Affective Mindfulness Scale Research Articles

Preliminary validation of the Cognitive Affective Mindfulness Scale-Revised in cancer populations.

A brief, valid, and comprehensive measure of mindfulness is needed for cancer populations. This study examined the factor structure, internal consistency, construct validity, and measurement invariance of the 10-item Cognitive Affective Mindfulness Scale-Revised (CAMS-R) in patients with cancer. Patients with breast, gastrointestinal, lung, or prostate cancer (N=404, 50% stage IV cancer, 51% women) were recruited from academic and public clinics in Indianapolis, IN. Patients completed the CAMS-R and other psychological measures at one time point. Confirmatory factor analysis (CFA) was used to examine the dimensionality of the CAMS-R. Internal consistency and construct validity were also assessed. Measurement invariance was examined for gender, cancer type, and cancer stage. CFA showed that the original CAMS-R structure with four first-order factors (attention, present focus, awareness, and acceptance) and one second-order factor (mindfulness) had a reasonable fit (RMSEA=0.09, CFI=0.95, SRMR=0.04). Internal consistency was excellent (α=0.90). The CAMS-R total score showed significant positive associations with several subscales of a widely used mindfulness questionnaire and self-compassion (rs=0.61-0.66) and significant negative associations with anxiety, depressive symptoms, rumination, psychological inflexibility, and avoidant coping (rs=-0.35-0.58). Measurement invariance testing indicated that the CAMS-R was invariant across populations of varying genders, cancer types, and stages. Findings provide preliminary support for using the CAMS-R in cancer populations. Future research should assess the responsiveness of the CAMS-R to intervention.

Adult Attachment and Fear of Missing Out: Does a Mindful Attitude Matter?

Fear of missing out (FoMO) involves the desire or urge to stay continuously connected to and kept up-to-date with a social reference group. The present study explored the relationships between adult attachment and FoMO and the potential mediating effect of a mindful attitude. The present study was carried out on 192 participants (meanage = 23.24 years; SDage = 4.33 years), of whom 151 (78.6%) were female and the remaining 41 (21.4%) were male. The participants completed the Adult Attachment Scale—Revised (AAS-R), which evaluates Close, Depend, and Anxiety attachment, the Cognitive and Affective Mindfulness Scale—Revised (CAMS-R) and the Fear of Missing Out Scale (FoMOs). The results indicated that the three forms of adult attachment (Close, Depend, and Anxiety) were associated with FoMO through the indirect effect of mindful attitudes. This study yielded relevant theoretical and practical implications regarding the critical role of a mindful attitude as a protective factor against FoMO. Limitations and future research directions were also discussed.

Does Mindfulness Practice Affect the Quality of Life of Working Mothers? An Empirical Test Using SEM Analysis

Purpose: Working mothers are leading several industries, and they strive to balance work and family. Mothers at work face their biggest challenges and live with constant guilt when they leave their children. Due to this stressful lifestyle, working mothers struggle to regulate their emotional health and may exhaust themselves, breakdown, or burnout. They can manage this chaos with mindfulness. Working mothers need mindfulness to stay sane. Mindfulness protects against stress, depression, anxiety and other mental health issues and improves human functioning and quality of life as well.
 
 Theoretical framework: Working mothers need mindfulness to stay sane. Mindfulness protects against stress, depression, anxiety and other mental health issues and improves human functioning and quality of life as well. Thus, by analyzing the significance of mindfulness among working mothers, this study was proposed to examine the relationship between mindfulness practice (MP) and the quality of life (QOL) of working mothers.
 
 Design/methodology/approach: Data was collected from the sample size of 217 respondents who were working mothers in different sectors. Mindfulness and QOL are measured using standardized questionnaires like the Cognitive Affective Mindfulness Scale (CAMS-R) and the World Health Organization’s Quality of Life (WHOQOL) scale, respectively. Following data collection, structural equation modelling (SEM) analysis was employed using the partial least squares method. 
 
 Findings: The findings reveal that there is a significant positive impact of Mindfulness practice on the Quality of work life of working mothers.
 
 Research, Practical & Social implications: The research results indicate that working mothers need to practice mindfulness in their routine lives to excel in parenting and to combat challenges in balancing work and life thus improving their QOL.
 
