Abstract
BackgroundMaintaining a sense of self-care while providing patient centered care, can be difficult for practitioners in palliative medicine. We aimed to pilot an “on the job” mindfulness and compassion-oriented meditation training for interdisciplinary teams designed to reduce distress, foster resilience and strengthen a prosocial motivation in the clinical encounter.MethodsOur objective was to explore the feasibility and effectiveness of this newly developed training. The study design was an observational, mixed-method pilot evaluation, with qualitative data, self-report data, as well as objective data (cortisol) measured before and after the program.Twenty-eight staff members of an interdisciplinary palliative care team participated in the 10-week training conducted at their workplace.Measures were the Perceived Stress Questionnaire, the Maslach Burnout Inventory, the somatic complaints subscale of the SCL-90-R, the Emotion Regulation Skills Questionnaire, the Hospital Anxiety and Depression Scale, and a Goal Attainment Scale that assessed two individual goals. Semi-structured interviews were employed to gain insight into the perceived outcomes and potential mechanisms of action of the training. T-tests for dependent samples were employed to test for differences between baseline and post-intervention.ResultsSignificant improvements were found in two of three burnout components (emotional exhaustion and personal accomplishment), anxiety, stress, two emotional regulation competences and joy at work. Furthermore, 85% of the individual goals were attained. Compliance and acceptance rates were high and qualitative data revealed a perceived enhancement of self-care, the integration of mindful pauses in work routines, a reduction in rumination and distress generated in the patient contact as well as an enhancement of interpersonal connection skills. An improvement of team communication could also be identified.ConclusionsOur findings suggest that the training may be a feasible, effective and practical way of reducing caregiver-distress and enhancing the resources of palliative care teams.
Highlights
Developing a mindful presence at workFinding the inner source(s) of compassionCompassion-oriented Meditation in action5, 6, 7, 8, 9 and 10Mindful presence in difficult situations anote that some contents, were repeatedly taught in more than 1 week
Conclusions the work in palliative care can be highly rewarding, there are inherent stressors that can affect the wellbeing of palliative care practitioners
We aimed to address this gap and elucidate how mindfulness and compassion-oriented practices can be implemented within the clinical setting
Summary
Developing a mindful presence at workFinding the inner source(s) of compassionCompassion-oriented Meditation in action5, 6, 7, 8, 9 and 10Mindful presence in difficult situations anote that some contents, were repeatedly taught in more than 1 week. Maintaining a sense of self-care while providing patient centered care, can be difficult for practitioners in palliative medicine. Contrary to what one would intuitively think about the work with the dying, palliative care practitioners have reported that frequent exposure to death can help them to live in the present, enhance meaning, cultivate a spiritual life and develop curiosity about the continuity of life [2]. Difficulties in managing emotions arise for example through moral distress and frequent exposure to suffering [7]. These results emphasize the specific need for self-care interventions, while highlighting the importance of addressing relational skills since this seems to remain a significant issue in palliative care [8]
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