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BMC Psychiatry
Published in: BMC Psychiatry 1/2020

01-12-2020 | Burnout Syndrome | Study protocol

Study protocol of a multicenter randomized controlled trial of mindfulness-based intervention versus relaxation to reduce emotional exhaustion in medical students in France: the “Must prevent” study

Authors: Carolina Baeza-Velasco, Catherine Genty, Isabelle Jaussent, Myriam Benramdane, Philippe Courtet, Emilie Olié

Published in: BMC Psychiatry | Issue 1/2020

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Abstract

Background

Medical students are exposed to an emotionally exhausting training/work environment and to stressful academic demands. Consequently, psychopathologies, burnout and suicidal ideation are frequent in this population. These factors can also affect their empathy and quality of care. Therefore, the development and implementation of programs to promote resilience to stress specifically in medical students and the evaluation of their efficiency are a priority. Here, we describe the protocol of the first French study to assess the long-term effectiveness and acceptability of a mindfulness-based intervention (MBI) compared with relaxation training (RT) to reduce emotional exhaustion in medical students.

Methods

This multicenter randomized controlled trial (“Must prevent”) plans to enroll 612 students in the fourth and fifth year of medical studies from nine French universities. After inclusion, they will be assigned randomly to the MBI or RT group. Both interventions are structured around an 8-week program that includes one group class per week and daily at-home exercises. The primary endpoint is the emotional exhaustion score assessed with the Maslach Burnout Inventory at month 12 of the follow-up. Secondary endpoints include anxiety-depressive symptomatology, suicidality, psychoactive substance use, depersonalization, psychological and physical pain, empathy, emotional regulation, self-compassion, mindfulness, quality of life, and program acceptability. Evaluations will be done before and immediately after the 8-week intervention, and at month 6 and 12 of the post-intervention follow-up.

Discussion

If the proposed interventions are well accepted and useful to decrease negative emotions and/or increase wellbeing among medical students, they should be disseminated among this population and even included as part of the training on emotional skills needed for the routine medical practice.

