Effects of a brief mindfulness-based intervention program for stress management among medical students: the Mindful-Gym randomized controlled study

Advances in Health Sciences Education

Volumn 20, Issue 5, 2015, Pages 1115-1134

  Phang, Cheng Kar ^a   Mukhtar, Firdaus ^a   Ibrahim, Normala ^a   Keng, Shian Ling ^b   Mohd Sidik, Sherina ^a  

^a UNIVERSITY PUTRA MALAYSIA   (Malaysia)

^b NATIONAL UNIVERSITY OF SINGAPORE   (Singapore)

Author keywords

Coping; Medical students; Mental health; Mindfulness; Stress management

Indexed keywords

COGNITIVE THERAPY; CONTROLLED STUDY; COPING BEHAVIOR; FEMALE; HUMAN; MALAYSIA; MALE; MEDICAL STUDENT; MENTAL STRESS; MINDFULNESS; PREVENTION AND CONTROL; PROCEDURES; PSYCHOLOGY; RANDOMIZED CONTROLLED TRIAL; SELF CONCEPT; THERAPY; YOUNG ADULT;

ADAPTATION, PSYCHOLOGICAL; COGNITIVE THERAPY; FEMALE; HUMANS; MALAYSIA; MALE; MINDFULNESS; SELF EFFICACY; STRESS, PSYCHOLOGICAL; STUDENTS, MEDICAL; YOUNG ADULT;

EID: 84947036464     PISSN: 13824996     EISSN: 15731677     Source Type: Journal    
DOI: 10.1007/s10459-015-9591-3     Document Type: Article

References (78)

