- 2018 - Pilot Grant
Medical residents experience substantially higher levels of stress and burnout than the general population (Dyrbye et al., 2014). Burnout is a work-related syndrome involving emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment. Notably, over 50% of internal medicine residents met criteria for burnout in a national study (West et al., 2011). Medical institutions have attempted to address this problem through implementation of organizational changes, such as schedule reform, and/or providing residents with programs such as educational wellness curricula. In a recent meta-analysis of interventions to reduce physician burnout, both individual-focused and organizational changes resulted in meaningful reductions in burnout (Shanafelt et al., 2016). Practical programs that provide residents with cognitively-based stress-regulation skills, such as resilience-training programs (Goldhagen et al., 2015) and programs such as mindfulness-based stress reduction have shown promise for improving several indicators of psychological health in medical residents (Taylor et al., 2016).
Yoga is a multicomponent mind-body practice consisting of physical postures and exercises, relaxation techniques, breathing techniques, as well as meditation and mindfulness. As a comprehensive set of mind- body practices, yoga has been shown to improve resilience, mindfulness, and mood, as well as reduce measures of burnout, perceived stress, depression, anxiety, and pain in high stress professional populations and workplace settings (Hartfiel et al., 2011; 2012) including frontline professionals (Jeter et al., 2013; Trent et al 2018) and healthcare providers (Alexander 2013; 2015; Lin et al., 2015). Recently, an 8-week Kripalu yoga- based stress management program for mental health care professionals resulted in improvements in a wide range of psychological health measures, including depression, stress, mindfulness, and aspects of self- compassion (Riley et al., 2016). While yoga has also recently been shown to reduce stress in medical students (Prasad et al., 2016), yoga has yet to be investigated as a mind-body practice that resident physicians will adopt as a means to impact their risk of burnout.
We aim to initiate and complete the first investigation of the effect of yoga (via RISE) on resident physicians’ psychological health using an RCT, mixed method, comprehensive approach measuring outcomes across several psychological and physiological systems.
To meet the goals of the proposed project we have identified 3 specific aims:
Specific Aim 1: Explore the feasibility of whether a 6-week yoga program (RISE) provided at the BWH would be acceptable to resident physicians.
Specific Aim 2. Examine whether the outcome measures were perceived as relevant to the participants’ work environment and were not burdensome as to the length and content of the battery via a post-study questionnaire.
Specific Aim 3. Assess the acceptability, feasibility, and efficacy of the yoga program through conducting formal standardized interviews with a subset of yoga participants.
Exploratory Aim: Conduct exploratory statistical efficacy analyses and correlational and mediational analyses of the questionnaire outcomes in preparation for subsequent NIH grant proposals.
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