Trial registration

This trial is registered under the number NCT04026594 (July 18, 2019).
Literature
1.
Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81:354–73.CrossRefPubMed
2.
Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50(1):132–49.CrossRefPubMed
3.
Rotenstein L, Ramos M, Torre M, et al. Prevalence of depression, depressive symptoms and suicidal ideation among medical students. A systematic review and meta-analysis. JAMA. 2016;316(21):2214–36.CrossRefPubMedPubMedCentral
4.
5.
Ishak W, Nikravesh R, Lederer S, Perry R, Ogunyemi D, Bernstein C. Burnout in medical students: a systematic review. Clin Teach. 2013;10(4):242–5.CrossRefPubMed
6.
Rabin S, Fieldman D, Kaplan Z. Stress and intervention strategies in mental health professionals. Br J Med Psychol. 1999;72(Pt 2):159–69.CrossRefPubMed
7.
8.
Sinclair S, McClement S, Raffin-Bouchal S, Hack TF, Hagen NA, McConnell S, Chochinov HM. Compassion in health care: an empirical model. J Pain Symptom Manag. 2016;51:193–203.CrossRef
9.
Ogle J, Bushnell JA, Caputi P. Empathy is related to clinical competence in medical care. Med Educ. 2013;47:824–31.CrossRefPubMed
10.
Hojat M, Vergare MJ, Maxwell K, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med. 2009;84:1182–91.CrossRefPubMed
11.
Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte; 1990.
12.
Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and a meta-analysis. J Altern Complement Med. 2009;15(5):593–600.CrossRefPubMed
13.
O'Driscoll M, Byrne S, Mc Gillicuddy A, Lambert S, Sahm LJ. The effects of mindfulness-based interventions for health and social care undergraduate students - a systematic review of the literature. Psychol Health Med. 2017;22:851–65.CrossRefPubMed
14.
McConville J, McAleer R, Hahne A. Mindfulness training for health profession students- the effect of mindfulness training on psychological well-being, learning and clinical performance of health professional students: a systematic review of randomized and non-randomized controlled trials. Explore. 2017;13:26–45.CrossRefPubMed
15.
Galante J, Dufour G, Vainre M, Wagner AP, Stochl J, Benton A, Lathia N, Howarth E, Jones PB. A mindfulness-based intervention to increase resilience to stress in university students (the mindful student study): a pragmatic randomized controlled trial. Lancet Public Health. 2018;3(2):e72–81.CrossRefPubMed
16.
Manzoni GM, Pagnini F, Castelnuovo G, Molinari E. Relation training for anxiety: a ten years systematic review with meta-analysis. BMC Psychiatry. 2008;8:41.CrossRefPubMedPubMedCentral
17.
18.
Yusufov M, Nicoloro-Santa Barbara J, Grey N, Moyer A, Lobel M. Meta-analytic evaluation of stress reduction interventions for undergraduate and graduate students. Int J Stress Manag. 2019;26(2):132–45.CrossRef
19.
Manansingh S, Tatum SL, Morote ES. Effects of relaxation techniques on nursing students’s academic stress and test anxiety. J Nurs Educ. 2019;58(9):534–7.CrossRefPubMed
20.
Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, Bell I, Schwartz G. A randomized controlled trial of mindfulness meditation versus relaxation training; effects on distress, positive states of mind, rumination, and distraction. Ann Behav Med. 2007;33(1):11–21.CrossRefPubMed
21.
Torabizadeh C, Bostani S, Yektatalab S. Comparison between the effects of muscle relaxation and support groups on the anxiety of nursing students: a randomized controlled trial. Complement Ther Clin Pract. 2016;25:106–13.CrossRefPubMed
22.
Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theorical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4:33–47.CrossRefPubMed
23.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.CrossRef
24.
Verweij H, van Ravesteijn H, van Hooff MLM, Lagro-Janssen ALM, Speckens AEM. Mindfulness-based stress reduction for residents: a randomized controlled trial. J Gen Intern Med. 2018;33:429–36.CrossRefPubMed
25.
Maslach C, Jackson SE. The measurement of experienced burnout. J Ocuppational Behav. 1981;2:99–113.CrossRef
26.
Dion G, Tessier R. Validation of the French translation of the Maslach burnout inventory (MBI). Can J Behav Sci. 1994;26:210–27.CrossRef
27.
Lecrubier Y, Sheehan DV, Weiller E, Amorim P, Bonora I, Harnett Sheehan K, Janavs J, Dunbar GC. The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry. 1997;12:224–31.CrossRef
28.
Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382–9.CrossRefPubMed
29.
Peyre F, Martinez R, Calache M, Verdoux H, Bourgeois M. New validation of the Montgomery and Asberg depression scale (MADRS) on a sample of 147 hospitalized depressed patients. Ann Med Psychol. 1989;147:762–7.
30.
Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S, Mann JJ. The Columbia–suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168:1266–77.CrossRefPubMedPubMedCentral
31.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRefPubMed
32.
33.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:386–96.CrossRef
34.
Bellinghausen L, Collange J, Botella M, Emery JL, Albert E. Validation factorielle de l’échelle française de stress perçu en milieu professionnel. Santé Publique. 2009;4:365–73.CrossRef
35.
Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2004;26(1):41–54.CrossRef
36.
Dan-Glauser ES, Scherer KR. The difficulties in emotion regulation scale (DERS): factor structure and consistency of a French translation. Swiss J Psychol. 2013;72:5–11.CrossRef
37.
Fagerström K. Determinants of tobacco use and renaming the FTND to the Fagerstrom test for cigarette dependence. Nicotine Tob Res. 2012;14(1):75–8.CrossRefPubMed
38.
Etter JF, Duc TV, Perneger TV. Validity of the Fagerström test for nicotine dependence and of the heaviness of smoking index among relatively light smokers. Addiciton. 1999;94:269–81.CrossRef
39.
Saunders JB, Aasland OG, Babor TF, De la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88:791–804.CrossRefPubMed
40.
Gache P, Michaud P, Landry U, Accietto C, Arfaoui S, Wenger O, Daeppen JB. The alcohol use disorders indentification test (AUDIT) as a screening tool for excessive drinking in primary care: realiability and validity of a French version. Alcohol Clin Exp Res. 2005;29:2001–7.CrossRefPubMed
41.
42.
Centre de toxicomanie et de santé mentale. Questionnaire sur la consommation de drogues (DAST-20). Toronto: Centre de toxicomanie et de santé mentale; 2011.
43.
Legleye S, Karila L, Beck F, Reynaud M. Validation of the CAST, a general population Cannabis abuse screening test. J Subst Use. 2007;12:233–42.CrossRef
44.
Hojat M, Mangione S, Nasca T, Cohen M, Gonnella J, Erdmann J, et al. The Jefferson scale of empathy: development and preliminary psychometric data. Med Educ. 2002;36:522–7.CrossRefPubMed
45.
Zenasni F, Boujut E, Bluffel de Vaure C, Catu-Pinault A, Tavani JL, Rigal L, Jaury P, Sultan S. Development of a French-language version of the Jefferson scale of physician empathy and association with practice characteristics and burnout in a sample of general practitioners. Int J Pers Cent Med. 2012;2:759–66.
46.
Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13:27–45.CrossRefPubMed
47.
Heeren A, Doulliez C, Peschard V, Debrauwere L, Philippot P. Cross-cultutal consistency of the five facet mindfulness questionnaire: adaptation and validation in a French sample. Eur Rev Appl Psychol. 2011;61:147–51.CrossRef
48.
Neff KD. Development and validation of a scale to measure self-compassion. Self Identity. 2003;2:223–50.CrossRef
49.
Kotsou I, Leys C. Self-compassion scale (SCS): psychometric properties of the French translation and its relations with psychological well-being, affect and depression. PLoS One. 2016;11:e0152880.CrossRefPubMedPubMedCentral
50.
The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28:551–8.CrossRef
51.
Baumann C, Erpelding ML, Régat S, Collin JF, Briançon S. The WHOQOL-BREF questionnaire: French adult population norms for the physical health, psychological health and social relationship dimensions. Rev Epidemiol Sante Publique. 2010;58:33–9.CrossRefPubMed
52.
Warnecke E, Quinn S, Ogden K, Towle N, Nelson MR. A randomised controlled trial of the effects of mindfulness practice on medical student stress levels. Med Educ. 2011;45(4):381–8.CrossRefPubMed
53.
Chung AS, Felber R, Han E, Mathew T, Rebillot K, Likourezos A. A targeted mindfulness curriculum for medical students during their emergency medicine clerkship experience. West J Emerg Med. 2018;19(4):762–6.CrossRefPubMedPubMedCentral
54.
Metadata
Title
Study protocol of a multicenter randomized controlled trial of mindfulness-based intervention versus relaxation to reduce emotional exhaustion in medical students in France: the “Must prevent” study
Authors
Carolina Baeza-Velasco
Catherine Genty
Isabelle Jaussent
Myriam Benramdane
Philippe Courtet
Emilie Olié
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02529-9

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