Mindfulness-based Stress Reduction Course Research Articles

Mindfulness for test anxiety and negative self-evaluation in high school

There is growing evidence that mindfulness-based interventions reduce test anxiety in university-level students, but less is known about high school students. Adolescence is a time of frequent testing, identity concerns, and increases in self-conscious emotions. We hypothesized that test anxiety would be associated with negative self-referential thinking (negative self-thinking, study 1) and that Mindfulness-based Stress Reduction (MBSR) would reduce test anxiety, negative self-thinking, and self-judgment (study 2). 455 high school students (M age = 17.1 years (SD = 1.07), 43.2% female) reported their test anxiety and negative self-thinking in a cross-sectional study (study 1) and 33 high school students (mean age = 17.5 years (SD = 1.60, 88% female) reported measures at the pre-, post, and one-year follow-up during an 8-week MBSR course (study 2). Test anxiety was positively related to negative self-thinking (study 1). Test anxiety and self-judgment were reduced after participating in MBSR and remained low one year after (study 2). Negative self-thinking was not reduced during the intervention. MBSR seems promising in reducing test anxiety and self-judgment in adolescents and might increase awareness of negative self-thinking, perhaps also reducing the impact of such thoughts by encouraging observation of the thoughts as “events in the mind” rather than facts. Mindfulness training seems promising for reducing test anxiety in high school, but results need to be replicated in larger samples with a control group.

Exploring mindfulness interventions for stress resilience in newly graduated nurses: A qualitative study.

In an aging society coping with workforce challenges, successful hospital management hinges on the recruitment and retention of nurses. It is of utmost priority to address job stress and fortify mental resilience. While quantitative research supports investigating the stress-alleviating effects of mindfulness for nursing staff, obtaining a direct perspective from nurses is essential to comprehend how they navigate burnout and apply mindfulness for stress management. This qualitative study aimed to explore newly graduated nurses' experiences who participated in a mindfulness course and evaluate the practical application of acquired strategies in their work and daily lives, providing insights for retention strategies in health-care institutions. Thirty-one recently graduated nurses participated in an 8-session weekly in the mindfulness program. Qualitative data were obtained through focus group discussions during each session and subjected to thematic analysis. Five key themes were generated to show how nurses experience mindfulness training: (1) shedding light on workplace stress and adaptation; (2) stress upon entering the workforce; (3) reactions to the vicious cycle of anxiety responses to stress through mindfulness practices; (4) discovery of daily life pleasures and obstacles encountered during the mindfulness course; (5) obstacles encountered during the mindfulness course. Through participation in the program, the subjects' levels of mindfulness of stress responses were enhanced. This study underscores the advantages of mindfulness courses for newly graduated nurses and emphasizes the crucial role of workplace support. Practical recommendations for nursing administrators and educators include fostering familiarity with the health-care environment, promoting teamwork, and addressing anxiety related to handovers. Mindfulness breathing training has proven effective in alleviating pressure during shift transitions. Nursing managers can enhance staff well-being by creating moments of happiness, encouraging positive experience sharing, and organizing outdoor activities. Suggestions for future research involve refining the implementation of the Mindfulness-Based Stress Reduction course for accessibility and effectiveness, extending courses to other health-care professionals to promote team harmony, and positively impacting nursing staff's well-being and performance.

A brief mindfulness-based intervention for stress, pain, emotion and attention regulation in military service members with mild traumatic brain injury.

