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Objectives Health care professionals have elevated rates of burnout and compassion fatigue which are correlated with poorer quality of life and patient care, and inversely correlated with self-compassion. Primary studies have evaluated the extent to which mindfulness-based interventions increase self-compassion with contradictory findings. A meta-analytic review of the literature was conducted to quantitatively synthesize the effects of mindfulness-based interventions on self-compassion among health care professionals. Methods Twenty-eight treatment outcome studies were identified eligible for inclusion. Five cumulative effect sizes were calculated using random-effects models to evaluate differences of changes in self-compassion for treatment and control groups. Within and between group comparisons were evaluated. Sub-group and moderator analyses were conducted to explore potential moderating variables. Results Twenty-seven articles (k = 29, N = 1020) were utilized in the pre-post-treatment meta-analysis. Fifteen samples (52%) included health care professionals and fourteen (48%) professional health care students. Results showed a moderate effect size between pre-post-treatment comparisons (g = .61, 95% CI = .47 to .76) for self-compassion and a strong effect size for pre-treatment to follow-up (g = .76, 95% CI = .41 to 1.12). The effect size comparing post-treatment versus post-control was moderate. One exploratory moderator analysis was significant, with stronger effects for interventions with a retreat component. Conclusions Findings suggest mindfulness-based interventions improve self-compassion in health care professionals. Additionally, a variety of mindfulness-based programs may be useful for employees and trainees. Future studies with rigorous methodology evaluating effects on self-compassion and patient care from mindfulness-based interventions are warranted to extend findings and explore moderators. Electronic supplementary material The online version of this article (10.1007/s12671-020-01342-5) contains supplementary material, which is available to authorized users.

Nursing aides working in long-term care settings experience high rates of injury, musculoskeletal symptoms, and exposure to resident aggression. Some of these injuries and exposure to aggression may be related to trait mindfulness. The aim of this study was to examine the relationships between trait mindfulness, job training, injury, sources of injury, and musculoskeletal symptoms among nursing aides working in long-term care residential settings. Nursing aides working in long-term care settings across Ohio, USA (n = 152) were recruited for the study. Measures of sociodemographic characteristics, job tenure, job training, mindfulness, work injuries, sources of injuries, and musculoskeletal symptoms were obtained. Correlational analyses demonstrated that higher levels of mindfulness and training were associated with lower levels of injury and musculoskeletal symptoms. They were also significantly inversely associated with the following injury sources: lifting/repositioning resident, bumping/hitting equipment, and resident aggression. Results of hierarchical linear regressions indicated that mindfulness was a significant and unique predictor of injuries, exposure to the most common sources of injury, and musculoskeletal symptoms. Specifically, nursing aides with higher levels of mindfulness were less likely to report experiencing injuries, exposure to the most common sources of injury, and musculoskeletal symptoms. Given that mindfulness can be trained and modified, adding mindfulness training to nursing aide educational programs could potentially help reduce risk for injury among this vulnerable population of workers. Further research exploring the potential benefit of mindfulness training could address this possibility.

Nursing home settings contain unique environmental factors that may promote the acquisition and maintenance of problematic interpersonal behaviors. Functional Analytic Psychotherapy (FAP) is a contextually-based behavior therapy that can be used to modify problematic interpersonal behaviors via carefully provided and contingent in-session responses of the therapist to client behaviors. Thus, FAP would appear to be a particularly well-suited intervention approach for nursing home residents. To date, the effects of FAP have not been reported for nursing home residents. The current single case study assessed the effects of FAP on three nursing home residents using a single-subject AB design. The AB design consisted of a 2-weeks baseline phase followed by a 4-week FAP treatment phase. The nursing home residents completed pre-treatment and post-treatment measures of interpersonal relating. Client interpersonal behaviors were also recorded during each session and coded into two categories: Maladaptive in-session behaviors and adaptive in-session behaviors. Using the reliable change index and Swanson’s dsw to evaluate questionnaire outcomes, results indicated that all three participants reported a significant change in interpersonal functioning. Analysis of in-session behavior indicated that there were significant decreases in maladaptive behaviors and an increase in adaptive behaviors for two clients. Finally, observed in-session behavior changes were congruent with self-reported changes in interpersonal behavior. These results indicate that FAP was an effective intervention for these nursing home residents.

