Mindfulness

, Volume 7, Issue 3, pp 764–774 | Cite as

A Pilot Evaluation of a Mindful Self-care and Resiliency (MSCR) Intervention for Nurses

  • Mark Craigie
  • Susan Slatyer
  • Desley Hegney
  • Rebecca Osseiran-Moisson
  • Eric Gentry
  • Sue Davis
  • Tony Dolan
  • Clare Rees
ORIGINAL PAPER

Abstract

It is now well established that a significant number of nurses have less than optimal levels of wellness as a result of the stressful nature of their work. Identifying effective workplace strategies to help improve the resilience of nurses is therefore a high priority. In this study, we evaluated the feasibility of a mindfulness-based intervention aimed at reducing compassion fatigue and improving emotional well-being in nurses. A total of 21 nurses recruited from a large teaching hospital in Western Australia, participated in a mindful self-care and resiliency (MSCR) intervention. The intervention consisted of a 1-day compassion fatigue prevention educational workshop, followed by a series of weekly mindfulness training seminars conducted over 4 weeks (12 h total intervention time). Participants completed a number of standardized measures at pre, post, and 1-month follow-up. Significant improvements were observed following the intervention for compassion satisfaction, burnout, trait-negative affect, obsessive passion, and stress scores. At pre-intervention, 45 % of the sample had high burnout scores, but this reduced to just 15 % by post-intervention. No significant changes were observed for general resilience, anxiety, or secondary traumatic stress post-intervention or at follow-up. The results of this preliminary study indicate that MSCR may represent a feasible approach to improving resilience and well-being among nurses. Further research utilizing a control group is required to strengthen conclusions.

Keywords

Compassion fatigue Nurses Burnout Mindfulness Resilience Intervention 

Supplementary material

12671_2016_516_MOESM1_ESM.pdf (159 kb)
ESM 1(PDF 158 kb)