1. Agee, J. D., Danoff-Burg, S., & Grant, C. A. (2009). Comparing brief stress management courses in a community sample: Mindfulness skills and progressive muscle relaxation. Explore: The Journal of Science and Healing,5(2), 104–109.
2. Alvi, T., Assad, F., Ramzan, M., & Khan, F. A. (2010). Depression, anxiety and their associated factors among medical students. Journal of the College of Physicians and Surgeons Pakistan,20(2), 122–126.
3. Barbosa, P., Raymond, G., Zlotnick, C., Wilk, J., Toomey, R., & Mitchell, J. (2013). Mindfulness-based stress reduction training is associated with greater empathy and reduced anxiety for graduate healthcare students. Education for Health: Change in Learning and Practice,26(1), 9–14.
4. Bondolfi, G., Jermann, F., Van der Linden, M., Gex-Fabry, M., Bizzini, L., Rouget, B. W., & Bertschy, G. (2010). Depression relapse prophylaxis with mindfulness-based cognitive therapy: Replication and extension in the Swiss health care system. Journal of Affective Disorders,122(3), 224–231.
5. Bramness, J. G., Fixdal, T. C., & Vaglum, P. (1991). Effect of medical school stress on the mental health of medical students in early and late clinical curriculum. Acta Psychiatrica Scandinavica,84(4), 340–345.
6. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology,84(4), 822–848.
7. Buttner, T. R., & Dlugosch, G. E. (2013). Students’ stress: The relationship between self-efficacy, mindfulness and stress experience of students. Prevention and Health Promotion,8(2), 106.
8. Chan, D. W. (1991). Depressive symptoms and depressed mood among Chinese medical students in Hong Kong. Comprehensive Psychiatry,32(2), 170–180.
9. Chiesa, A. A., & Serretti, A. A. (2009). Mindfulness-based stress reduction for stress management in healthy people: A review and meta-analysis. Journal of Alternative and Complementary Medicine (New York N.Y.),15(5), 593–600.
10. Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd ed.). Hillsdale: Lawrence Erlbaum Associates.
11. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior,24(4), 385–396.
12. Cook, R. J., & Sackett, D. L. (1995). The number needed to treat: A clinically useful measure of treatment effect. BMJ (Clinical Research Ed.),310(6977), 452–454.
13. De Vibe, M., Solhaug, I., Tyssen, R., Friborg, O., Rosenvinge, J. H., Sørlie, T., & Bjørndal, A. (2013). Mindfulness training for stress management: A randomised controlled study of medical and psychology students. BMC Medical Education, 13(107). doi:10.1186/1472-6920-13-107.
14. Dobkin, P. L., & Hutchinson, T. (2013). Teaching mindfulness in medical school: Where are we now and where are we going? Medical Education,47(8), 768–779.
15. Dufon, M. A., & Christian, J. (2013). The formation and development of the mindful campus. New Directions for Teaching and Learning,134, 65–72.
16. Dyrbye, L. N., Thomas, M. R., Huschka, M. M., Lawson, K. L., Novotny, P. J., Sloan, J. A., & Shanafelt, T. D. (2006a). A multicenter study of burnout, depression, and quality of life in minority and nonminority US medical students. Mayo Clinic Proceedings,81(11), 1435–1442.
17. Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006b). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine,81(4), 354–373.
18. Erogul, M., Singer, G., McIntyre, T., & Stefanov, D. G. (2014). Abridged mindfulness intervention to support wellness in first-year medical students. Teaching and Learning in Medicine,26(4), 350–356.
19. Firdaus, M., & Oei, T. P. S. (2011). A review on the prevalence of depression in Malaysia. Current Psychiatry Reviews,7(3), 234–238.
20. Garland, E., Gaylord, S., & Park, J. (2009). The role of mindfulness in positive reappraisal. Explore: The Journal of Science and Healing,5(1), 37–44.
21. Golderberg, D., & Williams, P. (1988). A user's guide to the general health questionnaire. Windsor: NFER-Nelson.
22. Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickel, M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: A randomized, double-blind, controlled study. Psychotherapy and Psychosomatics,76(6), 332–338.
23. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research,57(1), 35–43.
24. Gupta, S. K. (2011). Intention-to-treat concept: A review. Perspectives in Clinical Research,2(3), 109–112.
25. Haahr, M. (1998). RANDOM.ORG—True Random Number Service. Retrieved December 27, 2013, from http://www.random.org/.
26. Hassed, C., De Lisle, S., Sullivan, G., & Pier, C. (2009). Enhancing the health of medical students: Outcomes of an integrated mindfulness and lifestyle program. Advances in Health Sciences Education,14(3), 387–398.
27. Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics,6(2), 65–70.
