Topical Collection "Mindfulness in Healthcare"

A topical collection in Healthcare (ISSN 2227-9032). This collection belongs to the section "Nursing".

Editors

Dr. Helen Noble
E-Mail Website
Guest Editor
Medical Biology Centre, School of Nursing and Midwifery, Queen’s University, Belfast BT9 7BL, UK
Interests: mindfulness; well-being; quality of life; complimentary therapies; Palliative care; nephrology; qualitative
Special Issues, Collections and Topics in MDPI journals
Dr. Ian Walsh
E-Mail Website
Guest Editor
School of Medicine, Queen’s University Belfast, Belfast BT9 7BL, UK
Interests: mindfulness; medicine and humanities; cognition and metacognition; human factors; healthcare education

Topical Collection Information

Dear Colleagues,

This Special Issue of Healthcare will focus on mindfulness in healthcare and mindful self-compassion. Mindfulness is known to positively impact numerous measures of personal health, including stress, anxiety, and depression, and improve mental and physical health. Mindfulness-based interventions have been effective in relieving pain and other symptoms, supporting and enhancing resilience, and improving academic success. In addition, both interpersonal relationships and behavioral clinical skills are improved by fostering and developing empathy and compassion. Mindfulness training is therefore promoted among healthcare providers and patients alike. Its huge potential to promote health and enrich the lives of those who participate is encouraged in healthcare. In addition, mindful self-compassion which is the combination of mindfulness skills and practice with the emotional practice of self-compassion offers participants the motivation to encourage and self-soothe when we suffer or feel inadequate.

We welcome papers exploring the cognitive and neurobiological mechanisms underlying the benefits of mindfulness and mindfulness self-compassion training; and mindfulness-based interventions to improve stress, resilience, and general well-being for both patients and healthcare staff and the impact of innovative mindfulness training programs in healthcare. We will feature original research and include interesting clinical studies, reviews, short reports, narratives, and opinion pieces from researchers interested in this research topic.

Dr. Helen Noble
Dr. Ian Walsh
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Mindfulness
  • Mindfulness-based stress reduction
  • Compassion
  • Healthcare
  • Well-being

Published Papers (13 papers)

