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The effect of a biofeedback-based stress management tool on physician stress: a randomized controlled clinical trial.

Lemaire JB, Wallace JE, Lewin AM, de Grood J, Schaefer JP - Open Med (2011)

Bottom Line: Physicians often experience work-related stress that may lead to personal harm and impaired professional performance.Biofeedback has been used to manage stress in various populations.Stress was measured with a scale developed to capture short-term changes in global perceptions of stress for physicians (maximum score 200).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Calgary, Health Sciences Center, 3330 University Drive NW, Calgary AB T2N 4N1; 403 220-4506, Canada. lemaire@ucalgary.ca

ABSTRACT

Background: Physicians often experience work-related stress that may lead to personal harm and impaired professional performance. Biofeedback has been used to manage stress in various populations.

Objective: To determine whether a biofeedback-based stress management tool, consisting of rhythmic breathing, actively self-generated positive emotions and a portable biofeedback device, reduces physician stress.

Design: Randomized controlled trial measuring efficacy of a stress-reduction intervention over 28 days, with a 28-day open-label trial extension to assess effectiveness.

Setting: Urban tertiary care hospital.

Participants: Forty staff physicians (23 men and 17 women) from various medical practices (1 from primary care, 30 from a medical specialty and 9 from a surgical specialty) were recruited by means of electronic mail, regular mail and posters placed in the physicians' lounge and throughout the hospital.

Intervention: Physicians in the intervention group were instructed to use a biofeedback-based stress management tool three times daily. Participants in both the control and intervention groups received twice-weekly support visits from the research team over 28 days, with the intervention group also receiving re-inforcement in the use of the stress management tool during these support visits. During the 28-day extension period, both the control and the intervention groups received the intervention, but without intensive support from the research team.

Main outcome measure: Stress was measured with a scale developed to capture short-term changes in global perceptions of stress for physicians (maximum score 200).

Results: During the randomized controlled trial (days 0 to 28), the mean stress score declined significantly for the intervention group (change -14.7, standard deviation [SD] 23.8; p = 0.013) but not for the control group (change -2.2, SD 8.4; p = 0.30). The difference in mean score change between the groups was 12.5 (p = 0.048). The lower mean stress scores in the intervention group were maintained during the trial extension to day 56. The mean stress score for the control group changed significantly during the 28-day extension period (change -8.5, SD 7.6; p < 0.001).

Conclusion: A biofeedback-based stress management tool may be a simple and effective stress-reduction strategy for physicians.

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Changes in stress scores for individual physicians over days 0 to 28, by group
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figure2: Changes in stress scores for individual physicians over days 0 to 28, by group

Mentions: The baseline mean stress score of 81.3 (SD 29.5) for the intervention group dropped to 65.0 (SD 26.6) at day 28, corresponding to a statistically significant mean change of –14.7 (SD 23.8; p = 0.013) (Table 2). The baseline mean stress score of 74.1 (SD 24.5) for the control group dropped to 69.8 (SD 26.6) at day 28, corresponding to a mean change of –2.2 (SD 8.4), but this change was not statistically significant (p = 0.30). The difference in score change between the groups was significant (12.5; p = 0.048). A sensitivity analysis of the individual components of the stress score (Perceived Stress Scale and items derived from the POQA-R) showed a statistically significant decrease in mean stress scores for the intervention group but not for the control group, which mirrored the main study results (results available upon request). Fifteen (75%) of 20 physicians in the intervention group but only 10 (59%) of 17 in the control group had reduced stress scores at day 28 relative to day 0 (χ2 p value = 0.30) (Figure 2).


The effect of a biofeedback-based stress management tool on physician stress: a randomized controlled clinical trial.

Lemaire JB, Wallace JE, Lewin AM, de Grood J, Schaefer JP - Open Med (2011)

Changes in stress scores for individual physicians over days 0 to 28, by group
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3345375&req=5

figure2: Changes in stress scores for individual physicians over days 0 to 28, by group
Mentions: The baseline mean stress score of 81.3 (SD 29.5) for the intervention group dropped to 65.0 (SD 26.6) at day 28, corresponding to a statistically significant mean change of –14.7 (SD 23.8; p = 0.013) (Table 2). The baseline mean stress score of 74.1 (SD 24.5) for the control group dropped to 69.8 (SD 26.6) at day 28, corresponding to a mean change of –2.2 (SD 8.4), but this change was not statistically significant (p = 0.30). The difference in score change between the groups was significant (12.5; p = 0.048). A sensitivity analysis of the individual components of the stress score (Perceived Stress Scale and items derived from the POQA-R) showed a statistically significant decrease in mean stress scores for the intervention group but not for the control group, which mirrored the main study results (results available upon request). Fifteen (75%) of 20 physicians in the intervention group but only 10 (59%) of 17 in the control group had reduced stress scores at day 28 relative to day 0 (χ2 p value = 0.30) (Figure 2).

Bottom Line: Physicians often experience work-related stress that may lead to personal harm and impaired professional performance.Biofeedback has been used to manage stress in various populations.Stress was measured with a scale developed to capture short-term changes in global perceptions of stress for physicians (maximum score 200).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Calgary, Health Sciences Center, 3330 University Drive NW, Calgary AB T2N 4N1; 403 220-4506, Canada. lemaire@ucalgary.ca

ABSTRACT

Background: Physicians often experience work-related stress that may lead to personal harm and impaired professional performance. Biofeedback has been used to manage stress in various populations.

Objective: To determine whether a biofeedback-based stress management tool, consisting of rhythmic breathing, actively self-generated positive emotions and a portable biofeedback device, reduces physician stress.

Design: Randomized controlled trial measuring efficacy of a stress-reduction intervention over 28 days, with a 28-day open-label trial extension to assess effectiveness.

Setting: Urban tertiary care hospital.

Participants: Forty staff physicians (23 men and 17 women) from various medical practices (1 from primary care, 30 from a medical specialty and 9 from a surgical specialty) were recruited by means of electronic mail, regular mail and posters placed in the physicians' lounge and throughout the hospital.

Intervention: Physicians in the intervention group were instructed to use a biofeedback-based stress management tool three times daily. Participants in both the control and intervention groups received twice-weekly support visits from the research team over 28 days, with the intervention group also receiving re-inforcement in the use of the stress management tool during these support visits. During the 28-day extension period, both the control and the intervention groups received the intervention, but without intensive support from the research team.

Main outcome measure: Stress was measured with a scale developed to capture short-term changes in global perceptions of stress for physicians (maximum score 200).

Results: During the randomized controlled trial (days 0 to 28), the mean stress score declined significantly for the intervention group (change -14.7, standard deviation [SD] 23.8; p = 0.013) but not for the control group (change -2.2, SD 8.4; p = 0.30). The difference in mean score change between the groups was 12.5 (p = 0.048). The lower mean stress scores in the intervention group were maintained during the trial extension to day 56. The mean stress score for the control group changed significantly during the 28-day extension period (change -8.5, SD 7.6; p < 0.001).

Conclusion: A biofeedback-based stress management tool may be a simple and effective stress-reduction strategy for physicians.

Show MeSH