The primary aim of this study was to conduct an open pilot clinical trial of a brief mindfulness-based intervention for persistent postconcussion symptoms that occur after mild traumatic brain injury in military service members. For many service members, operational tempo and other time constraints may prevent them from completing a standard mindfulness-based stress reduction course. Thus, this study sought to examine the effectiveness of a five-session intervention called mindfulness-based stress, pain, emotion, and attention regulation (MSPEAR). Participants were active duty service members with a history of mild traumatic brain injury (TBI) and persisting postconcussion symptoms, all of whom were recruited from an outpatient TBI rehabilitation program at a military treatment facility. Of the 38 service members that were initially enrolled, 25 completed the 5-session MSPEAR intervention, and 20 returned for a 5-week follow-up evaluation. Questionnaires assessing perceived stress, positive affect, pain interference and catastrophizing, sleep disturbances, perceived behavioral and attention regulation, self-efficacy and satisfaction with life were administered at preintervention, postintervention, and at 5-week follow-up intervals. Neuropsychological testing at preintervention and 5-week follow-up included performance validity measures, attention, working memory, and executive function measures. T-tests were run to compare for questionnaire measures at preintervention (Time 1) to postintervention (Time 2). Repeated analysis of variances were conducted to compare questionnaire and neuropsychological measures at Time 1, Time 2, and at Time 3 which is the 5-week follow-up. Improvements in perceived stress, positive affect, behavioral regulation, metacognition, sleep disturbance, self-efficacy, and satisfaction with life were found immediately after the MSPEAR intervention and were maintained at the 5-week follow-up. Magnification and helplessness aspects of pain catastrophizing improved when comparing preintervention to the 5-week follow-up. Pain interference was not significantly different across study assessment times. Neuropsychological testing revealed improvements in sustained attention, working memory, cognitive flexibility, and inhibitory control when comparing preintervention to the 5-week follow-up assessment. The MSPEAR intervention appears to show promise as a brief and effective therapy for specific postconcussion symptoms after mild traumatic brain injury in military service members. Each of the components of MSPEAR including stress, pain catastrophizing, emotion and attention regulation showed improvements in this study, and bears further investigation in a larger scale, preferably randomized controlled trial in those active duty military service members who experience persisting symptoms after a mild traumatic brain injury.

An online self-study mindfulness-based stress reduction course for people suffering from mental fatigue after an acquired brain injury

ABSTRACT Objective The Mindfulness-Based Stress Reduction (MBSR) program has shown promising results for people suffering from mental fatigue after an acquired brain injury. The aim was to evaluate the feasibility of a MBSR program performed as an online self-study course for this group of people. Methods Sixty participants who had suffered an acquired brain injury with lasting mental fatigue were randomized to an online MBSR course or to a waitlist control group. They answered self-report questionnaires before start and after the course. Results Sixteen completed the MBSR program. With the repeated ANOVA no significant difference between groups was found, although there was a significant change in time (the repetition factor). The post-hoc paired t-test indicated a significant reduction and a large-to-median effect size in mental fatigue (p = 0.003, d = 0.896), depression (p = 0.038, d = 0.569) and anxiety (p = 0.030, d = 0.598) for the MBSR group. No significant changes were found for the control group. Conclusion An online self-study MBSR program for people suffering from mental fatigue after an acquired brain injury can be a feasible option for those suffering from less severe mental fatigue and emotional symptoms, while others may require a program adapted to their needs.

Awareness As a Vehicle for Well-Being: College Students’ Lived Experiences Participating in a Mindfulness-Based Intervention During the COVID-19 Pandemic

ABSTRACT College students are experiencing increasing rates of mental health problems, with difficulties exacerbated by the effects of the COVID-19 pandemic. Mindfulness-Based Stress Reduction (MBSR) has demonstrated efficacy in treating psychological problems and promoting well-being within this population. Less well-understood, however, are MBSR participants’ perceptions of the mechanisms underlying this therapeutic change. The current qualitative study examined nonclinical college students’ experiences participating in a randomized controlled trial of an online adaptation of MBSR, administered during the fall 2020 COVID-19 pandemic lockdown. In-depth, semi-structured interviews were conducted with nine participants who had recently completed the MBSR course. The qualitative data were analyzed using thematic analysis. Participants described greater self-awareness, relational awareness, present-moment awareness, and body awareness as resulting in improved emotion regulation, empathy, communication, and well-being, while reducing anxiety and physical pain. These findings support and extend other theoretical models of change in mindfulness-based interventions. The results further suggest that online MBSR adaptations may be beneficial in promoting mental health for college students and that cultivating greater awareness may help in bolstering psychological well-being within this population.

