scholarly journals A novel Mindful-Compassion Art Therapy (MCAT) for reducing burnout and promoting resilience for end-of-life care professionals: A waitlist RCT protocol (Preprint)

2019 ◽  
Author(s):  
Andy Hau Yan Ho ◽  
Geraldine Tan-Ho ◽  
Thuy Anh Ngo ◽  
Grace Ong ◽  
Poh Heng Chong ◽  
...  
Keyword(s):  
End Of Life ◽  
Art Therapy ◽  
End Of Life Care ◽  
Intervention Group ◽  
Control Group ◽  
Post Intervention ◽  
Work Related ◽  
Waitlist Control Group ◽  
Related Stress ◽  
Eol Care

BACKGROUND End-of-life (EoL) care professionals are at prone to burnout given the intense emotional nature of their work. Previous research supports the efficacy of art therapy in reducing work-related stress and enhancing emotional health among professional EoL caregivers. Integrating mindfulness meditation with art therapy, with reflective awareness complementing emotional expression, has immense potential for self-care and collegial support. OBJECTIVE Mindful-Compassion Art Therapy (MCAT) is a novel, empirically-informed and highly structured intervention that aims to reduce work-related stress, cultivate resilience and promote wellness. This study aims to assess the potential effectiveness of MCAT for supporting EoL care professionals in Singapore. METHODS An open label waitlist randomized controlled trial. 60 EoL care professionals including doctors, nurses, social workers and personal care workers are randomly allocated to one of two groups: (i) intervention group who receives MCAT immediately, and (ii) waitlist-control group who receives MCAT after intervention group completes treatment. Face-to-face self-administered outcome assessments are collected at three different time points including baseline for both groups, post intervention and 6-week follow-up for intervention group, as well as second baseline and post-intervention for waitlist-control group. RESULTS Primary outcome measure includes burnout, and secondary measures include emotional regulation, resilience, compassion, quality of life and death attitudes. Between- and within-participant comparisons of outcomes are conducted and the appropriate effect size estimates reported. An acceptability and feasibility study is to be conducted using a triangulation of qualitative data with framework analysis. CONCLUSIONS The outcomes of this study will contribute to advancements in both theories and practices for supporting professional EoL caregivers around the world. It will also inform policy makers about the feasibility, acceptability and effectiveness of delivering a multimodal psycho-socio-spiritual intervention within a community institutional setting. The study has received ethical approval from the Institutional Review Board of Nanyang Technological University. CLINICALTRIAL ClinicalTrails.gov NCT034406Burnout, Resilience, Mindful-Compassion, Art Therapy, Multimodal Intervention, End of Life Care, Palliative Care, Randomized Control Trial06.

60. Using a pocket card to improve end-of-life care on clinical teaching units: A controlled trials

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
J. Downar ◽  
J. Mikhael
Keyword(s):  
End Of Life ◽  
Symptom Management ◽  
End Of Life Care ◽  
Palliative Medicine ◽  
Clinical Teaching ◽  
Intervention Group ◽  
Comfort Level ◽  
Control Group ◽  
Life Care ◽  
Comfort Levels

Although palliative and end-of-life is a critical part of in-hospital medical care, residents often have very little formal education in this field. To determine the efficacy of a symptom management pocket card in improving the comfort level and knowledge of residents in delivering end-of-life care on medical clinical teaching units, we performed a controlled trial involving residents on three clinical teaching units. Residents at each site were given a 5-minute questionnaire at the start and at the end of their medicine ward rotation. Measures of self-reported comfort levels were assessed, as were 5 multiple-choice questions reflecting key knowledge areas in end-of-life care. Residents at all three sites were given didactic teaching sessions covering key concepts in palliative and end-of-life care over the course of their medicine ward rotation. Residents at the intervention site were also given a pocket card with information regarding symptom management in end-of-life care. Over 10 months, 137 residents participated on the three clinical teaching units. Comfort levels improved in both control (p < 0.01) and intervention groups (p < 0.01), but the intervention group was significantly more comfortable than the control group at the end of their rotations (z=2.77, p < 0.01). Knowledge was not significantly improved in the control group (p=0.07), but was significantly improved in the intervention group (p < 0.01). The knowledge difference between the two groups approached but did not reach statistical significance at the end of their rotation. In conclusion, our pocket card is a feasible, economical educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on clinical teaching units. Oneschuk D, Moloughney B, Jones-McLean E, Challis A. The Status of Undergraduate Palliative Medicine Education in Canada: a 2001 Survey. Journal Palliative Care 2004; 20:32. Tiernan E, Kearney M, Lynch AM, Holland N, Pyne P. Effectiveness of a teaching programme in pain and symptom management for junior house officers. Support Care Cancer 2001; 9:606-610. Okon TR, Evans JM, Gomez CF, Blackhall LJ. Palliative Educational Outcome with Implementation of PEACE Tool Integrated Clinical Pathway. Journal of Palliative Medicine 2004; 7:279-295.

