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

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

4. 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

5. 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),

6. 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)

7. 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

8. 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

9. 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

12. 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?

13. 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%

14. 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):

15. 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

16. 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: