Global advances in integrative medicine and health最新文献

Background: The beginning of the career of teachers is a demanding phase. In the combined roles of teacher and trainee, and in the shift from academic to practical learning, trainee teachers have to acquire competencies in teaching as well as coping with stress. In this phase, the phenomenon of "reality shock" is widely observed.

Objective: A mindfulness training was developed to support teacher trainees during their first year. This intervention study investigated perceived and physiological stress at teachers' career start and the stress reducing effects of the mindfulness training in this phase.

Methods: In a quasi-experimental design, 19 out of 42 participants from this sample underwent mindfulness-based stress reduction training and a wait-list control group (N = 23) underwent a compact course after post measurements. We measured physiological stress parameters and perceived stress at 3 different time points. Heart rate signals were acquired in ambulatory assessment sequences, including teaching, rest periods, and cognitive tasks. The data were analyzed in linear mixed-effects models.

Results: We found high physiological stress in the very beginning of teacher training, which attenuated over time. The mindfulness intervention only led to a greater reduction in heart rate (d = .53 to .74) in situations where the intervention group had shown higher heart rate levels initially, but not in heart rate variability. However, the mindfulness group significantly reduced (d = .63) their perceived stress and maintained (d = .55) this improvement, while the control group maintained a highly elevated perceived stress level throughout.

Conclusion: The mindfulness training could reduce subjective stress, which otherwise seems to be a long-lasting aspect of beginning teachers' "reality shock". Indications of a superior reduction of physiological stress in demanding situations were weak, while generally, undue physiological stress seems to be a temporary phenomenon in the initial phase of teacher induction.

Background: Whole health is a holistic approach encompassing integrative medicine, emotional, and spiritual health and is critical to improving health outcomes among individuals with multimorbidity.

Objective: To examine the prevalence of Whole Health activities and the association of multimorbidity and Whole Health activities using nationally representative datasets.

Methods: As no single dataset has information on Whole Health self-care activities, data from the 2017 National Health Interview Survey (n = 25 134) was used to measure participants' mind-body therapy usage, sleep, mental health, and physical activity. We used the 2017 Behavioral Risk Factor Surveillance System (n = 347 029) to assess regular vegetable and/or fruit consumption.

Results: A significantly lower percentage of adults with multimorbidity had adequate sleep (58.2%vs.67.1%), no psychological distress (71.8%vs.82.1%), adequate physical activity (48.2%vs.62.1%), and regular vegetable and/or fruit consumption (54.2%vs.56.6%) compared to those without multimorbidity. Although lower percentages of adults with multimorbidity utilized mind-body therapies (22.9%vs.25.2%), the association was reversed when adjusted for socioeconomic factors. In the fully adjusted models, adults with multimorbidity were more likely to use mind-body therapies (AOR = 1.19, 95%CI = 1.09, 1.31). Furthermore, when adjusting for other independent variables, the associations of multimorbidity with sleep, psychological distress, and diet were exacerbated, and the association of multimorbidity with physical activity was attenuated.

Conclusion: Adults with multimorbidity were less likely to engage in most of the Whole Health activities except mind-body therapies compared to the no multimorbidity group. Findings suggest that adjustment for other factors such as age and socioeconomic status changed the magnitude and direction of the association of multimorbidity with Whole Health activities.

Background: Meditation, including Mindfulness-Based Interventions (MBI), is a required Complementary and Integrative Health intervention at the US Department of Veterans Affairs (VA). Training VA clinicians to provide MBI at scale must address fidelity concerns and the assessment of clinician competency.

Objective: The psychometric properties of the Mindfulness-Based Intervention: Teaching Assessment Criteria (MBI:TAC), a widely used tool for assessing facilitator competence, continue to be explored. To support the dissemination of MBI, the utility of using the MBI:TAC for self-assessment for clinicians in a national training program was evaluated.

Methods: In a training cohort of VA clinicians (n = 39), participant self evaluations on 2 domains of the MBI:TAC are compared to the competency scores of 2 expert evaluators as based on the observations of a 10-minute exercise. Additionally, the inter-rater reliability between the 2 experts was explored.

Results: Intraclass Correlation for the 2 expert evaluators for Guiding Practice was significant (ρ = .83, P = .003), but was not significant for Embodiment of Mindfulness (ρ = .34, P = .186). Self-evaluation scores were not significantly correlated to expert rater scores such that participants rate their level of competence higher than expert scores.

