Study: Transcendental meditation for health care employees

reference

joshi sp, wong ai, brucker a, et al. Effectiveness of transcendental meditation for reducing stress among employees in the healthcare system: a randomized clinical study. Jama Netw Open . 2022; 5 (9): E2231917.

Study goal

Determination of the effectiveness of transcendental meditation (TM) for stress reduction in employees in the healthcare sector

Key to take

Among the healthcare workers, transcendental meditation could not reduce stress during the three -month study period. It reduced the burnout characteristics of emotional exhaustion as well as insomnia and anxiety.

Design

single -centered, open, randomized clinical study

participant

The researchers randomized 80 participants: 41 in the TM group and 39 in the control group. The demographic data of the 80 participants are as follows:

• women, 66 (82.5 %), with an average age of 40 years

• Indian or Alaska-Urbender, 1 (1.3 %)

• Asian, 5 (6.3 %)

• black, 12 (15.0 %)

• white, 59 (73.8 %)

• unknown or not reported breed, 3 (3.8 %)

• Latinx, 4 (5.0 %)

• non-Latin American, 76 (95.0 %)

Intervention

The participants of the TM group practiced TM for 20 minutes for 3 months twice a day.

The control group received access to wellness resources such as mindfulness-based stress reduction, journaling workshops, stress and resilience training as well as access to fitness and nutritional advice.

studied study parameters

The researchers measure the psychological stress using global severity index and changes in burnout using the Maslach burnout inventory. They measure insomnia Severity Index and anxiety based on the "Generalized Anxiety Disorder-7" scale.

primary result

The primary endpoint was the comparison of the changes in the acute psychological stress between the groups, measured based on the total number of global severity index (GSI-018). All other indices were secondary results.

most important knowledge

In the TM group, 38 participants (92.7 %) adhered to the regime and practiced TM twice a day for 3 months. The TM Group had an average GSI-18 reduction by 5.6 points and the control group an average reduction by 3.6 points. This difference was not statistically significant ( p = 0.13).

However, in the TM group there were significantly stronger reductions in the secondary endpoints compared to the control group:

• burn out. Subscore of the Maslach-Burnout inventory: −8.0 points vs. −2.6 points; Difference between the groups: −5.4 points; 95 %-KI, −9.2 to −1.6 points ( p = 0.006)

• insomnia. severe degree scale for insomnia: −4.1 points vs. −1.9 points; Difference between the groups: −2.2 points; 95 %KI, −4.4 to 0 points ( p = 0.05)

• fear. generalized anxiety disorder 7 score: −3.1 points vs. −0.9 points; Difference between the groups: −2.2 points; 95 %-Ki, –3.8 to –0.5 ( p = 0.01)

Transparency

This study was financed by Grant 2678 by the Marcus Foundation (Joshi, Brucker, Chow and Lee), Grant W81XWH-21-1-0977 from the US Department of Defense (Joshi, Brucker, Chow, Vaishnavi and Lee) and Grant Ul1tr002553 For Advancing Translational Sciences and the National Institutes of Health Roadmap for Medical Research Initiative. Wong was involved outside of the submitted work on Ataia Medical. Vaishnavi received scholarships from Duke University during his studies. No further disclosures were reported.

Effects and restrictions for practice

burnout is defined by three characteristics: emotional exhaustion, depersonalization and a reduced feeling of personal performance. Burnout represents a significant professional risk of healthcare employees and occurs primarily in some specialist areas. In the Burnout survey of Medscape 2022, 47 % of the doctors stated characteristics of burnout, whereby the rates are up to 60 % depending on the field. ^{1 meditation was suggested as a possibility to tackle individual factors in connection with burnout in healthcare.}

burnout is defined by three characteristics: emotional exhaustion, depersonalization and a reduced feeling of personal performance.

This is one of the few studies that has evaluated transcendental meditation (TM) as an intervention compared to a control group. ^{4.5 TM is a kind of meditation, in which practicing still and without concentration a single mantra (a sound of no meaning) is recited. Studies have shown that an increased parasympathetic reaction leads to a reduced stress response in TM users. 6.7 Although the acute psychological stress in the TM group was not statistically significantly reduced in this study compared to the control group, emotional exhaustion (a characteristic of burnout), insomnia and anxiety were lower. One reason that the study does not achieve statistical significance for group comparison is the low values ​​for acute stress between the groups at the start of the course. In addition, the GSI may not be the right instrument for assessing the psychological stress on healthcare employees. The results for the secondary endpoints support a further examination of TM to reduce the burnout of health personnel.}

disclosure of conflicts of interest

The author is CEO of AWaken Breath, LLC, consultant for 2ndmd and speaker for Astra Zeneca.