Top

Gepubliceerd in:

15-06-2017 | ORIGINAL PAPER

Impact of a Blended Web-Based Mindfulness Programme for General Practitioners: a Pilot Study

Auteurs: Jesus Montero-Marin, Jorge Gaete, Ricardo Araya, Marcelo Demarzo, Rick Manzanera, Melchor Álvarez de Mon, Javier García-Campayo

Gepubliceerd in: Mindfulness | Uitgave 1/2018

Abstract

General practitioners (GPs) report high levels of distress. This study examined whether a brief blended web-based mindfulness intervention could be effective at enhancing well-being for GPs and assessed the possible mediating role of awareness. An open uncontrolled trial, with pre-post measurements, was conducted. The programme comprised one face-to-face meeting (4 h) and eight online practice sessions with no support (two weekly sessions over 4 weeks). The primary outcome was positive affect (PANAS-positive). The secondary outcomes were as follows: negative affect (PANAS-negative), awareness (MAAS), resilience (CDRISC), and the burnout subtypes (BCSQ-12). Mixed-effects analysis for repeated measures and mediation analysis by regression models were performed. Two hundred ninety Spanish GPs took part in the study, attending the face-to-face meeting. Nearly one out 10 participants (n = 28) completed ‘one weekly practice’, and 10.4% (n = 30) accomplished ‘two or more weekly practices’. There were benefits for those with ‘two or more weekly practices’ in PANAS-positive (B = 2.97; p = 0.007), and MAAS (B = 4.65; p = 0.023). We found no benefits for those with ‘one weekly practice’ in any of the outcomes. There were mediating effects of MAAS in PANAS-positive (explaining a 60.8% of total effects). A brief blended mindfulness intervention, with minimum face-to-face contact and web-based practice sessions, seems to confer improvements in the well-being of Spanish GPs. The benefits may be mediated by awareness. The implementation of this kind of programme might enhance the well-being among GPs, but there is a need to improve adherence to practice. Further research using randomized controlled designs will be needed to support the evidence found in our study.

vorige artikel Impact of Mindfulness-Based Teacher Training on MBSR Participant Well-Being Outcomes and Course Satisfaction

volgende artikel Trait Mindfulness Moderates the Relationship Between Early Maladaptive Schemas and Depressive Symptoms

Alda, M., Puebla-Guedea, M., Rodero, B., Demarzo, M., Montero-Marin, J., Roca, M., et al. (2016). Zen meditation, length of telomeres, and the role of experiential avoidance and compassion. Mindfulness, 7, 651–659.

Al-Sareai, N. S., Al-Khaldi, Y. M., Mostafa, O. A., & Abdel-Fattah, M. M. (2013). Magnitude and risk factors for burnout among primary health care physicians in Asir Province, Saudi Arabia. Eastern Mediterranean Health Journal, 19(5), 426–434.PubMed

Atanes, A. C., Andreoni, S., Hirayama, M. S., Montero-Marin, J., Barros, V. V., Ronzani, T. M., et al. (2015). Mindfulness, perceived stress, and subjective well-being: a correlational study in primary care health professionals. BMC Complementary and Alternative Medicine, 15, 303.CrossRefPubMedPubMedCentral

Back, A. L., Steinhauser, K. E., Kamal, A. H., & Jackson, V. A. (2016). Building resilience for palliative care clinicians: an approach to burnout prevention based on individual skills and workplace factors. Journal of Pain and Symptom Management, 52(2), 284–291.CrossRefPubMed

Baer, R. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.

Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.CrossRefPubMed

Bakker, J. M., Lieverse, R., Menne-Lothmann, C., Viechtbauer, W., Pishva, E., Kenis, G., et al. (2014). Therapygenetics in mindfulness-based cognitive therapy: do genes have an impact on therapy-induced change in real-life positive affective experiences? Translational Psychiatry, 4, e384.CrossRefPubMedPubMedCentral

Bell, M. L., Kenward, M. G., Fairclough, D. L., & Horton, N. J. (2013). Differential dropout and bias in randomized controlled trials: when it matters and when it may not. BMJ, 346, e8668.CrossRefPubMedPubMedCentral

Berger, T., Hämmerli, K., Gubser, N., Andersson, G., & Caspar, F. (2011). Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help. Cognitive Behaviour Therapy, 40(4), 251–266.CrossRefPubMed

Bernstein, A., Hadash, Y., Lichtash, Y., Tanay, G., Shepherd, K., & Fresco, D. M. (2015). Decentering and related constructs: a critical review and metacognitive processes model. Perspectives on Psychological Science, 10(5), 599–617.CrossRefPubMedPubMedCentral

Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.

Bogosian, A., Hughes, A., Norton, S., Silber, E., Moss-Morris, R. (2016). Potential treatment mechanisms in a mindfulness-based intervention for people with progressive multiple sclerosis. British Journal of Health Psychology, 21(4), 859–880.

Brown, K., & Ryan, R. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.CrossRefPubMed

Byrne, E., Donaldson, L., Manda-Taylor, L., Brugha, R., Matthews, A., MacDonalds, S., et al. (2016). The use of technology enhanced learning in health research capacity development: lessons from a cross country research partnership. Globalization and Health, 12:19.

Campbell-Sills, L., & Stein, M. (2007). Psychometric analysis and refinement of the Connor-Davidson Resilience Scale (CD-RISC): validation of a 10-item measure of resilience. Journal of Traumatic Stress, 20, 1019–1028.CrossRefPubMed

Carmody, J. (2009). Evolving conceptions of mindfulness in clinical settings. Journal of Cognitive Psychotherapy, 23(3), 270–280.CrossRef

Cebolla, A., Garcia-Campayo, J., & Demarzo, M. (2014). Mindfulness y ciencia: de la tradición a la modernidad. Madrid: Alianza Editorial.

Christensen, H., Griffiths, K., & Farrer, L. (2009). Adherence in internet interventions for anxiety and depression. Journal of Medical Internet Research, 11(2), e13.CrossRefPubMedPubMedCentral

Cohn, M. A., Fredrickson, B. L., Brown, S. L., Mikels, J. A., & Conway, A. M. (2011). Happiness unpacked: positive emotions increase life satisfaction by Buiding resilience. Emotion, 9(3), 361–368.CrossRef

National Research Council (US) Panel on Handling Missing Data in Clinical Trials (2010). The prevention and treatment of missing data in clinical trials. Whashington, DC: National Academies Press (US).

Cramer, H., Hall, H., Leach, M., Frawley, J., Shang, Y., Leung, B., et al. (2016). Prevalence, patterns, and predictors of meditation use among US adults: a national representative survey. Scientific Reports, 6, 36760.CrossRefPubMedPubMedCentral

Cullen, M. (2011). Mindfulness-based interventions: an emerging phenomenon. Mindfulness, 2(3), 186–193.CrossRef

Demarzo, M., Montero-Marin, J., Cuijpers, P., Zabaleta-del-Olmo, E., Mahtani, K. R., Vellinga, A., et al. (2015a). The efficacy of mindfulness-based interventions in primary care: a meta-analytic review. Annals of Family Medicine, 13(6), 573–582.CrossRefPubMedPubMedCentral

Demarzo, M., Cebolla, A., & Garcia-Campayo, J. (2015b). The implementation of mindfulness in healthcare systems: a theoretical analysis. General Hospital Psychiatry, 37(2), 166–171.

Dolan, E. D., Mohr, D., Lempa, M., Joos, S., Fihn, S. D., Nelson, K. M., et al. (2014). Using a single item to measure Burnout in primary care staff: a psychometric evaluation. Journal of General Internal Medicine, 30(5), 582–587.CrossRefPubMedPubMedCentral

Dowd, H., Hogan, M. J., McGuire, B. E., Davis, M. C., Sarma, K. M., Fish, R. A., et al. (2015). Comparison of an online mindfulness-based cognitive therapy intervention with online pain management psychoeducation: a randomized controlled study. The Clinical Journal of Pain, 31(6), 517–527.CrossRefPubMed

