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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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Characteristics of participants in a randomized controlled trial of a stress management tool for physicians
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table1: Characteristics of participants in a randomized controlled trial of a stress management tool for physicians

Mentions: Forty-one potential participants were screened, and 40 physicians from various medical practices participated (19 in the control group and 21 in the intervention group), all of whom completed the study protocol (Figure 1). No adverse effects of the intervention were reported. Complete primary outcome data were available for all but one participant in the control group at day 0 and for all but one person in each group at day 28. The eligible participants consisted of 23 men (11 control and 12 intervention) and 17 women (8 control and 9 intervention) (Table 1). The mean age was 44.8 years in the control group and 47.8 years in the intervention group. Fifteen participants in the control group and 18 in the intervention group were married. Participants in the control and intervention groups had been practising medicine for a mean of 13.0 and 14.3 years, respectively. The mean age of starting practice (32 years) likely reflected the makeup of the cohort, which consisted almost exclusively of specialist physicians, who spend up to 5 years in residency before completing their training. Participants were from a variety of medical practices (1 [2%] from primary care, 30 [76%] from a medical specialty and 9 [22%] from a surgical specialty). With the exception of mean baseline heart rate (67 beats/minute v. 74 beats/minute in the intervention and control groups; p = 0.030), there were no statistically significant differences between the two groups (Table 1).


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)

Characteristics of participants in a randomized controlled trial of a stress management tool for physicians
© Copyright Policy - open-access
Related In: Results  -  Collection

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

table1: Characteristics of participants in a randomized controlled trial of a stress management tool for physicians
Mentions: Forty-one potential participants were screened, and 40 physicians from various medical practices participated (19 in the control group and 21 in the intervention group), all of whom completed the study protocol (Figure 1). No adverse effects of the intervention were reported. Complete primary outcome data were available for all but one participant in the control group at day 0 and for all but one person in each group at day 28. The eligible participants consisted of 23 men (11 control and 12 intervention) and 17 women (8 control and 9 intervention) (Table 1). The mean age was 44.8 years in the control group and 47.8 years in the intervention group. Fifteen participants in the control group and 18 in the intervention group were married. Participants in the control and intervention groups had been practising medicine for a mean of 13.0 and 14.3 years, respectively. The mean age of starting practice (32 years) likely reflected the makeup of the cohort, which consisted almost exclusively of specialist physicians, who spend up to 5 years in residency before completing their training. Participants were from a variety of medical practices (1 [2%] from primary care, 30 [76%] from a medical specialty and 9 [22%] from a surgical specialty). With the exception of mean baseline heart rate (67 beats/minute v. 74 beats/minute in the intervention and control groups; p = 0.030), there were no statistically significant differences between the two groups (Table 1).

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