Effects of a brief mindfulness-based intervention program for stress management among medical students: the Mindful-Gym randomized controlled study
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Pursuing undergraduate medical training can be very stressful and academically challenging experience. A 5-week mindfulness-based stress management (MBSM/Mindful-Gym) program was developed to help medical students cope with stress. The aim of this study was to evaluate the effectiveness of the intervention in reducing stress among students in a medical school in Malaysia. Seventy-five medical students participated in the program. They were stratified according to years of studies and randomly allocated to intervention (N = 37) and control groups (N = 38). The following outcome variables were measured at pre- and post-intervention: mindfulness (with Mindful Awareness Attention Scale); perceived stress (with Perceived Stress Scale); mental distress (with General Health Questionnaire), and self-efficacy (with General Self-efficacy Scale). Hierarchical multiple regressions were used to analyse the effect of group (intervention vs. control) on changes in the outcome variables. There were significant improvements at one week post-intervention in all outcome variables: mindfulness (β = 0.19, ΔR2 = 0.04, p = .040, f 2 = 0.05), perceived stress (β = −0.26, ΔR2 = 0.07, p = .009, f 2 = 0.10); mental distress (β = −0.28, ΔR2 = 0.10, p = .003, f 2 = 0.15); and self-efficacy (β = 0.30, ΔR2 = 0.09, p < .001, f 2 = 0.21). Six months after the intervention, those who had joined the program reported higher self-efficacy compared to those in the control group (β = 0.24, ΔR2 = 0.06, p = .020, f 2 = 0.08); but there was no difference in other outcome measures. More than 90 % of the participants found the program applicable in helping patients and all reported that they would recommend it to others. This study indicates that the program is potentially an effective stress management program for medical students in Malaysia.
KeywordsMindfulness Medical students Stress management Mental health Coping
This study was supported by the Department of Psychiatry, Faculty of Medicine & Health Sciences, UPM, and a research grant from UPM (Project Number: 04-05-11-1583RU). The authors would like to thank the medical students who participated in, and provided feedback for enhancement of the program.
- Alvi, T., Assad, F., Ramzan, M., & Khan, F. A. (2010). Depression, anxiety and their associated factors among medical students. Journal of the College of Physicians and Surgeons Pakistan, 20(2), 122–126.Google Scholar
- Barbosa, P., Raymond, G., Zlotnick, C., Wilk, J., Toomey, R., & Mitchell, J. (2013). Mindfulness-based stress reduction training is associated with greater empathy and reduced anxiety for graduate healthcare students. Education for Health: Change in Learning and Practice, 26(1), 9–14.Google Scholar
- Bondolfi, G., Jermann, F., Van der Linden, M., Gex-Fabry, M., Bizzini, L., Rouget, B. W., & Bertschy, G. (2010). Depression relapse prophylaxis with mindfulness-based cognitive therapy: Replication and extension in the Swiss health care system. Journal of Affective Disorders, 122(3), 224–231.CrossRefGoogle Scholar
- Buttner, T. R., & Dlugosch, G. E. (2013). Students’ stress: The relationship between self-efficacy, mindfulness and stress experience of students. Prevention and Health Promotion, 8(2), 106.Google Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd ed.). Hillsdale: Lawrence Erlbaum Associates.Google Scholar
- De Vibe, M., Solhaug, I., Tyssen, R., Friborg, O., Rosenvinge, J. H., Sørlie, T., & Bjørndal, A. (2013). Mindfulness training for stress management: A randomised controlled study of medical and psychology students. BMC Medical Education, 13(107). doi: 10.1186/1472-6920-13-107.
- Golderberg, D., & Williams, P. (1988). A user's guide to the general health questionnaire. Windsor: NFER-Nelson.Google Scholar
- Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickel, M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: A randomized, double-blind, controlled study. Psychotherapy and Psychosomatics, 76(6), 332–338.CrossRefGoogle Scholar
- Haahr, M. (1998). RANDOM.ORG—True Random Number Service. Retrieved December 27, 2013, from http://www.random.org/.
- Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6(2), 65–70.Google Scholar
- Jain, S., Shapiro, S. L. P., Swanick, S., Roesch, S. C. P., Mills, P. J. P., Bell, I., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33(1), 11–21.CrossRefGoogle Scholar
- Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.Google Scholar
- Kaviani, H., Hatami, N., & Javaheri, F. (2012). The impact of mindfulness-based cognitive therapy (MBCT) on mental health and quality of life in a sub-clinically depressed population. Archives of Psychiatry and Psychotherapy, 14(1), 21–28.Google Scholar
- Kaviani, H., Javaheri, F., & Hatami, N. (2011). Mindfulness-based cognitive therapy (MBCT) reduces depression and anxiety induced by real stressful setting in non-clinical population. International Journal of Psychology and Psychological Therapy, 11(2), 285–296.Google Scholar
- Ko, S. M., Kua, E. H., & Fones, C. S. (1999). Stress and the undergraduates. Singapore Medical Journal, 627, 627–630.Google Scholar
- Krusche, A., Cyhlarova, E., & Williams, J. M. G. (2013). Mindfulness online: An evaluation of the feasibility of a web-based mindfulness course for stress, anxiety and depression. BMJ Open, 3(11). doi: 10.1136/bmjopen-2013-003498.
- Lovibond, S., & Lovibond, P. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychology Foundation.Google Scholar
- Mazwin, N. A. (2008). Fatwa Council says yoga with worshipping, chanting is prohibited. Kuala Lumpur: The Star Online.Google Scholar
- Phang, C. K., & Oei, T. P. S. (2012). From Mindfulness to meta-mindfulness: Further integration of meta-mindfulness concept and strategies into cognitive-behavioral therapy. Mindfulness, 3(2), 104–116.Google Scholar
- Quince, T. A., Wood, D. F., Parker, R. A., & Benson, J. (2012). Prevalence and persistence of depression among undergraduate medical students: A longitudinal study at one UK medical school. BMJ Open, 2(4). doi: 10.1136/bmjopen-2012-001519.
- Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman, S. Wright, & M. Johnston (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). Windsor: NFER-Nelson.Google Scholar
- Sherina, M. S., & Kanesan, N. (2003). The prevalence of depression among medical students. Malaysia Journal of Psychiatry, 11(1), 12–17.Google Scholar
- Singh, A., Lal, A., & Shekhar, A. (2010). Prevalence of depression among medical students of a private medical college in India. Online Journal of Health and Allied Sciences, 9(4), from http://www.ojhas.org/issue36/2010-4-8.htm.
- Smith, S., & Hayes, S. C. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy (p. 190). Oakland: New Harbinger Publications.Google Scholar
- Soper, D. S. (2013). Free a priori sample size calculator for hierarchical multiple regression (Software). Retrieved on December 28, 2013, from http://www.danielsoper.com/statcalc3/calc.aspx?id=16.
- Turakitwanakan, W., Mekseepralard, C., & Busarakumtragul, P. (2013). Effects of mindfulness meditation on serum cortisol of medical students. Journal of the Medical Association of Thailand, 96(SUPPL 1), S90–S95.Google Scholar
- Williams, P. M., & Penman, D. D. (2011). Mindfulness: A practical guide to finding peace in a frantic world (p. 288). London: Piatkus.Google Scholar
- Yusoff, M. S. B. (2011). Effects of a brief stress reduction intervention on medical studentss depression, anxiety and stress during stressful period. Asean Journal of Psychiatry, 12(1), from http://www.aseanjournalofpsychiatry.org/index.php/aseanjournalofpsychiatry/article/view/42.
- Yusoff, M. S. B., & Abdul Rahim, A. F. (2010). Impact of medical student well-being workshop on the medical student’s stress level: A prelimiary study. Asean Journal of Psychiatry, 11(1), from http://www.aseanjournalofpsychiatry.org/oe11107.htm.
- Yusoff, M. S. B., Abdul Rahim, A. F., & Yaacob, M. J. (2010a). Prevalence and sources of stress among Universiti Sains Malaysia medical students. Malaysian Journal of Medical Sciences, 17(1), 30–37.Google Scholar
- Yusoff, M. S. B., & Esa, A. R. (2012). Stress management for medical students: A systematic review. In A. Lopez-Varela (Ed.), Social Sciences and Cultural Studies—Issues of Language, Public Opinion, Education and Welfare. InTech. doi: 10.5772/37095.
- Yusoff, M. S. B., Yaacob, M. J., & Rahim, A. F. A. (2010b). The sensitivity, specificity and reliability of the malay version 12-items general health questionnaire (GHQ-12) in detecting distressed medical students. ASEAN Journal of Psychiatry, 11(2), 135–142.Google Scholar
- Zaid, Z. A., Chan, S. C., & Ho, J. J. (2007). Emotional disorders among medical students in a Malaysian private medical school. Singapore Medical Journal, 48(10), 895–899.Google Scholar