 trials, totaling 125 comparisons. Pre-to-post and pre-to-follow-up between-group effect sizes (Hedges g) were calculated for depression, anxiety, stress, well-being, and mindfulness using a random effects model.

Results: The findings revealed statistically significant moderate pre-to-post effects on depression (g=0.34, 95% CI 0.18-0.50; P<.001), stress (g=0.44, 95% CI 0.32-0.55; P<.001), and mindfulness (g=0.40, 95% CI 0.30-0.50; P<.001) and small effects on anxiety (g=0.26, 95% CI 0.18-0.33; P<.001). For well-being, a significant small effect was found only when omitting outliers (g=0.22, 95% CI 0.15-0.29; P<.001) or low-quality studies (g=0.26, 95% CI 0.12-0.41; P<.001). Significant but small follow-up effects were found for depression (g=0.25, 95% CI 0.12-0.38) and anxiety (g=0.23, 95% CI 0.13-0.32). Subgroup analyses revealed that online MBIs resulted in higher effect sizes for stress when offered with guidance. In terms of stress and mindfulness, studies that used inactive control conditions yielded larger effects. For anxiety, populations with psychological symptoms had higher effect sizes. Adherence rates for the interventions ranged from 35% to 92%, but most studies lacked clear definitions or cut-offs.

Conclusions: Our findings not only demonstrate that online MBIs are booming but also corroborate previous findings that online MBIs are beneficial for improving mental health outcomes in a broad range of populations. To advance the field of online MBIs, future trials should pay specific attention to methodological quality, adherence, and long-term follow-up measurements.

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