Evidence table
| Author, date, study design | Participants (n, mean age, % male) | Intervention (n, mean age) | Control (n, mean age) | Positive outcome measure | Other outcome measure | Baseline scores | Postintervention score | Follow-up score (mean, SD, n) | Results—summary |
| Allen et al41 Panel survey linked with Quality and Outcomes Framework (QOF) data 2004/2005 (first year) and 2007/2008 (fourth year) | GPs in the UK. 2004: n=1950, 47.0 years, 66.2% male. 2005: n=2000, 47.9 years, 63.6% male. 2008: n=1986, 48.7 years, 63.3% male | Pay for performance (P4P) scheme; QOF introduced in NHS in 2004 | NA | Job satisfaction (JSS WCW). Life satisfaction | P4P exposure | Mean. 2004: Life satisfaction (4.649). Overall JS (4.567), physical working conditions (4.862), choose method of working (4.636), colleagues (5.515), recognition for good work (4.224), responsibility (4.976), remuneration (4.376), opportunity to use abilities (4.787), hours of work (3.914), variety in job (5.011). | Time at 12 months. Mean. 2005: Life satisfaction (5.095). Overall JS (5.201), physical working conditions (5.044), choose method of working (4.892), colleagues (5.599), recognition for good work (4.726), responsibility (5.406), remuneration (5.387), opportunity to use abilities (5.147), hours of work (4.802), variety in job (5.269). | Time at 48 months. Mean. 2008: Life satisfaction (5.008). Overall JS (4.728), physical working conditions (5.129), choose method of working (4.640), colleagues (5.602), recognition for good work (4.495), responsibility (5.276), remuneration (4.849), opportunity to use abilities (5.074), hours of work (4.205), variety in job (5.276). | Between 2004 and 2005 overall job satisfaction increased (also see ref.56), then fell from 2005 to 2008. There is a positive effect (though not statistically significant) between QOF/P4P income exposure and job satisfaction in 2005 (t-ratio 1.74), though not so in 2008 (t-ratio 0.14). The P4P exposure shows now significant effect on GPs job satisfaction. |
| Amutio et al42 RCT | Physicians (approx. 70% primary care) in public or private practice in Spain (n=42, 47.3 years, 42.9%) | 8-week MBSR programme (group course 8×2.5 hours/week, 1×8 hour retreat plus homework), 10-month mainten-ance period (group course 10×2.5 hours/month plus homework) (n=21) | WLC (n=21) | Mindfulness (FFMQ), relaxation (SRSI-3) | Heart rate | Mean and SD INTERVENTION (n=21) FFMQ total (3.34, 0.44), FFMQ observing (3.33, 0.60), FFMQ describing (3.58, 0.72), FFMQ act with awareness (3.16, 0.87), FFMQ non-judging (3.42, 0.64), FFMQ non-reactivity (3.17, 0.51). SRSI relaxation (2.54, 0.53), SRSI positive energy (3.09, 0.64), SRSI mindfulness (3.74, 0.89), SRSI transcendence (2.67, 0.82). CONTROL (n=21) FFMQ total (3.51, 0.25), FFMQ observing (3.02, 0.88), FFMQ describing (3.88, 0.53), FFMQ act with awareness (3.93, 0.70), FFMQ non-judging (4.19, 0.52), FFMQ non-reactivity (3.23, 0.57). SRSI relaxation (2.52, 0.5), SRSI positive energy (3.01, 0.62), SRSI mindfulness (4.29, 0.92), SRSI transcendence (2.64, 0.93). | Time at 8 weeks. Mean and SD INTERVENTION (n=21) FFMQ total (3.71, 0.51), FFMQ observing (3.98, 0.64), FFMQ describing (3.83, 0.62), FFMQ act with awareness (3.48, 0.65), FFMQ non-judging (3.78, 0.66), FFMQ non-reactivity (3.46, 0.63). SRSI