Egbewale, B. E., Lewis, M., & Sim, J. (2014). Bias, precision and statistical power of analysis of covariance in the analysis of randomized trials with baseline imbalance: a simulation study. BMC Medical Research Methodology, 14, 49.CrossRefPubMedPubMedCentral

Farb, N., Anderson, A., & Segal, Z. (2012). The mindful brain and emotion regulation in mood disorders. Canadian Journal of Psychiatry, 57(2), 70–77.CrossRefPubMedPubMedCentral

Feise, R. J. (2002). Do multiple outcome measures require p-value adjustment? BMC Medical Research Methodology, 2, 8.CrossRefPubMedPubMedCentral

Fortney, L., Luchterhand, C., Zakletskaia, L., Zgierska, A., & Rakel, D. (2013). Abbreviated mindfulness intervention, quality of life and compassion in primary care clinicians: a controlled study. Annals of Family Medicine, 11(5), 412–420.CrossRefPubMedPubMedCentral

Frenk, J., Chen, L., Bhutta, Z. A., Cohen, J., Crisp, N., Evans, T., et al. (2010). Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet, 376(9756), 1923–1958.CrossRefPubMed

Garcia-Campayo, J., & Piva-Demarzo, M. (2015). Mindfulness y compasión. La nueva revolución. Madrid: Ilus Books.

Gotink, R., Chu, P., Busschbach, J. J., Benson, H., Fricchione, G. L., & Hunink, M. G. (2015). Standardised mindfulness-based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs. PloS One, 10(4), e0124344.CrossRefPubMedPubMedCentral

Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57(1), 35–43.CrossRefPubMed

Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review, 37, 1–12.CrossRefPubMed

Hayes, S., & Shenk, C. (2004). Operationalizing mindfulness without unnecessary attachments. Clinical Psychology: Science and Practice, 11, 249–254.

Hayes, S., Strosahl, K., & Wilson, K. (2012). Acceptance and commitment therapy: the process and practice of mindful change (2nd ed.). New York: Guilford Press.

Heras-Mosteiro, J., Sanz-Barbero, B., & Otero-Garcia, L. (2016). Health care austerity measures in times of crisis: the perspectives of primary health care physicians in Madrid, Spain. International Journal of Health Services, 46(2), 283–299.CrossRefPubMed

Hölzel, B., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6, 537–559.

Irving, J., Dobkin, P., & Park, J. (2009). Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR). Complementary Therapies in Clinical Practice, 15(2), 61–66.CrossRefPubMed

Jha, A., Krompinger, J., & Baime, M. (2007). Mindfulness training modifies subsystems of attention. Cognitive, Affective, & Behavioral Neuroscience, 7(2), 109–119.CrossRef

Johnson, J. R., Emmons, H. C., Rivard, R. L., Griffin, K. H., & Dusek, J. A. (2015). Resilience training: a pilot study of a mindfulness-based program with depressed healthcare professionals. Explore (New York, N.Y.), 11(6), 433–444.CrossRef

Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47.CrossRefPubMed

Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your mind to face stress. Pain and illness. New York: Dell.

Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present and future. Clinical Psychology: Science and Practice, 10(2), 144–156.

Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8, 163–190.CrossRefPubMed

Klatt, M., Buckworth, J., & Malarkey, W. (2009). Effects of low-dose mindfulness-based stress reductions (MBSR-Id) on working adults. Healt Eduction & Behavior, 36, 601–614.CrossRef

Kleiboer, A., Donker, T., Seekles, W., van Straten, A., Riper, H., & Cuijpers, P. (2015). A randomized controlled trial on the role of support in Internet-based problem solving therapy for depression and anxiety. Behaviour Research and Therapy, 72, 63–71.CrossRefPubMed

Krasner, M. (2009). Association of an educational program in mindful communication with burnout, empathy and attitudes among primary care physicians. JAMA, 302(12), 1284–1293.CrossRefPubMed

Liu, Q., Peng, W., Zhang, F., Hu, R., Li, Y., & Yan, W. (2016). The effectiveness of blended learning in health professions: systematic review and meta-analysis. Journal of Medical Internet Research, 18(1), e2.CrossRefPubMedPubMedCentral

Lopez, A., Sanderman, R., & Schroevers, M. J. (2016). Mindfulness and self-compassion as unique and common predictors of affect in the general population. Mindfulness, 7(6), 1289–1296.CrossRefPubMedPubMedCentral

López-Gómez, I., Hervás, G., & Vázquez, C. (2015). Adaptación de las “escalas de afecto positivo y negativo” (panas) en una muestra general Española. Behavioral Psychology, 23(3), 529–548.

