UPMC study probing stress-reduction interventions among high-burden specialties begins enrollment

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New study probes mindfulness and physical interventions for aimed at helping specialists deal with stress

A new study aiming to establish whether a series of mindfulness and physical interventions can help reduce stress and burnout among physicians who treat high-acuity patients has started recruitment at the University of Pittsburgh Medical Center (UPMC) in Pennsylvania.

Led by Rabih Chaer, MD, chief of vascular surgery at UPMC Presbyterian, the research is being conducted with grant funding from the UPMC Physician THRIVE program, and is double-pronged. One cohort of participants will be made up of practitioners from specialties working with high-acuity patients—the likes of vascular surgeons, cardiac surgeons and cardiologists. The other is comprised of providers who care for those who have contracted COVID-19, including nurses.

Chaer has personal experience of the effects of burnout, recently telling Pitt Med, a quarterly publication of the University of Pittsburgh, how running had helped him overcome its ravages and how he had been prompted to look for ways to help colleagues. In a recent interview with Vascular Specialist, he explained that the genesis of the study was rooted in establishing road-tested methods providers could use to alleviate stress. “For physicians who deal with complex patients, with high-acuity patients, there is a stressful component to the job,” he says. “Parts of this are the stress of the complex situations, so more of a mental stress. And other parts are physical stress, either because you are wearing loupes, your neck is bent, you are wearing a lead apron, or because cases can be long.”

The interventions being tested cover emotional, mental and physical stressors. Questionnaires will be disseminated, but the research team will also objectively measure stress by collecting samples of hair to measure cortisol levels. “Hair cortisol level is a marker of chronic stress, meaning we will have to wait about three months or so before we test it in order to see a difference,” explains Chaer.

The first intervention involves mindfulness, with routines centered on providing short breathing and self-awareness exercises that can be carried out between patients or cases. Physical interventions focus on the neck and upper shoulders, and the lower back—the areas typically affected through the use of lead aprons and loupes. They involve short yoga-like exercises put to video that providers can use to incorporate into their schedule. Experts from the fields of psychology, exercise and physical therapy helped develop the interventions.

“The eventual goal is that if this pans out to be useful, and the people who take part are compliant—we will be seeking their feedback to see if they like it—then maybe this can become part of an institutional protocol that can be made available to everyone. We can say, ‘We tested this, it works, you might want to consider it.’ It can potentially be endorsed by the institution as an intervention that can reduce stress and improve wellness.”

Chaer and colleagues expect tangible findings from the study to be available in about six months.

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