 Originality/value: There is meagre research conducted on mindfulness, thus this current study extends its originality on researching on impact of mindfulness practice on quality of life.

Well-being factors associated with confidence in providing calm, compassionate care in pediatric residents

ObjectiveEngagement in calm, compassionate care (CCC) is important in fostering patient-centered care. We aimed to study factors which predict confidence in providing CCC in pediatric residents. MethodsWe performed a retrospective, multi-center, cohort study utilizing data from the Pediatric Resident Burnout and Resilience Study (PRB-RSC) from 2016 to 2018. The Calm Compassionate Care Scale (CCCS) was used to assess confidence in delivering CCC. We examined cross-sectional associations between CCC, demographic measures, programmatic features, and psychological scales. ResultsThe following showed significant positive associations with confidence in providing CCC: Cognitive and Affective Mindfulness Scale, Neff’s Self Compassion, Patient Reported Outcomes Measures-mental health, and Interpersonal Reactivity Index-empathetic concern. For the Maslach Burnout Index subscales, decreased personal accomplishment, increased emotional exhaustion, and increased depersonalization showed significant negative associations. ConclusionsWe found that several well-being measures and an increased sense of personal accomplishment are associated with increased confidence in providing CCC. These findings underscore the interrelatedness of these measures and highlight the importance of personal accomplishment as a positive factor in trainee development. Practice implicationsProgram level interventions that decrease trainee burnout and enhance resiliency as well as support trainees’ development of empathy and compassion may help trainees develop skills that promote patient-centered, compassionate care.

Does Mindfulness Practice Affect the Quality of Life of Working Mothers? An Empirical Test Using Sem Analysis

Purpose: Working mothers are leading several industries, and they strive to balance work and family. Mothers at work face their biggest challenges and live with constant guilt when they leave their children. Due to this stressful lifestyle, working mothers struggle to regulate their emotional health and may exhaust themselves, breakdown, or burnout. They can manage this chaos with mindfulness. Working mothers need mindfulness to stay sane. Mindfulness protects against stress, depression, anxiety and other mental health issues and improves human functioning and quality of life as well. Theoretical framework: Working mothers need mindfulness to stay sane. Mindfulness protects against stress, depression, anxiety and other mental health issues and improves human functioning and quality of life as well. Thus, by analyzing the significance of mindfulness among working mothers, this study was proposed to examine the relationship between mindfulness practice (MP) and the quality of life (QOL) of working mothers. Design/methodology/approach: Data was collected from the sample size of 217 respondents who were working mothers in different sectors. Mindfulness and QOL are measured using standardized questionnaires like the Cognitive Affective Mindfulness Scale (CAMS-R) and the World Health Organization’s Quality of Life (WHOQOL) scale, respectively. Following data collection, structural equation modelling (SEM) analysis was employed using the partial least squares method. Findings: The findings reveal that there is a significant positive impact of Mindfulness practice on the Quality of work life of working mothers. Research, Practical & Social implications: The research results indicate that working mothers need to practice mindfulness in their routine lives to excel in parenting and to combat challenges in balancing work and life thus improving their QOL. Originality/value: There is meagre research conducted on mindfulness, thus this current study extends its originality on researching on impact of mindfulness practice on quality of life.

Nivo majndfulnesa u interpersonalnim odnosima - validnost i pouzdanost skale procene

