Enhancing Clinicians' Well-Being and Patient-Centered Care Through Mindfulness

被引:37
作者
Dobkin, Patricia Lynn [1 ]
Bernardi, Nicolo Francesco [2 ]
Bagnis, Corinne Isnard [3 ,4 ]
机构
[1] McGill Univ, Dept Med, Programs Whole Person Care, Montreal, PQ H3A 0C7, Canada
[2] McGill Univ, Dept Psychol, Montreal, PQ H3A 0C7, Canada
[3] Univ Paris 06, Grp Hosp Pitie Salpetriere, Dept Nephrol, Paris, France
[4] Univ Paris 06, Chaire Rech Educ Therapeut Patient, Paris, France
关键词
mindfulness; burnout; stress management; meaningfulness; quality improvement; communication skills; profession-physician; reflective practice; PROGRAM; BURNOUT; COMMUNICATION; PROFESSIONALS; PHYSICIANS; STRESS;
D O I
10.1097/CEH.0000000000000021
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
Introduction:Mindful clinicians are resilient and more likely to provide patient-centered care. We aimed to enhance clinicians' well-being by offering a Mindfulness-Based Stress Reduction (MBSR) course that teaches mindfulness and stress management and then determine whether this impacted their subsequent medical encounters.Methods:In a longitudinal cohort study with 27 clinicians, MBSR was taught by a certified instructor. Pre-MBSR and post-MBSR online questionnaires assessed burnout, depression, stress, meaningfulness, and mindfulness. Patients independently rated their clinicians using the Rochester Communication Rating Scale (RCRS) after a clinical encounter before and after their clinician took the MBSR course. Nine medical doctors audiorecorded the consultations before and after MBSR; the tapes were coded and analyzed by an independent team using the Roter interaction analyses system.Results:Significant reductions in stress and burnout were found, and increases in mindfulness and meaningfulness. The decrease in stress was correlated with less judgmental attitudes and less reactivityfacets of mindfulness. The decrease in emotional exhaustion was correlated with more acting with awareness and less judgmental attitudesfacets of mindfulness. Patients' perceptions of the clinical encounter suggested that patient-centered care improved after MBSR. Decreased depersonalization was significantly associated with the RCRS subscale, understanding of the patient's experience of illness. At both time points, doctors dominated the exchange and were patient-centered.Discussion:Mindfulness has a direct and positive impact on clinicians' well-being. When clinicians' experienced less depersonalization, their patients reported being better understood.
引用
收藏
页码:11 / 16
页数:6
相关论文
共 27 条
[1]  
[Anonymous], MINDFUL MED PRACTICE
[2]  
[Anonymous], 2009, Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness
[3]   THE STRUCTURE AND PROPERTIES OF THE SENSE OF COHERENCE SCALE [J].
ANTONOVSKY, A .
SOCIAL SCIENCE & MEDICINE, 1993, 36 (06) :725-733
[4]   A Multicenter Study of Physician Mindfulness and Health Care Quality [J].
Beach, Mary Catherine ;
Roter, Debra ;
Korthuis, P. Todd ;
Epstein, Ronald M. ;
Sharp, Victoria ;
Ratanawongsa, Neda ;
Cohn, Jonathon ;
Eggly, Susan ;
Sankar, Andrea ;
Moore, Richard D. ;
Saha, Somnath .
ANNALS OF FAMILY MEDICINE, 2013, 11 (05) :421-428
[5]   PSYCHOMETRIC PROPERTIES OF THE BECK DEPRESSION INVENTORY - 25 YEARS OF EVALUATION [J].
BECK, AT ;
STEER, RA ;
GARBIN, MG .
CLINICAL PSYCHOLOGY REVIEW, 1988, 8 (01) :77-100
[6]  
Blacker M., 2009, Stress Reduction Clinic Mindfulness-Based Stress Reduction (MBSR) Curriculum Guide
[7]   Psychometric Properties of the Five Facet Mindfulness Questionnaire in Depressed Adults and Development of a Short Form [J].
Bohlmeijer, Ernst ;
ten Klooster, Peter M. ;
Fledderus, Martine ;
Veehof, Martine ;
Baer, Ruth .
ASSESSMENT, 2011, 18 (03) :308-320
[8]   A GLOBAL MEASURE OF PERCEIVED STRESS [J].
COHEN, S ;
KAMARCK, T ;
MERMELSTEIN, R .
JOURNAL OF HEALTH AND SOCIAL BEHAVIOR, 1983, 24 (04) :385-396
[9]   For Whom May Participation in a Mindfulness-Based Stress Reduction Program be Contraindicated? [J].
Dobkin, Patricia L. ;
Irving, Julie A. ;
Amar, Simon .
MINDFULNESS, 2012, 3 (01) :44-50
[10]  
Dobkin PL, 2011, WHOLE PERSON CARE: A NEW PARADIGM FOR THE 21ST CENTURY, P69, DOI 10.1007/978-1-4419-9440-0_7