Virtual Mindfulness-Based Therapy for the Management of Endometriosis Chronic Pelvic Pain: A Novel Delivery Platform to Increase Access to Care

ObjectivesThis study assessed the effectiveness of a virtual mindfulness-based stress reduction (MBSR) program to improve quality of life and pain in people with endometriosis. MethodsThis was a multiple-method, before and after study design. Fifteen patients with a clinical or surgical diagnosis of endometriosis were recruited from a Canadian outpatient gynaecology clinic. Participants completed the Endometriosis Health Profile, a validated survey tool, and a pain medication use questionnaire before and after a virtual 8-week MBSR program run by an experienced social worker. A focus group was held upon completion of the program to assess participants’ experiences using mindfulness for management of endometriosis symptoms. Quantitative data was analyzed with paired-samples t tests. Qualitative data was thematically analyzed. ResultsA total of 67% of people enrolled completed the MBSR course (10/15). Following the MBSR program, participants had a statistically significant decrease in 4 components of the Endometriosis Health Profile: control and powerlessness (P = 0.012), emotional well-being (P = 0.048), social support (P = 0.030), and self-image (P = 0.014). There was no change in pain scores or medication use. Participants felt the program’s benefits came from a sense of community, education about their condition, and application of mindfulness tools when approaching pain. Participants felt more comfortable with the virtual format over in-person sessions. ConclusionsA virtual MBSR course can improve quality of life domains in people with endometriosis. The virtual format was effective and preferred by participants. Virtual MBSR programs may increase access to this type of care.

Integrating mindfulness practice into everyday life after completing a course in mindfulness-based stress reduction

While the immediate positive effects of mindfulness-based stress reduction (MBSR) are undisputed, it is still a matter of debate whether the effects also last in the long term and on which factors this depends. The major aim of this study was to examine the extent to which former MBSR course completers continue mindfulness exercises and how this practice is related to life satisfaction, experience of stress, and mindfulness. A total of 992 non-clinical MBSR course completers were contacted via E-Mail. A total of 192 participants responded and took part in this study. Online, we administered standardized questionnaires to assess life satisfaction, stress, and mindfulness. In addition, single items were used to ask for practice related details. Participants experienced the immediate positive effects (e.g. stress reduction, increase of concentration, and well-being) of MBSR to last over several years (m = 3.79) after course completion. The majority of participants (74.2%) reported to have continued the practice over time. Continuation of mindful exercises was positively related to well-being, mindfulness, and less stress with better effects for those participants who practice more frequently. The relaxing effect of mindfulness motivated participants to practice while the lack of time was the main reason not to practice. For sustainable effects, MBSR course completers should be supported to maintain their practice. In particular, they could benefit from learning to manage scarce time resources. Further research should investigate the usefulness of respective learning contents – within an MBSR course and for aftercare programs.

Mindful Eco-Wellness: Steps Toward Personal and Planetary Health.

Rising greenhouse gas levels heat the earth's surface and alter climate patterns, posing unprecedented threats to planetary ecology and human health. At the same time, obesity, diabetes, and cardiovascular disease have reached epidemic proportions across the globe, caused in part by decreases in physical activity and by over-consumption of carbon-intensive foods. Thus, interventions that support active transportation (walking or cycling rather than driving) and healthier food choices (eating plant-based rather than meat-based diets) would yield health and sustainability "co-benefits." Emerging research suggests that mindfulness-based practices might be effective means toward these ends. At the University of Wisconsin-Madison, we have developed a mindfulness-based group program, Mindful Eco-Wellness: Steps Toward Healthier Living. Loosely based on the Mindfulness-Based Stress Reduction course, our curriculum teaches mindfulness practices in tandem with sustainability principles, following weekly themes of Air, Water, Food, Energy, Transportation, Consumption, Nature Experience, and Ethics. For example, the "Air" class offers participants practice in guided breath meditations while they learn about the benefits of clean air. The theme of "Food" is presented through mindful eating, accompanied by educational videos highlighting the consequences of food production and consumption. "Transportation" includes walking/movement meditations and highlights the health benefits of physical activity and detriments of fossil-fueled transportation. Pedagogical lessons on energy, ecological sustainability, and the ethics of planetary health are intertwined with mindful nature experience and metta (loving-kindness) meditation. Curricular materials, including teaching videos, are freely available online. Pilot testing in community settings (n = 30) and in group medical visits (n = 34) has demonstrated feasibility; pilot data suggests potential effectiveness. Rigorous evaluation and testing are needed.