Introduction. The multidimensional concept of mindfulness includes voluntary attention, focus on the "present moment", monitoring of mental processes, and inhibition of impulsive reactions. Examining the impact of the level of mindfulness on the quality of the relationship between the special educator and the student requires an instrument with satisfactory psychometric characteristics. Objectives. The goal of this research was to determine the internal consistency, test-retest reliability, convergent and discriminative validity of the Interpersonal mindfulness scale. Methods. The reliability of the Interpersonal mindfulness scale was checked by calculating Cronbach's Alpha in a sample of 114 students (age: M = 20.75, SD = 2.20). For the test-retest reliability check, a sample of 32 students was formed (age: M = 21.41, SD = 2.46). The relationship between the Interpersonal mindfulness scale and the Cognitive and affective mindfulness scale was determined in a sample of 59 students (age: M = 20.93, SD = 1.92). For examining the Pearson correlations of the Interpersonal mindfulness scale and the Perceived Stress Scale-10, the sample included 55 students (age: M = 20.55, SD = 2.47). Results. It was determined that the values of the internal consistency of the Interpersonal mindfulness scale and its subscales were acceptable (a = .69 - .88), the level of test-retest reliability was moderate to high (ICC = .58 -.91), the correlation with the overall results of the Cognitive and affective mindfulness scale was statistically significant and positive (r = .58, p < .001), while it was not statistically significant (p > .05) on the Perceived Stress Scale-10. Conclusion. Based on the established reliability and validity, the Interpersonal mindfulness scale can be recommended as an instrument for obtaining reliable data on the quality and level of mindfulness manifested in social interactions

Self-compassion training in palliative care during COVID-19: A pilot study.

This pilot project replicated a self-compassion program to support health-care professionals in palliative care settings. We anticipated that undertaking this program would enhance participants' psychological well-being. Participants were recruited by convenience sampling from palliative care services in an area of Melbourne, Australia. Because of the COVID-19 pandemic, the program was offered online and comprised six once-weekly gatherings. Three survey rounds with identical questions were conducted prior to, immediately after, and 3 months after the training. The surveys consisted of 6 scales: the Self-Compassion Scale, the Santa Clara Brief Compassion Scale, the Cognitive and Affective Mindfulness Scale, the Depression Anxiety Stress Scale, the Professional Quality of Life Scale, and the Interpersonal Reactivity Index Scale. Paired-sample t-test and repeated measures analysis of variance analyses were used to compare participant responses. Nine participants working in palliative care completed the training and 3 surveys and included qualitative responses. The experience was overwhelmingly positive. Self-compassion (F=14.44; p<0.05) and mindfulness (F=18.44; p<0.05) scores significantly increased post-training, were picked up in a short time and endured. The emotional state improved by compassion satisfaction, showing a positive improvement 3 months post-training, along with there being no changes in compassion satisfaction, burnout, and dispositional empathy. Participants all worked in a supportive environment, which encouraged self-care. Even against the pandemic difficulties, a short online program was effective, assisting participants to cultivate their inner resources in mindfulness and self-compassion. While a small sample size, expansion of the training may benefit the wider palliative care workforce.

Mindful Engagement Mediates the Relationship Between Motivational Climate Perceptions and Coachability for Male High School Athletes

The purpose of this study was to examine the mediating role of mindful engagement in the relationship between male high school athletes’ motivational climate perceptions on their teams (i.e., caring, task-, and ego-involving climate) to athlete coachability. Athletes (N = 164, Mage = 15.58 years) from multiple sports completed measures assessing mindful engagement in sport (Cognitive and Affective Mindfulness Scale—Revised), Caring Climate Scale, task- and ego-involving climate perceptions (Perceived Motivational Climate in Sport Questionnaire), and coachability (Athletic Coping Skills Inventory). Initial bivariate correlations linked mindful engagement and coachability positively with perceptions of a caring and task-involving climate and negatively with ego-involving climate perceptions. Structural equation modeling analyses then revealed mindful engagement mediated the relationship between climate and coachability. Encouraging coaches and players to foster a caring/task-involving climate might assist in enhancing athletes’ mindful engagement in sport, which may positively influence the degree to which they are coachable.

Adaptation of the Cognitive and Affective Mindfulness Scale (CAMS-R) to Indonesian Version and Its Validation: Muslim Mothers-Data Driven

