Mindfulness Training Improves Quality of Life and Reduces Depression and Anxiety Symptoms Among Police Officers: Results From the POLICE Study—A Multicenter Randomized Controlled Trial

Background: Police officers'' high-stress levels and its deleterious consequences are raising awareness to an epidemic of mental health problems and quality of life (QoL) impairment. There is a growing evidence that mindfulness-based interventions are efficacious to promote mental health and well-being among high-stress occupations. Methods: The POLICE study is a multicenter randomized controlled trial (RCT) with three assessment points (baseline, post-intervention, and 6-month follow-up) where police officers were randomized to mindfulness-based health promotion (MBHP) (n = 88) or a waiting list (n = 82). This article focuses on QoL, depression and anxiety symptoms, and religiosity outcomes. Mechanisms of change and MBHP feasibility were evaluated. Results: Significant group × time interaction was found for QoL, depression and anxiety symptoms, and non-organizational religiosity. Between-group analysis showed that MBHP group exhibited greater improvements in QoL, and depression and anxiety symptoms at both post-intervention (QoL d = 0.69 to 1.01; depression d = 0.97; anxiety d = 0.73) and 6-month follow-up (QoL d = 0.41 to 0.74; depression d = 0.60; anxiety d = 0.51), in addition to increasing non-organizational religiosity at post-intervention (d = 0.31). Changes on self-compassion mediated the relationship between group and pre-to-post changes for all QoL domains and facets. Group effect on QoL overall health facet at post-intervention was moderated by mindfulness trait and spirituality changes. Conclusion: MBHP is feasible and efficacious to improve QoL, and depression and anxiety symptoms among Brazilian officers. Results were maintained after 6 months. MBHP increased non-organizational religiosity, although the effect was not sustained 6 months later. To our knowledge, this is the first mindfulness-based intervention RCT to empirically demonstrate these effects among police officers. Self-compassion, mindfulness trait, and spirituality mechanisms of change are examined. Clinical Trial Registration: www.ClinicalTrials.gov. identifier: NCT03114605.

Frenetic, under-challenged, and worn-out burnout subtypes among brazilian primary care personnel: Validation of the Brazilian “burnout clinical subtype questionnaire” (BCSQ-36/BCSQ-12)

Primary healthcare personnel show high levels of burnout. A new model of burnout has been developed to distinguish three subtypes: frenetic, under-challenged, and worn-out, which are characterized as overwhelmed, under-stimulated, and disengaged at work, respectively. The aim of this study was to assess the psychometric properties of the long/short Brazilian versions of the “Burnout Clinical Subtypes Questionnaire” (BCSQ-36/BCSQ-12) among Brazilian primary healthcare staff and its possible associations with other psychological health-related outcomes. An online cross-sectional study conducted among 407 Brazilian primary healthcare personnel was developed. Participants answered a Brazil-specific survey including the BCSQ-36/BCSQ-12, “Maslach Burnout Inventory-General Survey”, “Utrecht Work Engagement Scale”, “Hospital Anxiety/Depression Scale”, “Positive-Negative Affect Schedule”, and a Visual Analogue Scale of guilt at work. The bifactor was the model with the best fit to the data using the BCSQ-36, which allowed a general factor for each subtype. The three-correlated factors model fit better to the BCSQ-12. Internal consistence was appropriate, and the convergence between the long-short versions was high. The pattern of relationships between the burnout subtypes and the psychological outcomes suggested a progressive deterioration from the frenetic to the under-challenged and worn-out. In sum, the Brazilian BCSQ-36/BCSQ-12 showed appropriate psychometrics to be used in primary healthcare personnel

Educational Exhibit Abstract No. 294. Financial impact of a resident-run vascular and interventional radiology clinic

Resident-run Vascular and Interventional Radiology (VIR) resident clinics represent an emerging trend in the education of VIR trainees. As the concept is not widely adopted, the financial impact of a clinic on an existing training program has not been described. We present data regarding reimbursement over a three-year period at a resident-run VIR clinic at a single institution. We detail reimbursement patterns of the training institution and the private practice group staffing the VIR section.Background The Maine Medical Center Model and referral patterns of a resident-run VIR clinic has been presented previously. We believe the clinical access offered by direct patient care from referral through follow-up provides a means to maintain clinical competence. A clinic fosters the development of patient care skills specific to VIR and provides correlative experience relevant to VIR imaging. The clinic serves to improve access for patients with limited financial resources.Clinical Findings/Procedure DetailsThe first 40 clinic referrals generated 34 consult visits with a total of 56 clinic visits. Consults generated 36 imaging studies and 31 unique procedures. Total professional charges for the VIR physician group were $126,642. Nearly half was categorized as free care ($58,333) under identical criteria for the hospital and radiology group. Of the remaining charges, 23.8% ($16,291, or 12.9$347,264. Of available data, approximately 30.5% was reimbursed. Medicare and Medicaid (Maine Care) accounted for the majority of reimbursement.Conclusion and/or Teaching PointsA resident-run VIR clinic represents an exceptional opportunity for trainees to build the clinical skills necessary for contemporary practice. With the introduction of the dual certificate training pathway, we expect that resident clinics will be explored at more institutions. Patients served within the institutional clinic environment traditionally have limited financial resources, and reimbursement is expected to be minimal. Our reimbursement data serves as a realistic benchmark for programs that wish to develop similar clinics at other training institutions