Brief Mindfulness-Based Self-Care Curriculum for an Interprofessional Group of Palliative Care Providers (FR469-B)

Abstract

Objectives • Describe and give examples of formal and informal mindfulness techniques. • Demonstrate use of brief mindfulness-based exercises. • Identify self-care strategies that they use to cope with work-stress. Background. Studies demonstrating high burnout rates for clinicians in hospice and palliative care have raised awareness of the importance of provider self-care. Mindfulness-based interventions have shown self-care benefits, including improved quality of life, job satisfaction, and burnout symptoms. Established programs are time-intensive (most 18-52 hours of instruction) and target primary care physicians and nurses. This curriculum is a 5-hour mindfulness-based intervention targeting an interprofessional group of palliative care providers within the regular workday schedule. Methods. The curriculum was executed in five monthly 1-hour sessions. The content was based on consultation with texts (primarily books by Jon Kabat- Zinn and Thich Nhat Hanh) and with experts (a mindfulness-based stress reduction teacher and a physician with experience designing and delivering a published physician mindfulness curriculum of longer length [see Krasner MS et al, JAMA, 2009]). Pre- and postintervention surveys were collected assessing participant mindfulness, burnout, and stress levels on validated scales and reported mindfulness practice frequency. Satisfaction and narrative data were also collected. Results. Participants reported being very satisfied with the series and showed statistically significant improvements in mindfulness levels (3 of 5 subscales) and burnout scores (1 of 3 subscales) and increased frequency of self-reported informal and formal practice. Open-ended narrative evaluation also demonstrated retention of concepts presented during the series. Participants expressed a preference for continuing elements of the series in ongoing program activities. Discussion. While mounting evidence suggests that mindfulness-based approaches may be useful for selfcare, most of the formally evaluated curricula have not been directly applicable to a clinical work setting. This curriculum offers a brief intervention that was well-received by an interprofessional team of practicing palliative care providers. While the pre-/postintervention design prevents us from excluding confounding factors, participants did show improved mindfulness and burnout scores on postintervention evaluation. The curriculum was executed initially on a monthly basis; feedback from participants included requests for more frequent sessions, and it could be adapted to the team's usual schedule as necessary. Conclusion. Delivery of a brief, 5-hour mindfulnessbased self-care curriculum within the regular workday was feasible, well liked, and associated with improvements in mindfulness and burnout levels.