CAMS-R is a measurement instrument designed for normal adult participants. There have been a few studies conducting lingua-cultural adaptation of CAMS-R in the Indonesian context, but such studies have not touched on the discourse of Muslim mothers. Accordingly, this study aimed to conduct linguistic adaptation of CAMS-R by translating it into Bahasa Indonesia. Also, it aimed to examine the measurement model to find whether the structure of CAMS-R was confirmed relevant to empirical data or not. At the stage of forward translation, this study involved 5 participants, namely two translators and three psychologists with doctoral academic qualifications. The stage of back translation engaged 3 participants, namely a bachelor in English and two linguistics experts. The pilot study incorporated 10 readers, and the try-out involved 103 Muslim mothers between the ages of 20-40 years old. Data analysis used confirmatory factor analysis (CFA). Results demonstrated that the measurement of mindfulness construct had high goodness of fit. The results of model fit evaluation indicated chi square of 8.742 (p=.557), GFI of .976, AGFI of .932, CFI of 1.000, TLI of 1.014, and RMSEA of .000. The foregoing depicted a good fit of goodness. CAMS-R contained 12 items and left 7 items with loading factors above 0.5. (.585 – .887). Composite reliability (CR) sub-scale resulted in the scores of .713 – .785, and its overall CR scale was .936 and AVE of .736 – .739. The foregoing data indicated good convergent and discriminant validity. This study emphasized that CAMS-R could ideally be used to measure mindfulness for the Indonesian population of Muslim mothers between the ages of 20-40 years.

Role of mindfulness in well-being: mediating effect of emotion regulation

Research evidence has suggested the positive impact of mindfulness on wellbeing. However the aim of the study was to find out the mediating effect of emotion regulation (cognitive reappraisal) between mindfulness and well-being. The Cognitive and Affective Mindfulness scale, Emotion Regulation Questionnaire, and Brief Inventory of Thriving Scale measuring wellbeing were administered on a sample of 375 participants. Findings provide evidence that cognitive reappraisal dimension of emotion regulation plays the positive mediating role between mindfulness and well-being by enhancing wellbeing. The indirect effect is b = 0.19, the direct effect is b = 0.76, and the total effect is b = 0.95. Both direct effect, indirect effect, and total effect are significant. This explains the partial mediation of emotion regulation in which the path from mindfulness to well-being is reduced in absolute size but is still not zero when the mediator is introduced. This study highlights the importance of cognitive reappraisal strategy of emotion regulation in the relationship between mindfulness and well-being. The findings also provide suggestions for understanding how mindfulness and emotion regulation together may enhance healthy adaptation and well-being.

Anxiety and Depression during COVID-19 in Elite Rugby Players: The Role of Mindfulness Skills.

The COVID-19 pandemic created stressors that raised the likelihood of elite athletes experiencing mental health problems. Understanding how individual traits promote resilience is key to offering treatments specific to this population. This prospective study explores the relationship between mindfulness skills, resilience, and athletic identity on anxiety and depression. The initial assessment was during the first UK lockdown April–May 2020 (T1), and the second during the return to competition July-August 2020 (T2). The sample was 160 elite rugby players. Measures included: Personal Health Questionnaire-9, General Anxiety Disorder-7, Cognitive Affective Mindfulness Scale, Connor-Davidson Resilience Scale, and Athletic Identity Measurement. The prevalence of anxiety and depression was profiled with descriptive statistics, and relationships between variables with bi-variate correlations and forward stepwise regression modelling. Depression decreased significantly between lock down (T1) and return to competition (T2) (MT1 = 4.20, MT2 = 3.24, p < 0.01), with no significant change in anxiety. Significant correlations were found between mindfulness, resilience, and anxiety and depression (≤0.001). Regression showed that mindfulness (T1) predicted lower anxiety and depression during the return to competition (T2) after controlling for baseline mental health symptoms. Returning to competition after lockdown was associated with a reduction in depression but not anxiety. Mindfulness skills potentially confer protection against anxiety and depression.

Implementation of an Internet-Based Acceptance and Commitment Therapy for Promoting Mental Health Among Migrant Live-in Caregivers in Canada: Protocol.

