Mindfulness Exercises Reduce Acute Physiologic Stress Among Female Clinicians.

Q4 Medicine Critical care explorations Pub Date : 2024-10-25 eCollection Date: 2024-11-01 DOI:10.1097/CCE.0000000000001171
Amy H J Wolfe, Pamela S Hinds, Adre J du Plessis, Heather Gordish-Dressman, Vicki Freedenberg, Lamia Soghier
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Abstract

Importance: Approximately 50% of clinicians experience excessive emotional, physical, and mental stress, with repercussions across the entire medical system. Mindfulness exercises may mitigate this excessive stress. Heart rate variability (HRV) is an objective stress measure that can quantify which mindfulness exercises provide the greatest stress reduction.

Objectives: To define the impact of specific mindfulness exercises on HRV, a surrogate for physiologic stress, and the relationship between physiologic (HRV) and subjective stress measured by the State-Trait Anxiety Inventory during a one-day mindfulness workshop.

Design, setting, and participants: This was a prospective observational pilot study performed at a quaternary children's hospital with diverse subspecialists of pediatric nurses, nurse practitioners, and physicians.

Main outcomes and measures: Our primary outcome measure was change in HRV from baseline during three mindfulness exercises.

Results: The grounding, deep breathing, and body scan exercises all produced statistically significant changes in HRV among our 13 female participants. The body scan exercise produced statistically significant changes in all studied HRV parameters compared with baseline. We observed significant increases in Root Mean Square of Successive Differences between normal heartbeats (p = 0.026), high frequency (p ≤ 0.001), and the parasympathetic nervous system index (p ≤ 0.001) reflecting increased parasympathetic tone (e.g., relaxation), whereas sd 2/sd 1 ratio (p ≤ 0.001) and the stress index (p = 0.004) were decreased reflecting sympathetic withdrawal (e.g., decreased stress). Subjective stress decreased after 1-day mindfulness training (44.6 to 27.2) (p < 0.001). Individuals with the largest decrease in subjective stress also had the most improvement in HRV during the body scan exercise.

Conclusions: Clinician stress levels (HRV) improved after participating in grounding, deep breathing, and body scan meditations, which may highlight their importance as stress reduction tools for clinicians. Monitoring of HRV during mindfulness exercises may provide deeper understanding of which specific exercises produce the greatest physiologic stress reduction for individual participants and the trend of these changes over time.

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正念练习能减轻女临床医生的急性生理压力。
重要性:约有 50% 的临床医生会承受过大的情绪、身体和精神压力,并对整个医疗系统产生影响。正念练习可以减轻这种过度的压力。心率变异性(HRV)是一种客观的压力测量方法,可以量化哪些正念练习能最大程度地减轻压力:明确特定正念练习对心率变异(生理压力的替代物)的影响,以及在为期一天的正念工作坊期间,生理压力(心率变异)与状态-特质焦虑量表测量的主观压力之间的关系:这是一项前瞻性观察试验研究,在一家由儿科护士、执业护士和医生等不同专业人员组成的四级儿童医院进行:我们的主要结果指标是三种正念练习期间心率变异从基线到基线的变化:在 13 名女性参与者中,接地、深呼吸和身体扫描练习都对心率变异产生了统计学意义上的显著变化。与基线相比,身体扫描练习使所有研究的心率变异参数都发生了统计学意义上的显著变化。我们观察到,正常心跳间连续差值的均方根(p = 0.026)、高频率(p ≤ 0.001)和副交感神经系统指数(p ≤ 0.001)均有明显增加,反映出副交感神经张力增强(如放松),而 sd 2/sd 1 比率(p ≤ 0.001)和压力指数(p = 0.004)则有所下降,反映出交感神经功能减退(如压力减小)。为期一天的正念训练后,主观压力有所下降(从 44.6 降至 27.2)(p < 0.001)。主观压力下降幅度最大的人在身体扫描练习中心率变异的改善幅度也最大:临床医生在参加接地、深呼吸和身体扫描冥想后,压力水平(心率变异)得到改善,这可能凸显了它们作为临床医生减压工具的重要性。在正念练习过程中监测心率变异可能会让人更深入地了解哪些特定练习能最大程度地减轻参与者的生理压力,以及这些变化随时间推移的趋势。
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