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Brief Mindfulness Meditation Course to Reduce Stress in Healthcare Professionals

Brief Mindfulness Meditation Course to Reduce Stress in Healthcare Professionals and Trainees: A Randomized Clinical Trial

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03781336
Enrollment
82
Registered
2018-12-19
Start date
2017-10-01
Completion date
2018-06-15
Last updated
2021-05-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Stress, Professional, Stress, Psychological

Keywords

mindfulness, stress, resilience building, meditation, healthcare professionals, trainees, physicians, nurses

Brief summary

Stress among healthcare professionals is well documented. Untreated stress can lead to anxiety, depression, substance use, and suicide. The use of mindfulness-based programs to reduce stress and enhance wellbeing, among health care professionals, has increased with promising results. Typical mindfulness-based programs are 30 hours in length across 9 sessions. The purpose of this study is to assess the effectiveness of a shorter and more practical program that could be offered during work hours to health care professionals at the NIH Clinical Center. The program will be delivered in five weekly 1.5 hour sessions.

Detailed description

This abridged program was designed by Dr. Rezvan Ameli who is an expert in mindfulness-based practices/therapies and was in response to the expressed needs of the NIH clinical staff and the NIH fellowship training program. Participants completed all primary and secondary outcome measure questionnaires at week -1, 5 and 13. The life as usual control group completed all primary and secondary outcome measures at week -1, and 5. The program is described below: The program consisted of 5 sessions. A class binder was prepared for the participants and included information about mindfulness and its practice, practices covered in each session, Practice Plan work sheets to design home practices, pertinent reference list, guide to online services, programs and apps, selected poetry, and information regarding recorded instructions for body scan and mindful breathing by the instructor which was made available on the institution's website and could be downloaded by the participants. Each session was 1.5 hours in length and was offered on Fridays from 3-4:30 pm. Classes were instructed by Rezvan Ameli, Ph.D., clinical psychologist, an experienced mindfulness practitioner since 2003 and teacher since 2008. In addition to her background as a licensed clinical psychologist, mindfulness practitioner, teacher and writer (Ameli 2013), RA is a certified yoga teacher and is registered with the Yoga Alliance (RYT-200). Common Elements of the Sessions The first 4 classes began with 20-25 minutes of mindful movement/ light yoga (TNH sounds true, ITP kata). We did not include movements in the 5th (last) session due to time constraints. The emphasis during mindful movements was on the coordination of movement and the breath with the instruction that when the mind wandered away to gently bring it back and refocus on the breath and movements. Participants were encouraged to only engage in movements that felt comfortable but not straining, painful, or felt unsafe. Each class had a period of check in. During the first check in, participants shared their names, a brief statement about the reason for their participation, and their current self-care practice/s if any. Class guidelines including confidentiality were reviewed at this time. In subsequent check-ins the participants addressed their questions regarding mindfulness practices and class teachings, described their practice with a focus on self-care, their existing self-care practices and new learnings from the class, and any obstacles to their practice and to their self-care during the preceding week. Other common elements of the sessions included a period of inquiry, i.e. question and answer, after each new practice was introduced, planning a week of practice based on class learnings, post class ratings, and concluding the class with a relevant poem. Home practice planning was done in dyads of participants who were then encouraged to stay in touch, become a buddy to their class partner, and communicate during the week about their practice. Every session included a period of mindful breathing. The length of mindful breathing (sitting meditation) was gradually increased from 10 minutes in the 1st session to 30 minutes in the 5th session. Session Specific Practices In addition to these common elements, each session included a theme and other specific mindfulness practices as follows: * Session 1- Theme: Introduction to mindfulness. This session included definition of mindfulness and its foundations (Kabat-Zin, 1992), mindful breathing and body scan. * Session 2- Theme: Enhancing Awareness & Focused Attention. This session included mindfulness of sounds, a short body scan, mindful breathing, and mindful eating, i.e. the raisin exercise (ref). In addition, a discussion of mindful consumption and its relevance to self-care was explored (Ameli 2013). * Session 3 -Theme: Awareness of pleasurable experiences. This session included mindfulness of the breath (briefly incorporating sounds, body sensation, thoughts, feelings and then focusing on the breath), and mindful walking. The importance of awareness of pleasurable experiences were discussed and an exercise to enhance attention to pleasurable experiences was performed in dyads (Ameli 2013). * Session 4- Theme: Transformation of difficult emotions through mindfulness. In this session the concept of transforming difficult emotions through the practice of mindfulness was discussed, explored, and practiced. The acronym RAIN (recognize, accept/allow, investigate, and non-identification) was utilized to facilitate this practice. * Session 5- Theme: Compassion. This session mindful breathing and a general discussion of compassion, compassion towards self and other, and the practice of loving kindness (Ameli 2013). The class was concluded with a check-out where participants briefly shared their overall experiences and learnings and their goals/vision for future self-care activities and practices.

