Mantra meditation for mental health in the general population: a systematic review

Introduction: Meditation has attracted increased attention in the literature as a non-pharmacological strategy to foster positive mental health amongst the general population. This systematic review aims to summarise studies of mantra meditation (which includes Transcendental Meditation, TM®) to understand its potential value in fostering positive mental health and alleviating negative affectivity in non-clinical populations. Methods: Electronic databases were searched for English language, peer-reviewed empirical studies (published between 1970 and 2018) that related to mantra meditation, reported at least one outcome of mental health and utilised healthy, non-clinical populations. Studies were assessed for quality and risk of bias using the Quality Appraisal Tool for Quantitative Studies (QATQS). Data abstraction was facilitated by a tailored data extraction form. Results: A total of 2171 records were identified, of which 37 were included in this review. Studies report on outcomes of anxiety, stress, depression, burnout, anger and psychological distress. 78% of studies utilised the TM programme. Findings indicate that mantra meditation interventions may have minimal to moderate beneficial effects on mental health in general populations. Over 90% of studies were considered to be of weak quality. Conclusions: There is some evidence that mantra meditation can improve mental health and negative affectivity in non-clinical populations, however poor study quality may hinder the extent to which one can be certain about the accuracy of these findings. Mantra meditation may be considered a useful adjunct to workplace wellbeing initiatives or educational programmes. Further studies of higher quality that incorporate cost-effectiveness analyses are warranted

Mantra meditation programme for emergency department staff: a qualitative study

Objectives Rates of burnout and stress in healthcare practitioners are steadily increasing. Emergency department (ED) staff are particularly susceptible to such poor outcomes. Mantra meditation (MM) may contribute to increased well-being. The primary aim of this study was to obtain indepth qualitative feedback on ED staff’s experience of a MM programme. A secondary objective was to harness staff’s perception of the ED working environment. Design Qualitative study. Participants Doctors, nurses, allied health professionals and administrative staff (n=10, eight women, mean age 35.6 years) working in the ED who attended a MM programme. Methods Semistructured interviews were conducted by a trained independent researcher. Interviews were transcribed and thematically analysed. Results Five main themes and six subthemes were identified: work pressure and perceived stress; perceived benefits of meditation (with subthemes of increased attention/awareness, improved emotion regulation and new coping mechanisms, relaxation and sleep quality); conflicting attitudes to practice; barriers to meditation practice (with subthemes of schedule, length of practice and individual differences); and facilitators to practice. Conclusion ED staff in this study described the demands of their work and voiced a need for a workplace well-being programme. Our findings suggest that MM might represent a viable tool to develop attention and awareness, improve emotion regulation and improve their capacity to cope with stress, which may impact their workplace well-being, wider health service, patient safety and quality of care. Support from the organisation is considered to be integral to embedding of a workplace well-being programme, such as the practice of meditation into their daily lives

Home FIRsT: interdisciplinary geriatric assessment and disposition outcomes in the Emergency Department

Background: Older people in the Emergency Department (ED) are clinically heterogenous and some presentations may be better suited to alternative out-of-hospital pathways. A new interdisciplinary comprehensive geriatric assessment (CGA) team (Home FIRsT) was embedded in our acute hospital's ED in 2017.Aim: To evaluate if routinely collected CGA metrics were associated with ED disposition outcomes.Design: Retrospective observational study.Methods: We included all first patients seen by Home FIRsT between 7th May and 19th October 2018. Collected measures were sociodemographic, baseline frailty (Clinical Frailty Scale), major diagnostic categories, illness acuity (Manchester Triage Score) and cognitive impairment/delirium (4AT). Multivariate binary logistic regression models were computed to predict ED disposition outcomes: hospital admission; discharge to GP and/or community services; discharge to specialist geriatric outpatients; discharge to the Geriatric Day Hospital.Results: In the study period, there were 1,045 Home FIRsT assessments (mean age 80.1 years). For hospital admission, strong independent predictors were acute illness severity (OR 2.01, 95% CI 1.50-2.70, PConclusions: Routinely collected CGA metrics are useful to predict ED disposition. The ability of baseline frailty to predict ED outcomes needs to be considered together with acute illness severity and delirium.</p