Daugiaperspektyvinė interpretacinė ir fenomenologinė slaugytojų streso ir minčių kontrolės analizė Jungtinėje Karalystėje, Jungtinėse Amerikos Valstijose ir Šveicarijoje

Background. Nurses constitute a worldwide community of human resources committed to critical care. They are exposed to stress and intruding thoughts so they are at the risk of poor performance. The study aimed to ask experts about how can nurses manage stress effectively in Asian developing countries.
 The aim. To explore stress management skills for nurses to be applied in developing Asian countries through the personal lived experience of experts from developed countries. Multiperspectival Interpretive Phenomenological Analyses (MIPA) are performed case by case and across the participants to establish convergence and divergence.
 Methods. This experiential exploratory descriptive qualitative study was carried out by conducting semi-structured interviews with experts residing, educated, and professionally practising in the United States of America, United Kingdom, and Switzerland, with a purposing sample of 11 stress experts who were subjected to interpretative phenomenological analysis (IPA). The current study uses HyperResearch software v.4.5.4 and also uses qualitative criteria (Lincoln & Guba, 1985) to increase data rigour and the Graneheim and Lundman method to analyse content (Graneheim & Lundman, 2004).
 Results. The research data showed 102 codes, 4 experiential statements, and 15 personal experiential themes/subcategories. Strategies for stress management and thought control include the practiceof mindfulness and meditation through mindfulness-based stress reduction courses, mindfulnessbased cognitive therapy courses; and the conduction of mindfulness-based organisational education on a larger scale. Nurses can beneft from thought labelling, and cognitive defusion to challenge automatic thoughts. Systematically, nursing management can improve through intervision, on-the-job support, and balance of power gradient. Nurses must adopt stress relief strategies such as practicing self-compassion, yoga, the method of active noticing, rational emotive behaviour skills, afrmations, and acceptance.
 Conclusion. Nurses face stress in daily life. Continuous and practical methods of stress management are important and contribute to stress reduction for them. It is essential for nurses to practice mindfulness, meditation, thought control, and stress relief processes to work optimally.
 Keywords: stress management, thought control, nursing, psychology, qualitative.

The influence of mindfulness-based stress reduction on the work life of healthcare professionals – A qualitative study

Backgroundand purpose: Quantitative studies show that mindfulness-based interventions can reduce stress and burnout in healthcare professionals. Few qualitative studies have explored healthcare professionals' experiences with mindfulness training. The aim of the study was to explore healthcare professionals’ experiences of how attending a course in Mindfulness-Based Stress Reduction influenced their work life, including their relationship with patients and colleagues. MethodsFifty-six healthcare professionals attended a Mindfulness-Based Stress Reduction course between January and June 2022. Participant observation followed by six semi-structured focus group interviews and 15 individual interviews were conducted. Data were collected in a cardiology department and in an obstetrics and gynaecology department. Thematic data analysis was performed. Reporting followed COREQ guidelines. ResultsSix themes were identified: 1) Allowing a pause and focusing on one thing at a time, 2) Awareness of the freedom to choose, 3) The need for self-compassion, as a prerequisite for taking care of others, 4) The value of presence and calmness in patient encounters, 5) Awareness of how stressful behavior affects oneself and others, 6) The value of practicing mindfulness with colleagues. ConclusionThis study suggests that offering Mindfulness-Based Stress Reduction to healthcare professionals can start a positive process of change from a tendency to neglect personal needs to becoming more compassionate towards oneself and others. Mindfulness training may thus prevent burnout and lead to a more compassionate workplace culture that also manifests in better patient care. However, a collective understanding and knowledge of mindfulness in the work setting may be necessary to sustain these changes.