Mackinnon, D., & Dwyer, J. (1993). Estimating mediated effects in prevention studies. Evaluation Review, 17(2), 144–158.CrossRef

Molina Siguero, A., García Perez, M. A., Alonso González, M., & Cecilia Cermeño, P. (2003). Prevalence of worker burnout and psychiatric illness in primary care physicians in a health care area in Madrid. Atencion Primaria, 31(9), 564–571.CrossRefPubMed

Montero-Marin, J., García-Campayo, J., Fajó-Pascual, M., Carrasco, J. M., Gascón, S., Gili, M., & Mayoral-Cleries, F. (2011). Sociodemographic and occupational risk factors associated with the development of different burnout types: the cross-sectional University of Zaragoza study. BMC Psychiatry, 11, 49.CrossRefPubMedPubMedCentral

Montero-Marín, J., Skapinakis, P., Araya, R., Gili, M., & García-Campayo, J. (2011). Towards a brief definition of burnout syndrome by subtypes: Development of the “Burnout Clinical Subtypes Questionnaire” (BCSQ-12). HQLO, 9, 74.PubMedPubMedCentral

Montero-Marín, J., Araya, R., Blazquez, B. O., Skapinakis, P., Vizcaino, V. M., & García-Campayo, J. (2012). Understanding burnout according to individual differences: ongoing explanatory power evaluation of two models for measuring burnout types. BMC Public Health, 12, 922.CrossRefPubMedPubMedCentral

Montero-Marin, J., Tops, M., Manzanera, R., Piva-Demarzo, M. M., Álvarez de Mon, M., & García-Campayo, J. (2015). Mindfulness, resilience, and burnout subtypes in primary care physicians: the possible mediating role of positive and negative affect. Frontiers in Psychology, 6, 1895.CrossRefPubMedPubMedCentral

Morris, S., & DeShon, R. (2002). Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychological Methods, 7, 105–125.CrossRefPubMed

Morrison, A. B., Goolsarran, M., Rogers, S. L., & Jha, A. P. (2014). Taming a wandering attention: short-form mindfulness training in student cohorts. Frontiers in Human Neuroscience, 7, 897.

Notario-Pacheco, B., Solera-Martínez, M., Serrano-Parra, M. D., Bartolomé-Gutiérrez, R., Carcía-Campayo, J., & Martínez-Vizcaíno, V. (2011). Reliability and validity of the Spanish version of the 10-item Connor-Davidson Resilience Scale (10-item CD-RISC) in young adults. HQLO, 9, 63.PubMedPubMedCentral

Ong, A. D., Zautra, A. J., & Carrington Reid, M. (2010). Psychological resilience predicts decreases in pai catastrophizing through positive emotions. Psychology and Aging, 25, 516–523.CrossRefPubMedPubMedCentral

Piva-Demarzo, M., & Garcia-Campayo, J. (2015). Manual práctico mindfulness. Curiosidad y aceptación. Madrid: Ilus Books.

Rabatin, J., Williams, E., Baier Manwell, L., Schwartz, M. D., Brown, R. L., & Linzer, M. (2015). Predictors and outcomes of burnout in primary care physicians. Journal of Primary Care Community Health, 7(1), 41–43.

Ruiz, J., Mintzer, M., & Leipzig, R. (2006). The impact of E-learning in medical education. Academic Medicine, 81(3), 207–212.CrossRefPubMed

Sanada, K., Alda, M., Salas, M., Pérez-Yus, M. C., Demarzo, M. M., Montero-Marín, J., et al. (2017). Effects of mindfulness-based interventions on biomarkers in healthy and cancer populations: a systematic review. BMC Complementary and Alternative Medicine, 17(1), 125.CrossRefPubMedPubMedCentral

Sandín, B., Chorot, P., Lostao, L., Joiner, T. E., Santed, M. A., & Valiente, R. M. (1999). Escalas PANAS de afecto positivo y negativo: Validación factorial y convergencia transcultural. Psicothema, 11, 37–51.

