Compassion and palliative care

Compassionate, loving kindness and mindfulness interventions in a palliative care setting.

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Authors: Claudia Orellana-Rios, Lukas Radbruch, Martina Kern, Yesche Regel, Andreas Anton, Shane Sinclair and Stefan Schmidt

Year: 2017

Title: Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program

Summary: Notwithstanding the extensive body of work exploring meditation and mindfulness, there is a shortage of studies that address the potential of compassion based interventions in the workplace. A national survey of palliative care practitioners had established that for 42% of respondents, frequent patient deaths was a challenging aspect of their work. Although many people report beneficial effects from delivering compassionate care, extensive exposure to suffering can be a problem for workers. This investigation recruited participants from a palliative care centre in Bonn, Germany.  Ten weeks of training in meditation combining a number of elements including, mindfulness, loving kindness and tong-len was provided. A range of mixed measures was used to establish the benefits of the practice including, a battery of self-reporting questionnaires, semi-structured interviews and a physiological measure. In conclusion, no evidence that participants experienced an increase in compassion was observed. However, improvements were reported by participants in areas including self-care and emotional regulation. The was no significant change to the cortisol levels taken as part of the trial.

Given the complex nature of introducing compassion into this particular work environment, the mixed method approach should be commended. Where compassion, loving-kindness and mindfulness are brought together as an ‘omnibus’ approach, a degree of epistemological plurality is likely to be required to gain a full understanding of the results. Reliably evaluating the effects of one approach (such as compassion) in such a trial can be a challenge in itself. However to integrate three approaches (mindfulness, compassion and loving-kindness) into a working environment, then to understand their effect individually and collectively, is making great demands of the self-reporting instruments.

It should be noted that in a recent meta-study investigating the pro-social effects of meditation, the teaching of the meditation practice by a co-author of the research was seen to be an influential factor. The precise nature of the meditation taught in this case is unclear and may, to some extent, be related to the individual approach of the teacher. The assumption that different kinds of meditation, such as compassion (tong-len), all fit within an easily replicated framework is perhaps the result of the theoretical uncertainty withing psychology towards contemplative science. There is still a shortage of data exploring how interrelated constructs such as loving-kindness and compassion might influence behaviour in the workplace. In this regard, the study provides useful information that may help the understanding of these constructs in particular working environments.

Link: https://bmcpalliatcare.biomedcentral.com

Compassion, meditation and depression

Can cognitive based compassion therapy (CBCT) help with depression?

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Authors: Jennifer S. Mascaro,  Sean Kelley, Alana Darcher, Lobsang Tenzin Negi, Carol Worthman, Andrew Miller, Charles Raison

Year: 2018

Title: Meditation buffers medical student compassion from the deleterious effects of depression

Summary: The body of evidence demonstrating that compassion training offers significant benefit to its practitioners (and the wider community) is growing.  This particular study investigated cognitive-based compassion training’s (CBCT) relationship to the wellbeing of medical students in their second year of training. Compassion is a particularly important issue for people working in clinical settings. Because of the nature of their activity, a degree of compassion is desirable if not essential. However, there is concern over issues connected to ‘compassion fatigue and ‘burn out’. A total of 59 students engaged in the research, those participants that received CBCT reported increased compassion and decreased loneliness and depression.

Perspective: Contemplative science, health psychology

Link:  http://www.tandfonline.com/doi/abs/10.1080/17439760.2016.1233348