BackgroundPsychological distress, isolation, feelings of powerlessness, and limited social support are realities faced by temporary migrant live-in caregivers in Canada. Furthermore, they experience multiple barriers in accessing mental health services due to their long work hours, limited knowledge of health resources, precarious employment, and immigration status.ObjectiveThe Women Empowerment - Caregiver Acceptance & Resilience E-Learning (WE2CARE) project is a pilot intervention research project that aims to promote the mental well-being and resiliency of migrant live-in caregivers. The objectives include exploring the effectiveness of this program in achieving the following: (1) reducing psychological distress (depression, anxiety, and stress); (2) promoting committed actions of self-care; and (3) building mutual support social networks. Further, participants’ satisfaction with the intervention and their perceived barriers to and facilitators of practicing the self-care strategies embedded in WE2CARE will be examined.MethodsA total of 36 live-in caregivers residing in the Greater Toronto Area will be recruited and randomly assigned to either the intervention or waitlist control group. The intervention group will receive a 6-week web-based psychosocial intervention that will be based on Acceptance and Commitment Therapy (ACT). Standardized self-reported surveys will be administered online preintervention, postintervention, and at 6 weeks postintervention to assess mental distress (Depression, Anxiety and Stress Scale), psychological flexibility (Acceptance and Action Questionnaire), mindfulness (Cognitive and Affective Mindfulness Scale – Revised), and resilience (Multi-System Model of Resilience Inventory). In addition, two focus groups will be held with a subset of participants to explore their feedback on the utility of the WE2CARE program.ResultsWE2CARE was funded in January 2019 for a year. The protocol was approved by the research ethics boards of Ryerson University (REB 2019-036) and the University of Toronto (RIS37623) in February and May 2019, respectively. Data collection started upon ethics approval and was completed by May 2020. A total of 29 caregivers completed the study and 20 participated in the focus groups. Data analyses are in progress and results will be published in 2021.ConclusionsWE2CARE could be a promising approach to reducing stress, promoting resilience, and providing a virtual space for peer emotional support and collaborative learning among socially isolated and marginalized women. The results of this pilot study will inform the adaptation of an ACT-based psychological intervention for online delivery and determine its utility in promoting mental health among disadvantaged and vulnerable populations.International Registered Report Identifier (IRRID)DERR1-10.2196/31211

The Adaptation and Evaluation of a Pilot Mindfulness Intervention Promoting Mental Health in Student Athletes

The objective of this study was to examine the effectiveness of a pilot mindfulness program for student athletes by assessing mental health, mindfulness ability, and perceived stress before and after the intervention. The mindfulness program was adapted from a program developed at the University of Southern California. The four-session intervention taught the basics of mindfulness, self-care skills, and guided meditations. Participants completed surveys before and after the intervention. Mindfulness ability was assessed with the Cognitive and Affective Mindfulness Scale, mental health was assessed with a modified Short Form Health Survey, and stress was assessed with the Perceived Stress Scale. After the intervention, participants reported improvement in mindfulness ability, t(28) = −2.61, p = .014, mental health, t(28) = −2.87, p = .008, and a trending improvement in perceived stress, t(28) = 1.86, p = .073. A short mindfulness program may be effective for improving mental health and mindfulness ability in collegiate student athletes.