scholarly journals Impact of a University-Community Partnership Approach to Improving Health Behaviors and Outcomes Among Overweight/Obese Hispanic Adults

2016 ◽  
Vol 11 (6) ◽  
pp. 479-488 ◽  
Author(s):  
Carolyn M. Tucker ◽  
Tasia M. Smith ◽  
Guillermo M. Wippold ◽  
Nicole E. Whitehead ◽  
Tara A. Morrissette ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Healthy Eating ◽  
Intervention Group ◽  
Control Group ◽  
Post Intervention ◽  
Community Based ◽  
Hispanic Adults ◽  
Waitlist Control Group ◽  
Health Promotion Interventions

Objective. To examine the impact of a community-informed and community-based Health-Smart Church (HSC) Program on engagement in health promoting behaviors (healthy eating and physical activity) and health outcomes (body mass index, weight, and systolic and diastolic blood pressure). Design. A total of 70 overweight/obese Hispanic adults participated in an intervention group (n = 37) or a waitlist control group (n = 33) in 2 Hispanic churches in Bronx, New York. Results. Post-intervention the intervention group significantly increased in frequency of healthy eating and physical activity compared to the waitlist control group. Although no significant changes in body mass index or systolic blood pressure were found for either group, the intervention group decreased significantly in weight from pre-intervention to post-intervention. Conclusions. The results of the present study add to the growing body of literature evidencing the successful use of community-engaged and community-based participatory health promotion interventions with racial/ethnic minority populations and highlight important practices and considerations for similar health promotion interventions with these communities.

Evaluating the Impact of Teacher-designed, Wellbeing and Sustainability Play-based Learning Experiences on Young Children's Knowledge Connections: A Randomised Trial

2018 ◽  
Vol 43 (4) ◽  
pp. 33-42
Author(s):  
Heather Morris ◽  
Susan Edwards ◽  
Amy Cutter-Mackenzie ◽  
Leonie Rutherford ◽  
Janet Williams-Smith ◽  
...  
Keyword(s):  
Digital Media ◽  
Randomised Trial ◽  
Learning Experiences ◽  
Intervention Group ◽  
Parent Report ◽  
Control Group ◽  
Post Intervention ◽  
Waitlist Control Group ◽  
Children's Interests ◽  
The Impact

THIS PAPER REPORTS FINDINGS from a randomised investigation into the effect of teacher-designed, play-based learning experiences on preschool-aged children's knowledge connections between healthy eating and active play as wellbeing concepts, and sustainability. The investigation used a ‘ funds of knowledge’ theoretical framework to situate young children's interests in digital media and popular culture, as a site for learning these knowledge connections. The findings suggest that the intervention group children created more wellbeing and sustainability knowledge connections than the waitlist control group children. Additionally, the intervention group children demonstrated an increase in vegetable serves and a decrease in unhealthy food servings post intervention (measured by parent report). The paper suggests that more attention should be paid to early childhood teachers’ capacity for actively building children's knowledge about wellbeing and sustainability concepts through play-based learning, as opposed to top-down approaches towards obesity education and prevention alone.

Art therapy and self-image: A 5-year follow-up art therapy RCT study of women diagnosed with breast cancer

2021 ◽  
pp. 1-9
Author(s):  
Karin Egberg Thyme ◽  
Björn Tavelin ◽  
Inger Öster ◽  
Jack Lindh ◽  
Britt Wiberg
Keyword(s):  
Breast Cancer ◽  
Art Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Long Term Effects ◽  
Post Intervention ◽  
Follow Up Study ◽  
Self Image ◽  
Behavioral System

Abstract Objective This follow-up study on perceived self-image and psychophysical distress/psychic symptoms was based on a ranomized contolled study of art therapy on women with breast cancer. Method The aim was to examine the long-term effects of time-limited art therapy using the instruments of Structural Analysis of Social Behavior (SASB) and Symptom Check List-90 (SCL-90). Results Three attachment clusters of the SASB showed significant changes post therapy: Autonomous self (cluster 1), Accepting self (cluster 2), and Loving self (cluster 3). Clusters 2 and 3 continued to change in favor of the intervention group at the 5-year follow-up. There were no significant differences in the SCL-90 results between the intervention group and the control group in the follow-up study. Significance of results The art therapy intervention was both therapeutic and psycho-educative. The conclusion of this study is that approaching emotions through time-limited art therapy seems to have a long-lasting effect on the attachment behavioral system shown in the SASB model post intervention, and this effect remained 5 years later.

