Search

Background Work stress is a common problem among the health personnel of the Spanish National Health System. The objective of this paper is to assess the state of mindfulness among Spanish primary care providers and to evaluate its potential relationship with work stress and basic labor and sociodemographic characteristics. Methods Cross-sectional, multi-centric study. Primary care nurses, teachers, teaching collaborators and residents assigned to six Spanish Family Medicine/Family and Community Care Departments were invited to participate (n = 475). A template was designed in Google Forms, including sociodemographic and work-related variables. The state of mindfulness was measured with the Five Facet Mindfulness Questionnaire (FFMQ), while work-related stress was measured using an ordinal scale ranging from 0 to 10 points. Descriptive and inferential statistical analyses were carried out, as well as bivariate and multivariate statistics. Results The mean age of participants was 40,14 ± 13.12 (range:23–65 years); 66.9% were women, 42.5% internal medicine residents, 29.3% family physicians, and 20.2% nurses. More than half (54.5%) knew about mindfulness, with 24.0% have received training on it, and 22.5% were usual practitioners. The average level of mindfulness was 127.18 ± 15.45 (range: 89–177). The average score of stress at work was 6.00 ± 2.44; 49.9% (range: 0–10). 49.9% of participants scored 7 or more on the stress at work scale. There was an inverse correlation between the levels of mindfulness (FFMQ total score) and work-related stress (Spearman’s r = − 0.155, p = 0.003). Significant relationships between the mindfulness practice and the level of mindfulness (F = 29.80, p p = 0.042), were also found. Conclusions Levels of mindfulness in primary care health providers were in line with those levels observed in other groups of health professionals. Half of all of the primary care providers suffered from a high degree of stress. Although weak, inverse relationships were observed between levels of mindfulness and stress at work, with lower values of stress at work among those who practiced mindfulness. Trial registration NCT03629457.

Interest of the study: mindfulness is a concept describing the focus on the present moment, intentionally and without judgement. This approach has only recently been applied to sport psychology. Objectives: the aim of the current review is to investigate which indicators and questionnaires are used in mindfulness research in sport, being specifically interested in mindfulness assessment. Methods: PRISMA guidelines for systematic reviews and the recommendations of the Cochrane Collaboration were used. Literature searches were conducted in Psychinfo, PubMed, EMBASE and the Cochrane Library. Results: From 2, 203 records initially retrieved, 17 articles were included. The results show that mindfulness, anxiety and acceptance are the most commonly studied psychological indicators. The Five Facet Mindfulness Questionnaire is the most frequently used mindfulness scale. We also discuss the possibility of using physiological indicators as complementary assessment. Conclusions: It is recommended to specifically adapt some questionnaires, such is already done with the Sport Anxiety Scale or the Mindfulness Inventory for Sport, for their use in sport psychology.

Introduction Depressive, anxiety and adjustment disorders are highly prevalent among mental health outpatients. The lack of funding for mental health problems produces inefficient results and a high burden of disease. New cost-effective group interventions aimed at treating these symptoms might be an appropriate solution to reduce the healthcare burden in mental health units. Mindfulness-based interventions (MBIs) have shown significant reductions in anxious, depressive and adjustment symptomatology. Recent research highlights the influence of compassion as a key mechanism of change. However, MBIs only address compassion implicitly, whereas compassion-based protocols consider it a core aspect of psychotherapy. In this randomised controlled trial, we hypothesise that the provision of attachment-based compassion therapy (ABCT), which is a compassion-based protocol, will be more effective than mindfulness-based stress reduction (MBSR), which is a conventional MBI programme, for the treatment of depressive, anxious and adaptive symptoms in patients in mental health settings. Methods and analysis Approximately 90 patients suffering from depressive, anxious or adjustment disorders recruited from Spanish mental health settings will be randomised to receive 8 weekly 2 hours group sessions of ABCT, 8 weekly 2.5 hours group sessions of adapted MBSR (with no full-day silent retreat) or treatment as usual (TAU), with a 1:1:1 allocation rate. Patients in the ABCT and adapted MBSR groups will also receive TAU. The main outcome will be general affective distress measured by means of the 'Depression Anxiety Stress Scales-21' at post-test as primary endpoint. Other outcomes will be quality of life, mindfulness, self-compassion and the use of healthcare services. There will be a 6-month follow-up assessment. Intention-to-treat analysis will be conducted using linear mixed models. Per-protocol and secondary outcome analyses will be performed. A data monitoring committee comprising the trial manager, the ABCT and MBSR teachers and an independent clinical psychologist will monitor for possible negative side effects. Ethics and dissemination Approval was obtained from the Ethics Committee of the General University Hospital of Castellon, Spain. The results will be submitted to peer-reviewed specialised journals, and brief reports will be sent to participants on request.