ЕФЕКТИВНІСТЬ ПСИХОТЕРАПЕВТИЧНИХ ПРАКТИК МАЙНДФУЛНЕС У РЕГУЛЯЦІЇ СТРЕСОСТІЙКОСТІ В ЮНАЦЬКОМУ ВІЦІ

The article is devoted to the theoretical study and empirical research of the effectiveness of mindfulness psychotherapeutic practices in the regulation of stress resistance in adolescence. It is theoretically determined that the consequences of stress are manifested in increased anxiety, irritability, emotional tension, fatigue, insomnia, etc. Stress resistance is associated with the tendency of the individual to be responsible for events in his life and the results of their activities; adolescence is experimental for identifying by a personality the stress coping strategies that are not always productive. It is noted that in Ukraine the direction of studying the mindfulness problem is currently at the origins of its development. Scientific attempts are being made to determine the role of mindfulness in various aspects of reducing personal stress, the ability to influence stress resistance processes by improving the mental health culture, through the formation of values ​​and competencies in recognizing their own psychological problems, but but scientists have paid insufficient attention to the implementation of the role of mindfulness practices in the educational space, establishing relationships between the mindfulness characteristics and students’ stress resistance. This refers to the fact that the development of stress resistance involves a variety of technologies, including psychotherapy. It is pointed out that one of the new achievements of psychological science is the introduction of mindfulness practices in the educational space, as the priority of the educational environment is to find ways of effective psychological care, technologies of psychological support for young people, minimization of distressing phenomena in schools. The following mindfulness techniques are singled out: meditative techniques, which include relaxation and developmental effects, teach to be fully present “here and now” and to notice the usual states of our consciousness. It is noted that the awareness factor helps to calm down, stabilize well-being, return from thoughts to the actual students’ experience of the “here and now” situation, turn on the consciousness state of “just being”, plays a significant role in choosing behaviors in difficult life circumstances. The mindfulness psychotherapeutic practices effectiveness in the stress resistance regulation in adolescence through the prism of empirical measurement is determined. A sample of respondents was formed on the basis of the lyceum “Olympus” №30 in Kremenchuk. The total number of respondents is 70 adolescents (15-17 years old). The results of the summative assessment are highlighted. The results of using a comprehensive psychodiagnostic methodology are analyzed: Cognitive and Affective Mindfulness Scale – Revised, CAMS – R (Feldman, G., Hayes); the Difficulties in Emotion Regulation Scale (DERS) K. L. Gratz, L.Roemer, the “Man in the rain” graphic psychodiagnostic technique During the empirical research, the theoretical results of the Ukrainian scientists studies on a problem of stress resistance are generalized and features of students’ behavior strategies in stressful situations by the “Man in the rain” technique are distinguished empirically. Therefore, the novelty of the study is in figuring out the characteristics of students’ psychological states according to the following criteria of comfort / discomfort: resourcefulness, ambivalence, insecurity and their regulation depending on the level of mindfulness development in adolescents. A psychotherapeutic program for the development of mindfulness skills in everyday life for adolescents has been developed, which aims to develop the individual’s ability to perceive, feel and remember phenomena in the internal and external environment. It is important to note that psychological stability is supported by both internal (personal) and external (interpersonal, social support) resources, which are based on mindfulness control and are not limited to mental and emotional automatic reactions. The psychotherapeutic program provides students with the means that allow them to act more effectively in everyday life, to solve routine problems. The relationships between the mindfulness characteristics and stress resistance in adolescents were revealed through the results of a summative assessment.

Streaming mindfulness: Well-being and mindfulness among subscribers to a video streaming service

ObjectiveInternet and smartphone technology have advanced the dissemination of mindfulness practices and philosophy. This study explored how individuals interact with Spectiv, a subscription-based video streaming service (VSS) that advertises content for meditation, and measured levels of mindfulness and well-being. We hypothesized that users engaging with Spectiv for longer sessions and on a regular basis would report higher levels of mindfulness and well-being. MethodA 46-question online survey was developed and distributed to all active subscribers of Spectiv (N = 119). The survey included two validated scales: (1) The Cognitive and Affective Mindfulness Scale, and (2) The Warwick-Edinburgh Mental Well-being Scale. A series of one-way ANOVAs were performed, along with a simple linear regression and descriptive statistics. ResultsUsers reported relaxation as the most common activity. Levels of mindfulness and well-being were significantly higher for users whose session-duration lasted 2 hours (p = .01) and 3 hours (p = .03). Users engaging with the VSS daily had significant levels of both mindfulness (p < .001) and well-being (p < .001). There was no difference between subscription length and mindfulness and well-being. Mindfulness was found to be a significant positive predictor of well-being (p < .0001). ConclusionVSS could be valuable to facilitating mindfulness. Users engaging with a VSS for longer durations and more frequently may be more likely to experience benefits. Future research using controlled designs such as randomized control trials and feasibility studies should be conducted to determine if VSS can maintain or increase levels of mindfulness and well-being.

Mindfulness in Motion and Dietary Approaches to Stop Hypertension (DASH) in Hypertensive African Americans.