References

  1. Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: a validation study. American Journal of Orthopsychiatry, 76(1), 103–108. doi:10.1037/0002-9432.76.1.103.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Adams, R., Figley, C., & Boscarino, J. (2008). The compassion fatigue scale: its use with social workers following urban disaster. Research on Social Work Practice, 18(3), 238–250. doi:10.1177/1049731507310190.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Adriaenssens, J., De Gucht, V., & Maes, S. (2014). Determinants and prevalence of burnout in emergency nurses: a systematic review of 25 years of research. International Journal of Nursing Studies, 52(2), 649–661. doi:10.1016/j.ijnurstu.2014.11.004.CrossRefPubMedGoogle Scholar
  4. American Psychological Association (2015). The road to resilience. Washington DC: American Psychological Association. http://www.apa.org/helpcenter/road-resilience.aspx. Accessed 20 September, 2015.
  5. Bados, A., Gómez-Benito, J., & Balaguer, G. (2010). The state-trait anxiety inventory, trait version: does it really measure anxiety? Journal of Personality Assessment, 92(6), 560–567. doi:10.1080/00223891.2010.513295.CrossRefPubMedGoogle Scholar
  6. Barlow, D. H. (2004). Anxiety and its disorders: the nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.Google Scholar
  7. Beck, C. T. (2011). Secondary traumatic stress in nurses: a systematic review. Archives of Psychiatric Nursing, 25(1), 1–10. doi:10.1016/j.apnu.2010.05.005.CrossRefPubMedGoogle Scholar
  8. Berger, R., & Gelkopf, M. (2011). An intervention for reducing secondary traumatization and improving professional self-efficacy in well baby clinic nurses following war and terror: a random control group trial. International Journal of Nursing Studies, 48(5), 601–610. doi:10.1016/j.ijnurstu.2010.09.007.CrossRefPubMedGoogle Scholar
  9. Breslau, N., Peterson, E., Kessler, R., & Schultz, L. (1999). Short screening scale for PTSD. American Journal of Psychiatry, 156, 908–911. doi:10.1176/ajp.156.6.908.CrossRefPubMedGoogle Scholar
  10. Breslau, N., & Schultz, L. (2013). Neuroticism and post-traumatic stress disorder: a prospective investigation. Psychological Medicine, 43(8), 1697–1702. doi:10.1017/S0033291712002632.CrossRefPubMedGoogle Scholar
  11. Brown, R. L., & Rounds, L. A. (1995). Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Wisconsin Medical Journal, 94(3), 135–140.PubMedGoogle Scholar
  12. Campbell‐Sills, L., & Stein, M. B. (2007). Psychometric analysis and refinement of the Connor–Davidson resilience scale (CD‐RISC): validation of a 10‐item measure of resilience. Journal of Traumatic Stress, 20(6), 1019–1028. doi:10.1002/jts.20271.CrossRefPubMedGoogle Scholar
  13. Carmody, J., & Baer, R. A. (2009). How long does a mindfulness-based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress. Journal of Clinical Psychology, 65(6), 627–638. doi:10.1002/jclp.20555.CrossRefPubMedGoogle Scholar
  14. Carver, C. S., & Connor-Smith, J. (2010). Personality and coping. Annual Review of Psychology, 61(1), 679–704. doi:10.1146/annurev.psych.093008.100352.CrossRefPubMedGoogle Scholar
  15. Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (second ed.). Lawrence Erlbaum Associates.Google Scholar
  16. Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: the Connor‐Davidson resilience scale (CD‐RISC). Depression and Anxiety, 18(2), 76–82. doi:10.1002/da.10113.CrossRefPubMedGoogle Scholar
  17. Connor, K. M., Davidson, J. R. T., & Lee, L.-C. (2003). Spirituality, resilience, and anger in survivors of violent trauma: a community survey. Journal of Traumatic Stress, 16, 487–494. doi:10.1023/A:1025762512279.CrossRefPubMedGoogle Scholar
  18. Craigie, M., Osseiran-Moisson, R., Hemsworth, D., Aoun, S., Francis, K., Brown, J., Hegney, D., & Rees, C. (2015). The influence of trait-negative affect and compassion satisfaction on compassion fatigue in Australian nurses. Psychological Trauma: Theory, Research, Practice, and Policy. doi:10.1037/tra0000050.Google Scholar
  19. Crawford, J. R., Cayley, C., Wilson, P. H., Lovibond, P. F., & Hartley, C. (2011). Percentile norms and accompanying interval estimates from an Australian general adult population sample for self-report mood scales. The Australian Psychologist, 46, 3–14. doi:10.1111/j.1742-9544.2010.00003.x.CrossRefGoogle Scholar
  20. Dharmawardene M., Givens J., Wachholtz A., Makowski, S., & Tjia, J. (2015). A systematic review and meta-analysis of meditative interventions for informal caregivers and health professionals. BMJ Supportive & Palliative Care, 1–10. doi:10.1136/bmjspcare2014-000819.