2022

Jump to: 2021, 2020

Protocol
Examining the Acceptability and Feasibility of the Compassionate Mindful Resilience (CMR) Programme in Adult Patients with Chronic Kidney Disease: The COSMIC Study Protocol
Healthcare 2022, 10(8), 1387; https://doi.org/10.3390/healthcare10081387 - 25 Jul 2022
Viewed by 473
Abstract
Kidney disease is often progressive, and patients experience diminished health-related quality of life. In addition, the impact of the coronavirus (COVID-19) pandemic, and its associated restrictions, has brought many additional burdens. It is therefore essential that effective and affordable systems are explored to [...] Read more.
Kidney disease is often progressive, and patients experience diminished health-related quality of life. In addition, the impact of the coronavirus (COVID-19) pandemic, and its associated restrictions, has brought many additional burdens. It is therefore essential that effective and affordable systems are explored to improve the psychological health of this group that can be delivered safely during the COVID-19 pandemic. The aim of this study is to support a new service development project in partnership with the UK’s leading patient support charity Kidney Care UK by implementing the four-session Compassionate Mindful Resilience (CMR) programme, developed by MindfulnessUK, and explore its effectiveness for patients with stage 4 or 5 chronic kidney disease or have received a kidney transplant. The study will utilise a quasi-experimental, pretest/posttest design to measure the effect of the CMR programme on anxiety, depression, self-compassion, the ability to be mindful, wellbeing, and resilience, using pre- and posttests, alongside a qualitative exploration to explore factors influencing the feasibility, acceptability, and suitability of the intervention, with patients (and the Mindfulness Teacher) and their commitment to practice. Outcomes from this study will include an evidence-based mindfulness and compassion programme for use with people with kidney disease, which is likely to have applicability across other chronic diseases. Full article
Review
Mediating Mindfulness-Based Interventions with Virtual Reality in Non-Clinical Populations: The State-of-the-Art
Healthcare 2022, 10(7), 1220; https://doi.org/10.3390/healthcare10071220 - 29 Jun 2022
Viewed by 498
Abstract
Mindfulness is one of the most popular psychotherapeutic techniques that help to promote good mental and physical health. Combining mindfulness with immersive virtual reality (VR) has been proven to be especially effective for a wide range of mood disorders for which traditional mindfulness [...] Read more.
Mindfulness is one of the most popular psychotherapeutic techniques that help to promote good mental and physical health. Combining mindfulness with immersive virtual reality (VR) has been proven to be especially effective for a wide range of mood disorders for which traditional mindfulness has proven valuable. However, the vast majority of immersive VR-enhanced mindfulness applications have focused on clinical settings, with little evidence on healthy subjects. This narrative review evaluates the real effectiveness of state-of-the-art mindfulness interventions mediated by VR systems in influencing mood and physiological status in non-clinical populations. Only studies with an RCT study design were considered. We conclude that most studies were characterized by one single meditation experience, which seemed sufficient to induce a significant reduction in negative mood states (anxiety, anger, depression, tension) combined with increased mindfulness skills. However, physiological correlates of mindfulness practices have scarcely been investigated. The application of VR-enhanced mindfulness-based interventions in non-clinical populations is in its infancy since most studies have several limitations, such as the poor employment of the RCT study design, the lack of physiological measurements (i.e., heart rate variability), as well as the high heterogeneity in demographical data, technological devices, and VR procedures. We thus concluded that before applying mindfulness interventions mediated by VR in clinical populations, more robust and reliable methodological procedures need to be defined. Full article
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Article
The ATENción Plena en Enfermedad de Alzheimer (ATENEA—Mindfulness in Alzheimer’s Disease) Program for Caregivers: Study Protocol for a Randomized Controlled Trial
Healthcare 2022, 10(3), 542; https://doi.org/10.3390/healthcare10030542 - 15 Mar 2022
Viewed by 1024
Abstract
A person affected by Alzheimer’s disease (AD) gradually loses the ability to perform activities of daily living and becomes dependent on caregivers, thereby having a negative impact on the caregivers’ quality of life. There is evidence that suggests that interventions aimed at caregivers, [...] Read more.
A person affected by Alzheimer’s disease (AD) gradually loses the ability to perform activities of daily living and becomes dependent on caregivers, thereby having a negative impact on the caregivers’ quality of life. There is evidence that suggests that interventions aimed at caregivers, such as mindfulness, may be effective at reducing this burden and emotional issues, such as depression and anxiety, and improving their quality of life. However, there is a lack of consistency in the findings and conclusions remain tentative. In addition, as neuropsychiatric symptoms (NPSs) of AD are major determinants of the caregiver’s burden, these interventions should examine the relationship between these symptoms and caregiver outcomes. Importantly, to improve the design of therapeutic interventions for caregivers and complement the treatment of AD, aspects related to occupational performance and the participation of people with AD and their caregivers should also be considered. Therefore, this study will aim to examine first, the effects of a mindfulness-based program designed for caregivers on NPSs of AD and caregivers’ anxiety and depression; second, the effects of this program on patients’ functional capacity, cognitive performance, executive functions, and quality of life, and on caregivers’ burden, quality of life, occupational balance, executive functions, psychological wellbeing, and self-compassion. We believe that the findings of this study will have significant implications for future healthcare strategies focused on improving the quality of life and wellbeing of caregivers. Full article
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2021