Hypertension increases the risk of developing Alzheimer's disease or related dementias. This pilot study's purpose was to examine the feasibility and acceptability of a novel intervention, Mindfulness in Motion (MIM) and Dietary Approaches to Stop Hypertension DASH (MIM DASH), to improve diet, mindfulness, stress, and systolic blood pressure (BP) in older African Americans with mild cognitive impairment (MCI) and hypertension. Cluster randomized controlled trial. Intergenerational community center in a large metropolitan area. African Americans with MCI and hypertension. Participants were divided into six groups randomized 1:1:1 to the MIM DASH group, attention only (non-hypertensive education) group, or true control group. The MIM DASH and attention only interventions were delivered in 8-weekly 2 hour group sessions. MIM included mindful movements from chair/standing, breathing exercises, and guided meditation. The DASH component used a critical thinking approach of problem solving, goal setting, reflection, and self-efficacy. The true control group received a DASH pamphlet at the end. Feasibility was tracked through enrollment and attendance records; acceptability was assessed through interviews. Blood pressure was measured using the Omron HEM-907XL Monitor. Dietary intake was measured by DASH-Q. Mindfulness was measured by the Cognitive and Affective Mindfulness Scale. Stress was measured by the Perceived Stress Scale. MCI was determined using the Self-Administered Gerocognitive Examination. Data were collected at baseline and 3-months. Median session attendance was six for the MIM DASH group and six for the attention only group. There were no changes in diet, mindfulness, or stress. There was a clinically significant reduction in systolic BP in the MIM DASH group (-7.2 mmHg) relative to the attention only group (-.7), and no change between the MIM DASH and true control groups. Results indicate that the MIM DASH intervention was feasible and culturally acceptable in African Americans with hypertension and MCI.

The Relationship between Mindfulness and Sleep Quality is Mediated by Emotion Regulation

Background: Sleep is critical to a person’s overall physical and mental health. The current study investigated the relationship between mindfulness and sleep quality, to determine if this relationship is influenced by emotion regulation and perceived stress. Method: Three hundred sixty-seven undergraduate students responded to five self-report measures, (1) The Cognitive and Affective Mindfulness Scale (CAMS-R), (2) The Impact of Event Scale (IES-R), (3) The Five Facet Mindfulness Questionnaire (FFMQ), (4) The Emotion Regulation Questionnaire (ERQ), and (5) The Pittsburgh Sleep Quality Index (PSQI). Results: Results revealed (1) sleep quality was predicted by the presence of hyperarousal, acting with awareness, and the CAMS-R, (2) the Impact of Event Scale was moderately positively correlated with a person’s global score on the Pittsburgh Sleep Quality Index, and (3) the relationship between mindfulness and sleep quality was mediated by hyperarousal. Conclusions: Together, our findings suggest that higher levels of intrusive thoughts, avoidance, and hyperarousal are correlated with lower overall sleep quality, and the use of mindfulness techniques such as acting with awareness and being non-reacting to negative thoughts or hyperarousal may help predict an individual’s sleep quality.

Do Internal or External Characteristics More Reliably Predict Burnout in Resident Physicians: A Multi-institutional Study

Surgical residents have been shown to experience high rates of burnout. Whether this is influenced predominately by intrinsic characteristics, external factors, or is multifactorial has not been well studied. The aim of this study was to explore the relationship between these elements and burnout. We hypothesized that residents with higher emotional intelligence scores, greater resilience and mindfulness, and better work environments would experience lower rates of burnout. General surgery residents at 7 sites in the US were invited to complete an electronic survey in 2019 that included the 2-item Maslach Burnout Inventory, Brief Emotional Intelligence Scale, Revised Cognitive and Affective Mindfulness Scale, 2-Item Connor-Davidson Resilience Scale, Utrecht Work Engagement Scale, and Job Resources scale of the Job Demands-Resources Questionnaire. Individual constructs were assessed for association with burnout, using multivariable logistic regression models. Residents' scores were evaluated in aggregate, in groups according to demographic characteristics, and by site. Of 284 residents, 164 completed the survey (response rate 58%). A total of 71% of respondents were at high risk for burnout, with sites ranging from 57% to 85% (p = 0.49). Burnout rates demonstrated no significant difference across gender, PGY level, and respondent age. On bivariate model, no demographic variables were found to be associated with burnout, but the internal characteristics of emotional intelligence, resilience and mindfulness, and the external characteristics of work engagement and job resources were each found to be protective against burnout (p < 0.001 for all). However, multivariable models examining internal and external characteristics found that no internal characteristics were associated with burnout, while job resources (coeff. -1.0, p-value <0.001) and work engagement (coeff. -0.76, p-value 0.032) were significantly protective factors. Rates of engagement overall were high, particularly with respect to work "dedication." A majority of residents at multiple institutions were at high risk for burnout during the study period. Improved work engagement and job resources were found to be more strongly associated with decreased burnout rates when compared to internal characteristics. Although surgical residents appear to already be highly engaged in their work, programs should continue to explore ways to increase job resources, and further research should be aimed at elucidating the mediating effect of internal characteristics on these external factors.