28. IsHak, W., Nikravesh, R., Lederer, S., Perry, R., Ogunyemi, D., & Bernstein, C. (2013). Burnout in medical students: A systematic review. The Clinical Teacher,10(4), 242–245.
29. Jain, S., Shapiro, S. L. P., Swanick, S., Roesch, S. C. P., Mills, P. J. P., Bell, I., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine,33(1), 11–21.
30. Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice,10(2), 144–156.
31. Kang, C., & Whittingham, K. (2010). Mindfulness: A dialogue between buddhism and clinical psychology. Mindfulness,1(3), 161–173.
32. Kaviani, H., Hatami, N., & Javaheri, F. (2012). The impact of mindfulness-based cognitive therapy (MBCT) on mental health and quality of life in a sub-clinically depressed population. Archives of Psychiatry and Psychotherapy,14(1), 21–28.
33. Kaviani, H., Javaheri, F., & Hatami, N. (2011). Mindfulness-based cognitive therapy (MBCT) reduces depression and anxiety induced by real stressful setting in non-clinical population. International Journal of Psychology and Psychological Therapy,11(2), 285–296.
34. Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., & Hofmann, S. G. (2013). Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review,33(6), 763–771.
35. Ko, S. M., Kua, E. H., & Fones, C. S. (1999). Stress and the undergraduates. Singapore Medical Journal,627, 627–630.
36. Krasner, M. S., Epstein, R. M., Beckman, H., Suchman, A. L., Chapman, B., Mooney, C. J., & Quill, T. E. (2009). Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA,302(12), 1284–1293.
37. Krusche, A., Cyhlarova, E., & Williams, J. M. G. (2013). Mindfulness online: An evaluation of the feasibility of a web-based mindfulness course for stress, anxiety and depression. BMJ Open, 3(11). doi:10.1136/bmjopen-2013-003498.
38. Liu, X. C., Oda, S., Peng, X., & Asai, K. (1997). Life events and anxiety in Chinese medical students. Social Psychiatry and Psychiatric Epidemiology,32(2), 63–67.
39. Lovibond, S., & Lovibond, P. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychology Foundation.
40. Mazwin, N. A. (2008). Fatwa Council says yoga with worshipping, chanting is prohibited. Kuala Lumpur: The Star Online.
41. Moore, P. P. (2008). Introducing mindfulness to clinical psychologists in training: an experiential course of brief exercises. Journal of Clinical Psychology in Medical Settings,15(4), 331–337.
42. Phang, C. K., & Oei, T. P. S. (2012). From Mindfulness to meta-mindfulness: Further integration of meta-mindfulness concept and strategies into cognitive-behavioral therapy. Mindfulness, 3(2), 104–116.
43. Pinson, L., & Gray, G. E. (2003). Psychopharmacology: Number needed to treat: An underused measure of treatment effect. Psychiatric Services,54(2), 145–154.
44. Pipe, T. B. P. R. N., Bortz, J. J. P. A. C. N., Dueck, A., Pendergast, D., Buchda, V., & Summers, J. (2009). Nurse leader mindfulness meditation program for stress management: A randomized controlled trial. Journal of Nursing Administration,39(3), 130.
45. Quince, T. A., Wood, D. F., Parker, R. A., & Benson, J. (2012). Prevalence and persistence of depression among undergraduate medical students: A longitudinal study at one UK medical school. BMJ Open, 2(4). doi:10.1136/bmjopen-2012-001519.
46. Ree, M. J., & Craigie, M. A. (2007). Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients. Behaviour Change,24(2), 70–86.
47. Roberts, L. W. (2010). Understanding depression and distress among medical students. JAMA: Journal of the American Medical Association,304(11), 1231–1233.
48. Roh, M. S., Jeon, H. J., Kim, H., Han, S. K., & Hahm, B. J. (2010). The prevalence and impact of depression among medical students: A nationwide cross-sectional study in South Korea. Academic Medicine,85(8), 1384–1390.
49. Rosenthal, J. M., & Okie, S. (2005). White coat, mood indigo: Depression in medical school. New England Journal of Medicine,353(11), 1085–1088.
50. Rosenzweig, S., Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2003). Mindfulness-based stress reduction lowers psychological distress in medical students. Teaching and Learning in Medicine,15(2), 88–92.
51. Ryan, A., Safran, J. D., Doran, J. M., & Muran, J. C. (2012). Therapist mindfulness, alliance and treatment outcome. Psychotherapy Research,22(3), 289–297.
52. Saipanish, R. (2003). Stress among medical students in a Thai medical school. Medical Teacher,25(5), 502–506.
53. Schlomer, G. L., Bauman, S., & Card, N. A. (2010). Best practices for missing data management in counseling psychology. Journal of Counseling Psychology,57(1), 1–10.
54. Schulz, K. F., Altman, D. G., & Moher, D. (2010). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials. Annals of Internal Medicine,152(11), 726–732.
55. Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman, S. Wright, & M. Johnston (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). Windsor: NFER-Nelson.
56. Schwenk, T. L., Davis, L., & Wimsatt, L. A. (2010). Depression, stigma, and suicidal ideation in medical students. JAMA: Journal of the American Medical Association,304(11), 1181–1190.
57. Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine,21(6), 581–599.
58. Shapiro, S. L., Shapiro, D. E., & Schwartz, G. E. R. (2000). Stress management in medical education: A review of the literature. Academic Medicine,75(7), 748–759.
59. Sherina, M. S., & Kanesan, N. (2003). The prevalence of depression among medical students. Malaysia Journal of Psychiatry,11(1), 12–17.
60. Shiralkar, M. T., Harris, T. B., Eddins-Folensbee, F. F., & Coverdale, J. H. (2013). A systematic review of stress-management programs for medical students. Academic Psychiatry,37(3), 158–164.
61. Singh, A., Lal, A., & Shekhar, A. (2010). Prevalence of depression among medical students of a private medical college in India. Online Journal of Health and Allied Sciences, 9(4), from http://www.ojhas.org/issue36/2010-4-8.htm.
62. Smith, S., & Hayes, S. C. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy (p. 190). Oakland: New Harbinger Publications.
63. Soper, D. S. (2013). Free a priori sample size calculator for hierarchical multiple regression (Software). Retrieved on December 28, 2013, from http://www.danielsoper.com/statcalc3/calc.aspx?id=16.
64. Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology,68(4), 615–623.
65. Turakitwanakan, W., Mekseepralard, C., & Busarakumtragul, P. (2013). Effects of mindfulness meditation on serum cortisol of medical students. Journal of the Medical Association of Thailand,96(SUPPL 1), S90–S95.
66. Walter, G., Soh, N. L.-W., Norgren Jaconelli, S., Lampe, L., Malhi, G. S., & Hunt, G. (2013). Medical students’ subjective ratings of stress levels and awareness of student support services about mental health. Postgraduate Medical Journal,89(1052), 311–315.
67. Warnecke, E., Quinn, S., Ogden, K., Towle, N., & Nelson, M. R. (2011). A randomised controlled trial of the effects of mindfulness practice on medical student stress levels. Medical Education,45(4), 381–388.
68. Weinstein, N., Brown, K. W., & Ryan, R. M. (2009). A multi-method examination of the effects of mindfulness on stress attribution, coping, and emotional well-being. Journal of Research in Personality,43(3), 374–385.
69. Williams, P. M., & Penman, D. D. (2011). Mindfulness: A practical guide to finding peace in a frantic world (p. 288). London: Piatkus.
70. Williams, J. M. G., Russell, I., & Russell, D. (2008). Mindfulness-based cognitive therapy: Further issues in current evidence and future research. Journal of Consulting and Clinical Psychology,76(3), 524–529.
71. Yusoff, M. S. B. (2011). Effects of a brief stress reduction intervention on medical studentss depression, anxiety and stress during stressful period. Asean Journal of Psychiatry, 12(1), from http://www.aseanjournalofpsychiatry.org/index.php/aseanjournalofpsychiatry/article/view/42.
72. Yusoff, M. S. B. (2013). Interventions on medical students’ psychological health: A meta-analysis. Journal of Taibah University Medical Sciences,9(1), 1–13.
73. Yusoff, M. S. B., & Abdul Rahim, A. F. (2010). Impact of medical student well-being workshop on the medical student’s stress level: A prelimiary study. Asean Journal of Psychiatry, 11(1), from http://www.aseanjournalofpsychiatry.org/oe11107.htm.
74. Yusoff, M. S. B., Abdul Rahim, A. F., & Yaacob, M. J. (2010a). Prevalence and sources of stress among Universiti Sains Malaysia medical students. Malaysian Journal of Medical Sciences,17(1), 30–37.
75. Yusoff, M. S. B., Abdul Rahim, A. F., & Yaacob, M. J. (2011). Depression among final year medical students in universiti sains malaysia (USM): Associated, risk and determinant factors. European Psychiatry,26(Supple 1), 706.
76. Yusoff, M. S. B., & Esa, A. R. (2012). Stress management for medical students: A systematic review. In A. Lopez-Varela (Ed.), Social Sciences and Cultural Studies—Issues of Language, Public Opinion, Education and Welfare. InTech. doi:10.5772/37095.
77. Yusoff, M. S. B., Yaacob, M. J., & Rahim, A. F. A. (2010b). The sensitivity, specificity and reliability of the malay version 12-items general health questionnaire (GHQ-12) in detecting distressed medical students. ASEAN Journal of Psychiatry,11(2), 135–142.
78. Zaid, Z. A., Chan, S. C., & Ho, J. J. (2007). Emotional disorders among medical students in a Malaysian private medical school. Singapore Medical Journal,48(10), 895–899.