Abstract
Objectives
Mindfulness-based programs (MBPs) have been tested as promising alternatives for managing stress in Primary health care (PHC) providers. The study compared the feasibility and efficacy of an MBP on burnout symptoms in Brazilian PHC providers with a briefer relaxation-based program and with a nonactive control group.
Methods
A nonrandomized controlled trial was conducted with mixed-methods evaluation on self-reported symptoms of burnout, and positive and negative affection, mindfulness, self-compassion, decentering, and rumination. The MBP arm (MF) (n = 62) consisted of eight mindfulness sessions, the relaxation arm (RE) (n = 35) attended four relaxation sessions, and the control arm (CO) (n = 45) comprised a waitlist group.
Results
The reduction in exhaustion was significantly higher in MF compared with CO (d = − 0.58; p = 0.020), and in RE compared with CO (d = − 0.63; p = 0.017). MF was significantly superior to CO for reducing cynicism (d = − 0.48; p = 0.024). There was also significant superiority of MF compared with CO in positive and negative affect, observing, describing, nonreacting, mindfulness, identification, and rumination. MF and RE were significantly superior to CO for reducing criticism and isolation. Finally, MF was significantly superior to RE and CO for improving nonjudging, self-kindness, and decentering.
Conclusions
Mindfulness and relaxation may be efficacious in addressing burnout symptoms in PHC providers, probably with synergistic effects and distinct mechanisms of action. Further studies with a randomized design and larger sample sizes should be performed to confirm these preliminary data and to test whether a mix of mindfulness and relaxation techniques would be more effective than either program on its own.
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Data Availability
The individual anonymized participant data are available for any analytical purpose that may be related to the aims of the present study upon reasonable request made to the corresponding author.
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Funding
This study was funded by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil (grant number 303413/2014-0) and DS was supported by a PhD fellowship from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) (grant number: 1457323). JM-M is supported by the Wellcome Trust Grant (104908/Z/14/Z).
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DS codesigned and conducted the study, assisted with the data analyses, and wrote the first version of the manuscript. SA analyzed the data and wrote part of the results. EF collaborated on the study design. SF collaborated on the study design. JMM assisted with the data analyses, review of the literature, and the writing and editing of the paper. GL assisted with the qualitative data transcription. LP conducted part of the study. AG collaborated with the study design and review of the literature. TS collaborated on the study design. JGC collaborated on the study design. MD designed and supervised the study and collaborated in the writing and editing of the manuscript. All authors revised and approved the final version of the manuscript.
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Sopezki, D., Andreoni, S., Montero-Marin, J. et al. Feasibility and Effectiveness of a Mindfulness-Based Program Vs. Relaxation in the Treatment of Burnout in Brazilian Primary Care Providers: a Mixed-Methods Pragmatic Controlled Study. Mindfulness 11, 2573–2588 (2020). https://doi.org/10.1007/s12671-020-01472-w
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DOI: https://doi.org/10.1007/s12671-020-01472-w