A Comprehensive Wellness Program (SKY) to Mitigate Physician Burnout

Study Overview
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Brief Summary
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The primary objective of the study was to determine whether the yoga-based breathing and meditation program SKY could improve wellness indicators in currently practicing physicians. The hypothesis of this study is that SKY is effective in reducing anxiety and depression, increasing subjective optimism, and reducing physician burnout in healthy, actively practicing physicians.

Detailed Description
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Physicians are exposed to high stress and strain that results in burnout, affecting not only them, their families, patients, but the whole healthcare system. Thus there is an urgent need to develop methods to increase resiliency of physicians. A comprehensive yoga breathing and meditation-based online program (Sudarshan Kriya Yoga, or SKY) is a potential approach to mitigate physician burnout. This is a randomized clinical trial assessing the potential efficacy of SKY compared to a stress management education (SME) training as control, conducted online. Both groups received training for three consecutive days, 1,5 hours per day, through group video conference. Active physicians participated in the study from November 2021 to March 2022. Of the 280 physicians who showed interest and prescreened, 238 were eligible and randomized to receive either the SKY or the control intervention.

Official Title
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A Comprehensive Meditation and Breath Program (SKY) as an Adjunct Tool to Increase Resilience and Wellness in Frontline Healthcare Workers - A Randomized Pilot Study

Conditions
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Depression, Anxiety, Stress, Insomnia, Optimism, Interpersonal Disengagement, Professional Fulfillment, Work Exhaustion, Self-reported Medical Errors, Physician Burnout

Intervention / Treatment
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* Behavioral: Meditation and breathing program : Sudarshan Kriya Yoga (SKY)
* Behavioral: Stress management education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Actively working physicians without any chronic disease with documented interest in being part of a study to evaluate breath/meditation-derived exercises and a willingness to do some form of relaxation exercises every day for 8 weeks. Exclusion Criteria: Presence of psychiatric illness or other major illnesses, such as bipolar disorder, post-traumatic stress disorder (PTSD), schizophrenia or schizoaffective disorder, uncontrolled hypertension, lung disease, liver disease, cancer, or heart disease; maintaining a regular mind-body program practice such as meditation, yoga, and breathing techniques.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SKY intervention group<br>Meditation and breath program: includes gentle stretches (office yoga' in a sitting position) and three different types of specific breathing exercises. 3x1,5 hours. Daily practice thereafter for about 30 minutes for 8 weeks. In addition, there are weekly one-hour sessions for group practice and discussion. | Behavioral: Meditation and breathing program : Sudarshan Kriya Yoga (SKY)<br>* The SKY sessions (3x1,5 h on consecutive days) included online instruction in gentle stretches ('office yoga' in a sitting position), specific breathing exercises and meditation, and discussion of cognitive/behavioral coping skills. After the 3-day program, participants asked to practice the techniques once a day for about 30 min. In addition, there were weekly group exercise sessions of 1 hour where all participants were asked to join.<br>|
| Active Comparator: Control group<br>Group discussion-based viewing of online educational videos that demonstrate ways to mitigate psychological distress, including the use of cognitive coping techniques. 3x1,5 hours. It includes weekly online meetings with group discussions, experience sharing, and watching brief videos on the key elements of the program for 8 weeks. | Behavioral: Stress management education<br>* This control intervention included viewing of educational videos on stress management and group discussions, where the sessions were equal in length to the SKY intervention. There were also weekly follow-up sessions as in the SKY group where the educational points were reviewed and experiences of the subjects during the previous week was discussed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline Depression, Anxiety, and Stress scale immediately after the intervention and at 8 weeks | Scores assessed by the Depression, Anxiety, and Stress Scale 42 (DASS-42). | At baseline, right after the 3-day intervention, and at 8 weeks post-intervention | 
| Change from baseline in Professional Satisfaction index post-intervention and at 8 weeks | Scores assessed by the Professional Satisfaction Index (PFI). | At baseline, right after the 3-day intervention, and at 8 weeks post-intervention | 
| Change from baseline in optimism post-intervention and at 8 weeks | Optimism scores assessed by the Life Orientation Test (Revised) (LOT-R) and the | At baseline, right after the 3-day intervention, and at 8 weeks post-intervention | 
| Change from baseline in Insomnia post-intervention and at 8 weeks | Insomnia scores assesed by the Regensburg Insomnia Scale (RIS). | At baseline, right after the 3-day intervention, and at 8 weeks post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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physician burnout, medical doctor, burnout, stress, depression, wellness, meditation, breathing exercise