Utilizing Mindfulness Training to Reduce Stress and Improve Well-being in CF Staff Elizabeth Hente, MPH Cincinnati Children’s Hospital Cincinnati, OH

Disclosure Elizabeth Hente, MPH There are no relationships to disclose related to this presentation.

Why focus on staff stress management? CF Wellness, Education, and Learning Laboratory (CF WELL) On a scale from 1-10 (10=high), how stressful is your job? Range = 3-9, Mean = 6.55 Why is it stressful? 40% Competing demands/lack of time 30% Stress is relative/comes and goes 10% Good self-regulation, Chronic care population, Pressure to perform

How does stress impact us? Depression, emotional exhaustion, and anxiety Psychosocial isolation Decreased job satisfaction Reduced self-esteem Disrupted personal relationships Loneliness Poor attention and concentration Weakened decision-making skills Reduced ability to establish effective relationships with patients Shapiro, S., Brown, K., & Biegel, G. (2007). Teaching Self-Care to Caregivers: Effects of Mindfulness-Based Stress Reduction on the Mental Health of Therapists in Training, Training and Education in Professional Psychology, 1(2), 105-115.

Mindfulness Mindfulness is “the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to things as they are.” (Williams, Teasdale, Segal, and Kabat-Zinn, 2007)

Mindfulness-Based Cognitive Therapy (MBCT) Pioneered by Segal, Teasdale, & Williams Based on components of Jon Kabat-Zinn’s mindfulness-based stress reduction Originally adapted to prevent relapse of depression Incorporates elements of cognitive behavioral therapy (CBT) Recognizing cognitive distortions Relapse prevention plan Relating to others in different ways, changing behaviors

Overview of Staff Training MCBT expert and trainer, Dr. Richard Sears Six 1-hour sessions held at Cincinnati Children’s Hospital during work hours (9a-5p) Homework, skill-building completed between sessions Sessions video recorded, available online All CF health professionals invited - adult and pediatric, multi-disciplinary team

Practical Application 3 minute breathing exercise, body scan Acknowledgement of automatic thoughts Mindful walking, eating Identification of positive/negative experiences + observation of our reactions Acceptance of current state, stepping into difficult situations www.psych-insights.com/mindfulness

Nurturing or Depleting? Write down your daily activities Label each item: Nurturing or Depleting Look at your list as a whole: What is your ratio of Nurturing to Depleting? Are there opportunities to add more Nurturing tasks? Are there Depleting tasks you can reduce or remove entirely? How can you balance this ratio when you know you’ll have a draining day?

Feasibility and Acceptability of Training 15-28 people attended each session, average=19 On average, how often did you practice skills between sessions? On a 1-10 scale (10=high), how important has this program been for you? 0 times 1-2 times 3-4 times 5-7 times 8+ times 17% 39% 11% 1 2 3 4 5 6 7 8 9 10 18% 0% 6% 35% 12%

Effectiveness of Training Assessment p value Empathy <0.0005 Perspective Taking 0.02 Resiliency Perceived Stress 0.00 Negative Affect 0.04 Positive Affect 0.64 Anxiety Depression 0.06 Fatigue 0.25 Sleep Disturbance 0.86 Depersonalization 0.01 Emotional Exhaustion 0.46 Differences in pre-post surveys (n=24):

Lessons Learned Anticipate challenges before starting training (scheduling poll, videotape for future viewing) Better engagement of staff between sessions Find a trainer with practical application These are not useful skills for everyone…and that’s okay! Emphasize these skills as standard practice

Thank you! Research Team: Thomas Boat, MD – Pulmonary Medicine, Cincinnati Children’s Hospital Sian Cotton, PhD – Center for Integrative Health and Wellness, University of Cincinnati Harini Pallerla, MS – Senior Research Assistant, University of Cincinnati Richard Sears, PhD – Center for Integrative Health and Wellness, University of Cincinnati Christopher Siracusa, MD – Pulmonary Medicine, Cincinnati Children’s Hospital Resources available on Dr. Richard Sears’ website: www.psych-insights.com/mindfulness