scholarly journals Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones

Thorax ◽  
2019 ◽  
Vol 74 (4) ◽  
pp. 328-336 ◽  
Author(s):  
Carmen H M Houben ◽  
Martijn A Spruit ◽  
Hans Luyten ◽  
Herman-Jan Pennings ◽  
Vivian E M van den Boogaart ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Death And Dying ◽  
Intervention Group ◽  
Control Group ◽  
Life Care ◽  
Quality Of Death ◽  
Advance Care

RationaleAdvance care planning (ACP) is uncommon in patients with chronic obstructive pulmonary disease (COPD).ObjectivesTo assess whether a nurse-led ACP-intervention can improve quality of patient-physician end-of-life care communication in patients with COPD. Furthermore, the influence of an ACP-intervention on symptoms of anxiety and depression in patients and loved ones was studied. Finally, quality of death and dying was assessed in patients who died during 2-year follow-up.MethodsA multicentre cluster randomised-controlled trial in patients with advanced COPD was performed. The intervention group received an 1.5 hours structured nurse-led ACP-session. Outcomes were: quality of patient-physician end-of-life care communication, prevalence of ACP-discussions 6 months after baseline, symptoms of anxiety and depression in patients and loved ones and quality of death and dying.Results165 patients were enrolled (89 intervention; 76 control). The improvement of quality of patient-physician end-of-life care communication was significantly higher in the intervention group compared with the control group (p<0.001). The ACP-intervention was significantly associated with the occurrence of an ACP-discussion with physicians within 6 months (p=0.003). At follow-up, symptoms of anxiety were significantly lower in loved ones in the intervention group compared with the control group (p=0.02). Symptoms of anxiety in patients and symptoms of depression in both patients and loved ones were comparable at follow-up (p>0.05). The quality of death and dying was comparable between both groups (p=0.17).ConclusionOne nurse-led ACP-intervention session improves patient-physician end-of-life care communication without causing psychosocial distress in both patients and loved ones.

scholarly journals Self-reported sick leave following a brief preventive intervention on work-related stress

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
A-M Hultén ◽  
P Bjerkeli ◽  
K Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Brief Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Work Related Stress ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background General practitioners (GPs) play an important role for early identification and prevention of sick leave among patients perceiving ill health due to work-relates stress. In order to fulfil the role, they need adequate methodologies and tools. This study aimed to evaluate the effectiveness of a brief intervention in primary health care including early identification of work-related stress combined with feedback at consultation on the number of self-reported sick leave days. Methods A randomised controlled trial was performed at seven primary health care centres in western Sweden. Self-reported sick leave data collected between November 2015 and January 2017 were analysed prospectively. The study included 271 employed, non-sick-listed patients aged 18-64 years seeking care for mental and/or physical health complaints. The intervention group received a brief intervention about work-related stress, including training for GPs, screening of patients' work-related stress, feedback to patients on screening results and discussion of measures at GP consultation. The control group received treatment as usual. Results At 6-month follow-up 59/105 (56%) in the intervention group and 61/115 (53%) in the control group reported no sick leave. At 12-month follow-up the corresponding numbers were 61/119 (51%) and 57/122 (47%) respectively. There were no statistically significant differences between the intervention group and the control group in the median number of self-reported sick leave days. Conclusions The brief intervention showed no effect on the numbers of self-reported sick leave days. However, using sick leave as an outcome measure was difficult, as sick leave is multifactorial and the data has a non-normal distribution. In addition, sick leave might be used as an indicator as well as a possible treatment of ill health. Other actions and interventions to address patients perceiving ill health due to work-related stress should be explored. Key messages Sick leave is used as an indicator and as a treatment of ill health, which can complicate the evaluation of studies. The complexity of primary health care trials calls for other evaluation methods.

