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Feasibility of a mindfulness-based stress reduction intervention on health care safety

Date

2016

Authors

Valley, Morgan Anne, author
Stallones, Lorann, advisor
Graham, Daniel, committee member
Fisher, Gwenith, committee member
Zimmerman, Toni, committee member

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Abstract

Occupational injuries represent a significant and costly social and public health problem, especially among health care workers, whose well-being impacts patient safety and quality of care. Mindfulness training, which teaches individuals to bring awareness and acceptance to the present moment, could decrease occupational injury rates while improving worker well-being. Mindfulness training has been proven effective in improving the health and well-being of clinical and healthy populations, but it has not yet been tested as an intervention to improve worker safety. Using a randomized waitlist controlled trial design with a mixed methods approach, the current study sought to: 1) conceptualize hospital health care workers’ experiences in adopting mindfulness practices within the context of an established health behavior theory; and 2) assess the impact of mindfulness training on safety outcomes among hospital health care workers. Hospital health care workers involved in direct patient care at two hospitals in Colorado were recruited to participate in the study.  Participants were randomly assigned to a group that participated in an 8-week Mindfulness-Based Stress Reduction (MBSR) course first or to a waitlist control group, which completed the MBSR training after the first group completed the course.  The MBSR intervention included eight 2.5-hour group sessions of meditation, yoga, and group discussion and one 7-hour silent session to train participants to incorporate the skills in their daily lives. All participants completed questionnaires measuring covariates and safety outcomes at baseline, post-intervention, and six months after they completed the training. Participants also answered open-ended questions about their experiences when adopting mindfulness practices taught in the course. In the qualitative portion of the study, a theory-driven thematic analysis approach was used to analyze the qualitative data with the key constructs of the Health Belief Model acting as the framework for the analysis. In the quantitative portion of the study, mean scores were calculated for each participant on the study variables at each time point. Univariate repeated measures analyses of variance (RM ANOVA) time X group interaction effects with alpha level .05 were used to compare the baseline and post-intervention scores on the outcome variables between groups.  Paired-samples t-tests were used to examine the stability of the intervention effects from both groups’ post-intervention time point to the 6-month follow-up data collection on the significant outcomes for all participants. Hospital health care workers from a university hospital system in Colorado volunteered to participate and were randomized to the immediate MBSR intervention (n=11) or waitlist control group (n=12).  The majority of participants were female and nurses. Qualitative results highlighted the benefits of mindfulness practice among health care workers, which included enhanced awareness and improvements in social relationships and interactions with patients and colleagues. Participants described the lack of healthcare-specific recommendations for incorporating mindfulness practices at work and minimal discussion of evidence supporting mindfulness training as barriers to adopting and adhering to mindfulness practices. Viewed within the context of the Health Belief Model, these qualitative findings may help practitioners design and tailor workplace mindfulness programs to fit the needs of health care workers. Quantitative results of the study indicated that mindfulness training can decrease workplace cognitive failures and increase safety compliance behaviors among hospital health care workers. The qualitative and quantitative results contribute to the novel understanding of the role mindfulness practice plays in health care worker occupational safety and health and can support future larger-scale studies testing the longer-term impacts of mindfulness on health care safety.

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