Meditation Program and Healthcare Providers’ Interoceptive Awareness, Compassion Fatigue, and Burnout

Research suggests that meditation can relieve stress, cultivate self-regulation skills, improve ability to focus, and modify risk for compassion fatigue (CF) and burnout in healthcare providers | Journal of Hospice & Palliative Nursing

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This pilot study examined a novel 6-week technology-assisted meditation program, coherently grounded in the system of yoga therapy that required minimal time. Five 10- to 12-minute meditations were offered via smartphone apps supported by biweekly e-mails. Hospice and palliative professionals at a Midwestern US healthcare network participated in the program (n = 36). Each meditation integrated attention, synchronized breath, gentle movements and a meditation focus. Weekly e-mails introduced a new meditation and reminded participants how and why to practice.

The participants used the meditations a mean of 17.18(SD, 8.69) times. Paired t tests found significant presurvey to postsurvey improvements for CF/burnout and interoceptive awareness. Participation significantly heightened perceived ability and propensity to direct attention to bodily sensations, increased awareness of physical sensations’ connections to emotions, and increased active body listening. The technology-assisted yoga therapy meditation program successfully motivated providers to meditate. The program required minimal time yet seemed to reduce CF/burnout and improve emotional awareness and self-regulation by heightening attention to present-moment bodily sensations.

Full reference: Heeter, C. et al. (2017) Effects of a Technology-Assisted Meditation Program on Healthcare Providers’ Interoceptive Awareness, Compassion Fatigue, and Burnout.Journal of Hospice & Palliative Nursing. Volume 19 (Issue 4) pp. 314–322

Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams

Maintaining a sense of self-care while providing patient centered care, can be difficult for practitioners in palliative medicine | BMC Palliative Care

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Background: We aimed to pilot an “on the job” mindfulness and compassion-oriented meditation training for interdisciplinary teams designed to reduce distress, foster resilience and strengthen a prosocial motivation in the clinical encounter.

Results: Significant improvements were found in two of three burnout components (emotional exhaustion and personal accomplishment), anxiety, stress, two emotional regulation competences and joy at work. Furthermore, 85% of the individual goals were attained. Compliance and acceptance rates were high and qualitative data revealed a perceived enhancement of self-care, the integration of mindful pauses in work routines, a reduction in rumination and distress generated in the patient contact as well as an enhancement of interpersonal connection skills. An improvement of team communication could also be identified.

Conclusions: Our findings suggest that the training may be a feasible, effective and practical way of reducing caregiver-distress and enhancing the resources of palliative care teams.

Full reference: Orellana-Rios, C.L. et al. (2017) Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program. BMC Palliative Care. Published: 6th July 2017

Compassion: a scoping review of the healthcare literature

Sinclair, S. et al. BMC Palliative Care. 2016 15:6

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Image source: Sam Caplet

Background: Recent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care is expected by patients and is a professional obligation of clinicians; however, little is known about the state of research on clinical compassion. The purpose of this scoping review was to map the literature on compassion in clinical healthcare.

Methods: Searches of eight electronic databases and the grey literature were conducted to identify empirical studies published over the last 25 years. Eligible studies explored perceptions or interventions of compassionate care in clinical populations, healthcare professionals, and healthcare students. Following the title and abstract review, two reviewers independently screened full-texts articles, and extracted study data. A narrative approach to synthesizing and mapping the literature was used.

Results and discussion: Of 36,637 records, 648 studies were retrieved and 44 studies were included in the review. Less than one third of studies included patients. Six themes emerged from studies that explored perceptions of compassionate care: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. Intervention studies included two compassionate care trials with patients and eight educational programs that aimed to improve compassionate care in clinicians and students.

Conclusions: This review identifies the limited empirical understanding of compassion in healthcare, highlighting the lack of patient and family voices in compassion research. A deeper understanding of the key behaviors and attitudes that lead to improved patient-reported outcomes through compassionate care is necessary.

View the full article here

Choice and compassion at the end of life

End of life care in England has recently been framed by two very different discourses. One (connected to advance care planning) promotes personal choice, the other promotes compassionate care; both are prominent in professional, policy and media settings. The article outlines the history of who promoted each discourse from 2008 to early 2015, when, why and how and this was done. Each discourse is then critically analysed from a standpoint that takes account of bodily decline, structural constraints, and human relationality. We focus on the biggest group of those nearing the end of their life, namely frail very old people suffering multiple conditions. In their care within contemporary healthcare organisations, choice becomes a tick box and compassion a commodity. Informed choice, whether at the end of life or in advance of it, does not guarantee the death the person wants, especially for those dying of conditions other than cancer and in the absence of universally available skilled and compassionate care. Enabling healthcare staff to provide compassionate, relational care, however, implies reversing the philosophical, political and financial direction of healthcare in the UK and most other Anglophone countries.

Reference: Choice and compassion at the end of life: A critical analysis of recent English policy discourse. Social Science & Medicine Volumes 136–137, July 2015, Pages 99–105