relaxation (3.08, 0.61), SRSI positive energy (3.80, 0.82), SRSI mindfulness (4.45, 0.71), SRSI transcendence (3.27, 1.02). CONTROL (n=21) FFMQ total (3.34, 0.33), FFMQ observing (2.83, 0.98), FFMQ describing (3.82, 0.58), FFMQ act with awareness (3.91, 0.61), FFMQ non-judging (4.16, 0.52), FFMQ non-reactivity (3.26, 0.67). SRSI relaxation (2.60, 0.51), SRSI positive energy (3.01, 0.6), SRSI mindfulness (4.24, 0.95), SRSI transcendence (2.40, 0.92). | Time at 12 months. Mean and SD INTERVENTION FFMQ total (3.85, 0.49), FFMQ observing (4.09, 0.62), FFMQ describing (4.01, 0.58), FFMQ act with awareness (3.55, 0.69), FFMQ non-judging (3.96, 0.66), FFMQ non-reactivity (3.58, 0.55). SRSI relaxation (3.16, 0.78), SRSI positive energy (3.99, 0.81), SRSI mindfulness (4.60, 1.01), SRSI transcendence (3.65, 1.36). | The MBSR programme (statistically) significantly improves mindfulness and relaxation measures (particularly positive energy and transcendence) at 8 weeks after baseline. Sustained and even improved long-term effects at 12 months follow-up are shown. |
| Asuero et al43 RCT (2010–2012) | Primary healthcare professionals (41 physicians) in Spain, public system (n=68 total, 47 years, 8% male) | 8-week MB psychoeducational programme: didactic material, mindful-ness meditation, narrative/appreciative enquiry, discussion. Group course 8×2.5 hours/week, 1×8 hour retreat plus homework (n=43 total, 23 physicians, 48.8 years) | WLC (n=25 total, 18 physicians, 46.9 years) | Mindfulness (FFMQ), empathy (JSPE), also self-report on energy, well-being and activity | Burnout (MBI), mood disturbance (POMS), intervention evaluation | Mean and SD INTERVENTION (n=43). FFMQ total (129.6, 22.2), FFMQ observing (26.1, 8.6), FFMQ describing (28.2, 5.7), FFMQ act with awareness (25.3, 5.9), FFMQ non-judging (27.1, 8.0), FFMQ non-reactivity (21.9, 4.3). JSPE total (119.5, 13.1), JSPE perspective taking (54.8, 6.5), JSPE compassionate care (47.2, 5.1), JSPE standing in pts shoes (13.1, 1.8). CONTROL (n=25). FFMQ total (120.5, 14.4), FFMQ observing (24.5, 4.3), FFMQ describing (26.4, 5.2), FFMQ act with awareness (23.6, 6.8), FFMQ non-judging (26.3, 6.5), FFMQ non-reactivity (19.8, 2.9). JSPE total (120.8, 10.1), JSPE perspective taking (59.8, 7.0), JSPE compassionate care (47.4, 4.9), JSPE standing in pts shoes (13.6, 0.9). | Time at 8 weeks. Mean and SD INTERVENTION (n=43) FFMQ total (141.6, 16.5), FFMQ observing (30.4, 5.1), FFMQ describing (28.9, 5.3), FFMQ act with awareness (27.4, 4.7), FFMQ non-judging (30.6, 6.2), FFMQ non-reactivity (24.1, 3.0). JSPE total (123.0, 9.2), JSPE perspective taking (56.1, 5.3), JSPE compassionate care (49.0, 3.9), JSPE standing in pts shoes (13.5, 1.1). CONTROL (n=25) FFMQ total (121.5, 16.0), FFMQ observing (24.1, 4.5), FFMQ describing (26.5, 5.5), FFMQ act with awareness (23.0, 5.9), FFMQ non-judging (27.4, 6.8), FFMQ non-reactivity (20.2, 3.5). JSPE total (119.0, 10.7), JSPE perspective taking (59.6, 6.3), JSPE compassionate care (46.9, 4.6), JSPE standing in pts shoes (12.5, 3.0). | NA | For mindfulness total, there is significant improvement for the intervention (moderate change). For empathy total, there is a non-significant increase from pre to post measure in the intervention group, only an increase in compassionate care was statistically significant. Overall mindfulness and empathy (compassionate care) were improved by the programme. |