Effects of Mindfulness-Based Stress Reduction on Positive Affect, Negative Affect, and Emotional Exhaustion of Employees With Occupational Stress

Background & Aims: An increase in occupational stress can cause physical and psychological disorders as well as mental complications and emotional distress in employees. The present study aimed to investigate the effects of mindfulness-based stress reduction (MBSR) on positive affect, negative affect, and emotional exhaustion of employees with occupational stress. Materials and Methods: This quasi-experimental research adopted a pretest-posttest control group design with follow-up. The statistical population included all employees with occupational stress at public organizations in Isfahan (Isfahan Province, Iran) in 2021. The convenience sampling method was employed to select 30 employees, who were randomly assigned to two 15-member groups called the MBSR group and the control group. The members of the MBSR group participated in eight intervention sessions, whereas the members of the control group received no intervention. After the participants completed the positive and negative affect and emotional exhaustion questionnaires in three stages, the repeated measures analysis of variance (ANOVA) was used for data analysis in SPSS 26. Results: The posttest and follow-up results indicated that the MBSR intervention decreased negative affect and exhaustion and increased positive affect in employees with occupational stress (P<0.001). The repeated measures ANOVA results of within-group effects showed that the effects of treatment were persistent (P<0.001). Conclusion: According to the results, MBSR could improve positive affect and mitigate negative affect and emotional exhaustion in employees. Organizations can use MBSR courses to promote the psychological and emotional well-being of their staff.

Effects of mindfulness-based stress reduction meditation on the emotional reaction to affective pictures assessed by electrodermal activity

ObjectiveIn recent years the psychophysiological benefits of Mindfulness meditation on emotional processing have drawn great interest in scientific research. Currently, the effects of this meditation practice on stress, anxiety and well-being have been mostly evaluated using self-reporting questionnaires, which lead to a quite subjective assessment. This study assesses the effect of Mindfulness practice on the reaction to emotionally charged visual stimuli through Electrodermal Activity (EDA) data. MethodsTwenty-five healthy volunteers, without any previous experience of meditation techniques completed a 12-week Mindfulness-Based Stress Reduction (MBSR) course. EDA and psychological measures were collected longitudinally in 4 scheduled sessions. Statistical analysis was performed to find changes in the most relevant EDA parameters throughout the 4 sessions of data collection. ResultsWe found an increase in response latency, and a decrease in amplitude, area, number of specific responses, and skin conductance level along Mindfulness training. Both outcomes might suggest a reduction in the reactivity to the presented stimuli and an improvement in the emotional well-being of the practitioners. Furthermore, this study showed preliminary evidence that women improve more their attitude towards stressful stimuli than man, after the mindfulness practice.The statistical analysis also showed a correlation between the main EDA parameters and the scores reported by each participant in the depression, anxiety, and stress scale (DASS) questionnaire. Conclusion and SignificanceThis study contributed to a more objective evaluation of the physiological changes observed during Mindfulness practice, and so to understand the underlying mechanisms that explain the benefits of meditation training.

Intermediate effects of mindfulness practice on the brain activity of college students: An EEG study.

Mindfulness is an intervention that was used in many psychiatry treatments. In this study, the subject experienced two different states: (1) attention (i.e., listening to a podcast) and (2) mindfulness (i.e., meditation). Twenty-two students were included in a Mindfulness-Based Stress Reduction (MBSR) course with EEG recording sessions on week four and week six. Brain dynamics were investigated to elucidate the complexity and connectivity of the brain. The alpha PSD increased in all brain areas during mindfulness in both weeks. For complexity, Fractal Dimension (FD) increased significantly during meditation in the week six recording. When comparing the FD in the mindfulness state of week four and week six, we also witnessed a significant increase in the following week. The coherence of the interhemispheric frontal and temporal regions increased significantly in both weeks. In conclusion, the subject successfully transferred from attention to mindfulness, demonstrated by the alpha changes when going from podcast to meditating. An enhancement in brain complexity was found, suggesting an augmentation in cognitive function. Finally, the coherence exhibits strengthened connections in the frontal area.