Acceptance and chronic pain is an emerging topic both for research and intervention. Initial studies have demonstrated that acceptance is correlated with higher quality of daily emotional, social, and physical functioning in chronic pain populations. The purpose of the present study was to clarify the nature of the relationship between acceptance, appraisals that are relevant to chronic pain (i.e., control and catastrophizing), and coping among migraine headache sufferers. Seventy four participants with migraine headaches completed self report measures assessing appraisal, coping strategies, acceptance, and pain related disability. Sixty three participants also completed a 28-day daily dairy assessing headache activity, catastrophizing, control, acceptance, and coping strategies. Hierarchical regression and multilevel modeling were used to examine the relations between these variables. Results indicated that higher levels of pain-related acceptance were associated with lower levels of catastrophizing and pain-related interference, and increased perceived control. Participants who endorsed higher levels of pain-related acceptance also reported engaging in a higher level of activity and indicated they used fewer coping strategies on a daily basis. Acceptance continues to show promise as a way of viewing pain that lessens the detrimental impact of certain types of thoughts (i.e., catastrophizing), and leads to increased participation in daily life.

The purpose of this study was to investigate how migraine headache sufferers and headache-free controls differ in their appraisal and coping responses to a cognitive (mental arithmetic) and a physical (cold pressor) laboratory stressor. Fifty-two women (26 migraine headache and 26 controls) completed the study. Results indicated that migraine sufferers rated the cold pressor task as significantly more painful compared to headache-free participants. Migraine headache sufferers also reported more wishful thinking and self-criticism in managing the mental arithmetic stressor. In addition, migraine participants reported the use of more social withdrawal and catastrophizing in managing stress and pain outside of the laboratory.

Research has indicated that the experience of stress reliably correlates with changes in immunological functioning. Further, interventions designed to reduce the experience of stress correlate with modest enhancement of immune function. The effects of such interventions vary widely, depending on the specific immune system variables measured and characteristics of the participants, including age and health status. To determine the effects of a cognitive-behavioral stress management intervention on salivary immunoglobulin A (sIgA), we randomly assigned 57 university undergraduates to a treatment or control condition. Treatment group participants met in groups of nine or ten students and received information about the stress response and immunity, training in diaphragmatic breathing and autogenic relaxation, and exposure to cognitive restructuring and assertiveness training. We assessed saliva samples, ratings of physical symptoms commonly associated with stress, and self-report of health complaints before and after the 5-week intervention period. Fifty-three participants completed the study. Reductions in stress levels from pre- to postintervention for both treatment and control participants were evident by increases in sIgA secretion rates and salivary flow and decreases in scores on the Undergraduate Stress Questionnaire, the Cohen–Hoberman Inventory of Physical Symptoms, and the Daily Stress Inventory. Treatment participants exhibited further reductions in stress, compared to control participants, as evidenced by lower scores on a subset of the self-report inventories. No treatment effects on sIgA were present. These results suggest that a stress management intervention such as the one used in this study can be beneficial in reducing levels of stress but may not be immunoenhancing.

Background An estimated up to 7% of high-risk cardiac surgery patients return to the operating room for bleeding. Aprotinin was used extensively as an antifibrinolytic agent in cardiac surgery patients for over 15 years and it showed efficacy in reducing bleeding. Aprotinin was removed from the market by the U.S. Food and Drug Administration after a large prospective, randomized clinical trial documented an increased mortality risk associated with the drug. Further debate arose when a meta-analysis of 211 randomized controlled trials showed no risk of renal failure or death associated with aprotinin. However, only patients with normal kidney function have been studied. Methods In this study, we look at a single center clinical trial using patients with varying degrees of baseline kidney function to answer the question: Does aprotinin increase odds of death given varying levels of preoperative kidney dysfunction? Results Based on our model, aprotinin use was associated with a 3.8-fold increase in odds of death one year later compared to no aprotinin use with p-value = 0.0018, regardless of level of preoperative kidney dysfunction after adjusting for other perioperative variables. Conclusions Lessons learned from our experience using aprotinin in the perioperative setting as an antifibrinolytic during open cardiac surgery should guide us in testing future antifibrinolytic drugs for not only efficacy of preventing bleeding, but for overall safety to the whole organism using long-term clinical outcome studies, including those with varying degree of baseline kidney function.