| Barcons et al12 CBA, mixed methods, 2016 - –2017 | Primary healthcare professionals in Spain, public system (n=38). | MTP and IBST group programme plus routine programme. 9×1 hours per week (6 hours training on psychology, 3 hours on psychiatry and 1 hour social work) (n=20) | Routine mental-health support programme for primary care (n=18) | Job satisfaction (FR-JS) | Burnout (MBI), Brief Psychiatric Rating Scale (BPRS), psychopharmacology use, opinions about mental illness, administrative and healthcare indicators | Median and IQR. INTERVENTION (n=20) FR satisfaction at work (15, 13, 16.25), FR work tension(12, 11, 14), FR professional competence (5, 4, 6), FR work pressure (12, 10, 12.25), FR professional promotion (12, 9, 13), FR relationship superiors (4, 4, 6.5), FR relationship peers (6, 5.75, 7), FR extrinsic status (5.5, 4, 6), FR monotony (4.5, 4, 6), FR total (75, 72, 77.5). BPRS total (23.50, 22, 24.25). CONTROL (n=18), FR satisfaction at work (14, 10.5, 16), FR work tension (13.5, 12.25, 16.75), FR professional competence (4.5, 3, 6), FR work pressure (12, 12, 13), FR professional promotion (11, 10, 13.75), FR relationship superiors (6, 4, 6.75), FR relationship peers (5, 5, 6), FR extrinsic status(5, 5, 6), FR monotony (5, 4, 5.75), FR total (76, 73, 80.5). | Time at 10 months. Median and IQR. INTERVENTION (n=20) FR satisfaction at work (16, 15, 17), FR work tension(13, 11, 16), FR professional competence (5, 4.5, 6), FR work pressure (12, 10, 12.50), FR professional promotion (12, 10,13), FR relationship superiors (4, 4, 6.5), FR relationship peers (5, 5, 6), FR extrinsic status (5, 5, 6.5), FR monotony (5, 4, 5), FR total (76, 73, 83). BPRS total (20.50, 19, 22). CONTROL (n=18), FR satisfaction at work (12, 9, 16), FR work tension (15, 1, 16), FR professional competence (5, 4,6), FR work pressure(11, 11, 12), FR professional promotion (12, 11,15), FR relationship superiors (4, 6, 8), FR relationship peers (6, 5, 7), FR extrinsic status (6, 4, 6), FR monotony(4, 3, 5), FR total (77, 75, 78). | NA | No statistically significant changes in job satisfaction (FR). For well-being, a statistically significant decrease was seen from pre to post measure in the intervention group, as the BPRS measures negative constructs, this is interpreted as an improvement of well-being. |
| Contratto et al45 NCBA, mixed methods | General medicine physicians in the USA, working part-time (n=7) | 1 clerical staff was hired in a GP practice to enter orders (n=7) | NA | Personal–professional balance, physician satisfaction defined as QoL | Burnout (MBI), physician productivity, EMR documentation. Quality interviews | QoL: 14% bad, 14% neutral, 71% good. Balance: 14% dissatisfied, 43% neutral, 43% good. | Time at 4 months. QoL: 0% bad, 0% neutral, 100% good. Balance: 0% dissatisfied, 29% neutral, 71% good. | QoL, personal balance, burnout improved. Productivity increased (work relative value unit) per session increased. Reports of feeling more supported, focussed on pt care, less stress, less fatigue. | |