  21. Figley, C. R. (2002). Treating compassion fatigue. New York, NY: Brunner-Routledge.Google Scholar
  22. Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress disorder: an overview. In C. R. Figley (Ed.), Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in those who Treat the Traumatized (pp. 1–20). NY: Brunner.Google Scholar
  23. Flarity, K., Gentry, J. E., & Mesnikoff, N. (2013). The effectiveness of an educational program on preventing and treating compassion fatigue in emergency nurses. Advanced Emergency Nursing Journal, 35(3), 247–258. doi:10.1097/TME.0b013e31829b726f.CrossRefPubMedGoogle Scholar
  24. Garland, E. L., Fredrickson, B., Kring, A. M., Johnson, D. P., Meyer, P. S., & Penn, D. L. (2010). Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clinical Psychology Review, 30(7), 849–864. doi:10.1016/j.cpr.2010.03.002.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Gauthier, T., Meyer, R. M., Grefe, D., & Gold, J. I. (2015). An on-the-job mindfulness-based intervention for pediatric ICU nurses: a pilot. Journal of Pediatric Nursing, 30(2), 402–409. doi:10.1016/j.pedn.2014.10.005.CrossRefPubMedGoogle Scholar
  26. Gentry, J. E. (2013). Powerpoint slides for compassion fatigue prevention and resilience. Retrieved from http://www.compassionunlimited.com/Resource/CF-PESI (2012).pptx, November 10, 2013.
  27. Gentry, J., & Baranowsky, A. (1998). Treatment manual for the accelerated recovery program. Toronto ON: Psych Ink Resource.Google Scholar
  28. Gillespie, B. M. (2007). The Predictors of Resilience in Operating Room Nurses. (PhD), Griffith, Gold Coast, Australia.Google Scholar
  29. Goodman, M. J., & Schorling, J. B. (2012). A mindfulness course decreases burnout and improves well-being among healthcare providers. The International Journal of Psychiatry in Medicine, 43(2), 119–128. doi:10.2190/PM.43.2.b.CrossRefPubMedGoogle Scholar
  30. Good, D. J., Lyddy, C. J., Glomb, T. M., Bono, J. E., Brown, K. W., Duffy, M. K., & Lazar, S. W. (2015). Contemplating mindfulness at work: an integrative review. Journal of Management, Online, November. doi:10.1177/0149206315617003.Google Scholar
  31. Hegney, D., Craigie, M., Osseiran-Moisson, R., Drury, V., Aoun, S., Hemsworth, D., & Francis, K. (2014). Compassion fatigue, compassion satisfaction, anxiety and depression in Western Australian nurses: a questionnaire survey. Journal of Nursing Management, 22, 506–518. doi:10.1111/jonm.12160.CrossRefPubMedGoogle Scholar
  32. Hinkin, C., Castellon, S., Dickson-Fuhrman, E., Daum, G., Jaffe, J., & Jarvik, L. (2001). Screening for drug and alcohol abuse among older adults using a modified version of the CAGE. American Journal of Addiction, 10(4), 319–326. doi:10.1111/j.1521-0391.2001.tb00521.x.CrossRefGoogle Scholar
  33. Hooper, C., Craig, J., Janvrin, D., Wetsel, M., & Reimels, E. (2010). Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36(5), 420–427. doi:10.1016/j.jen.2009.11.027.CrossRefPubMedGoogle Scholar
  34. Hülsheger, U. R., Alberts, H. J., Feinholdt, A., & Lang, J. W. (2013). Benefits of mindfulness at work: the role of mindfulness in emotion regulation, emotional exhaustion, and job satisfaction. Journal of Applied Psychology, 98(2), 310. doi:10.1037/a0031313.CrossRefPubMedGoogle Scholar
  35. Kabat-Zinn, J. (1990). Full catastrophe living. New York: Dell Publishing.Google Scholar
  36. Kabat‐Zinn, J. (2003). Mindfulness‐based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. doi:10.1093/clipsy.bpg016.Google Scholar
  37. Kimerling, R., Ouimette, P., Prins, A., Nisco, P., Lawler, C., Cronkite, R., & Moos, R. H. (2006). Utility of a short screening scale for DSM-IV PTSD in primary care. Journal of General Internal Medicine, 21(1), 65–67. doi:10.1111/j.1525-1497.2005.00292.x.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., & Hofmann, S. G. (2013). Mindfulness-based therapy: a comprehensive meta-analysis. Clinical Psychology Review, 33(6), 763–771. doi:10.1016/j.cpr.2013.05.005.CrossRefPubMedGoogle Scholar
  39. Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: a new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 1–7. doi:10.3928/0048-5713-20020901-06.CrossRefGoogle Scholar
  40. Laschinger, H. K. S., & Fida, R. (2014). New nurses burnout and workplace well-being: the influence of authentic leadership and psychological capital. Burnout Research, 1, 19–28. doi:http://dx.doi.org/10.1016/j.burn.2014.03.002.