Conclusion: The MBI:TAC, while an essential tool in teacher training, may not produce accurate scores when used for self-assessment. Instruction from a senior teacher is needed for accurate scoring. Interrater reliability may be improved with enhanced domain operationalization and training. Implications for MBI training are explored.

Background: Mindfulness in Motion (MIM) is a workplace resilience-building intervention that has shown reductions in perceived stress and burnout, as well as increased resilience and work engagement in health care workers.

Objective: To evaluate effects of MIM delivered in a synchronous virtual format on self-reported respiratory rates (RR), as well as perceived stress and resiliency of health care workers.

Methods: Breath counts were self-reported by 275 participants before and after 8 weekly MIM sessions. MIM was delivered virtually in a group format as a structured, evidence-based workplace intervention including a variety of mindfulness, relaxation, and resilience-building techniques. Participants counted their breaths for 30 seconds, which was then multiplied by 2 to report RR. Additionally, participants completed Perceived Stress Scale and Connor-Davidson Resiliency Scale.

Results: According to mixed effect analyses there were main effects of MIM Session (P < .001) and Weeks (P < .001), but no Session by Week interaction (P = .489) on RR. On average, RR prior to MIM sessions were reduced from 13.24 bpm (95% CI = 12.94, 13.55 bpm) to 9.69 bpm (95% CI = 9.39, 9.99 bpm). When comparing average Pre-MIM and Post-MIM RR throughout the MIM intervention, Week-2 (mean = 12.34; 95% CI = 11.89, 12.79 bpm) was not significantly different than Week-1 (mean = 12.78; 95% CI = 12.34, 13.23 bpm), but Week-3 through Week-8 demonstrated significantly lower average Pre-MIM and Post-MIM RR compared to Week-1 (average weekly difference range: 1.36 to 2.48 bpm, P < .05). Perceived stress was reduced from Week-1 (17.52 ± 6.25) to after Week-8 (13.52 ± 6.04; P < .001), while perceived resiliency was increased from Week-1 (11.30 ± 5.14) to after Week-8 (19.29 ± 2.58); P < .001).

Conclusion: Thus far, completion of MIM sessions has shown acute and long-term effects on self-reported RR, but more research is required to determine the extent of improved parasympathetic (relaxed) states. Collectively, this work has shown value for mind-body stress mitigation and resiliency-building in high stress acute health care environments.

[This corrects the article DOI: 10.1177/27536130221149791.].

Background: Resilience, a person's ability to adapt to adverse events, is associated with positive outcomes, especially in the field of healthcare. Research into the effects of the COVID-19 pandemic may help to understand and combat the long-term mental health burden for trainees in health care.

Objective: This cross-sectional study aimed to assess the impact of the pandemic on health profession students' educational experiences, determine the association between their self-reported resilience and psychological distress and assess group differences between students from different graduate health profession programs in an academic medical center.

Methods: Graduate health profession students completed a 44-question online survey and the 10-item Connor Davidson Resilience Scale (CD-RISC-10) during the COVID-19 pandemic period between January-March 2021. We used descriptive statistics, independent samples t test, Related-samples Wilcoxon signed rank test, Pearson correlations test and Analysis of variance (ANOVA) to analyze the data.

Results: Majority of respondents reported that COVID-19 had a negative impact on their education and caused a reduction in educational opportunities (76.6% and 73% respectively). Majority also reported feeling burned out, lonely/isolated, or frustrated by COVID-19 restrictions (70.0%, 67.4%, and 61.8% respectively). Students reported increased use of both avoidant and adaptive coping strategies during the pandemic. Higher resilience scores were associated with higher self-reported stress, fewer burnout symptoms, and better overall well-being.

Conclusion: The COVID-19 pandemic significantly affected students in graduate health profession programs. Instructional quality, educational opportunities, institutional trust, peer socialization, and personal health and wellbeing were perceived to be negatively impacted. Students may require additional support and resources from their training programs to mitigate these concerns. Future studies should evaluate the long-term impact of the COVID-19 pandemic among pandemic-era graduate health profession students.

[This corrects the article DOI: 10.1177/2164957X221094596.].

[This corrects the article DOI: 10.1177/2164957X221094596.].