| Dunn et al2 NCBA, 2000–2005 | Primary care in urban USA (n=32, 25 internists, 6 family medicine1 NP) | Organisational intervention programme to improve physician well-being (quality improvement project, participant data-guided intervention) (n=22–32 range over the intervention period) | NA | Physician satisfaction (ACP/ASIM) | Burnout (MBI), Quality Work Competence (QWC) | 2001: 55% of physicians were somewhat or very satisfied with their practice. | Time at 24 months. 2003: 84% were somewhat or very satisfied with their practice. | Time at 24 months. 2005: 74% were somewhat or very satisfied with their practice. | Intervention ongoing from 2000 onward. Emotional and work-related exhaustion decreased significantly over the study period. QWC measures of organisational health significantly improved initially and remained acceptable and stable during the rest of the study. Satisfaction fluctuated throughout. |
| Dyrbye et al46 RCT, 2017–2018 | Physicians in USA (67 generalists, 21 subspecialists) (n=88, 45.5% male) | 6 coaching sessions (3.5 hours) facilitated by a professsional coach over 5 months (n=44) | WLC (n=44) | Resilience (CD-RISC), Global Job Satisfaction-12 (subscale of PJSS), work engagement (UWES), empowerment at work scale | Burnout (MBI). | Means and SD INTERVENTION (n=44), resilience (31.0, 6.3), job satisfaction (43.4, 10.7), UWES vigour (3.9, 1.0), UWES dedication (4.5, 1.1), UWES absorption (4.2, 1.0), empowerment at work (55.5, 11.9). CONTROL (n=44), resilience (30.6, 5.7), job satisfaction (42.8, 10.6), UWES vigour (4.0, 1.2), UWES dedication (4.6, 1.0), UWES absorption (4.1, 1.1), empowerment at work (57.3, 14.0). | Time at 5 months. Means. INTERVENTION (n=44), resilience (32.3), job satisfaction (44.4), UWES vigour (4.1), UWES dedication (4.6), UWES absorption (4.1), empowerment at work (58.2). CONTROL (n=44), resilience (31.2), job satisfaction (43.2), UWES vigour (4.2), UWES dedication (4.7), UWES absorption (4.2), empowerment at work (60.3). | Statistically significant improvement for resilience from pre to post intervention, no change in job satisfaction. Burnout, emotional exhaustion decreased. QoL improved. No statistically significant differences in depersonalisation, engagement or meaning in work. | |
| Fortney et al10NCBA | Family medicine practitioners in the USA (n=30, 87% family medicine physicians) | Shortened MBSR course, 18 hours total, 14 hours weekend, 2×2 hour plus homework (n=30) | NA | Compassion (SCBC), resilience (RS-14) | Burnout (MBI), DepressionandAnxiety (DASS), Perceived Stress scale (PSS) | Mean score and CI. n=30. Resilience RS-14 (79.9, CI: 75.2 to 84.6), compassion SCBC (27.6, CI: 25.9 to 29.3). | Time at 4 weeks. Mean score and CI. n=28. Resilience RS-14 (82, CI: 77.1 to 86.8), Compassion SCBC (27.4, CI: 25.6 to 29.1). | Time at 9 months. Mean score and CI at 9 months. n=23. Resilience RS-14 (81.4, CI: 76.2 to 86.6), compassion SCBC (28.3, CI: 26.5 to 30.1). | No significant improvement in compassion and resilience over time. Participants had improvements compared with baseline at all follow-up time points for burnout, depression, anxiety and perceived stress. |