Segal, Z., Wiliams, J., & Teasdale, J. (2002). Mindfulness-based cognitive therapy for depresión. New York: Guilford Press.

Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: results from a randomized trial. International Journal of Stress Management, 12(2), 164–176.CrossRef

Soler, J., Tejedor, R., Feliú-Soler, A., Pascual, J. C., Cebolla, A., Soriano, J., et al. (2012). Psychometric properties of Spanish version of mindful attention awareness scale (MAAS). Actas Españolas de Psiquiatría, 40(1), 19–26.PubMed

Stallard, N. (2012). Optimal sample sizes for phase II clinical trials and pilot studies. Statistics in Medicine, 21(11–12), 1031–1042.CrossRef

Tancred, T., Schleiff, M., Peters, DH., Balabanova, D. (2015). Global mapping of health policy and systems research training. The Teaching and Learning Health Policy and Systems Research Thematic Working Group: Health Systems Global with support of the Alliance for Health Policy and Systems Research. At http://bit.ly/1N3a3jD. Accessed Jul 2016.

Treglown, L., Palaiou, K., Zarola, A., & Fumham, A. (2016). The dark side of resilience and burnout: a moderation-mediation model. PloS One, 11(6), e0156279.CrossRefPubMedPubMedCentral

Tugade, M. M., & Fredrickson, B. L. (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. Journal of Personality and Social Psychology, 86, 320–333.CrossRefPubMedPubMedCentral

Vinci, C., Peltier, M. R., Shah, S., Kinsaul, J., Waldo, K., McVay, M. A., et al. (2014). Effects of a brief mindfulness intervention on negative affect and urge to drink among college student drinkers. Behaviour Research and Therapy, 59, 82–93.CrossRefPubMed

Wang, L., Zhang, Z., McArdle, J. J., & Salthouse, T. A. (2009). Investigating ceiling effects in longitudinal data analysis. Multivariate Behavioral Research, 43(3), 476–496.CrossRefPubMedPubMedCentral

Watson, D., Clark, L., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.CrossRefPubMed

Wichers, M., Peeters, F., Geschwind, N., Jacobs, N., Simons, C. J. P., Derom, C., et al. (2010). Unveiling patterns of affective responses in daily life may improve outcome prediction in depression: a momentary assessment study. Journal of Affective Disorders, 124, 191–195.CrossRefPubMed

Windgassen, S., Goldsmith, K., Moss-Morris, R., & Chalder, T. (2016). Establishing how psychological therapies work: the importance of mediation analysis. Journal of Mental Health, 25(2), 93–99.CrossRefPubMed

Wolkin, J. (2015). Cultivating multiple aspects of attention through mindfulness meditation accounts for psychological well-being through decreased rumination. Psychology Research and Behavior Management, 8, 171–180.CrossRefPubMedPubMedCentral

Titel: Impact of a Blended Web-Based Mindfulness Programme for General Practitioners: a Pilot Study
Auteurs: Jesus Montero-Marin
Jorge Gaete
Ricardo Araya
Marcelo Demarzo
Rick Manzanera
Melchor Álvarez de Mon
Javier García-Campayo
Publicatiedatum: 15-06-2017
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 1/2018
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-017-0752-8

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 1/2018

Dispositional Mindfulness and Psychological Health: a Systematic Review

Once Again on Mindfulness and Memory in Early Buddhism

Factor Structure and External Validity of the Five Facet Mindfulness Questionnaire in Pregnancy

Trait Mindfulness Moderates the Relationship Between Early Maladaptive Schemas and Depressive Symptoms

Efficacy of a Mindfulness-Based Mobile Application: a Randomized Waiting-List Controlled Trial

A Randomised Controlled Trial of a Brief Online Mindfulness-Based Intervention on Paranoia in a Non-Clinical Sample