Mantra Meditation to Reduce Emotional Exhaustion in Emergency Department Staff

NCT02887300 | Unknown DMC

• 4 other identifiers: StJamesHRCPITCDHSE
• Study Type: interventional
• Target: 58
• Locations: 1 country
• Sites: 1

Brief Summary

Work in a healthcare setting, such as in an emergency department (ED), while rewarding, can be harmful to psychological well being, as demonstrated by the high numbers of Irish hospital doctors experiencing burnout. Burnout has been linked to poor healthcare quality, medical errors and low patient satisfaction. To prevent further escalation of this problem, there is a need for effective stress-reducing intervention, such as meditation. Meditation practice has a confirmed positive effect on well being; through greater insight and awareness, meditation could help ED staff to become more attentive to and understanding of their patients' complaints, enhancing patient satisfaction and safety. However, based on current research it is difficult to distinguish between the effects of meditation on well being and those associated with bringing people together. There is therefore a need for a larger randomised study (RCT) including a participants that receive no meditation intervention. This pilot study aims to examine the suitability of RCT to assess the effect of mantra meditation on burnout among ED staff. The investigators will also examine participant recruitment and retention, data management and outcomes assessment methods for well being, patient satisfaction and biological markers. There will be two groups: intervention group (meditation) and control group (non-meditation). 30 ED staff placed in the intervention group will discuss prescribed texts and learn mantra meditation over a 7-week period, accompanied by 20 minutes of daily meditation practice. 30 ED staff placed in the control group will work in the ED as usual and not receive any texts. Biological samples and questionnaires will be obtained at three time points. Participant feedback will also be sought through interviews. This study will highlight issues related to participant recruitment, retention, and adherence, questionnaires, logistics, and data management and pave the way for an efficient, effective, and larger study that will investigate mantra meditation as a means of reducing burnout in ED staff.

Conditions

Psychological Stress

Keywords

Quality of Health Care; Psychological Stress; Burnout; Health Care Professional; Mantra Meditation; Health Care Economics

Outcome Measures

Primary Outcomes (1)

• Change from baseline in ED staff burn out using the Maslach Burnout Inventory (MBI)

  Week 8 and 20

Secondary Outcomes (9)

• Change from baseline in retention and adherence of consenting participants to both arms of the study

  Week 8 and 20

• Change from baseline in ED staff anxiety and depression using the Depression, Anxiety and Stress Scale (DASS)

  Week 8 and 20

• Change from baseline in ED staff response to meditation using the Five Facets Mindfulness Scale (FFMS) at week 8 and 20

  Week 8 and 20

• Change from baseline in ED staff professional quality of life using the Professional Quality of Life Scale (PQoLS)

  Week 8 and 20

• Change from baseline in participant 24 h ambulatory blood pressure

  Week 8

Study Arms (2)

Passive control group

NO INTERVENTION

After randomisation, 30 consenting, eligible study participants will be allotted a place in the passive, parallel control group. Participants will work as usual in the ED. Biological and survey samples will be obtained from both groups of participants on the same days: T1 - one week before session one T2 - one week after session 4 T3 - three months following T2

Planned intervention - mantra meditation

EXPERIMENTAL

After randomisation, 30 randomly chosen, ED staff members will be taught mantra meditation by an experienced meditator. Each 4 hour session will occur once every two weeks for 8 weeks (total of 4 sessions) and consist of guided meditation as well as discussions around prescribed texts on the meaning of health care. In addition, participants will be asked to engage in home work (20 minutes of a guided mantra meditation on a twice daily basis). Biological and survey samples will be obtained from both groups of participants on the same days: T1 - one week before session one T2 - one week after session 4 T3 - three months following T2

Behavioral: Mantra Meditation

Interventions

Mantra Meditation BEHAVIORAL

Week 1: 20 minute meditation session. Prescribed text discussion. Encouraging a daily practice; the log, daily readings, timer etc. Week 2: Review of the practice followed by a 20 minute meditation period. Challenges to learning meditation. Second 20 minute meditation. Discussion of prescribed text. Week 3: 20 minute meditation. Review of Atul Gawande's lecture. Second 20 minute period of meditation. Discussion of prescribed text. Week 4: 20 minute meditation session. Discussion of prescribed text. A second 20 minute meditation. End of programme review.