| Gardiner et al47 CBA | GPs in metropolitan Australia (n=110) | Cognitive behavioural stress management course, 1×3 hours, 15 hours over 5 weeks (n=85) | Control group had other developmental courses (n=25) | Work-related morale measure (WRM-7), quality of work life (QoWL-6) | Work-related distress measure (WRD-7), general psychological distress (GHQ-12), coping styles. | Means and SD total measure without submeasures given. INTERVENTION (n=86), work-related morale total 31.83 (6.75). QoWL total 25.32 (6.64). CONTROL (n=24), Work-related morale total 31.42 (6.19). QoWL total 23.16 (5.86). | Time at 4 weeks. Means and SD INTERVENTION (n=77), Work-related morale total 34.62 (6.11). QoWL total 28.24 (6.35). CONTROL (n=19), Work-related morale total 32.21 (6.73). QoWL total 24.32 (6.36). | Time at 12 weeks. Means and SD INTERVENTION (n=62), work-related morale total 35.70 (6.01). | Overall, the intervention group showed higher scores postintervention than the control group (positive trend). However, no statistically significant change seen for work-related morale or QoWL for the intervention group. Only physiological distress significantly lower for intervention group. When looking at those GPs that scored low for morale, there was a 56% reduction preintervention to postintervention, compared with a 29% reduction in the control group. |
| Krasner et al48 NCBA | Primary care physicians in the USA (n=70, 54% male) | CME programme: didactic material, mindfulness meditation, narrative/appreciative enquiry, discussion. 28 hours total. 8×2.5 hours per week, 1×7 hours, 10-month maintenance phase (2.5 hours/month) (n=70) | NA | Mindfulness (BAER), empathy (JSPE) | Burnout (MBI), mood (POMS), Big 5 personality factors, physician belief (PBS) | Mean and CI. BAER mindfulness total (45.2, 95% CI: 43.3 to 47.1, n=60), BAER mindfulness observe (25.6, 95% CI: 24.4 to 26.8, n=60), BAER mindfulness non-react (19.7, CI: 95% 18.7 to 20.7, n=60). JSPE total (116.2, 95% CI: 114.2 to 118.9, n=60), JSPE compassionate care (48.6, 95% CI: 47.5 to 49.7, n=60), JSPE perspective taking (57.1, 95% CI: 55.6 to 58.6, n=60), JSPE standing in pts shoes (10.8, 95% CI: 10.4 to 11.5, n=60). | Time at 8 weeks. Mean and CI. BAER mindfulness total (52.9, 95% CI: 51 to 54.8, n=59), BAER mindfulness observe (30.6, 95% CI: 29.4 to 31.8, n=59), BAER mindfulness non-react (22.9, 95% CI: 21.8 to 23.9, n=59). JSPE total (120.6, 95% CI: 118.2 to 123.0, n=59), JSPE compassionate care (49.8, 95% CI: 48.7 to 50.9, n=59), JSPE perspective taking (59.1, 95% CI: 57.6 to 60.6, n=59), JSPE standing in pts shoes (11.7, 95% CI: 11.1 to 12.2, n=59). | Time at 12 months. Mean and CI. BAER mindfulness total (55, 95% CI: 53.0 to 56.9, n=56), BAER mindfulness observe (31.1, 95% CI: 29.8 to 32.3, n=56), BAER mindfulness non-react (23.9, 95% CI: 22.9 to 24.9, n=56). JSPE total (121.4, 95% CI: 119.0 to 123.8, n=56), JSPE compassionate care (50.4, 95% CI: 49.3 to 51.5, n=56), JSPE perspective taking (59.7, 95% CI: 58.2 to 61.2, n=56), JSPE standing in pts shoes (11.4, 95% CI: 10.9 to 11.9, n=56). | Baseline scores and follow-up scores at 15 months are not reported for the purpose of this SR. Over time, all measures for mindfulness, burnout, physician belief, mood and personality improved, the largest effect size was observed for mindfulness at 15 months. |