Interventions

BEHAVIORALMindfulness-based self care

Experimental: an abridged mindfulness-based program that is incorporated into the work day, which consists of five weekly 1.5 hour sessions.

Sponsors

National Institutes of Health Clinical Center (CC)
Lead SponsorNIH

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE

Intervention model description

Participants are allocated into the mindfulness-based self-care group or a wait list group for 5 weeks. Since the group is offered during work hours, the waitlist group could be best described as life as usual. After group allocation, all participants completed demographic and self report clinical assessments at baseline, and self report clinical assessments at follow-up.

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

* Any National Institutes of Health (NIH) employee, contractor, or trainee willing and able to participate in a 5-week mindfulness-based self-care course during the work day. * English speaking

Exclusion criteria

* Persons with medical and psychiatric conditions were advised to consult with their health care practitioners prior to enrollment.

Design outcomes

Primary

MeasureTime frameDescription
Perceived Stress Scale (PSS)Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)The Perceived Stress Scale (PSS) is used to assess self-reported perceived stress. It is a 10-item scale, with a total range from 0 (no symptoms) to 40 (highest severity).

Secondary

MeasureTime frameDescription
Mindful Attention Awareness Scale (MAAS) - State VersionWeek-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)The Mindful Attention Awareness Scale-State Version (MAAS-S) is used to assess self-reported state mindfulness. It is a 5-item scale, with a total range from 0 (high mindfulness) to 30 (low mindfulness).
Positive Affect Scores (PANAS)Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)The Positive And Negative Affect Scale (PANAS) is used to assess self-reported positive and negative affect. It is a two dimension scale, with total ranges for each scale from 0 (low positive/negative affect) to 50 (high positive/negative affect). These are the Positive Affect Scores
Visual Analog Scale-Anxiety (VAS-A)Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)Visual Analog Scale-Anxiety (VAS-A) is used to assess self-reported anxiety. It is a 1-item scale, with a total range from 1 (low anxiety) to 10 (high anxiety).
Mindful Attention Awareness Scale (MAAS) - Trait VersionWeek-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)The Mindful Attention Awareness Scale-Trait Version (MAAS-T) is used to assess self-reported trait mindfulness. It is a 15-item scale, with a total range from 0 (low mindfulness) to 90 (high mindfulness).
Maslach Burnout Inventory (MBI)Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)The Maslach Burnout Inventory (MBI 2-Item) is used to assess self-reported burnout. The 2-Item inventory assesses emotional exhaustion (Item-1) and depersonalization (Item-2) separately from 1 (no symptoms) to 7 (highest severity).
Negative Affect Scores (PANAS)Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)The Positive And Negative Affect Scale (PANAS) is used to assess self-reported positive and negative affect. It is a two dimension scale, with total ranges for each scale from 0 (low positive/negative affect) to 50 (high positive/negative affect). These are the Negative Affect Scores
Mindful Self Care Scale-General (MSCS-G)Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)Mindful Self Care Scale-General (MSCS-G) is used to assess self-reported mindful self care. It is a 3-item scale, with a total range from 0 (low self care) to 12 (high self care).