Impact of COVID Pandemic on the Mental State of Health Workers: A Study of Mindfulness-based Interventions

Background: An increasing number of studies have been conducted on the prevalence of COVID-19 to develop strategies to combat the disease. However, less attention has been paid to the mental health of medical professionals. Objectives: To investigate whether a mindfulness-based stress reduction (MBSR) course in Tibet could improve the mental health of medical personnel during the COVID-19 epidemic. Methods: One hundred and eighteen medical staff were randomly selected from July 2022 to September 2022. After baseline enrolment, the control group (n=59) received baseline healthcare services, while the intervention group (n=59) received a 2-month positive intervention MBSR course in addition to baseline healthcare services. After the intervention, the intervention group underwent a final assessment, and the control group was subjected to MBSR for 2 months. The Self-Rating Depression Scale (SDS), Self-Consciousness Scale (SCS), and the Chinese version of the Cohen Perceived Stress Scale (CPSS) were used to measure the emotional well-being of medical personnel. Results: The intervention group had significantly lower CPSS and SDS scores at the end of the MBSR course (P<0.01), and SCS scores were significantly increased during M2 (P=0.009), compared to M0. In the control group, the scores of SDS (P=0.223), SCS (P=0.112), and CPSS (P=0.131) in M2 were not significantly different from those in M0. The intervention and control groups showed statistically significant differences in CPSS scores (P=0.013), SDS scores (P=0.001), and SCS scores (P=0.029) at the end of the MBSR session. Conclusion: It can be concluded that MBSR sessions can effectively alleviate negative emotions triggered by work stress and depression and improve self-compassion during an epidemic. It is recommended to participate in a scientific MBSR course to improve emotional well-being to some extent.

Self-regulation mediates effects of adapted mindfulness-based stress reduction on anxiety among college students

Objective: Mindfulness-based stress reduction (MBSR) reduces anxiety among undergraduate students; however, there is limited evidence demonstrating mechanistic underpinnings. Theoretical models implicate cognitive self-regulation as a mechanism. This study explored whether an adapted MBSR embedded in a college course reduced anxiety and if self-regulation mediated any intervention effects. Participants: 144 undergraduate students participated in the study; 34 completed a MBSR course and 110 served as a matched control group. Methods: Mindfulness, self-regulation, and anxiety were measured at pre-MBSR, post-MBSR, and 1-month follow-up. Results: Repeated-measure ANOVAs indicated significant effects of MBSR for self-regulation and anxiety. Longitudinal mediation models indicated significant mediation effects of self-regulation on anxiety at post-intervention and 1-month follow-up. Conclusions: MBSR can be implemented within a college course to indirectly affect anxiety mechanistically via self-regulation. Given increasing rates of anxiety in college students and reduced capacity for counseling centers to meet need, MBSR holds promise for future clinical study.

Mindfulness-based stress reduction for community-dwelling older adults with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in primary care: a mixed-methods feasibility randomized control trial