| Linzer et al49 RCT | Primary care clinicians in the USA (n=166,>80% physicians, 47.3 years, 48% male) | Interventions to improve communication; workflow, quality improvement (QI) n=83 | WLC n=83 | Work Control, Satisfaction (survey tools adapted from the Physician Work Life study (PWS) and the MEMO study | Stress, burnout, chaos, intent to leave, varia | Number given in %. INTERVENTION (n=83) high work control (score >2) 96%, high satisfaction (>3) 38.5%. CONTROL (n=83) high work control 13.2%, high satisfaction (>3) 51.8%. | Time at 12–18 months. Number given in %. INTERVENTION (n=67) high work control (score>2) 4.6%, high satisfaction (>3) 40.0%. CONTROL (n=72) high work control 11.4%, high satisfaction (>3) 45.7%. | Satisfaction improved with workflow interventions, targeted QI projects, communication. | |
| Margalit et al50 RCT | GPs in Israel (n=44) | CPD teaching programmes (n=22 for interactive programme) | CPD teaching programme (n=22 didactic method) | Attitude to patient care, self-esteem | Knowledge, intention, attitude, burnout | Mean, SD self-esteem (72.1, 14.5), attitude to patient care (34.5, 12.2) (n=44) | Time at 6 months. Mean, SD self-esteem (76.5, 12.9), attitude to patient care (36.5, 19.9) (n=44) | NA | Significant improvement on self-esteem postintervention. The interactive teaching approach improved self-esteem more than the didactic teaching did. No improvement on attitude to patient care. |
| Montero-Marin et al51 NCBA | GPs in Spain (n=290, 49 years, 22.5% males) | Brief blended web-based mindfulness intervention,1×4 hour face to face, 8 online sessions (2 weekly sessions over 4 weeks) (n=58) | NA | Positive affect (PANAS), awareness (MAAS), resilience (CD-RISC) | Negative affect (PANAS), burnout subtypes (BCSQ) | Mean, SD 1 session/week (n=28): PANAS-pos (32.19, 6.72). MAAS (64, 12.07). CD-RISC (38.96, 8.96). 2 sessions/week (n=30). PANAS-pos (32.03, 6.38). MAAS (61.77, 13.41). CD-RISC (38.80, 8.58). | Time at 4 weeks. Mean, SD 1 session/week (n=28): PANAS-pos (33.44, 5.42). MAAS (66.67, 10.88). CD-RISC (40.19, 5.17). 2 sessions/week (n=30). PANAS-pos (35.00, 4.91). MAAS (66.37, 11.03). CD-RISC (41.28, 4.32). | Benefits in PANAS-pos and MAAS for two or more weekly meditation session. No benefits for 1 weekly practice. While face-to-face attendance was good, very high attrition rate for online component. | |
| Pozdnya-kova et al52 NCBA, 2007 | Academic general internal medicine clinic (n=6 faculty, n=325 patients) | Clinic sessions with and without a scribe | NA | Physician workplace satisfaction | Burnout, time spent on EHR documentation, patient satisfaction with doctor–patient relationship, attitudes towards scribes | n=6. Number of responses 'agree' or ’strongly agree'. Satisfied with clinic workflow 2/6 (33%). Calm atmosphere in work area 0/6 (0%). Satisfied with quality of patient interactions 5/6 (83%). Satisfied with quality of communication with patient 4/6 (67%). | Time at 3 months. n=6. Number of responses 'agree' or ’strongly agree'. Satisfied with clinic workflow 6/6 (100%). Calm atmosphere in work area 2/6 (33%). Satisfied with quality of patient interactions 6/6 (100%). Satisfied with quality of communication with patient 5/6 (83%). | Of six physicians, 100% were satisfied with clinic workflow postpilot (vs 33% prepilot), and 83% were satisfied with EHR use postpilot (vs 17% prepilot). Physician burnout was low at baseline and did not change postpilot. Mean time spent on postclinic EHR documentation decreased from 1.65 to 0.76 hour per clinic session (p=0.02). | |