Jump to: 2022, 2020

Article
The Effect of a Mindfulness-Based Education Program on Brain Waves and the Autonomic Nervous System in University Students
Healthcare 2021, 9(11), 1606; https://doi.org/10.3390/healthcare9111606 - 22 Nov 2021
Cited by 1 | Viewed by 818
Abstract
Background: Mindfulness, defined as the awareness emerging from purposefully paying attention to the present moment, has been shown to be effective in reducing stress and, thus, promoting psychological well-being. This study investigated the effects of a mindfulness-based education program on mindfulness, brain waves, [...] Read more.
Background: Mindfulness, defined as the awareness emerging from purposefully paying attention to the present moment, has been shown to be effective in reducing stress and, thus, promoting psychological well-being. This study investigated the effects of a mindfulness-based education program on mindfulness, brain waves, and the autonomic nervous system (ANS) in university students in Korea. Methods: This study is a quantitative and experimental research with a single-group pre-post design. Six sessions of mindfulness-based intervention were applied. In total, 42 students completed a mindfulness questionnaire before and after the intervention, and 28 among them completed pre-intervention and post-intervention measures of brain waves and ANS. Results: The level of mindfulness increased in the participants after intervention. Regarding brain waves, the alpha and theta waves increased, but the beta waves decreased. There was no significant difference in the ANS, presenting no change in heart rate variability. Conclusions: We identified the positive effects of the mindfulness-based education program for university students. The findings indicate that this program may help students not only relax, but also generate a mindfulness state in stressful situations, potentially leading to a successful university life. This study can be used as a basis for quality improvement and sustainability of mindfulness-based education programs for university students. Full article
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Review
Mindfulness-Based Interventions for Undergraduate Nursing Students in a University Setting: A Narrative Review
Healthcare 2021, 9(11), 1493; https://doi.org/10.3390/healthcare9111493 - 02 Nov 2021
Viewed by 1378
Abstract
(1) Introduction: Undergraduate (UG) nursing students are vulnerable to stress throughout their education, known to result in burnout, with high attrition rates of up to 33%. There is a growing body of evidence to suggest that mindfulness-based interventions are effective for the management [...] Read more.
(1) Introduction: Undergraduate (UG) nursing students are vulnerable to stress throughout their education, known to result in burnout, with high attrition rates of up to 33%. There is a growing body of evidence to suggest that mindfulness-based interventions are effective for the management of anxiety, depression and wellbeing, thereby reducing stress in healthcare provider populations. The aim of this narrative review was to synthesize and provide a critical overview of the current evidence in relation to mindfulness-based interventions for UG nursing students in a university setting. (2) Methods: A review of the literature was conducted in March 2020 and updated in May 2021, utilising the databases CINAHL, Medline and PsycINFO. (3) Results: Fifteen studies were included in the review, with three common themes identified: (i) the positive impact of mindfulness on holistic wellbeing, (ii) mindfulness-based techniques as a positive coping mechanism within academic and clinical practice, and (iii) approaches to the delivery of mindfulness-based interventions. (4) Conclusions: Mindfulness-based interventions are effective strategies for the management of stress, development of self-awareness and enhanced academic and clinical performance in undergraduate nursing students. No ideal approach to delivery or duration of these interventions was evident from the literature. Best practice in relation to delivery of mindfulness-based interventions for nursing students is recommended for future studies. Full article
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Article
Do Brief Mindfulness Interventions (BMI) and Health Enhancement Programs (HEP) Improve Sleep in Patients in Hemodialysis with Depression and Anxiety?
Healthcare 2021, 9(11), 1410; https://doi.org/10.3390/healthcare9111410 - 21 Oct 2021
Viewed by 874
Abstract
(1) Objective: to determine if a brief mindfulness intervention (BMI) and a health education program (HEP) could improve measures of insomnia in patients undergoing hemodialysis. (2) Methods: this was a planned secondary analysis of a randomized controlled trial of BMI vs. HEP for [...] Read more.