Fibromyalgia (FM) is a disabling syndrome characterized by chronic pain associated with fatigue. Its pathogenesis is unknown, but alterations in central sensitization, involving an imbalance of brain-derived neurotrophic factor (BDNF) and inflammatory biomarkers, appear to be implicated. The aim of this study was to evaluate the impact of attachment-based compassion therapy (ABCT) on levels of BDNF, the inflammatory markers TNF-a, IL-6, IL-10, and the C-reactive protein (CRP), analysing whether biomarkers play a mediating/moderating role in improvements in FM functional status. Thirty-four female patients with FM participated in a RCT and were assigned to ABCT or relaxation therapy. Blood extractions were conducted at baseline and post-intervention, with self-report assessments of functional status (FIQ) at baseline, post-intervention and 3-month follow-up. A pro-inflammatory composite was obtained by summing up IL-6, TNF-a and CRP normalized values. Non-parametric tests, analysis of variance and regression models were used to evaluate treatment and mediation/moderation. Compared to relaxation therapy, ABCT showed significant improvements in FIQ and decreases in BDNF, CRP, and pro-inflammatory composite. Changes in BDNF had a mediating role in FIQ. ABCT seems to reduce BDNF and appears to have anti-inflammatory effects in FM patients. Reductions in BDNF could be a mechanism of FM functional status improvement.Clinical Trial Registration: http://ClinicalTrials.gov , identifier NCT02454244. Date: May 27th, 2015.

As dimensions of effortful control (EC), activation control, attentional control, and inhibitory control could mediate the relationship between mindfulness meditation practice and the facets of mindfulness (i.e., observing, describing, acting with awareness, non-judging and non-reacting to inner experience). In this study, we tested whether participant status: meditators (n=330), healthy non-meditators (n=254) and individuals with borderline personality disorder (BPD) diagnosis (n=46) predicted the facets of mindfulness and if these potential effects were mediated through the three effortful control (EC) dimensions (activation, attentional and inhibitory control). Meditators scored higher than non-meditators on attentional and inhibitory control and on the facets of mindfulness with attentional and inhibitory control partially mediating this relationship between meditation status and mindfulness facets. Participants with BPD showed lower scores on EC along with lower scores on the facets of mindfulness compared with healthy non-meditators. All three aspects of EC partially mediated the relationship between BPD and mindfulness facets. Copyright (c) 2018 John Wiley & Sons, Ltd.

Background Mindfulness has been applied in the United States and Europe to improve physical and psychological health; however, little is known about its feasibility and efficacy in a Brazilian population. Mindfulness may also be relevant in tackling obesity and eating disorders by decreasing binge eating episodes—partly responsible for weight regain for a large number of people—and increasing awareness of emotional and other triggers for overeating. The aim of the present study protocol is to evaluate and compare the feasibility and efficacy of two mindfulness-based interventions (MBIs) addressing overweight and obesity in primary care patients: a general programme called Mindfulness-Based Health Promotion and a targeted mindful eating protocol called Mindfulness-Based Eating Awareness Training. Methods/design A randomised controlled trial will be conducted to compare treatment as usual separately in primary care with both programmes (health promotion and mindful eating) added to treatment as usual. Two hundred forty adult women with overweight and obesity will be enrolled. The primary outcome will be an assessment of improvement in eating behaviour. Secondary outcomes will be (1) biochemical control; (2) anthropometric parameters, body composition, dietary intake and basal metabolism; and (3) levels of mindfulness, stress, depression, self-compassion and anxiety. At the end of each intervention, a focus group will be held to assess the programme’s impact on the participants’ lives, diet and health. A feasibility study on access to benefits from and importance of MBIs at primary care facilities will be conducted among primary care health care professionals and participants. Monthly maintenance sessions lasting at least 1 hour will be offered, according to each protocol, during the 3-month follow-up periods. Discussion This clinical trial will result in more effective mindfulness-based interventions as a complementary treatment in primary care for people with overweight and obesity. If the findings of this study confirm the effectiveness of mindfulness programmes in this population, it will be possible to improve quality of life and health while optimising public resources and reaching a greater number of people. In addition, on the basis of the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy.

