Rosenzweig, Reibel, Greeson, Brainard, and Hojat (2003) are attentiveto the psychological well-being of medical students because they constantly confrontedwith different types of stressors especially during medical training. Mindfulnesspractice cultivates physiological relaxation by paying full non-judgemental concentrationto the present moment. While mindfulness-based stress reduction (MBSR) is an interventionthat fully utilised formal and informal mindfulness practice. The aim of thisstudy was to examine the effectiveness of MBSR seminar on the psychological well-beingof second-year medical students. Hence, Rosenzweig et al. hypothesised that MBSRwill reduce mood disturbance of medical student compared with participantwithout MBSR.
This was a prospective,nonrandomized, cohort-controlled study. Participants were recruited by the self-selected method. A total of 302 healthy second-year medical students participated in the study (MBSRgroup: 140 participants; Control group: 162 participants).
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For MBSR group, mindfulnessmeditation practices were taught during the seminar and participant are expectedto practice formal daily meditation at home. Besides, participants in the controlgroup participated in a didactic seminar that surveyscomplementary and alternative medicine on personal wellness. Bothseminars lasted for 10 weekly sessions.
Mood oraffectivestate of participants were measured usingProfile of Mood State (POMS) with 6 subscales(Tension-Anxiety, Depression-Dejection, Anger-Hostility, Vigor-Activity,Fatigue-Inertia and Confusion-Bewilderment). The total mood disturbance (TMD) scorewas calculated by totalling the 6 subscalesand weighing Vigor-Activity negatively. For each participant, the POMS wasadministered during pre-seminar and post-seminar. In addition, a courseevaluation survey is given at the end of the MBSR seminar. Two statistical testswere used to analyse the data, multivariateanalysis of variance (MANOVA) for repeated measure design and univariateanalysis of variance (ANOVA) to analyse changes on TMD score and to examine within-group difference in POMS subscale scores.
The result shows that it is statistically significant among between-group(MBSR, control) and the changes in POMSsubscale score or some individual POMS subscale score including the TMD score. ForMBSR group, the Vigor-Activity had increased significantly whereas revealeddecreases in Tension-Anxiety and the TMD score. Nonetheless, the control group showedsignificant inclined in Tension-Anxiety, Fatigue-Inertia and TMD score whileVigor-Activity shows a decline. Next, theeffect size of the difference in POMS subscale score within groups(effect size) is small to moderate. Furthermore, the course evaluation survey showed that participants generally think MBSRis a good intervention and very helpful.
98% ofthe participant would recommend MBSR toothers. Although the effect sizeis small to moderate. However, this study suggested that the participants inthe MBSR group demonstrated not only significant improvement over TMD baselinescore but had notably lower the post-seminar TMD score as compared with control.Even during a period which stress is significant among all medical students. After all, there are several inadequate of the studywhich includes the nonrandomized design of the study resulting in a significant difference in the TMD baseline score between groups.
Next, unlike thecontrol group, the MBSR group have a daily home assignment. Besides, neither ofthe groups can represent the general medical student population. Lastly, it hasbeen shown that the MBSR effect varies over a wide range of parameter so solelyusing POMS to measure the outcome is insufficient. Therefore, future studywithin medical student population should consider a wider range of outcome. Another study byShapiro, Schwartz and Bonner (1998) conducted a randomised, wait-list controltrial of MBSR in a mixed group of premedical and medical student. Althoughthere is no significant difference in pre-intervention score. However, post-interventionof MBSR group reported significantly less depression, less anxiety, greaterempathy and a greater sense ofspirituality than the control.
They also found that participants in MBSR groupdemonstrated a relatively stable anxiety level over time but the anxiety scoreof the control group increasedsignificantly. Therefore, both studies supported that MBSR is effective inreducing mood disturbance of medical student as compared to the control group.In conclusion, participantsfrom MBSR group reported significant improvement in psychological well-beingand reduction of mood disturbance as comparedwith control group.
Therefore, this study concluded that MBSR may be aneffective stress management intervention for a medicalstudent.