Use of a values inventory as a discussion aid about end-of-life care: A pilot randomized controlled trial

2015 ◽  
Vol 14 (4) ◽  
pp. 330-340 ◽  
Author(s):  
Shailaja Menon ◽  
Laurence B. McCullough ◽  
Rebecca J. Beyth ◽  
Marvella E. Ford ◽  
Donna Espadas ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
End Of Life ◽  
Medical Center ◽  
Controlled Trial ◽  
Intervention Group ◽  
Outpatient Setting ◽  
Control Group ◽  
Randomized Controlled ◽  
Eol Care ◽  
Pilot Randomized Controlled Trial

AbstractObjective:We examined the utility of a brief values inventory as a discussion aid to elicit patients' values and goals for end-of-life (EoL) care during audiotaped outpatient physician–patient encounters.Method:Participants were seriously ill male outpatients (n = 120) at a large urban Veterans Affairs medical center. We conducted a pilot randomized controlled trial, randomizing 60 patients to either the intervention (with the values inventory) or usual care. We used descriptive statistics and qualitative methods to analyze the data. We coded any EoL discussions and recorded the length of such discussions.Results:A total of 8 patients (13%) in the control group and 13 (23%) in the intervention group had EoL discussions with a physician (p = 0.77). All EoL discussions in the control group were initiated by the physician, compared with only five (38%) in the intervention group. Because most EoL discussions took place toward the end of the encounter, discussions were usually brief.Significance of results:The outpatient setting has been promoted as a better place for discussing EoL care than a hospital during an acute hospitalization for a chronic serious illness. However, the low effectiveness of our intervention calls into question the feasibility of discussing EoL care during a single outpatient visit. Allowing extra time or an extra visit for EoL discussions might increase the efficacy of advance care planning.

scholarly journals Destress 9-1-1—an online mindfulness-based intervention in reducing stress among emergency medical dispatchers: a randomised controlled trial

2019 ◽  
Vol 76 (10) ◽  
pp. 705-711 ◽  
Author(s):  
Michelle Lilly ◽  
Rebecca Calhoun ◽  
Ian Painter ◽  
Randal Beaton ◽  
Scott Stangenes ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Controlled Trial ◽  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Post Intervention ◽  
Work Related ◽  
Emergency Medical ◽  
Emergency Medical Dispatchers

ObjectivesEmergency medical dispatchers (EMDs) experience significant stress in the workplace. Yet, interventions aimed at reducing work-related stress are difficult to implement due to the logistic challenges associated with the relatively unique EMD work environment. This investigation tested the efficacy of a 7-week online mindfulness-based intervention (MBI) tailored to the EMD workforce.MethodsActive-duty EMDs from the USA and Canada (n=323) were randomly assigned to an intervention or wait list control condition. Participants completed surveys of stress and mindfulness at baseline, post intervention, and 3 months follow-up. Repeated measures mixed effects models were used to assess changes in stress and mindfulness.ResultsDifferences between the intervention group and control group in pre–post changes in stress using the Calgary Symptoms of Stress Inventory were statistically significant, with a difference of −10.0 (95% CI: −14.9, −5.2, p<0.001) for change from baseline to post intervention, and a difference of −6.5 (95% CI: −11.9, −1.1, p=0.02) for change from baseline to 3 months follow-up. Change in mindfulness scores did not differ between groups. However, increases in mindfulness scores were correlated with greater reductions in stress for all participants, regardless of group (r=−0.53, p<0.001).ConclusionsDevelopment of tailored online MBIs for employees working in challenging work environments offer a promising direction for prevention and intervention. This study found that a short, weekly online MBI for EMDs resulted in reductions in reports of stress. Implications of online MBIs in other emergency responding populations and directions for future research are discussed.

scholarly journals Does early identification of work-related stress in primary health care effect pharmacy dispensing?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Bjerkeli ◽  
I M Skoglund ◽  
K Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Pharmacological Treatment ◽  
Early Identification ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. Methods The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care were eligible participants. The intervention included general practitionerś (GP) training to use the WSQ, early identification of patientś work-related stress by the WSQ, and GPś feedback on the WSQ results during the consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for 12 months following the intervention were analysed using Mann Whitney U tests and chi-square tests. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Results The study population included 271 individuals (132 in the intervention group and 139 in the control group). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). Conclusions Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. Key messages Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. Patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics than controls.

scholarly journals Does early identification of high work related stress affect pharmacological treatment of primary care patients? - analysis of Swedish pharmacy dispensing data in a randomised control study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Pernilla J. Bjerkeli ◽  
Ingmarie Skoglund ◽  
Kristina Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Work Related ◽  
Primary Health ◽  
Related Stress ◽  
Pharmacy Dispensing Data ◽  
Dispensing Data

Abstract Background The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. Methods The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care centres (PHCCs) were eligible participants. The intervention included early identification of work-related stress by the WSQ, general practitioner (GP) training and GP feedback at consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for a period of 12 months following the intervention was used. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Data was analysed using Mann Whitney U tests and chi-square tests. Results The study population included 271 individuals (132 in the intervention group and 139 in the control group). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). Conclusion Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. In this randomised control trial, analysis of pharmacy dispensing data show that patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics. Trial registration ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.

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