BackgroundPrimary care is often the first point of contact when community-dwelling older adults experience subjective cognitive decline (SCD) or mild cognitive impairment (MCI). Living with SCD or MCI can be life-altering, resulting in low mood and increased anxiety, further exacerbating cognitive decline. However, there is scant literature on interventions that interprofessional primary care providers can provide to support those living with SCD or MCI. Practicing mindfulness-based stress reduction (MBSR) in an interprofessional primary care setting may support emotional health and well-being for those with cognitive decline, but it has not been studied in an interprofessional primary care context.ObjectivesThis study’s primary aim was to determine the feasibility of, and perceived benefits to and satisfaction with, a 9-Week MBSR program delivered in a team-based primary care setting. The secondary aim was to examine the acceptability of using technology (computer tablet and App Insight Timer®) for program delivery and home practice.MethodsA convergent mixed-methods, single-blind pilot randomized controlled trial (RCT) study design was used. A quantitative strand was used to evaluate the feasibility of the MBSR program. The qualitative strand used a focus group with older adult participants with SCD or MCI. Individual semi-structured interviews with occupational therapists who are qualified-MBSR teachers were conducted to explore the acceptability of using computer tablets for program delivery and home practice.Results27 participants were randomized (14 MBSR; 13 Control) with retention rates of 64.3% (9/14 completed ≥6 sessions), true adherence rates of 50% (7/14 met ≥19.5 hrs of home practice), 21.4% attrition rates, and 100% post-intervention follow-up. No participants who used computer tablets at the beginning of the intervention switched to low technology. Older adult participants found the use of computer tablets in the MBSR course acceptable and appreciated the portability of the tablets.ConclusionsBased on the lower-than-expected rates of recruitment, retention, and adherence, our study, as designed, did not meet the feasibility benchmarks that were set. However, with minor modifications to the design, including changing how participants who drop-out are analyzed, extending recruitment, and adding multiple sites, this intervention would be well suited to further study using a full-scale RCT. However, we found that embedding MBSR in an interprofessional primary care setting was feasible in practice and qualitative data highlighted the satisfaction and perceived benefits based on the intervention. The use of technology was acceptable and portable, as participants utilized their computer tablets consistently until the study’s end. Our study showed that older adults living with SCD or MCI were highly receptive to learning how to use technology, and future group intervention programs in interprofessional primary care settings may also incorporate tablet use.Trial registrationThis study was reviewed and approved by the Research Ethics Board in Toronto, Ontario, Canada (REB# 2017–0056-E); Queen’s University (REB# 6026418) in Kingston, Ontario, Canada, and Clinicaltrials.gov (08/03/2019; NCT03867474).

The HEADS: UP Development Study: Working with Key Stakeholders to Adapt a Mindfulness-Based Stress Reduction Course for People with Anxiety and Depression after Stroke.

Following stroke, rates of mood disorder are and remain high at five years (anxiety 34.4%; depression 23%). Structured mindfulness-based stress reduction (MBSR) courses are effective in a range of health conditions, but stroke survivors find adherence challenging. We aimed to adapt a standard MBSR course specifically for people affected by stroke. We recruited stroke survivors and family members with symptoms of anxiety and/or depression to take part in a co-development study comprising two rounds of MBSR 'taster' sessions, followed by focus groups in which views were sought on the practices sampled. Data were collected in October 2017 and May 2018 and were analysed using framework analysis, informed adaptations to mindfulness materials and delivery. Twenty-eight stroke survivors and seven family members participated. Nineteen (76%) stroke survivors had anxiety; 15 (60%) had depression. Five (71.4%) family members reported anxiety; n = 4 (57.1%) depression. Thirty participants attended the first round of taster sessions and focus groups; twenty (66%) the second and three (10%) were unable to attend either round. Framework analysis informed adaptations to course delivery, practices, and materials, ultimately resulting in a stroke-specific MBSR course, HEADS: UP (Helping Ease Anxiety and Depression after Stroke). HEADS: UP may provide a feasible, appropriate, and meaningful self-management intervention to help alleviate symptoms of mood disorder.

Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial.

Objective: To investigate the effects of a dyadic intervention of mindfulness-based stress reduction (MBSR) for informal dementia caregivers and home-based balance and progressive resistance training (PRT) for their loved ones. Methods: The study was a two arm, randomized, controlled, single-blinded, parallel-group trial. Dyads were randomized to an intervention group: an 8-week MBSR course (daily) and an 8-week PRT and balance training (3 days/week) for their loved ones or a waiting list control group. Results: Nine dyads were randomized [caregivers: median age 75 (40-81) years, loved ones: 77 (73-88) years]. The intervention significantly improved caregiver mindfulness [relative effect size (95% confidence interval) 1.35 (-0.10, 2.81); p = .009] and functional mobility in their loved ones [mean difference (95% confidence interval) 1.53 (-3.09, 6.14)] with no significant effects on caregiver burden [relative effect size (95% confidence interval) 0.22 (-1.09, 1.54); p = .622]. Conclusion: The study appeared feasible in the home environment and future large and longer trials should test the efficacy of a more abbreviated MBSR intervention and to optimize adoption and sustain adherence over time. Trial registry name: HOMeCare: Caring for the Dementia Caregiver and their Loved One via the HOMeCare Exercise and Mindfulness for Health Program Trial URL: https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12617000347369 Registration number: ACTRN12617000347369.

