Heeter, C.; Lehto, R.; McDaniel, P.
Hospice Professionals Use Mind, Body, and Movement Meditation to Reduce Stress. Oncology Nursing News, August 26, 2021.
This article describes research findings from a year-long study of Yoga Mind Tools meditations for hospice professionals. Six meditations (one per week for 6 weeks) were included in the study. Calming, Peaceful Feeling, Place in Nature, Stability, Releasing, and Cleansing Waves.
Hospice professionals could access our meditations though their workplace tablet or smartphone or via the web site. Due to covid, working from home was more common than from the office. 75% did a meditation from home, 29% in their car (not while driving!) between patient visits, and 23% did a meditation at the office.
The frequency of meditation was linked to significant improvements in mind-body integration, evidenced by increased attention regulation and self-regulation.In addition, higher interoceptive awareness was significantly related to lower burnout, particularly lower work exhaustion. Interpersonal disengagement became rare and temporary.
Heeter, C.; Allbritton, M.; Lehto, R.; Miller, P.; McDaniel, P.; Paletta, M. Feasibility, Acceptability, and Outcomes of a Yoga-Based Meditation Intervention for Hospice Professionals to Combat Burnout. International Journal of Environmental Research and Public Health18, 2515.
(1) Background. This research examined the feasibility, acceptability and outcomes of delivering a 6-week yoga-based meditation intervention to clinical teams of hospice professionals (HPs) at a large non-profit hospice organization. The intervention was designed to increase mind-body integration and combat burnout. This article was written for different audiences, including research scientists who study interoception, burnout, meditation, or yoga, designers of meditation interventions, and hospice organizations looking for ways to mitigate HP burnout.
(2) Methods. The intervention was launched within clinical teams, beginning with a half-hour online introduction to the program and exposure to the week 1 meditation at each team’s monthly all-staff meeting. Throughout the program, HPs could access the meditations on their own via their workplace computers, tablets, and smartphones. Online pre- and post-intervention surveys were submitted by 151 HPs, 76 of whom were exposed to the intervention and completed both surveys. The surveys assessed burnout using the Professional Fulfillment Index and mind-body integration using the Multidimensional Assessment of Interoceptive Awareness scales.
(3) Results. Two-thirds of HPs who were present at a staff meeting where the program was introduced went on to do a meditation on their own at least once. Half of HPs expressed a desire to continue with access to the meditations after the 6-week program ended. Due to COVID-19 work from home restrictions, three-fourth of HPs did a meditation at home, 29% in a car between patient visits (not while driving), and 23% at the office. Higher interoceptive awareness was significantly related to lower burnout, particularly lower work exhaustion. Meditation frequency was significantly related to higher interoceptive awareness but not to burnout. Interpersonal disengagement was rare and temporary.
(4) Conclusions. Findings showed that the yoga-based meditation intervention was feasible and acceptable and associated with higher interoceptive awareness. The results point to a role for interoceptive awareness in reducing the risk for burnout.
Heeter, C. & Allbritton, M. (2019). Beyond Scientific Mechanisms: Subjective Perceptions with Viniyoga Meditation. International Journal of Environmental Research and Public Health 2019, 16(12), 2200.
Healthcare professionals and research scientists generally recognize the potential value of mind–body practices grounded in ancient wisdom, but often have limited direct experience with such practices. Meditation participant self-reports provide a window into subjective experiences of three Viniyoga meditations and how and why those meditations could contribute to health and well-being outcomes.
Each of the meditations in this analysis had a unique structure and used a different aspect of the ocean as a meditation object. Yoga philosophy and yoga anatomy models of the human system are used to help explain participants’ experiences and associated personal benefits and insights.
Four aspects of the individual that can influence what happens for them in meditation are illustrated with tangible examples: (1) What is happening in generally in someone’s life; (2) the state of their system (mind, body, breath) around the time of the meditation; (3) reactions to the meditation steps and instructions; and (4) their prior experiences with the object of meditation.
Summaries of the practices, and why and for whom each meditation might be beneficial are discussed. The authors’ perspectives are grounded in Viniyoga and yoga therapy.
Allbritton M. & Heeter C. Meditation as an Intervention for Health: A Framework for Understanding Meditation Research. OBM Integrative and Complementary Medicine 2018;3(4):025.
We propose a framework for understanding meditation that can support greater scientific rigor in reporting meditation research, and selecting meditation health interventions. There is no consistent and thorough framework for describing meditation research interventions. This impedes rigor of meditation research design and interpretation of findings. This also limits meaningful comparisons across research studies.
The audience for this article includes researchers, meditation experts, healthcare professionals, and those with interest in meditation. The framework describes the key components of a meditation intervention. We also discuss how meditation can effect individuals differently, and provide suggestions for describing the qualifications of the expert who designed the meditations in an intervention.
The meditation framework supports (1) comparing different meditation interventions, and (2) understanding how meditation interventions lead to outcomes. We provide examples from a Yoga Therapy perspective of meditation (our domain of expertise), and from published research on meditation to illustrate applications of the meditation framework. The meditation framework provides a way of characterizing meditation interventions by distinguishing seven essential components.
