Study: Transcendental Meditation for Healthcare Workers

reference

Joshi SP, Wong AI, Brucker A, et al. Effectiveness of transcendental meditation for stress reduction in healthcare workers: a randomized clinical trial.JAMA Network Open. 2022;5(9):e2231917.

Study objective

Determining the Effectiveness of Transcendental Meditation (TM) for Stress Reduction in Healthcare Workers

Key to take away

Among healthcare workers, Transcendental Meditation failed to reduce stress during the three-month study period. It reduced the burnout characteristics of emotional exhaustion as well as insomnia and anxiety.

design

Single-center, open-label, randomized clinical trial

Participant

The researchers randomized 80 participants: 41 to the TM group and 39 to the control group. The demographics of the 80 participants are as follows:

• Frauen, 66 (82,5 %), mit einem Durchschnittsalter von 40 Jahren

• Indianer oder Alaska-Ureinwohner, 1 (1,3 %)

• Asiatisch, 5 (6,3 %)

• Schwarz, 12 (15,0 %)

• Weiß, 59 (73,8 %)

• Unbekannte oder nicht gemeldete Rasse, 3 (3,8 %)

• Latinx, 4 (5,0 %)

• Nicht-Lateinamerikaner, 76 (95,0 %)

intervention

Participants in the TM group practiced TM for 20 minutes twice a day for 3 months.

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

Evaluated study parameters

Researchers measured psychological distress using the Global Severity Index and changes in burnout using the Maslach Burnout Inventory. They measured insomnia using the Insomnia Severity Index and anxiety using the Generalized Anxiety Disorder-7 scale.

Primary outcome

The primary outcome of interest was the comparison of changes in acute psychological distress between groups as measured by the Global Severity Index total score (GSI-018). All other indices were secondary outcome measures.

Key findings

In the TM group, 38 participants (92.7%) adhered to the regimen and practiced TM for 20 minutes twice daily for 3 months. The TM group had an average GSI-18 reduction of 5.6 points and the control group had an average reduction of 3.6 points. This difference was not statistically significant (P=0.13).

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

• Ausbrennen. Subscore des Maslach-Burnout-Inventars: −8,0 Punkte vs. −2,6 Punkte; Unterschied zwischen den Gruppen: −5,4 Punkte; 95 %-KI, −9,2 bis −1,6 Punkte (P=0,006)

• Schlaflosigkeit. Schweregradskala für Schlaflosigkeit: −4,1 Punkte vs. −1,9 Punkte; Unterschied zwischen den Gruppen: −2,2 Punkte; 95 %-KI, −4,4 bis 0 Punkte (P=0,05)

• Angst. Generalisierte Angststörung-7-Score: −3,1 Punkte vs. −0,9 Punkte; Unterschied zwischen den Gruppen: −2,2 Punkte; 95 %-KI, –3,8 bis –0,5 (P=0,01)

transparency

This study was funded by Grant 2678 from 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 from the National Center for Advancing Translational Sciences and the National Institutes of Health Roadmap for Medical Research Initiative. Wong has been involved with Ataia Medical outside of the submitted work. Vaishnavi received scholarships from Duke University while studying. No further disclosures were reported.

Implications and limitations for practice

Burnout is defined by three characteristics: emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. Burnout represents a significant occupational risk for healthcare workers and is occurring at an epidemic rate, particularly in some specialist areas. In the Medscape 2022 Burnout Survey, an average of 47% of physicians reported characteristics of burnout, with rates as high as 60% depending on specialty.¹Meditation has been suggested as a way to address individual factors associated with burnout among healthcare workers, particularly mindfulness meditation.^2.3

Burnout is defined by three characteristics: emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment.

This is one of the few studies that has evaluated Transcendental Meditation (TM) as an intervention compared to a control group.^4.5TM is a type of meditation in which practitioners recite a single mantra (a sound without meaning) silently and without concentration. Studies have shown that increased parasympathetic response leads to decreased stress reactivity in TM users.^6.7Although acute psychological distress was not statistically significantly reduced in the TM group in this study compared to the control group, emotional exhaustion (a hallmark of burnout), insomnia, and anxiety were lower. One reason why the study did not reach statistical significance in group comparisons is the low values ​​for acute stress between the groups at the start of the study. Furthermore, the GSI may not be the right tool for assessing psychological distress in healthcare workers. The results for the secondary endpoints support further investigation of TM to reduce health worker burnout.

Disclosure of Conflicts of Interest

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