A longitudinal study published in the journal PLOS One revealed that physicians who scored higher in trait mindfulness when they began working in emergency care had lower depression, anxiety, and social impairment scores up to six months later.
Emergency room (ER) personnel regularly deal with high-stress situations, such as having to make critical decisions as they quickly assess and triage patients with life-threatening conditions. Notably, the COVID-19 crisis has only exacerbated the difficulties of the job.
Unsurprisingly, ER physicians have higher rates of depression, anxiety, and suicidality compared to the normal population. But there may be a dispositional trait that can buffer some of these mental health effects. Study authors Maren Westphal and her team say that mindfulness has been associated with reduced burnout and depression among health care workers. Trait mindfulness is defined as a tendency to observe and be attentive to the present without judgment — a mindset that has been suggested to protect against stress.
Using a longitudinal study, the researchers opted to explore how ER workers’ trait mindfulness would be associated with mental health outcomes three months and six months later. A final sample of 121 newly-hired emergency department personnel from three Swiss hospitals took part in the study. The personnel, who were either nurses, residents, or medical students, were an average of 30 years old, and 64% were female. Most (66%) were either very inexperienced or had little experience in emergency rooms at the start of the study.
The medical workers completed baseline questionnaires within the first two weeks of the job, responding to measures of work-related stress, life stress, dispositional mindfulness, perceived social support at work, anxiety, depression, and social functioning. All participants took part in at least one follow-up assessment either three months or six months later.
In line with expectations, mindfulness appeared to offer a “shielding” effect against distress. Participants who began the study with greater trait mindfulness tended to have lower depression, anxiety, and social impairment scores at the six-month follow-up. This was even after accounting for work-related stress, adverse life events, and perceived social support at work. The authors note that previous findings suggest that mindfulness improves emotion regulation and fosters more helpful responses to interpersonal conflict, which may help explain why mindfulness appeared to protect the physicians from psychological distress and social impairment.
Work stress — a measure of exposure to critical incidents such as death or severe treatment errors — did not significantly impact depression or anxiety scores when accounting for other predictors. However, work stress did predict worse social impairment. Adverse life events predicted worse anxiety, depression, and social impairment.
As far as protective factors, social support in the workplace predicted lower depression — but only among those who scored low in mindfulness. Among staff with high levels of mindfulness, the link between social support and depression was no longer significant. Social support also predicted better social functioning, regardless of mindfulness levels.
“The finding that low mindfulness was associated with elevated levels of depression in individuals with poor social support at work is noteworthy and consistent with extensive evidence for a strong relationship between social support and depression,” Westphal and colleagues say. “The moderating effect of mindfulness in the context of an unsupportive work environment also converges with findings that dispositional mindfulness protects against distress arising from rejection, a highly aversive experience that signals the threat of social isolation.”
The results lend support to previous findings which have shown that mindfulness interventions can diminish anxiety among medical students and physicians. “Our findings suggest that mindfulness interventions for physicians and other health care professionals may be beneficial at both individual and institutional levels by improving mental health and facilitating supportive relationships at work,” the study authors say.
The study, “Mindfulness predicts less depression, anxiety, and social impairment in emergency care personnel: A longitudinal study”, was authored by Maren Westphal, Melanie Wall, Thomas Corbeil, Dagmar I. Keller, Monika Brodmann-Maeder, Ulrike Ehlert, Aristomenis Exadaktylos, Roland Bingisser, and Birgit Kleim.