7. ASSOCIATION OF SELF-REPORTED QUALITY OF CARE MEASURES AND BURNOUT: AN INVESTIGATION FROM THE PEDIATRIC RESIDENT BURNOUT-RESILIENCE STUDY CONSORTIUM

Background The Pediatric Resident Burnout-Resilience Study Consortium (PRB-RSC), established in 2015, is committed to studying the epidemiology, natural history, and impact of interventions designed to address burnout and improve resilience in pediatric residents. Annual surveys demonstrate a prevalence of burnout of 40-55% over the last 4 years. Previous regional work has shown an association between resident burnout and sub-optimal patient care. Design/Methods The PRB-RSC distributed the annual survey to pediatric residents in participating programs in the spring of 2019. Data was de-identified, collected and maintained by the Association of Pediatric Program Directors’ Longitudinal Educational Assessment Research Network. Residents were classified as burned out on the basis of a 2-item screen for emotional exhaustion/depersonalization. An ordinal mixed effects generalized additive model regression was used to examine the effect of burnout on reported quality of care behaviors. For the ten behaviors queried, perceived stress scale (PSS), cognitive and affective mindfulness scale (CAMSR), and overall quality of life score (QOL) were compared between those with recent ( 12 months) poor quality behaviors reported. Results A total of 46 pediatric programs participated in the 2019 PRB-RSC survey, with an overall response rate of 62% (n=1648). The recency of reported sub-optimal behaviors between those with and without burnout is shown in the Figure. After controlling for training year, age, male gender, white race, program size and region, and clustering of learners in programs, each p-value is Conclusion(s) In this national survey, pediatric resident burnout is associated with sub-optimal care delivery, while recent experience with sub-optimal care is associated with higher stress, lower mindfulness, and decreased overall QOL.

Enhanced Stress Resilience Training in Surgeons: Iterative Adaptation and Biopsychosocial Effects in 2 Small Randomized Trials.

To determine the effects of ESRT (an iteratively adapted and tailored MBI) on perceived stress, executive cognitive function, psychosocial well-being (ie, burnout, mindfulness), and pro-inflammatory gene expression in surgical (ESRT-1) and mixed specialty (ESRT-2) PGY-1 volunteers. Tailored MBIs have proven beneficial in multiple high-stress and high-performance populations. In surgeons, tailored MBIs have been shown to be feasible and potentially beneficial, but whether mindfulness-based cognitive training can improve perceived stress, executive function, well-being or physiological distress in surgical and nonsurgical trainees is unknown. In 2 small single-institution randomized clinical trials, ESRT, a tailored mindfulness-based cognitive training program, was administered and iteratively adapted for first-year surgical (ESRT-1, 8 weekly, 2-hour classes, n = 44) and mixed specialty (ESRT-2, 6 weekly, 90-minute classes, n = 45) resident trainees. Primary and secondary outcomes were, respectively, perceived stress and executive function. Other prespecified outcomes were burnout (assessed via Maslach Burnout Inventory), mindfulness (assessed via Cognitive Affective Mindfulness Scale - Revised), and pro-inflammatory gene expression (assessed through the leukocyte transcriptome profile "conserved transcriptional response to adversity"). Neither version of ESRT appeared to affect perceived stress. Higher executive function and mindfulness scores were seen in ESRT-1, and lower emotional exhaustion and depersonalization scores in ESRT-2, at pre-/postintervention and/or 50-week follow-up (ESRT-1) or at 32-week follow-up (ESRT-2), compared to controls. Pooled analysis of both trials found ESRT-treated participants had reduced pro-inflammatory RNA expression compared to controls. This pilot work suggests ESRT can variably benefit executive function, burnout, and physiologic distress in PGY-1 trainees, with potential for tailoring to optimize effects.