Stress, Psychological Clinical Trial
Official title:
Meditation Practice in Pediatric Healthcare Professionals: a Randomized Controlled Clinical Trial
Rationale: Healthcare professionals face a growing burden of responsibilities and work
overload which may cause psychological suffering expressed by burnout, depression and other
negative psychological variables. Personal behavioral strategies may facilitate the coping
process. To maintain these positive characteristics, it is necessary that one decouples from
automatic thoughts, habits and patterns of unhealthy behaviors, leading to behavioral and
physiological regulation, through mindfulness techniques. More specifically, Yoga is an
ancient Indian philosophical and practical system and its ultimate goal is to calm the human
mind, and increase vital capabilities. In addition to the ethical precepts of Yoga,
practices involve asanas (postures), pranayama (breathing exercises) and dhyana
(meditation). Many studies have shown the positive effects of Yoga and meditation on
psychometric variables, however, there are few which address the effectiveness of Yoga on
improving psychometric variables of health care professionals. Thus, aiming to reduce the
symptoms that health care professionals experience when they are under burnout, this study
intends to use Yoga meditation, which may enable the professional to experience decoupling
of harmful feelings, improving, firstly, one's own inner self-relationship and therefore,
with patients and their families.
Objective: To investigate the effects of a 8-week yoga meditation program on psychometric
and physiological variables of Pediatrics health professionals.
Methods: randomized controlled clinical trial. Participants: 60 health professionals from
the Pediatrics Department of a tertiary hospital from Federal University of São Paulo
(UNIFESP) will be randomized to meditation or control (waiting list) groups. Subjects of the
meditation groups will have 2 30 min classes a week.
Evaluations: Psychometric and physiological variables will be accessed at study entry
(baseline) and after its completion (8-weeks).
Statistical Analysis: mixed general linear model (intervenient factors: groups - meditation
vs. control and moment - baseline vs. 8-weeks). Significance accepted with p<0.05.
Rationale: Healthcare professionals face a growing burden of responsibilities and work
overload which may cause psychological suffering expressed by burnout, depression and other
negative psychological variables. On the other hand, there are individual strategies which
may be involved and facilitate the coping process: resilience, self-compassion, subjective
well-being, subjective quality of life. In order to maintain these positive characteristics,
it is necessary that one may decouple from automatic thoughts, habits and patterns of
unhealthy behaviors, leading to behavioral and physiological regulation. There are many
mindfulness techniques, which hold in common the following operating parameters: use of a
specific technique, clearly defined and regularly practiced; use of muscle relaxation during
the process; existence of logical relaxation without the intention of analyzing, judging or
creating any expectation about the process. Specifically, Yoga is an ancient Indian
philosophical and practical system and its ultimate goal is to calm the human mind, and
increase vital capabilities. In addition to the ethical precepts of Yoga, its practices
involve asanas (postures), pranayama (breathing exercises) and dhyana (meditation).
Therefore, the process must be done in a gradual and progressive manner, from the outermost
to the innermost, from the simplest to the most complex - from the body to the mind, with
breath as a bridge between them. Many studies have shown the positive effects of Yoga and
meditation on psychometric variables, however, there are few which address the effectiveness
of Yoga on improving psychometric variables of health care professionals. Thus, aiming to
reduce the symptoms that health care professionals suffer when they are in burnout, this
study intends to use Yoga meditation, which may enable health professionals to experience
decoupling of harmful feelings, improving one's own inner self-relationship and therefore,
with patients and their families.
Primary Objective: To assess whether a 8-week intervention of a yoga meditation program
influences psychometric (burnout, resilience, self-compassion, subjective well-being, health
related quality of life and mindfulness) and physiological (polysomnography, glutathione,
catecholamine and serotonin) variables of Pediatrics health professionals.
Secondary Objective: To investigate the cross psychometric profile of Federal University of
São Paulo (UNIFESP) Pediatrics professionals at the inception of the program.
Methodology Experimental design: randomized controlled clinical trial.
Participants: 60 health professionals from the Pediatrics Department of a tertiary hospital
from UNIFESP will be randomized to meditation or control (waiting list) groups. At the end
of the protocol participants of the control group will be offered the possibility to
participate of an identical meditation program. Inclusion criteria: adults; both sexes; not
diagnosed with psychiatric/cognitive disorder or taking any medication which might bias the
evaluation process. The intervention group will participate in an 8-week course of
meditation (2 30-min classes a week).
Space: Evaluations and meditation program will be conducted in a quiet room specifically
reserved for this training at UNIFESP.
Primary outcome: Demonstrate that meditation can be a useful tool in improving burnout,
resilience, self-compassion, subjective well-being, quality of life and of health care
professionals.
Resources: All personnel and logistics necessary for this research will be provided by the
Sports Center of the University of São Paulo (CEPEUSP) and UNIFESP.
Procedures: Meditation training will follow a weekly stratified plan, through which
participants will be guided from the most exterior perceptions, towards the inner most ones,
focusing on yoga meditation processes. First week will have relaxation, and easy-to-perform
asanas along with introduction to pranayama; second week will have pranayamas and
introduction to concentration; from third week onwards, participants will have concentration
and meditation as main components of the classes.
Evaluation plan: Measurements will be done in two stages: study entry and after 8 weeks.
Assessment instruments: burnout (MBI-HSS), resilience (BRCS), self-pity (SCS), subjective
well-being (EBE), quality of life (WHOQOL BREF), attention and mindfulness (MAAS) scales;
venous puncture (by a nurse from Clinical Studies Development Centre Brazil) - 20ml of blood
for glutathione, catecholamine and serotonin analysis; polysomnography (Sleep Institute -
São Paulo, Brazil).
Statistical Analysis: mixed general linear model (intervenient factors: groups - meditation
vs. control and moment - baseline vs. 8-weeks). Significance accepted with p<0.05.
Potential impact: Investigators expect to have a great positive impact on health care
professionals. Through meditation, participants may improve burnout rates, resilience,
self-compassion, subjective well-being, quality of life and mindfulness. Such improvements
may improve work environment, work satisfaction, decrease absenteeism and increase the
professional-patient relationship. Besides, with positive results, it is possible to try and
spread the practice of Yoga to other public hospitals.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Health Services Research
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