(1) Objective: to determine if a brief mindfulness intervention (BMI) and a health education program (HEP) could improve measures of insomnia in patients undergoing hemodialysis. (2) Methods: this was a planned secondary analysis of a randomized controlled trial of BMI vs. HEP for hemodialysis patients with depression and/or anxiety symptoms. The primary outcome for the analysis was the Athens Insomnia Scale (AIS). The secondary outcome was consolidation of daily inactivity (ConDI), an actigraphy measure that describes sleep continuity and is based on a sleep detection algorithm validated by polysomnography. We also explored whether changes in AIS and ConDI were associated with changes in depression, anxiety, and quality of life scores over 8-week follow-up. (3) Results: BMI and HEP groups did not differ significantly from one another. Exposure to BMI or HEP improved sleep quality (baseline AIS 9.9 (±5.0) vs. 8-week follow-up 6.4 (±3.9), (V = 155.5, p = 0.015)), but not ConDI. Improvements in AIS were associated with lower depression scores (Rho = 0.57, p = 0.01) and higher quality-of-life scores (Rho = 0.46, p = 0.04). (4) Conclusions: mindfulness and HEP may be helpful interventions to improve self-reported sleep quality in patients undergoing hemodialysis. Decreases in insomnia scores were associated with decreased depression symptoms and increased quality of life scores. Full article
Review
Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis
Healthcare 2021, 9(10), 1342; https://doi.org/10.3390/healthcare9101342 - 09 Oct 2021
Cited by 1 | Viewed by 1530
Abstract
Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a [...] Read more.
Mindfulness-based interventions (MBIs) are reported by experimental studies as practical approaches to reduce burnout in primary healthcare professionals (PHCP). However, to date, no research has synthesized the evidence to determine the overall effects of MBIs for reducing burnout in PHCP. We conducted a systematic review and meta-analysis to analyze the effects of MBIs to reduce burnout in PHCP. We searched articles in the PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases from inception to September 2021 using MeSH terms: “mindfulness”, “burnout”, and “primary healthcare”. Two reviewers extracted the data and assessed the risk of bias. We used a random-effects meta-analysis to calculate the standardized mean differences (SMD) and mean differences (MD) with 95% confidence intervals (CI) of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) domains of burnout. Of 61 records, ten were included (n = 417). Overall, the studies were rated as having a high risk of bias and limited quality evidence. MBIs significantly reduced EE (SMD = −0.54, 95%CI: −0.72 to −0.36; MD = −5.89, 95%CI: −7.72 to −4.05), DP (SMD = −0.34, 95%CI: −0.52 to −0.17; MD = −1.96, 95%CI: −2.96 to −0.95), and significantly increased PA (SMD = 0.34, 95%CI: 0.17 to 0.52; MD = 2.05, 95%CI: 1.04 to 3.06). Although further high-quality research is needed, our findings support the implementation of MBIs for reducing burnout in PHCP. Full article
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Article
Mediating Effects of Emotion Regulation between Socio-Cognitive Mindfulness and Achievement Emotions in Nursing Students
Healthcare 2021, 9(9), 1238; https://doi.org/10.3390/healthcare9091238 - 21 Sep 2021
Cited by 3 | Viewed by 1045
Abstract
Background: Mindfulness is known as an effective emotion regulation strategy and is beneficial for improving emotions. While meditative mindfulness has been widely studied, socio-cognitive mindfulness has received little attention in nursing literature, despite its potential benefits to the field. This study investigated relationships [...] Read more.
Background: Mindfulness is known as an effective emotion regulation strategy and is beneficial for improving emotions. While meditative mindfulness has been widely studied, socio-cognitive mindfulness has received little attention in nursing literature, despite its potential benefits to the field. This study investigated relationships between nursing students’ socio-cognitive mindfulness, emotion regulation (reappraisal and suppression), and achievement emotions, and explored the mediating effects of emotion regulation. Methods: A total of 459 nursing students from three universities in Korea completed the questionnaire measuring the study variables. Structural equation modeling and path analysis were conducted to test the hypotheses. Results: Socio-cognitive mindfulness was found to positively influence reappraisal while negatively influencing suppression. Additionally, socio-cognitive mindfulness positively predicted positive achievement emotions but negatively predicted negative emotions. Reappraisal positively influenced positive emotions, whereas suppression positively influenced negative emotions. Furthermore, reappraisal mediated the link between mindfulness and positive emotions, and suppression mediated the link between mindfulness and negative emotions. Conclusions: Socio-cognitive mindfulness may be effective in regulating emotions among nursing students by enhancing reappraisal and reducing suppression. Mediating effects highlight the relevance of students’ emotion regulation in nursing education, suggesting the need to develop emotion regulation education programs. Full article