Countries

United States

Participant flow

Participants by arm

ArmCount
Mindfulness-based Self-care
Mindfulness-based self-care (5 weeks) Mindfulness-based self care: Experimental: an abridged mindfulness-based program that is incorporated into the work day, which consists of five weekly 1.5 hour sessions.
43
Life as Usual Control
Life as usual control (5 weeks)
35
Total78

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyWithdrawal by Subject22

Baseline characteristics

CharacteristicLife as Usual ControlTotalMindfulness-based Self-care
Age, Continuous36.4 years
STANDARD_DEVIATION 13
36.0 years
STANDARD_DEVIATION 14.3
35.7 years
STANDARD_DEVIATION 15.4
Current position
Administrator
3 Participants10 Participants7 Participants
Current position
Nurse
3 Participants5 Participants2 Participants
Current position
PhD Scientist
3 Participants9 Participants6 Participants
Current position
Physician
11 Participants18 Participants7 Participants
Current position
Social Worker
3 Participants5 Participants2 Participants
Current position
Training Fellow
12 Participants31 Participants19 Participants
Education level
Completed college
14 Participants36 Participants22 Participants
Education level
Graduate school or Advance degree
20 Participants40 Participants20 Participants
Education level
Some college
1 Participants2 Participants1 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants10 Participants5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
30 Participants68 Participants38 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Marital status
Divorced or separated
3 Participants6 Participants3 Participants
Marital status
Married
12 Participants20 Participants8 Participants
Marital status
Single
19 Participants47 Participants28 Participants
Marital status
Widowed or other
1 Participants5 Participants4 Participants
Preexisting condition
Medical condition
9 participants25 participants16 participants
Preexisting condition
Psychiatric condition
14 participants30 participants16 participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Asian
6 Participants13 Participants7 Participants
Race (NIH/OMB)
Black or African American
2 Participants5 Participants3 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
6 Participants11 Participants5 Participants
Race (NIH/OMB)
White
21 Participants48 Participants27 Participants
Religion
Agnostic
2 Participants3 Participants1 Participants
Religion
Atheism
3 Participants8 Participants5 Participants
Religion
Buddhism
2 Participants4 Participants2 Participants
Religion
Christianity
13 Participants31 Participants18 Participants
Religion
Hinduism
2 Participants5 Participants3 Participants
Religion
Islam
3 Participants5 Participants2 Participants
Religion
Judaism
2 Participants4 Participants2 Participants
Religion
Not affiliated or other
8 Participants18 Participants10 Participants
Sex: Female, Male
Female
28 Participants65 Participants37 Participants
Sex: Female, Male
Male
7 Participants13 Participants6 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 430 / 35
other
Total, other adverse events
0 / 430 / 35
serious
Total, serious adverse events
0 / 430 / 35

Outcome results

Primary

Perceived Stress Scale (PSS)

The Perceived Stress Scale (PSS) is used to assess self-reported perceived stress. It is a 10-item scale, with a total range from 0 (no symptoms) to 40 (highest severity).

Time frame: Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)

ArmMeasureGroupValue (MEAN)Dispersion
Mindfulness-based Self-carePerceived Stress Scale (PSS)Baseline19.63 score on a scaleStandard Deviation 6.26
Mindfulness-based Self-carePerceived Stress Scale (PSS)Postintervention17.29 score on a scaleStandard Deviation 5.84
Mindfulness-based Self-carePerceived Stress Scale (PSS)Follow-up13.80 score on a scaleStandard Deviation 6.45
Life as Usual ControlPerceived Stress Scale (PSS)Baseline18.80 score on a scaleStandard Deviation 6.36
Life as Usual ControlPerceived Stress Scale (PSS)Postintervention18.54 score on a scaleStandard Deviation 6.3
Life as Usual ControlPerceived Stress Scale (PSS)Follow-upNA score on a scale
Secondary

Maslach Burnout Inventory (MBI)

The Maslach Burnout Inventory (MBI 2-Item) is used to assess self-reported burnout. The 2-Item inventory assesses emotional exhaustion (Item-1) and depersonalization (Item-2) separately from 1 (no symptoms) to 7 (highest severity).