Planned intervention - mantra meditation

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Staff member (nurse or doctor) of the ED department of St. James' hospital, Dublin
• Preference to participate in the study
• Conscious patient
• Cognitively functioning to an adequate level
• Not actively abusing any substance
• Preference to participate
• Over the age of 18 years

You may not qualify if:

• Alcohol or substance abuse within the past 6 months
• Are currently using (at the time of enrolment) anti-psychotic medication or recently started on anti-depressant medication (less than 3 months at the time of enrolment). Participants on a stable dose of anti-depressant medication (for more than 3 months) will be permitted but advised to consult with their GP or psychiatrist prior to enrolment.
• A diagnosis of schizophrenia
• More than 4 consecutive classes of meditation training or mind-body practices (including yoga and tai-chi) in the past 2 years
• Current pregnancy or lactation
• Not available to attend all programme dates

Sponsors & Collaborators

• St. James's Hospital, Ireland: lead
• Royal College of Physicians: collaborator
• University of Dublin, Trinity College: collaborator
• Health Service Executive, Ireland: collaborator

Study Sites (1)

Trinity Health Centre, Centre for Learning and development, SJH

Dublin, Dublin, 0008, Ireland

Location

Related Publications (8)

• Hayes B, Fitzgerald D, Doherty S, Walsh G. Quality care, public perception and quick-fix service management: a Delphi study on stressors of hospital doctors in Ireland. BMJ Open. 2015 Dec 23;5(12):e009564. doi: 10.1136/bmjopen-2015-009564.

  PMID: 26700286 BACKGROUND

• Prinz P, Hertrich K, Hirschfelder U, de Zwaan M. Burnout, depression and depersonalisation--psychological factors and coping strategies in dental and medical students. GMS Z Med Ausbild. 2012;29(1):Doc10. doi: 10.3205/zma000780. Epub 2012 Feb 15.

  PMID: 22403595 BACKGROUND

• Amtul Z, Arena A, Hirjee H, Khan ZU, Maldeniya PM, Newman RI, Burhan AM, Wetmore S, Vasudev A. A randomized controlled longitudinal naturalistic trial testing the effects of automatic self transcending meditation on heart rate variability in late life depression: study protocol. BMC Complement Altern Med. 2014 Aug 19;14:307. doi: 10.1186/1472-6882-14-307.

  PMID: 25134497 BACKGROUND

• Beach MC, Roter D, Korthuis PT, Epstein RM, Sharp V, Ratanawongsa N, Cohn J, Eggly S, Sankar A, Moore RD, Saha S. A multicenter study of physician mindfulness and health care quality. Ann Fam Med. 2013 Sep-Oct;11(5):421-8. doi: 10.1370/afm.1507.

  PMID: 24019273 BACKGROUND

• Nieuwenhuijsen K, de Boer AG, Verbeek JH, Blonk RW, van Dijk FJ. The Depression Anxiety Stress Scales (DASS): detecting anxiety disorder and depression in employees absent from work because of mental health problems. Occup Environ Med. 2003 Jun;60 Suppl 1(Suppl 1):i77-82. doi: 10.1136/oem.60.suppl_1.i77.

  PMID: 12782751 BACKGROUND

• Carlson LE, Speca M, Faris P, Patel KD. One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain Behav Immun. 2007 Nov;21(8):1038-49. doi: 10.1016/j.bbi.2007.04.002. Epub 2007 May 22.

  PMID: 17521871 BACKGROUND

• Ryan M, Gerard K. Using discrete choice experiments to value health care programmes: current practice and future research reflections. Appl Health Econ Health Policy. 2003;2(1):55-64.

  PMID: 14619274 BACKGROUND

• Dunne PJ, Lynch J, Prihodova L, O'Leary C, Ghoreyshi A, Basdeo SA, Cox DJ, Breen R, Sheikhi A, Carroll A, Walsh C, McMahon G, White B. Burnout in the emergency department: Randomized controlled trial of an attention-based training program. J Integr Med. 2019 May;17(3):173-180. doi: 10.1016/j.joim.2019.03.009. Epub 2019 Mar 29.

  PMID: 30956141 DERIVED

MeSH Terms

Conditions

Stress, Psychological; Burnout, Psychological

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior

Study Officials

• Barry White, MD

  University of Dublin, Trinity College

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Research Fellow

Study Record Dates

• First Submitted: August 24, 2016
• First Posted: September 2, 2016
• Study Start: January 31, 2017
• Primary Completion: June 23, 2017
• Study Completion: December 1, 2017
• Last Updated: February 14, 2017

Record last verified: 2017-02

Data Sharing

• IPD Sharing: Will share

Locations

IE (1)