Heal the Healers: A pilot study evaluating the feasibility, acceptability, and exploratory efficacy of a Transcendental Meditation intervention for emergency clinicians during the coronavirus disease 2019 pandemic

Desiree R Azizoddin; Noelia Kvaternik; Meghan Beck; Guohai Zhou; Mohammad Adrian Hasdianda; Natasha Jones; Lily Johnsky; Dana Im; Peter R Chai; Edward W Boyer

doi:10.1002/emp2.12619

Heal the Healers: A pilot study evaluating the feasibility, acceptability, and exploratory efficacy of a Transcendental Meditation intervention for emergency clinicians during the coronavirus disease 2019 pandemic

J Am Coll Emerg Physicians Open. 2021 Dec 29;2(6):e12619. doi: 10.1002/emp2.12619. eCollection 2021 Dec.

Authors

Desiree R Azizoddin^{1

2

3}, Noelia Kvaternik¹, Meghan Beck¹, Guohai Zhou⁴, Mohammad Adrian Hasdianda¹, Natasha Jones⁵, Lily Johnsky¹, Dana Im^{1

3}, Peter R Chai^{1

2

3

6

7}, Edward W Boyer^{1

7

8}

Affiliations

¹ Department of Emergency Medicine Brigham and Women's Hospital Boston Massachusetts USA.
² Department of Psychosocial Oncology and Palliative Care Dana-Farber Cancer Institute Boston Massachusetts USA.
³ Department of Internal Medicine Harvard Medical School Boston Massachusetts USA.
⁴ Center for Clinical Investigation Brigham and Women's Hospital Boston Massachusetts USA.
⁵ Harvard Graduate School of Education Harvard University Cambridge USA.
⁶ The Koch Institute for Integrated Cancer Research Massachusetts Institute of Technology Cambridge Massachusetts USA.
⁷ The Fenway Institute Boston Massachusetts USA.
⁸ Department of Emergency Medicine The Ohio State University Columbus Ohio USA.

Abstract

Objective: Emergency clinicians face elevated rates of burnout that result in poor outcomes for clinicians, patients, and health systems. The objective of this single-arm pilot study was to evaluate the feasibility of a Transcendental Meditation (TM) intervention for emergency clinicians during the coronavirus disease 2019 (COVID-19) pandemic and to explore the potential effectiveness in improving burnout, sleep, and psychological health.

Methods: Emergency clinicians (physicians, nurses, and physician-assistants) from 2 urban hospitals were recruited to participate in TM instruction (8 individual or group in-person and remote sessions) for 3 months. Session attendance was the primary feasibility outcome (prespecified as attending 6/8 sessions), and burnout was the primary clinical outcome. Participant-reported measures of feasibility and validated measures of burnout, depression, anxiety, sleep disturbance, and stress were collected at baseline and the 1-month and 3-month follow-ups. Descriptive statistics and linear mixed-effects models were used.

Results: Of the 14 physicians (46%), 7 nurses (22%), and 10 physician-assistants (32%) who participated, 61% were female (n = 19/32). TM training and at-home meditation practice was feasible for clinicians as 90.6% (n = 29/32) attended 6/8 training sessions and 80.6% self-reported meditating at least once a day on average. Participants demonstrated significant reductions in burnout (P < .05; effect sizes, Cohen's d = 0.43-0.45) and in symptoms of depression, anxiety, stress, and sleep disturbance (P values < .001; Cohen's d = 0.70-0.87).

Conclusion: TM training was feasible for emergency clinicians during the COVID-19 pandemic and led to significant reductions in burnout and psychological symptoms. TM is a safe and effective meditation tool to improve clinicians' well-being.

Keywords: PA burnout; burnout; clinician intervention; covid‐19; meditation; nurse burnout; pandemic; physician burnout; pilot study; transcendental meditation; video‐delivery.