Time frame: Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)

ArmMeasureGroupValue (MEAN)Dispersion
Mindfulness-based Self-careMaslach Burnout Inventory (MBI)Baseline-item 12.95 score on a scaleStandard Deviation 1.56
Mindfulness-based Self-careMaslach Burnout Inventory (MBI)Postintervention-item 12.89 score on a scaleStandard Deviation 1.63
Mindfulness-based Self-careMaslach Burnout Inventory (MBI)Follow-up-item 12.31 score on a scaleStandard Deviation 1.64
Mindfulness-based Self-careMaslach Burnout Inventory (MBI)Baseline-item 21.76 score on a scaleStandard Deviation 1.32
Mindfulness-based Self-careMaslach Burnout Inventory (MBI)Postintervention-item 21.22 score on a scaleStandard Deviation 1.13
Mindfulness-based Self-careMaslach Burnout Inventory (MBI)Follow-up-item 21.34 score on a scaleStandard Deviation 1.21
Life as Usual ControlMaslach Burnout Inventory (MBI)Postintervention-item 21.57 score on a scaleStandard Deviation 1.36
Life as Usual ControlMaslach Burnout Inventory (MBI)Baseline-item 13.29 score on a scaleStandard Deviation 1.45
Life as Usual ControlMaslach Burnout Inventory (MBI)Baseline-item 21.6 score on a scaleStandard Deviation 1.42
Life as Usual ControlMaslach Burnout Inventory (MBI)Postintervention-item 12.74 score on a scaleStandard Deviation 1.62
Life as Usual ControlMaslach Burnout Inventory (MBI)Follow-up-item 2NA score on a scale
Life as Usual ControlMaslach Burnout Inventory (MBI)Follow-up-item 1NA score on a scale
Secondary

Mindful Attention Awareness Scale (MAAS) - State Version

The Mindful Attention Awareness Scale-State Version (MAAS-S) is used to assess self-reported state mindfulness. It is a 5-item scale, with a total range from 0 (high mindfulness) to 30 (low mindfulness).

Time frame: Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)

ArmMeasureGroupValue (MEAN)Dispersion
Mindfulness-based Self-careMindful Attention Awareness Scale (MAAS) - State VersionPostintervention3.74 score on a scaleStandard Deviation 1.18
Mindfulness-based Self-careMindful Attention Awareness Scale (MAAS) - State VersionFollow-up4.08 score on a scaleStandard Deviation 1.04
Mindfulness-based Self-careMindful Attention Awareness Scale (MAAS) - State VersionBaseline2.23 score on a scaleStandard Deviation 1.24
Life as Usual ControlMindful Attention Awareness Scale (MAAS) - State VersionPostintervention2.78 score on a scaleStandard Deviation 1.16
Life as Usual ControlMindful Attention Awareness Scale (MAAS) - State VersionFollow-upNA score on a scale
Life as Usual ControlMindful Attention Awareness Scale (MAAS) - State VersionBaseline2.48 score on a scaleStandard Deviation 1.08
Secondary

Mindful Attention Awareness Scale (MAAS) - Trait Version

The Mindful Attention Awareness Scale-Trait Version (MAAS-T) is used to assess self-reported trait mindfulness. It is a 15-item scale, with a total range from 0 (low mindfulness) to 90 (high mindfulness).

Time frame: Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)

ArmMeasureGroupValue (MEAN)Dispersion
Mindfulness-based Self-careMindful Attention Awareness Scale (MAAS) - Trait VersionBaseline3.74 score on a scaleStandard Deviation 0.99
Mindfulness-based Self-careMindful Attention Awareness Scale (MAAS) - Trait VersionPostintervention3.95 score on a scaleStandard Deviation 0.83
Mindfulness-based Self-careMindful Attention Awareness Scale (MAAS) - Trait VersionFollow-up4.33 score on a scaleStandard Deviation 0.85
Life as Usual ControlMindful Attention Awareness Scale (MAAS) - Trait VersionBaseline3.61 score on a scaleStandard Deviation 0.89
Life as Usual ControlMindful Attention Awareness Scale (MAAS) - Trait VersionPostintervention3.70 score on a scaleStandard Deviation 0.96
Life as Usual ControlMindful Attention Awareness Scale (MAAS) - Trait VersionFollow-upNA score on a scale
Secondary

Mindful Self Care Scale-General (MSCS-G)

Mindful Self Care Scale-General (MSCS-G) is used to assess self-reported mindful self care. It is a 3-item scale, with a total range from 0 (low self care) to 12 (high self care).