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Article
Brief Mindfulness Intervention vs. Health Enhancement Program for Patients Undergoing Dialysis: A Randomized Controlled Trial
Healthcare 2021, 9(6), 659; https://doi.org/10.3390/healthcare9060659 - 01 Jun 2021
Cited by 6 | Viewed by 1590
Abstract
Background: Between 20–50% of patients undergoing maintenance dialysis for end-stage kidney disease experience symptoms of depression and/or anxiety, associated with increased mortality, greater health care utilization, and decreased quality of life. It is unknown whether mindfulness-based interventions can improve depression and anxiety symptoms [...] Read more.
Background: Between 20–50% of patients undergoing maintenance dialysis for end-stage kidney disease experience symptoms of depression and/or anxiety, associated with increased mortality, greater health care utilization, and decreased quality of life. It is unknown whether mindfulness-based interventions can improve depression and anxiety symptoms in patients receiving this treatment. Methods: We conducted an 8-week multicenter randomized controlled trial comparing a brief mindfulness intervention (BMI) vs. an active control (Health Enhancement Program [HEP]) in 55 patients receiving dialysis with symptoms of depression and/or anxiety. The primary outcome was change in Patient Health Questionnaire-9 (PHQ-9) depression scores, with a primary analysis in participants with baseline PHQ-9 ≥ 10, and a secondary analysis including all participants. The secondary outcome was change in Generalized Anxiety Disorder-7 (GAD-7) anxiety scores with corresponding primary and secondary analyses. Results: Both BMI and HEP reduced depressive symptoms, with no difference between trial arms (PHQ-9 change = −7.0 vs. −6.1, p = 0.62). BMI was more effective than HEP in reducing anxiety (GAD-7 change = −8.7 vs. −1.4, p = 0.01). Secondary analyses revealed no differences between arms. Conclusions: For patients undergoing dialysis, both BMI and HEP may be helpful interventions for depression symptoms, and BMI may be superior to HEP for anxiety symptoms. Mindfulness-based and other psychosocial interventions may be further evaluated in those undergoing dialysis as treatment options for symptoms of depression and anxiety. Full article
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Article
The Effects of Mindfulness-Based Mandala Coloring, Made in Nature, on Chronic Widespread Musculoskeletal Pain: Randomized Trial
Healthcare 2021, 9(6), 642; https://doi.org/10.3390/healthcare9060642 - 28 May 2021
Cited by 2 | Viewed by 1354
Abstract
This study aimed to investigate the effects of mindfulness-based mandala coloring made within nature on individuals with chronic widespread musculoskeletal pain (CWP). Thirty-six participants were randomly allocated. In the experimental group, identical interventions and procedures were administered for each experiment. The control group [...] Read more.
This study aimed to investigate the effects of mindfulness-based mandala coloring made within nature on individuals with chronic widespread musculoskeletal pain (CWP). Thirty-six participants were randomly allocated. In the experimental group, identical interventions and procedures were administered for each experiment. The control group members were untreated and remained in an urban environment. Overall, the experiment showed significant improvements in tender points (f = 8.791, p = 0.006), total stress level (f = 14.570, p = 0.001), depressive symptoms (f = 15.205, p = 0.001), anger symptoms (f = 7.263, p = 0.011) and salivary cortisol (f = 10.619, p = 0.003) in the experimental group. The results reflect that MBMC within nature is effective in reducing pain, psychological stress responses, and cortisol levels in individuals with CWP. The positive results could be a product of the experimental design rather than the treatment itself. A rigorous experimental design provides better understanding of MBMC within nature. Full article
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2020