| Rees et al53 NCBA, mixed methods | Rural medical practitioners in Australia (57% GPs) (n=13 total, n=4 qual. research, n=7 quant. research, 40 years, 76.9% male) | MSCR, Mindful Self-Care and Resiliency programme (7 hour face-to-face session) and 3×1 hour video-conference (follow-up sessions) | NA | Well-being (WHO-5), positive affect (PANAS) | Burnout measure (short version 10-item), psychological strain (GHQ-12) | n=7. Mean. Well-being (61.1). Positive affect not reported. | Time at 4 weeks. n=7. Mean. Well-being (71.4). Positive affect not reported. | For the WHO-5 well-being scale, there was no change pre–post for one doctor, deterioration for two doctors with no reliable change, improvement for four doctors with no reliable change. | |
| Schroeder et al54 RCT, 2014–2015 | Primary care physicians in the USA (n=33, 42.76 years, 27% male) | Mindful Medicine Curriculum=modified version of MBSR, 1×13 hourand2×2 hour (n=16) | WLC (n=17) | Mindful Attention Awareness (MAAS), Resilience (BRS), Compassion (SCBC) | Stress (PPS), burnout (MBI), Meditation Practice (MPQ) | Mean, SD INTERVENTION (n=16) MAAS (3.42, 0.96), BRS (21.62, 4.45), SCBCS (26.31, 4.51). CONTROL (n=17) MAAS (3.32, 0.76), BRS (18.70, 5.13), SCBCS (27.00, 4.97). | Time at 4 weeks. Mean, SD INTERVENTION (n=15) MAAS (3.62, 0.89), BRS (22.33, 4.74), SCBCS (27.66, 3.22). CONTROL (n=14) MAAS (3.08, 0.76), BRS (19.42, 4.21), SCBCS (26.07, 4.73). | Time at 3 months. Mean, SD INTERVENTION (n=13) MAAS (4.04, 1.02), BRS (24.15, 5.47), SCBCS (27.84, 4.09). CONTROL (n=13) MAAS (3.18, 0.58), BRS (18.82, 5.32), SCBCS (25.07, 5.85). | Participants in the MMC group reported significant improvements over time for MAAS (also PSS and MBI), whereas in the control group, there were no improvements. There was no significant improvement for resilience or compassion. |
| Van Wietmar-schen et al55 NCBA, mixed methods, 2015–2016 | Primary care physicians in the Netherlands (n=54, 87% GPs, 40 years, 22% male) | Adapted MBSR programme, weekly group sessions for 8 weeks, 26 hours total | NA | Self-Compassion (SCS), Self-reflection (GRAS) | Cohen Perceived Stress Scale (PSS) | Mean, SD SCS (2.9, 0.7, n=50), GRAS (87.6, 7.7, n=44). | Time at 8 weeks. Mean, SD SCS (3.4, 0.6, n=50), GRAS (90.9, 6.7, n=44). | Time at 6 months. Mean, SD SCS (3.7, 0.7, n=21), GRAS (90.2, 10.9, n=17). | Significant improvement of self-compassion and self-reflection. Six months after PSS and SCS were still improved. PSS significantly reduced. Qual: awareness, acceptance, peacefulness and openness improved through intervention. |
| Verweij et al40 CBA, mixed methods | General practitioner trainers in the Netherlands (n=50, 54.9 years, 66% male) | MBSR training 8×2.5 hours, 1×8 hour retreat (n=30) | WLC (n=20) | Empathy (JSPE-20), Mindfulness (FFMQ-39) | Work engagement, Burnout (UBOS-C) | Mean, SE INTERVENTION (n=43) JSPE (117.4, 1.53), FFMQ total (136.21, 2.23), FFMQ observing (26.36, 0.69), FFMQ describing (28.26, 0.9), FFMQ acting with awareness (27.12, 0.71), FFMQ non-judging (31.16, 0.81), FFMQ non-reacting (23.34, 0.57). CONTROL (n=20) JSPE (116.18, 1.92). FFMQ total (135.48, 2.65), FFMQ observing (25.85, 0.82), FFMQ describing (28.33, 0.9), FFMQ acting with awareness (28, 0.9), FFMQ non-judging (30.49, 0.98), FFMQ non-reacting (23.12, 0.7). | Time at 8 weeks. Mean, SE