  41. Lavigne, G. L., Forest, J., & Crevier-Braud, L. (2012). Passion at work and burnout: a two-study test of the mediating role of flow experiences. European Journal of Work and Organizational Psychology, 21(4), 518–546. doi:10.1080/1359432X.2011.578390.CrossRefGoogle Scholar
  42. Leiter, M. P., & Maslach, C. (2009). Nurse turnover: the mediating role of burnout. Journal of Nursing Management, 17(3), 331–339. doi:10.1111/j.1365-2834.2009.01004.x.CrossRefPubMedGoogle Scholar
  43. Loprinzi, C. E., Prasad, K., Schroeder, D. R., & Sood, A. (2011). Stress management and resilience training (SMART) program to decrease stress and enhance resilience among breast cancer survivors: a pilot randomized clinical trial. Clinical Breast Cancer, 11(6), 364–368. doi:10.1016/j.clbc.2011.06.008.CrossRefPubMedGoogle Scholar
  44. Lovibond, S. F., & Lovibond, P. F. (2004). Manual for the depression anxiety stress scales (2nd ed.). Sydney: The Psychology Foundation of Australia.Google Scholar
  45. Mackenzie, C. S., Poulin, P. A., & Seidman-Carlson, R. (2006). A brief mindfulness-based stress reduction intervention for nurses and nurse aides. Applied Nursing Research, 19, 105–109. doi:10.1016/j.apnr.2005.08.002.CrossRefPubMedGoogle Scholar
  46. Mageau, G. A., Vallerand, R. J., Rousseau, F. L., Ratelle, C. F., & Provencher, P. J. (2005). Passion and gambling: investigating the divergent affective and cognitive consequences of gambling. Journal of Applied Social Psychology, 35(1), 100–118. doi:10.1111/j.1559-1816.2005.tb02095.x.CrossRefGoogle Scholar
  47. Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E. (2008). Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry, 8(1), 41. doi:10.1186/1471-244X-8-41.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Martin, A., Rief, W., Klaiberg, A., & Braehler, E. (2006). Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. General Hospital Psychiatry, 28(1), 71–77. doi:10.1016/j.genhosppsych.2005.07.003.CrossRefPubMedGoogle Scholar
  49. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52(1), 397–422. doi:10.1146/annurev.psych.52.1.397.CrossRefPubMedGoogle Scholar
  50. Mayfield, D., McLeod, G., & Hall, P. (1974). The CAGE questionnaire: validation of a new alcoholism screening instrument. American Journal of Psychiatry, 131(10), 1121–1123.PubMedGoogle Scholar
  51. Mantzios, M. (2014). Exploring the relationship between worry and impulsivity in military recruits: the role of mindfulness and self‐compassion as potential mediators. Stress and Health, 30(5), 397–404. doi:10.1002/smi.2617.CrossRefPubMedGoogle Scholar
  52. McVicar, A. (2003). Workplace stress in nursing: a literature review. Journal of Advanced Nursing, 44(6), 633–642. doi:10.1046/j.0309-2402.2003.02853.x.CrossRefPubMedGoogle Scholar
  53. Mealer, M., Conrad, D., Evans, J., Jooste, K., Solyntjes, J., Rothbaum, B., & Moss, M. (2014). Feasibility and acceptability of a resilience training program for intensive care unit nurses. American Journal of Critical Care, 23(6), 97–105. doi:10.4037/ajcc2014747.CrossRefGoogle Scholar
  54. Potter, P., Deshields, T., Berger, J. A., Clarke, M., Olsen, S., & Chen, L. (2013). Evaluation of a compassion fatigue resiliency program for oncology nurses. Oncology Nursing Forum, 40(2), 180–187. doi:10.1188/13.ONF.180-187.CrossRefPubMedGoogle Scholar
  55. Rees, C. S., Breen, L. J., Cusack, L., & Hegney, D. (2015). Understanding individual resilience in the workplace: the international collaboration of workforce resilience (ICWR) model. Frontiers in Psychology, 6, 73. doi:10.3389/fpsyg.2015.00073.CrossRefPubMedPubMedCentralGoogle Scholar
  56. Ruths, F. A., de Zoysa, N., Frearson, S. J., Hutton, J., Williams, J. M. G., & Walsh, J. (2013). Mindfulness-based cognitive therapy for mental health professionals—a pilot study. Mindfulness, 4(4), 289–295. doi:10.1007/s12671-012-0127-0.CrossRefGoogle Scholar
  57. Santos, M. C., Barros, L., & Carolino, E. (2010). Occupational stress and coping resources in physiotherapists: a survey of physiotherapists in three general hospitals. Physiotherapy, 96(4), 303–310. doi:10.1016/j.physio.2010.03.001.CrossRefPubMedGoogle Scholar
  58. Samios, C., Abel, L. M., & Rodzik, A. K. (2013). The protective role of compassion satisfaction for therapists who work with sexual violence survivors: an application of the broaden-and-build theory of positive emotions. Anxiety, Stress, & Coping, 26(6), 610–623. doi:10.1080/10615806.2013.784278.CrossRefGoogle Scholar
  59. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression. New York: The Guilford Press.Google Scholar