Mapping, Meeting and Modulating Stress and Emotion: Combining Mindfulness and the Workable Ranges Model

This article examines the practice of combining explorations of regulated and dysregulated states through the Workable Ranges Model (WRM) with the skills and qualities taught in Mindfulness-Based Stress Reduction (MBSR). MBSR was designed to help participants to self-regulate stress. Didactic teaching about stress reactivity is part of the curriculum and may contribute to positive outcomes. A practice-based embodied methodology utilised mindful inquiry in research methods. Seven graduates of MBSR courses that included the WRM became conceptual encounter research partners. Following a re-presentation of the WRM, data were gathered through a diagrammatic diary exercise, post-meditation inquiry and a group discussion. Reflexive thematic analysis identified an overarching theme that the WRM was a dynamic map for exploring stability and stress. Two non-hierarchical themes articulated interrelated self-reflective activities associated with using the WRM as a map. Mapping involved charting regulated and dysregulated embodied experience. Meeting was the embodied application to mindfulness practice. Modulating states through intentional orienting to and resourcing mindful self-regulation and self-care grew out of the mapping and meeting practices. The WRM provided a form and set of words to name mind-body states, and to develop and apply insights about them. The WRM was used to shape new meanings about the relationship between mindfulness and regulated and dysregulated experience. This is theorised through its connection with embodied metaphors. The combination of the WRM and mindfulness worked to frame and progress mindful self-regulation. The WRM may be a valuable resource for mindfulness teachers to support self-regulation and mental health.

Impacting employees' and managers' mental health skills using a workplace-adapted mindfulness-based intervention.

BackgroundDuring the past decades, the mental health of the population has been declining. Mindfulness-based stress reduction (MBSR) has been found effective in enhancing well-being along with reducing perceived stress and symptoms of anxiety and depression. Mindfulness-based interventions (MBIs) in the workplace have shown promising results relating to the mental health of employees and managers. However, the research field of organizational-level MBIs being offered to entire companies is still nascent. Practicing mindfulness may affect skills related to good mental health. Thus, the objective of this study was to investigate the impact of an organizational-level MBI on the mental health skills of employees and managers.MethodsThis qualitative study was part of a quasi-experimental multi-method study. Four small and medium-sized private enterprises with a total of 368 employees and managers were included. The intervention contained: 1. An obligatory introductory session on mental health and mindfulness, 2. Voluntary participation in a 10-week live online workplace-adapted MBSR course, and 3. A workshop for selected employee representatives and managers on further implementation of mindfulness in the organization. A total of 27 focus group interviews including 76 respondents were conducted pre- and post-intervention. Verbatim transcription was performed. Data was analyzed using inductive qualitative content analysis.ResultsThrough analysis, four pre-intervention categories emerged: 1. Bodily sensations and awareness in stressful situations, 2. Reactive and passive behavior during stressful situations, 3. Differences in perception as a stressor, 4. Self-criticism and low ability to practice self-care. Six post-intervention categories were identified: 1. Enhanced ability to be aware in the present moment, 2. Increased acknowledgement of how others may view things differently from oneself, 3. Increased kindness to oneself and being able to practice self-care, 4. Moving from reactive to responsive behavior in stressful situations, 5. Mindfulness as an accelerator for an ongoing personal process and 6. Practicing mindfulness – setting time aside or being mindful in everyday life.ConclusionThis study indicates that it is possible to enhance employees’ and managers’ mental health skills using an organizational-level MBI. Enhanced awareness in the present moment transcended through post-intervention categories, facilitating increased self-kindness and responsive behavior in stressful situations.