Well, not exactly. More like a planning guide for introducing Mindfulness Based Interventions in a hospital. This 2024 qualitative review of 18 studies synthesized the factors affecting implementation in hospital settings. The study identified three overall themes important for successful implementation. Reading this study reminded me of my experiences as a new graduate RN. I was employed in a rural hospital in the Catskill region of New York State. I was on a committee which was the “change agent” charged with replacing the “team nursing” model with the “primary nursing” model hospital wide. A guide like this paper would have been so helpful then. I recommend it to anyone planning to introduce Mindfulness to nursing or other hospital staff.
Knudsen, R. K., Skovbjerg, S., Pedersen, E. L.,…Timmermann, C. (2024). Factors affecting implementation of mindfulness in hospital settings: A qualitative meta-synthesis of healthcare professionals’ experiences. International Journal of Nursing Studies Advances 6 (2024) 100192 https://doi.org/10.1016/j.ijnsa.2024.100192
I find this study of particular interest because for each of the 18 studies included in the review, detailed descriptions of the Mindfulness Based Intervention used in each study is provided. Further, only studies which were variants of the definitive eight week programs Mindfulness Based Stress Reduction (MBSR) or Mindfulness Based Cognitive Therapy (MBCT) were included. I can recommend this study to anybody who is planning the implementation of Mindfulness Practices in a hospital or other healthcare setting, because the extensive discussion of facilitating and inhibiting factors will help assure the success of the project.
Introduction
The introduction reflects wide-spread interest in the benefits of mindfulness training on healthcare professionals due to work-related pressure and emotional challenges, which can increase the risk of compassion fatigue and burnout. Mindfulness-based interventions have demonstrated improved mental well-being, reduced symptoms of stress, anxiety, and depression, and improved self-care, stress management, and compassionate patient care. A supportive environment is necessary for the benefits to be realized, and to facilitate the change process. The study aims to synthesize qualitative data on healthcare professionals’ experiences of facilitating and inhibiting factors affecting the implementation of mindfulness-based interventions in hospital settings, and to provide recommendations for implementation.
Key Inclusion criteria
The Mindfulness-based intervention in a study:
- be based on first generation mindfulness-based interventions; i.e., Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and a range of programs developed from these.
- The program must be:
- informed by contemplative theories
- support present moment focus
- support the development of greater attentional, emotional, and behavioral self-regulation
- be taught by a qualified teacher who guides systematic training in formal and informal mindfulness meditation practice through an inquiry-based learning process.
Criteria noted that within these parameters “The program structure, length, and delivery form can be adjusted to fit the population and context.”
Excluded were studies where the mindfulness-based intervention was based solely on apps, self-help books, or online programs without an in-person teacher.
Characteristics of the studies
Eighteen studies were included in the meta-synthesis
The focus in three of the studies was implementation of mindfulness in hospital settings. The remaining studies focused on healthcare professionals’ experiences with mindfulness training, including information about facilitating and inhibiting factors to implementation.
The interventions consisted of
- adapted versions of Mindfulness-Based Stress Reduction (n = 11)
- adapted versions of Mindfulness-Based Cognitive Therapy (n = 3)
- and other mindfulness-based interventions (n = 4)
There was wide variance in the amount of teacher-led training
Home practice in between the teacher-led training was included in 15 studies.
All but one study used teacher-led in-person group training (the exception used video-conferencing).
- Nine studies were conducted at a hospital,
- two at a university or campus
- seven did not specify the setting.
Healthcare professionals (n = 410) providing direct patient care provided qualitative data
Studies focused on
- physicians (n = 4)
- nurses (n = 4)
- midwives (n = 1)
- mixed professions (n = 10
Review of Facilitating and Inhibiting Factors
Three key themes emerged regarding facilitating and inhibiting factors for successful implementation:
- Buying In: Participants experienced obstacles such as prejudices about mindfulness, concerns about self-care guilt, and worries about showing vulnerability to peers. To address these challenges, emphasizing the value of mindfulness training, associating self-care with better patient care, attending to inter-professional relationships (seniority, mixed professions, mixing staff and supervisors) and creating a safe space were identified as facilitating factors. Leadership buy-in and support was essential.
- Allocating time and space: Lack of time and physical or emotional challenges with practicing mindfulness were seen as inhibiting factors. Providing protected time during working hours, offering online participation options, and securing personnel coverage were facilitating factors identified to overcome the challenges of time constraints.
- Keeping it going: Challenges related to changing habits and sustaining mindfulness practices were observed. Follow-up training, integrating informal mindfulness practices, offering group training, and identifying committed local champions were identified as facilitating factors to help individuals continue their mindfulness practice and sustain its benefits.
Overall I recommend this study to anybody considering implementation of a Mindfulness in a hospital or other healthcare setting.