Time frame: Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)

ArmMeasureGroupValue (MEAN)Dispersion
Mindfulness-based Self-careMindful Self Care Scale-General (MSCS-G)Baseline5.60 score on a scaleStandard Deviation 2.75
Mindfulness-based Self-careMindful Self Care Scale-General (MSCS-G)Postintervention7.29 score on a scaleStandard Deviation 2.44
Mindfulness-based Self-careMindful Self Care Scale-General (MSCS-G)Follow-up6.37 score on a scaleStandard Deviation 2.76
Life as Usual ControlMindful Self Care Scale-General (MSCS-G)Baseline6.00 score on a scaleStandard Deviation 2.88
Life as Usual ControlMindful Self Care Scale-General (MSCS-G)Postintervention5.54 score on a scaleStandard Deviation 2.77
Life as Usual ControlMindful Self Care Scale-General (MSCS-G)Follow-upNA score on a scale
Secondary

Negative Affect Scores (PANAS)

The Positive And Negative Affect Scale (PANAS) is used to assess self-reported positive and negative affect. It is a two dimension scale, with total ranges for each scale from 0 (low positive/negative affect) to 50 (high positive/negative affect). These are the Negative Affect Scores

Time frame: Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)

ArmMeasureGroupValue (MEAN)Dispersion
Mindfulness-based Self-careNegative Affect Scores (PANAS)Baseline21.44 units on a scaleStandard Deviation 7.38
Mindfulness-based Self-careNegative Affect Scores (PANAS)Postintervention20.73 units on a scaleStandard Deviation 6.24
Mindfulness-based Self-careNegative Affect Scores (PANAS)Follow-up18.22 units on a scaleStandard Deviation 6.01
Life as Usual ControlNegative Affect Scores (PANAS)Baseline21.21 units on a scaleStandard Deviation 7.27
Life as Usual ControlNegative Affect Scores (PANAS)Postintervention19.09 units on a scaleStandard Deviation 7.6
Life as Usual ControlNegative Affect Scores (PANAS)Follow-upNA units on a scale
Secondary

Positive Affect Scores (PANAS)

The Positive And Negative Affect Scale (PANAS) is used to assess self-reported positive and negative affect. It is a two dimension scale, with total ranges for each scale from 0 (low positive/negative affect) to 50 (high positive/negative affect). These are the Positive Affect Scores

Time frame: Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)

ArmMeasureGroupValue (MEAN)Dispersion
Mindfulness-based Self-carePositive Affect Scores (PANAS)Baseline32.85 units on a scaleStandard Deviation 7.73
Mindfulness-based Self-carePositive Affect Scores (PANAS)Postintervention35.69 units on a scaleStandard Deviation 7.12
Mindfulness-based Self-carePositive Affect Scores (PANAS)Follow-up36.13 units on a scaleStandard Deviation 8.43
Life as Usual ControlPositive Affect Scores (PANAS)Baseline33.67 units on a scaleStandard Deviation 5.95
Life as Usual ControlPositive Affect Scores (PANAS)Postintervention31.42 units on a scaleStandard Deviation 7.27
Life as Usual ControlPositive Affect Scores (PANAS)Follow-upNA units on a scale
Secondary

Visual Analog Scale-Anxiety (VAS-A)

Visual Analog Scale-Anxiety (VAS-A) is used to assess self-reported anxiety. It is a 1-item scale, with a total range from 1 (low anxiety) to 10 (high anxiety).

Time frame: Week-1(baseline), Week-5 (post-intervention), Week-13 (follow-up)

ArmMeasureGroupValue (MEAN)Dispersion
Mindfulness-based Self-careVisual Analog Scale-Anxiety (VAS-A)Baseline4.72 score on a scaleStandard Deviation 1.62
Mindfulness-based Self-careVisual Analog Scale-Anxiety (VAS-A)Postintervention2.58 score on a scaleStandard Deviation 1.52
Mindfulness-based Self-careVisual Analog Scale-Anxiety (VAS-A)Follow-up3.29 score on a scaleStandard Deviation 1.47
Life as Usual ControlVisual Analog Scale-Anxiety (VAS-A)Baseline4.57 score on a scaleStandard Deviation 1.69
Life as Usual ControlVisual Analog Scale-Anxiety (VAS-A)Postintervention4.23 score on a scaleStandard Deviation 1.73
Life as Usual ControlVisual Analog Scale-Anxiety (VAS-A)Follow-upNA score on a scale

Source: ClinicalTrials.gov · Data processed: Feb 17, 2026