  60. Sood, A., Prasad, K., Schroeder, D., & Varkey, P. (2011). Stress management and resilience training among Department of Medicine faculty: a pilot randomized clinical trial. Journal of General Internal Medicine, 26(8), 858–861. doi:10.1007/s11606-011-1640-x.CrossRefPubMedPubMedCentralGoogle Scholar
  61. Southwick, S. M., & Charney, D. S. (2012). Resilience: the science of mastering life’s greatest challenges. New York: Cambridge University Press, NY.CrossRefGoogle Scholar
  62. Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  63. Stamm, B. (2010). The Concise ProQOL Manual. In ProQoL.org (Ed.): Pocatello.Google Scholar
  64. Swider, B., & Zimmerman, R. (2010). Born to burnout: a meta-analytic path model of personality, job burnout, and work outcomes. Journal of Vocational Behavior, 76(3), 487–506. doi:10.1016/j.jvb.2010.01.003.CrossRefGoogle Scholar
  65. Teper, R., Segal, Z. V., & Inzlicht, M. (2013). Inside the mindful mind: how mindfulness enhances emotion regulation through improvements in executive control. Current Directions in Psychological Science, 22(6), 449–454.CrossRefGoogle Scholar
  66. Thomas, J. T., & Otis, M. D. (2010). Intrapsychic correlates of professional quality of life: mindfulness, empathy, and emotional separation. Journal of the Society for Social Work and Research, 1(2), 83–98. http://www.jstor.org/stable/10.5243/jsswr.2010.7.CrossRefGoogle Scholar
  67. Thompson, R. W., Arnkoff, D. B., & Glass, C. R. (2011). Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma. Trauma, Violence and Abuse, 12, 220–235. doi:10.1177/1524838011416375.CrossRefPubMedGoogle Scholar
  68. Tremblay, M. A., & Messervey, D. (2011). The job demands-resources model: further evidence for the buffering effect of personal resources. SA Journal of Industrial Psychology, 37(2), 10–19. doi:10.4102/sajip.v37i2.876.CrossRefGoogle Scholar
  69. Vallerand, R. J., Blanchard, C., Mageau, G. A., et al. (2003). Les passions de l’ame: on obsessive and harmonious passion. Journal of Personality and Social Psychology, 85(4), 756. doi:10.1037/0022-3514.85.4.756.CrossRefPubMedGoogle Scholar
  70. Vallerand, R. J., Paquet, Y., Philippe, F. L., & Charest, J. (2010). On the role of passion for work in burnout: a process model. Journal of Personality, 78(1), 289–312. doi:10.1111/j.1467-6494.2009.00616.x.CrossRefPubMedGoogle Scholar
  71. van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., … & Piet, J. (2015). A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical Psychology Review, 37, 26–39. doi:10.1016/j.cpr.2015.02.001Google Scholar
  72. Watson, D., & Clark, L. A. (1984). Negative affectivity: the disposition to experience aversive emotional states. Psychological Bulletin, 96(3), 465–490. doi:10.1037/0033-2909.96.3.465.CrossRefPubMedGoogle Scholar
  73. Williams, J. M. G., & Penman, W. (2011). Mindfulness a practical guide to finding peace in a frantic world. London, UK: Piatkus.Google Scholar
  74. Wolever, R. Q., Bobinet, K. J., McCabe, K., Mackenzie, E. R., Fekete, E., Kusnick, C. A., & Baime, M. (2012). Effective and viable mind-body stress reduction in the workplace: a randomized controlled trial. Journal of Occupational Health Psychology, 17(2), 246–258. doi:10.1037/a0027278.CrossRefPubMedGoogle Scholar
  75. Zeidner, M., Hadar, D., Matthews, G., & Roberts, R. D. (2013). Personal factors related to compassion fatigue in health professionals. Anxiety, Stress, & Coping, 26(6), 595–609. doi:10.1080/10615806.2013.777045.CrossRefGoogle Scholar
  76. Zeller, J. M., & Levin, P. F. (2013). Mindfulness interventions to reduce stress among nursing personnel: an occupational health perspective. Workplace Health & Safety, 61(2), 85–89. doi:10.1177/216507991306100207.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Mark Craigie
    • 1
  • Susan Slatyer
    • 2
    • 3
  • Desley Hegney
    • 4
  • Rebecca Osseiran-Moisson
    • 2
  • Eric Gentry
    • 5
  • Sue Davis
    • 6
  • Tony Dolan
    • 7
  • Clare Rees
    • 1
  1. 1.School of Psychology and Speech PathologyCurtin UniversityPerthAustralia
  2. 2.School of Nursing, Midwifery and ParamedicineCurtin UniversityPerthAustralia
  3. 3.Centre for Nursing ResearchSir Charles Gairdner HospitalNedlandsAustralia
  4. 4.School of Nursing and MidwiferyThe University of Southern QueenslandDarling HeightsAustralia
  5. 5.Compassion Unlimited/International Association of Trauma ProfessionalsSarasotaUSA
  6. 6.Research and EducationSir Charles Gairdner HospitalNedlandsAustralia
  7. 7.Sir Charles Gairdner and Osborne Park Health Care Group & North Metropolitan Health ServiceNedlandsAustralia

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