Jump to: 2022, 2021

Article
Living the Full Catastrophe: A Mindfulness-Based Program to Support Recovery from Stroke
Healthcare 2020, 8(4), 498; https://doi.org/10.3390/healthcare8040498 - 19 Nov 2020
Cited by 2 | Viewed by 1893
Abstract
Decades of research suggest that Mindfulness-Based Stress Reduction (MBSR) training supports a greater capacity to live with chronic medical conditions and contributes to lowering stress levels. This paper introduces a model for a Mindfulness-Based Recovery from Stroke (MBRfS) for promoting stroke recovery, informed [...] Read more.
Decades of research suggest that Mindfulness-Based Stress Reduction (MBSR) training supports a greater capacity to live with chronic medical conditions and contributes to lowering stress levels. This paper introduces a model for a Mindfulness-Based Recovery from Stroke (MBRfS) for promoting stroke recovery, informed by the lived experience of the author (a stroke survivor and certified MBSR instructor), the research literature regarding MBSR training, and the specific challenges of stroke recovery. Four themes emerged from the autoethnographic analysis that informed the proposed model: Readiness to accept the stroke event and the acquired brain injury, navigating uncertainties of stroke recovery with awareness and self-responsibility for outcomes, trusting the inherent wisdom of the body as a stroke recovery “teacher”, and increased capacity to integrate complex emotions with self-compassion, and a sense of wholeness. A four-component MBRfS model is offered, which consists of an integration amongst a modified MBSR framework, emergent attitudinal themes, and insights from the autoethnographic vignettes. The MBRfS model offers a path for providing participants with a supportive experience within stroke recovery. Recommendations and suggestions for future studies are offered to support the development of MBRfS for stroke survivors and their caregivers, as well as contributing to healthcare providers. Full article
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Review
Mindfulness in Family Caregivers of Persons with Dementia: Systematic Review and Meta-Analysis
Healthcare 2020, 8(3), 193; https://doi.org/10.3390/healthcare8030193 - 30 Jun 2020
Cited by 3 | Viewed by 2089
Abstract
Social and healthcare problems associated with dementia not only affect those who suffer from this disease, but their caregivers as well. The purpose of this study was to analyze the efficacy of mindfulness intervention on psychological variables of caregivers of persons with dementia. [...] Read more.
Social and healthcare problems associated with dementia not only affect those who suffer from this disease, but their caregivers as well. The purpose of this study was to analyze the efficacy of mindfulness intervention on psychological variables of caregivers of persons with dementia. A search for scientific articles published from 2000 to 2019 in the PubMed, Web of Science and PsycINFO databases found a total of 282 articles. After screening with preestablished inclusion criteria, ten studies with participation of 161 caregivers remained for the meta-analysis. The results were significant in favor of mindfulness intervention for the variables studied with a standardized difference of mean of 0.71 at a 95% CI, 0.71 (0.52, 0.89); p ≤ 0.00001. Heterogeneity of the studies included was moderate (I2 = 40%). The main conclusion suggested by empirical evidence was that mindfulness intervention seems to be effective for the variables analyzed. However, continued in-depth study of this subject is recommended. Full article
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Article
The Effect of Loving-Kindness Meditation on Flight Attendants’ Spirituality, Mindfulness and Subjective Well-Being
Healthcare 2020, 8(2), 174; https://doi.org/10.3390/healthcare8020174 - 16 Jun 2020
Cited by 14 | Viewed by 2278
Abstract
Background: This study investigated: (1) the effects of the loving-kindness meditation (LKM) on mindfulness, subjective well-being (SWB), and spirituality and (2) the relationships between mindfulness, spirituality, and SWB. Methods: 98 flight attendants from Xiamen Airlines in China were recruited and randomly [...] Read more.
Background: This study investigated: (1) the effects of the loving-kindness meditation (LKM) on mindfulness, subjective well-being (SWB), and spirituality and (2) the relationships between mindfulness, spirituality, and SWB. Methods: 98 flight attendants from Xiamen Airlines in China were recruited and randomly assigned to the LKM training group (n = 49) or the waiting control group (n = 49). The LKM training group underwent an 8-week LKM training intervention, and the control group did not undergo intervention. The three main variables (SWB, mindfulness, and spirituality) were measured both before (pre-test) and after (post-test) the LKM training intervention. Results: In the experimental group, SWB and spirituality increased significantly. In the control group, no significant differences were observed for the three variables between the pre-test and post-test. Conclusions: Our results indicated that LKM may help to improve SWB and spirituality. However, the mechanisms which underlie the effects of the LKM on mindfulness, spirituality, SWB, and other psychological constructs require further elucidation. Full article
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