Making Mindfulness Accessible for Healthcare

Providers and Medical Students

Matthew McAdam

Jenifer Tabamo

Session B5 QF 2017

Disclosure

We are unable to identify any potential conflict of interest and have nothing to

disclose.

Context

• Promote awareness of benefits of mindfulness meditation

• Offer mindfulness training • Hospital-based health care workers,

and university-based medical students

Background

Background

0

5

10

15

20

25

30

35

40

45

Working Population Family Physicians

%

High Stress in Daily Life1,2

Background

0

5

10

15

20

25

CanadiansAge>15

CanadianPhysicians

%

Major Depressive Episode in Past 12 Months3,4

0

5

10

15

20

25

GeneralPopulation

Nurses

%

Moderate-Severe Depression5

Background Medical Students and Depression6-11

Severe Symptoms

Moderate/Mild Symptoms

Few/No Symptoms

Background

0

10

20

30

40

50

60

70

80

Nurses MedicalStudents

Residents Physicians

%

Burnout Rates12-16

Consequences17-23

1. Staff Attrition Compassion Medical Errors Mental Health 2. Patients Mortality Compliance Safety Satisfaction 3. Financial Strain Annual Cost of Canadian Physician Burnout = $213.1 million

Intervention

MINDFULNESS Non-judgmental awareness of present-moment conscious experience.

MINDFULNESS MEDITATION • A scientifically validated exercise in attentional training aimed at

developing mindfulness. • The practice of observing reality. • Entirely amenable to being taught in a secular context.

Impact24-32

Health Challenge Improved with Mindfulness?

1. Stress Reduced Stress

Improved Quality of Life

2. Mental Illness

- Depression

- Anxiety

- Substance Abuse

3. Burnout Reduced Burnout

- Increased Compassion

Mindfulness also improve symptoms, functioning and quality of life in a host of chronic physical diseases.

Intervention

• Free drop-in mindfulness meditation sessions offered by UBC Mindfulness and=

Meditation in Medicine.

• All hospital staff are welcome to attend.

• Proven benefits of developing a mindfulness meditation practice include:

§ Reduced Stress + Better Sleep

§ Reduced Symptoms of Depression + Anxiety, Improved Mood

§ Reduced Burnout, Improved Cognitive Performance

§ Enhanced Immune System Functioning § Increased Compassion Toward Self and Others

There will be two 10-minutes sessions every

Monday (3:05pm + 3:20pm) and Thursday (12:05pm + 12:20pm) Participants are Welcome to Attend One or Several Sessions.

MONDAY LOCATIONS: January – JP 11 Conference Rm April – CP7E Conference Rm February – CP8E Rehab Rm May – JP 14 Multi-purpose Rm

March – JP 10 Conference Rm June CP7G Conference Rm

THURSDAY LOCATION:

JP 6820

For more information and a detailed schedule that will include any cancellations

or additional sessions please visit:

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Mindfulness Meditation

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Assumptions

Participation, Engagement and Interest

Feedback

Stress Reduction Timing of Meditations Real-Life Applications

Significant Lesson

Accessibility

The Future

Engaging Physicians and Residents Further Evaluation of the Program Expansion of the Program

Beyond Ideas

Out beyond ideas of wrongdoing and rightdoing,

there is a field. I'll meet you there.

When the soul lies down in that grass,

the world is too full to talk about.

Ideas, language, even the phrase "each other"

doesn't make any sense.

— Jellaludin Rumi

References 1. Crompton, S. (2010). What's stressing the stressed? Main sources of stress among workers., 2016, from http://www.statcan.gc.ca/pub/11-008-

x/2011002/article/11562-eng.htm 2. Lee, F., Stewart, M., & Brown, J. (2008). Stress, burnout, and strategies for reducing them. what's the situation among canadian family physicians? Canadian Family Physician, 54, 2234. 3. Compton, M. T., & Frank, E. (2011). Mental health concerns among canadian physicians: Results from the 2007-2008 canadian physician health study. Comprehensive Psychiatry, 52(5), 542. 4. Statistics Canada. (2012). Canadian community health survery: Mental health, 2012., 2016, from http://www.statcan.gc.ca/daily-quotidien/130918/dq130918a-eng.pdf 5. Letvak, S., Ruhm, C. J., & McCoy, T. (2012). Depression in hospital-employed nurses. Clin Nurse Spec. (3): 177-82. 6. Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and canadian medical students. Acad Med, 81(4), 354. 7. Goebert, D., Thompson, D., Takeshita, J., Beach, C., Bryson, P., & Ephgrave, K. (2009). Depressive symptoms in medical students and residents: A multischool study. Acad Med, 84(2), 236. 8. Goldman, M. L., Shah, R. N., & Bernstein, C. A. (2015). Depression and suicide among physician trainees: Recommendations for a national response. JAMA Psychiatry, 72(5), 411. 9. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57(1), 35-43. 10. Schwenk, T. L. (2015). Resident depression: The tip of a graduate medical education iceberg. Jama, 314(22), 2357. 11. Shaw, D. L., Wedding, D., & Zeldow, P. B. (Eds.). (2001). Suicide among medical students and physicians, special problems of medical students (3rd ed.) 12. C Maslach, MP LeiterThe truth about burnout, Jossey-Bass, San Francisco (1997) 13. Aiken, L., et al. (2001). Nurses' reports on hospital care in five countries. Health Aff, 20(3), 43. 14. Ishak, W., Nikravesh, R., Lederer, S., Perry, R., Ogunyemi, D., & Bernstein, C. (2013). Burnout in medical students: A systematic review. The Clinical Teacher, 10(4), 242-245 15. Ishak, W. W., Lederer, S., Mandili, C., Nikravesh, R., Seligman, L., Vasa, M., et al. (2009). Burnout during residency training: A literature review. Journal of Graduate Medical Education, 1(2), 236-242. 16. Wallace, J. E., Lemaire, J. B., & Ghali, W. A. (2009). Physician wellness: A missing quality indicator. Lancet (London, England), 374(9702), 1714-1721. 17. Botha, E., Gwin, T., & Purpora, C. (2015). The effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol. JBI Database System Rev Implement Rep.(10): 21-9.