Communication between physicians and patients is a key pillar of psychosocial support for enhancing the healing process of patients and for increasing their well-being and quality of life. Physicians and other health professionals might benefit from interventions that increase their self-care, awareness, compassion, and other-focused concern, and reduce the chances of distress and burnout. There is substantial evidence for the contribution of different management strategies to achieve these aims. The goal of this article is to review the potential effect of mindfulness and compassion-based strategies for the improvement of physician-patient interactions. The acquisition of the necessary skills by physicians requires continuous education. Future research will be useful for identifying more evidence on the cost-effectiveness of this type of intervention.

Objectives. The purpose of this study was to conduct the first randomized controlled\ud trial (RCT) to evaluate the effectiveness of a second-generation mindfulness-based\ud intervention (SG-MBI) for treating fibromyalgia syndrome (FMS). Compared to firstgeneration\ud mindfulness-based interventions, SG-MBIs are more acknowledging of the\ud spiritual aspect of mindfulness.\ud Design. A RCT employing intent-to-treat analysis.\ud Methods. Adults with FMS received an 8-week SG-MBI known as meditation awareness\ud training (MAT; n = 74) or an active control intervention known as cognitive behaviour\ud theory for groups (n = 74). Assessments were performed at pre-, post-, and 6-month\ud follow-up phases.\ud Results. Meditation awareness training participants demonstrated significant and\ud sustained improvements over control group participants in FMS symptomatology, pain\ud perception, sleep quality, psychological distress, non-attachment (to self, symptoms, and\ud environment), and civic engagement. A mediation analysis found that (1) civic engagement\ud partially mediated treatment effects for all outcome variables, (2) non-attachment\ud partially mediated treatment effects for psychological distress and sleep quality, and (3)\ud non-attachment almost fully mediated treatment effects for FMS symptomatology and\ud pain perception. Average daily time spent in meditation was found to be a significant\ud predictor of changes in all outcome variables.\ud Conclusions. Meditation awareness training may be a suitable treatment for adults with\ud FMS and appears to ameliorate FMS symptomatology and pain perception by reducing\ud attachment to self.

Objective: To compare the structure and explanatory power of the traditional and the subtype burnout definitions on symptoms of distress. Methods: We used a cross-sectional design with a random sample of university employees (n=429), who completed the MBI-GS, BCSQ-12 and HSCL-30. The structure of the scales was assessed using parallel analysis from polychoric correlations, unweighted least squares and pro- min rotation. Multivariate regression models were built among symptoms and burnout models. Results: The HSCL showed a two-factor structure (psychological and somatic; IFS=0.87; GFI=0.99; RMSR=0.05); the MBI a forced three-factor structure (exhaustion, efficacy and cyni- cism; IFS=0.95; GFI>0.99; RMSR=0.03); the BCSQ a three-factor structure (neglect, lack of development and overload; IFS=0.98; GFI>0.99; RMSR=0.02). The variance of psychological distress was for 40% explained by MBI-GS and for 27% by BCSQ-12; the variance of somatic symptoms was for 31% explained by MBI-GS and 16% by BCSQ-12. All the BCSQ-12 factors contributed to explain psychological and somatic symptoms, but only exhaustion from MBI-GS. Conclusions: The typological definition showed better structure, but worse explanatory power on symptoms, than the traditional perspective. Exhaustion seems to be the burnout core dimension, althought the subtypes would explain a specific characterization of the syndrome.