A randomized controlled trial of mindfulness-based stress reduction (MBSR) in Chilean health workers

INTERVENTION: Participants in the trial are full‐time health workers employed by the UC Christus Health Network working at the "UC Christus Marcoleta Health Complex" in Santiago, Chile. All health workers will be invited via e‐mail, leaflet, brochure, and oral communication to participate in the study. Those interested will be asked to respond a questionnaire used to determine participant's eligibility based on a predefined set of inclusion/exclusion criteria (details below). Those selected to participate in the trial will be randomly assigned to one of three arms: Arm 1. Mindfulness Based Stress Reduction (MBSR) (Experimental): The group will participate in a MBSR program, as was originally developed by Dr. Kabat‐Zinn at the University of Massachusetts, consisting of eight weekly group sessions of 2.5 hours combining experiential exercises and meditation. The MBSR program will be conducted by a MBSR‐certified psychologist with vast teaching experience. Arm 2. Stress Education and Self‐Management Workshop (active control): The group will participate in an educational stress management intervention consisting in eight weekly group sessions of 2.5 hours about self‐care and stress management techniques for effective work development. Arm 3. Waiting list (passive control): The group will not participate in either the MBSR program or the Stress Education and Self‐Management Workshop during the trial, but will be offered the opportunity to participate in either course once the trial has ended (i.e. 6 months following the intervention). CONDITION: Psychological distress/occupational stress (i.e. quality of life, perceived stress, burnout, depressive symptoms). ; Mental and Behavioural Disorders ; Stress PRIMARY OUTCOME: 1. Psychological distress measured using the 12‐item General Health Questionnaire (GHQ‐12) ; 2. Burnout, as measured by the Maslach Burnout Inventory (MBI) ; 3. Perceived stress, as measured by the Perceives Stress Scale (PSS); 4. Symptoms of distress (SD), interpersonal relations (IR) and social role (SR) performance, as measured by the Outcome Questionnaire (OQ 45) ; 5. Circadian excursions of salivary cortisol concentrations, as measured by LC/MS‐MS. Salivary samples for cortisol measurements will be collected at 3 time points/day (at awakening, 30 min after awakening and at bedtime or around 10 pm) prior to intervention (1 day = 3 measurements/person) and post intervention (1 day = 3 measurements/ person). Saliva samples will be collected using a Salivette Cortisol (Sarsted, Germany) device. ; All primary outcomes except cortisol concentration will be measured at baseline (T0), at week 8 immediately after the intervention (T1) and 6 months after baseline (T2) in all participants.; ; Cortisol concentration will only be measured at T0 and T1 and only in participants receiving MBSR or passive controls; Updated 10/08/2018: Cortisol concentration will only be measured at T0 and T1 SECONDARY OUTCOME: 1. Job satisfaction, as measured by the Job Satisfaction Scale (JSS) ; 2. Number of sick leaves in the previous three months; 3. Mindfulness skills, as measured by the Five Facet Mindfulness Questionnaire (FFMQ); 4. Other quality‐of‐life indicators (e.g. comorbidity, sleep quality); All secondary outcomes will be measured at T0, T1, and T2 in all participants. INCLUSION CRITERIA: 1. Health worker at UC Christus Marcoleta Health Complex 2. Has direct patient contact 3. Gives consent