INTERVENTION (n=43) JSPE (119.35, 1.49), FFMQ total (143.08, 2.19), FFMQ observing (28.4, 0.68), FFMQ describing (29.77, 0.71), FFMQ acting with awareness (28.1, 0.69), FFMQ non-judging (32.36, 0.79), FFMQ non-reacting (24.47, 0.56, 0.57). CONTROL (n=20) JSPE (117.93, 1.98). FFMQ total (135.45, 2.67), FFMQ observing (26.33, 0.83), FFMQ describing (28.2, 0.91), FFMQ acting with awareness (27.41, .91), FFMQ non-judging (30.32, 0.99), FFMQ non-reacting (23.49, 0.7). | Mindfulness skills increased significantly in the MBSR group. Empathy remained the same. The qualitative data indicated that the MBSR course increased their well-being and compassion towards themselves and others, including their patients. | |
| Whalley et al56 Panel survey, 2004, 2005 | GPs in the UK. 2004: n=2105, mean age 46.9 years, 66% male. 2005: n=1349, mean age 48.6 years, 65% male. | New introduction of pay for performance system happened in 2004 (after the 2004 survey) | NA | JSS WCW | Job pressure, job design and time pressures | Mean, SD. 2004: JSS total (4.58, 1.39, n=2081) | Time at 1 year. Mean, SD. 2005: JSS total (5.17, 1.28, n=1345) | Statistically significant improvement in job satisfaction. Job pressure and work hours significantly declined. Most GPs reported that the new contract had increased their income (88%), but decreased their professional autonomy (71%), and increased their administrative (94%) and clinical (86%) workloads. |
ACP, College of Physicians; ASIM, American Society of Internal Medicine; BCSQ, Burnout Clinical Subtype Questionnaire; BPRS, Brief Psychiatric Rating Scale; BRS, Brief Resilience Scale; CBA, controlled before and after trial; CD-RISC, Connor-Savidson Resilience Scale; CME, Continuing Medical Education; CPD, Continuing Professional Development; DASS, Depression and Anxiety Scale; EHR, electronic health record; EMR, Electronic Medical Record; FFMQ, Five Facet Mindfulness Questionnaire; FR-JS, Font Roja Job Satisfaction Questionnaire; GHQ, General Health Questionnaire; GPs, general practitioners; GRAS, Groningen Reflection Ability Scale; IBST, Integrated Brief Systemic Therapy; JS, job satisfaction; JSPE, Jefferson Scale of Physician Empathy; JSS, Job Satisfaction Scale; MAAS, Mindful Attention Awareness Scale; MBI, Maslach Burnout Inventory; MPQ, Meditation Practice Questionnaire; MTP, multimodal training programme; NA, not applicable; NCBA, non-controlled before and after trial; NHS, National Health Service; NP, nurse practitioner; PANAS, Positive And Negative Affect Scale; PBS, Physician Belief Scale; PJSS, Physician Job Satisfaction Scale (3 dimensions JS, career satisfaction, and specialty satisfaction), 12-item global job satisfaction subscale used; POMS, profile of mood states; P4P, pay for performance; PPS, Perceived Stress Scale; pt/pts, patients; QOF, quality and outcomes framework; QoL, quality of life; RCT, randomised controlled trial; SCBCS, Santa Clara Brief Compassion Scale (an abbreviation of the Sprecher and Fehr’s compassionate love scale); SCS, Self Compassion Scale (Neff); SRSI, Smith Relaxation States Inventory; UBOS-C, Utrecht Burnout Scale for Contractual Occupations (this isthe validated Dutch version of the Maslach Burnout Inventory); UWES, Utrecht Work Engagement Score; WCW, Warr Cook Wall; WLC, Wait List Control group.