Dr. Jay Thimmapuram, MRCP, MD

Academic Hospitalist

Internal Medicine Dept, York Hospital

Clinical Assistant Professor of Medicine, Penn State College of Medicine

Wellness Ambassador, Wellspan Health .

• Work place related: increasing bureaucratic tasks and workload, loss of autonomy, lack of control over schedule, feeling overwhelmed etc.,

• Work-home interference

• Home support

• Individual characteristics

Predicting and preventing physician burnout: Results from the United States and the Netherlands. Am J Med. 2001;111:170-175.

Risk Factors

• Workload: long hours, having few breaks, or juggling a heavy workload.

• Work roles: too many roles

• Leadership: no employee empowerment, policies not family-friendly.

• Relationships: problems with managers or co-workers

• Fear for your future: worried about security

Causes

• Absenteeism• High employee turnover • Decreased job satisfaction• Increased mistakes• Fatigue• Insomnia• Depression• Anxiety• Relationship struggles

Michie S, Williams S. Reducing work-related psychological ill health and sickness absence: a systematic literature review. Occup Environ Med 2003;60(1):3-9.Murray A et al. Doctor discontent. J Gen Intern Med. 2001 Jul;16(7):452-9

Consequences

Science

A systematic study of the structure and behavior of natural world through

observation and experiment.

Relies on reproducibility of the results.

Research Studies

Decreased

Depressive

Anxiety

and

Panic

Symptoms

W Ramel et al; The Effects of Mindfulness Meditation on Cognitive Processes and Affect in Patients with Past Depression. Cognitive Therapy and Research. August 2004, Volume 28, Issue 4, pp 433-455

Research Studies

Stress

Reduction

in

Health care

Professionals

Shapiro et al; Mindfulness-Based Stress Reduction for Health Care Professionals: Results From a Randomized Trial. International Journal of Stress Management,

Vol 12(2), May 2005, 164-176

Research Studies

Cortical thickness of the brain

Changes in

gray and white matter.

Kang DH et al; The effect of meditation on brain structure: cortical thickness mapping and diffusion tensor imaging. Soc Cogn Affect Neurosci. 2013

January;8(1):27-33.

Luders E et al; The unique brain anatomy of meditation practitioners: alterations in cortical gyrification. Front Hum Neurosci. 2012 Feb 29;6:34.

Lazar SW et al; Neuroreport. 2005 Nov 28;16(17):1893-7.

Research Studies

Gene

Expression

and

Relaxation

Response

Bhasin MK, Dusek JA, Chang BH, Joseph MG, Denninger JW, Fricchione GL, Benson H, Libermann TA. Relaxation response induces temporal transcriptome changes

in energy metabolism, insulin secretion and inflammatory pathways.PLoS One. 2013 May 1;8(5):e62817

Research Studies

Heart

Coherence

Courtesy: www.heartmath.org

Heart and Brain

‘‘If all of the knowledge and advice about how to beat

burnout could be summed up in 1 word, that word would

be balance—balance between giving and getting, balance

between stress and calm, balance between work and home.’’

Maslach C. Burnout: The Cost of Caring. Englewood Cliffs, NJ: Prentice-Hall; 1982.

Meditation and Brain waves

Stage 1 Sleep Pattern (Theta waves)Accentuated Alpha rhythm

Stage 2 Sleep Pattern (Theta with K complexes) Stage 3 Sleep Pattern (Delta waves)

Life is led by feelings and inspirations, and that is the role of the heart.

When we listen to those feelings and capture the inspirations that come from within, we can master our life by listening to our heart.

This exercise of fine tuning the heart with the mind is done through meditation on the heart. This is Heartfulness.

Heartfulness

York Hospital Study with Heartfulness Meditation

Aim of the study

To assess the effect of a Heart Based Meditation Practice on Physician and Nurse Burnout, Emotional Wellness and Telomere length.

Research

Assess Burnout with Maslach Burnout Inventory.

Assess Emotional Wellness with Emotional Wellness Assessment.

Assess Salivary Telomere length.

Research

• Good start for the day

• Maintain the inner state

• Gym effect

• Trainer effect

• Prepares for the day

• Good night’s sleep

• Refreshes oneself

Evening session

Night meditation

Morning meditation

Group meditation

Research

Practice Information

Burnout: Three components assessedA: Emotional Exhaustion (EE)

B: Depersonalization (DP)

C: Personal Accomplishment (PA)

Research

Results

Emotional Wellness Assessment – Section A

Emotional Wellness Assessment – Section B

Research

Results

Telomere Length Analysis

Meditation Group vs Control

Research

Results

Blinded Analysis

DNA extraction performed at University of Pennsylvania, Philadelphia.

Telomere length measured at University of Washington, Seattle.

Not aware of the details of the study.

Research

Results

0.94

0.96

0.98

1

1.02

1.04

1.06

1.08

1.1

1.12

Telomere 1

Telomere 2

* P = 0.036

*

Age Matched Comparison (up to age 33 yrs)

Sleep

A time of rest and recovery from the stresses of everyday life.

A dynamic activity, during which many processes vital to health and well-being take place.

Essential to helping maintain mood, memory, and cognitive performance.

Daytime alertness and memory are impaired by the loss of eight hours of sleep, especially when sleep loss is sustained over a few nights.

A growing body of medical evidence links inadequate sleep with anger, anxiety, and sadness.

https://sleepfoundation.org/sites/default/files/SleepWakeCycle.pdf, NSF. Backgrounder: Why Sleep Matters, op.cit,

Dement WC, Vaughan CC. The Promise of Sleep. New York: Delacorte Press; 1999:274

0

2

4

6

8

10

12

14

16

18

20

ISI 1 ISI 2

ISI 1

ISI 2

P = <.001

Insomnia Severity Index scores with 8 weeks of Heartfulness Meditation

Meditation Conference

Meditation is a Life Skill

Thank you for your time!

Music: www.Bensound.com