The first four components describe the meditation session (individual, object, experience, and immediate effects). Approach describes the foundation and source of a meditation practice. The outcome component represents both intended goals or reasons for prescribing the meditation intervention and other longer term effects that may occur. The engagement component refers to duration, spacing and frequency of doing the practice and quality of attention.
These seven components can be applied to any type of meditation intervention. We explain the components of the framework and then offer examples. Our goal is to express the importance of having a framework for describing components of meditation across systems of knowledge and methods of application. We hope this article begins a dialogue with experts in other forms of meditation interventions, as they apply, adapt and respond to the proposed framework
Heeter, C., Lehto, R.H. (July 31, 2018). Meditation App Benefits Hospice and Palliative Care. Oncology Nursing News.
This study demonstrated effectiveness of the shorter length, portability, and convenience of a yoga-based movement meditation app and the brief informational and motivational support emails that minimized time demands compared with meditation interventions used in most studies. The meditation program is scalable, optimizing both reach and efficacy and, once normed, can be adapted for other groups. The approach could potentially transform the delivery and effectiveness of meditation training programs for the healthcare industry.
Lehto, R., Heeter, C., Allbritton, M., & Wiseman, M. (2018). Hospice and Palliative Care Provider Experiences With Meditation Using Mobile Applications. Oncology Nursing Forum 45(3):380-388.
Excellence in palliative and end-of-life care for patients with cancer is dependent on resilient and motivated healthcare providers (HCPs). In the face of high patient acuity and demanding assignments, time-effective organizational strategies are needed to strengthen HCP capacity to manage increasingly complex and stressful challenges associated with delivering care.
A focus group study was conducted to evaluate palliative and end-of-life care providers’ experiences following participation in a six-week stress management mobile application (app)– and email-based meditation pilot program that was developed to combat compassion fatigue and improve professional quality of life. The study purpose was to evaluate perceived benefits and challenges, as well as any user recommendations to incorporate before progression to a larger-scale efficacy trial.
Heeter, C., Lehto, R.H., Allbritton, M., Day, T., & Wiseman, M. (2017). Effects of a Technology-Assisted Meditation Program on Healthcare Providers’ Interoceptive Awareness, Compassion Fatigue, and Burnout. Journal of Hospice and Palliative Nursing,August 2017, Volume 19, No 4.
Research suggests that meditation can relieve stress, cultivate self-regulation skills, improve ability to focus, and modify risk for compassion fatigue (CF) and burnout in healthcare providers. However, studied interventions are time-consuming and combining disparate approaches, resulting in unclear mechanisms of effect.
This pilot study examined a novel 6-week technology-assisted meditation program, coherently grounded in the system of yoga therapy that required minimal time. Five 10- to 12-minute meditations were offered via smartphone apps supported by biweekly e-mails. Hospice and palliative professionals at a Midwestern US healthcare network participated in the program (n = 36).
Each meditation integrated attention, synchronized breath, gentle movements and a meditation focus. Weekly e-mails introduced a new meditation and reminded participants how and why to practice.
The participants used the meditations a mean of 17.18(SD, 8.69) times. Paired t tests found significant presurvey to postsurvey improvements for CF/burnout (P=.05) and interoceptive awareness (P=.001).
Participation significantly heightened perceived ability and propensity to direct attention to bodily sensations, increased awareness of physical sensations’ connections to emotions, and increased active body listening. The technology-assisted yoga therapy meditation program successfully motivated providers to meditate. The program required minimal time yet seemed to reduce CF/burnout and improve emotional awareness and self-regulation by heightening attention to present-moment bodily sensations.
Heeter, C., & Allbritton, M. (2015). Being There: Implications of Neuroscience and Meditation for Self-Presence in Virtual Worlds. Journal For Virtual Worlds Research 8(2).
New discoveries in neuroscience show that the human brain and body work together to experience and evaluate emotions and thoughts and to create a felt sense of presence in the material (or virtual) world. The brain engenders (creates) bodily feelings that represent emotions and thoughts. By directing attention to present moment bodily sensations we experience embodied presence. Practicing meditation increases the capacity and propensity to experience embodied presence. Virtual worlds are experienced by the human system that is deeply grounded in bodily sensations. In this essay we explore the implications of neuroscience and meditation for designing and studying self-presence in virtual worlds. We explain how presence is a dynamic, ongoing internal process that is the active result of sustained directed attention.
Heeter, C., & Allbritton, M. (2015). Playing with Presence: How meditation can increase the experience of embodied presence in a virtual world. Foundations of Digital Games, Asilomar, CA.
Feeling deeply connected to yourself and your body creates a richer experience of presence in a virtual world, even when your body is sitting in a chair wearing VR googles. We call this embodied presence. Connection to the self and body (paying attention to present-moment sensations and feelings) enhances the sense of self and the sense of presence, regardless of whether you are in the natural world or a VR world. Our Beach VR Meditation demonstrates how meditation can be designed to increase the experience of embodied presence in a virtual world.