References 18. Fralick, M., & Flegel, K. (2014). Physician burnout: Who will protect us from ourselves? Can Med Assoc J 19. Shanafelt, T. D. (2009). Enhancing meaning in work: A prescription for preventing physician burnout and promoting patient-centered care. JAMA, 302(12), 1338-1340. 20. CP West, AD Tan, TM Habermann, JA Sloan, & TD Shanafelt. (2009) Association of resident fatigue and distress with perceived medical errors. JAMA, 302, pp. 1294–1300. 21. Shanafelt, T.D., Balch, C.M., Bechamps, G., et al. (2015) Burnout and medical errors among American surgeons. Ann Surg, 251, pp. 995–1000 22. Lyndon, A. (2016). Burnout among health professionals and its effects on patient safety. https://psnet.ahrq.gov/perspectives/perspective/190/burnout-amoung-health-professionals-and-its-effects-on-patient-safety. (February, 2016) (accessed July 24, 2016). 23. Welp, A., Meier, L.L., & Manser, T. (2014). Emotional exhaustion and workload predict clinician-rated and objective patient safety. Front Psychol, 2015 Jan 22;5:1573. doi: 10.3389/fpsyg.2014.01573. eCollection 2014. 24. Khoury, B., Sharma, M., Rush, S. E., & Fournier, C. (2015). Mindfulness-based stress reduction for healthy individuals: A meta-analysis. Journal of Psychosomatic Research, 78(6), 519-528. 25. Demarzo, M. M., Montero-Marin, J., Cuijpers, P., Zabaleta-del-Olmo, E., Mahtani, K. R., Vellinga, A., et al. (2015). The efficacy of mindfulness-based interventions in primary care: A meta-analytic review. Annals of Family Medicine, 13(6), 573-582. 26. Fjorback, L. O., Arendt, M., Ornbol, E., Fink, P., & Walach, H. (2011). Mindfulness-based stress reduction and mindfulness-based cognitive therapy: A systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica, 124(2), 102-119. 27. Gard, T., Holzel, B. K., & Lazar, S. W. (2014). The potential effects of meditation on age-related cognitive decline: A systematic review. Annals of the New York Academy of Sciences, 1307, 89-103. 28. Gotink, R. A., Chu, P., Busschbach, J. J., Benson, H., Fricchione, G. L., & Hunink, M. G. (2015). Standardised mindfulness-based interventions in healthcare: An overview of systematic reviews and meta-analyses of RCTs. PloS One, 10(4), e0124344. 29. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57(1), 35-43. 30. Holzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science : A Journal of the Association for Psychological Science, 6(6), 537-559. 31. Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, 31(6), 1041-1056 32. Schutte, N. S., & Malouff, J. M. (2014). A meta-analytic review of the effects of mindfulness meditation on telomerase activity. Psychoneuroendocrinology, 42, 45-48.

Acknowledgement

Dr. Devon Christie Dr. Marco Garate-Madariaga

Candace Tegart VGH Fitness and Wellness Program

VGH Medicine Program Clinical Nurse Educators and Nurse Clinicians

For more Information…

Matthew McAdam Founder and Director of Mindfulness and Meditation in Medicine at UBC B.Sc. (Hon) | M.D. Candidate, Class of 2019 Email: m.mcadam@alumni.ubc.ca https://mmmatubc.wordpress.com

Jenifer Tabamo, RN, BSN, MSN Clinical Nurse Specialist Medicine Program, Vancouver Acute Vancouver General Hospital Mobile: 604-803-1862 Tel: 604-875-4111 Local 64143 Email: jenifer.tabamo@vch.ca