Andrea Croom

Background: Mindfulness-based interventions for health care providers have shown benefits for provider wellbeing and for their patients, but established programs are time-intensive. Objective: To establish the feasibility of a brief mindfulness-based curriculum focused on self-care for an interprofessional group of palliative care providers within the regular workday, and to evaluate the effectiveness of the curriculum in improving the levels of burnout, mindfulness, use of mindfulness meditation practices, and stress levels. Design: Pre-, one-week post-, and seven-month post-intervention survey assessment. The intervention was conducted in five monthly one-hour sessions. Setting: Participants were 29 mixed-professional-background usual-attendees of a monthly educational conference in a well-established palliative care group within an academic medical center. Measurements: Paired, confidential assessments using validated scales (the Five Facet Mindfulness Questionnaire, the Maslach Burnout Inventory, the Ten-item Perceived Stress Scale), report of use of informal and formal mindfulness techniques, narrative data, and satisfaction ratings. Results: Participants reported high satisfaction with the series and showed statistically significant improvements in dimensions of mindfulness and mindfulness practices, sustained for seven months. Burnout levels in this group were much lower than reported national rates; no statistically significant change was seen in burnout over the study period. Narrative data demonstrated retention of curricular content. Conclusions: Delivery of a mindfulness-based self-care series to an interprofessional group of palliative care providers within the regular workday was feasible, well received, and associated with increased mindfulness levels, mindfulness practices, and knowledge.

OBJECTIVE: To examine associations of parent-adolescent relationship quality (parental acceptance and parent-adolescent conflict) with adolescent type 1 diabetes management (adherence and metabolic control) and depressive symptoms in Latinos and Caucasians. METHODS: In all, 118 adolescents and their mothers (56 = Latino, 62 = Caucasian) completed survey measures of parental acceptance, diabetes conflict, adolescent adherence, and adolescent depressive symptoms. Glycemic control was obtained from medical records. RESULTS: Across ethnic groups, adolescent-reported mother and father acceptance were associated with better diabetes management, whereas mother-reported conflict was associated with poorer diabetes management and more depressive symptoms. Independent of socioeconomic status, Latinos reported lower parental acceptance and higher diabetes conflict with mothers than Caucasians. Ethnicity moderated some associations between relationship quality and outcomes. Specifically, diabetes conflicts with mothers (mother and adolescent report) and fathers (adolescent report) were associated with poorer mother-reported adherence among Caucasians, but not among Latinos. CONCLUSIONS: Parent-adolescent relationship quality differs and may have different relations with diabetes management across Latinos and Caucasians.