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BACKGROUND: Most research on the impact of mind-body training does not ask about participants\u27 baseline experience, expectations, or preferences for training. To better plan participant-centered mind-body intervention trials for nurses... more
BACKGROUND: Most research on the impact of mind-body training does not ask about participants\u27 baseline experience, expectations, or preferences for training. To better plan participant-centered mind-body intervention trials for nurses to reduce occupational stress, such descriptive information would be valuable. METHODS: We conducted an anonymous email survey between April and June, 2010 of North American nurses interested in mind-body training to reduce stress. The e-survey included: demographic characteristics, health conditions and stress levels; experiences with mind-body practices; expected health benefits; training preferences; and willingness to participate in future randomized controlled trials. RESULTS: Of the 342 respondents, 96% were women and 92% were Caucasian. Most (73%) reported one or more health conditions, notably anxiety (49%); back pain (41%); GI problems such as irritable bowel syndrome (34%); or depression (33%). Their median occupational stress level was 4...
Research Interests: Health Psychology, Nursing, Integrative Medicine, Behavioral Medicine, Social Work and Mental Health, and 7 moreTherapeutic Touch, Transcendental Meditation, Irritable Bowel Syndrome, Comparative Effectiveness Research, Occupational Stress, Alternative and Complementary Medicine, and Psychiatry and Psychology
Research article How do parents of children with juvenile idiopathic arthritis (JIA) perceive their therapies?
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Background. There is increasing interest in brief, online training in mind-body skills to improve resilience in health professionals. Methods. We analyzed data from an online training program in focused attention meditation. Resilience,... more
Background. There is increasing interest in brief, online training in mind-body skills to improve resilience in health professionals. Methods. We analyzed data from an online training program in focused attention meditation. Resilience, relaxation, stress, positive and negative affect, and flourishing were measured before and after training using standardized scales. Results. The 379 participants included nurses (31%), physicians (21%), social workers and psychologists (10%), and others (38%). At baseline, participants reported high levels of stress (mean 16.7 compared with population norms of 12-14). Completing modules was associated with small but significant improvements in relaxation, resilience, stress, positive and negative affect, and flourishing ( P
1988–1993 Assistant Professor Pediatrics, University of Washington 1993–1994 Associate Professor Pediatrics, University of Washington 1993–1998 Adjunct Associate Professor Health Services, University of Washington 1994–1998 Associate... more
1988–1993 Assistant Professor Pediatrics, University of Washington 1993–1994 Associate Professor Pediatrics, University of Washington 1993–1998 Adjunct Associate Professor Health Services, University of Washington 1994–1998 Associate Clinical Professor Pediatrics, University of Washington
Background: Internet education is increasingly provided to health professionals, but little is known about the most effective strategies for delivering the content. The purpose of this study is to compare four strategies for delivering an... more
Background: Internet education is increasingly provided to health professionals, but little is known about the most effective strategies for delivering the content. The purpose of this study is to compare four strategies for delivering an Internet-based (e-) curriculum on clinicians' knowledge (K), confidence (CONF), and communication (COMM) about herbs and other dietary supplements (HDS). Methods: This national randomized 2 × 2 factorial trial included physicians, pharmacists, nurses, nutritionists and trainees in these fields. Participants were randomly assigned to one of four curriculum delivery strategies for 40 brief modules about HDS: a) delivering four (4) modules weekly over ten (10) weeks by email (drip-push); b) modules accessible on web site with 4 reminders weekly for 10 weeks (drip-pull); c) 40 modules delivered within 4 days by email (boluspush); and d) 40 modules available on the Internet with one email informing participants of availability (bolus-pull). Results:...
Research Interests: Communication, Health Care, Medicine, CONTINUING EDUCATION, Curriculum, and 15 moreHerbal Medicine, Humans, Female, Male, Dietary Supplements, Nurses, Health Professionals, Electronic mail, Educational Models, Adult, Curriculum and Pedagogy, Pharmacists, Dietary Supplement, Internet, and Education Continuing
Pediatric mood disorders (unipolar depression and bipolar disorder) are serious, common, persistent and recurrent medical conditions. The US National Institute of Mental Health (NIMH) and World Health Organization (WHO) estimate that in... more
Pediatric mood disorders (unipolar depression and bipolar disorder) are serious, common, persistent and recurrent medical conditions. The US National Institute of Mental Health (NIMH) and World Health Organization (WHO) estimate that in the U.S. depression is the leading cause of disability and worldwide it is the 2nd leading contributor to the global burden of disease for persons 15–44 years old.1
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BACKGROUND Music appears to reduce stress in premature infants, but little is known about the attitudes and expectations about music among clinicians caring for these infants. The study questions were: a) would staff like to have music... more
BACKGROUND Music appears to reduce stress in premature infants, but little is known about the attitudes and expectations about music among clinicians caring for these infants. The study questions were: a) would staff like to have music played in the Neonatal Intensive Care Unit (NICU), b) would they prefer live to recorded music, and c) how would their attitudes be affected by their profession and experience? DESIGN Cross sectional survey of NICU staff in the winter of 2003. METHODS Eligible subjects were 37 physicians and 150 nurses and other clinical staff in the NICU. After pilot testing and revision, the self-administered questionnaires contained 57 Likert type or multiple choice items. They were distributed by e-mail and in staff mailboxes with two reminders. Data were analyzed using simple descriptive statistics, Chi-square, and logistic regression. RESULTS The response rate was 75%. Most were nurses and 27 were MD's. Most (84%) were female and most (70%) reported some pre...
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Background. Online training is feasible, but the impact of brief mindfulness training on health professionals needs to be better understood. Methods. We analyzed data from health professionals and trainees who completed self-reflection... more
Background. Online training is feasible, but the impact of brief mindfulness training on health professionals needs to be better understood. Methods. We analyzed data from health professionals and trainees who completed self-reflection exercises embedded in online mindfulness training between May 2014 and September, 2015; their changes in mindfulness were measured using standardized scales. Results. Participants included nurses (34%), physicians (24%), social workers and psychologists (10%), dietitians (8%), and others (25%); 85% were women, and 20% were trainees. The most popular module was Introduction to Mindfulness (n 1⁄4 161), followed by Mindfulness in Daily Life (n 1⁄4 146), and Mindful Breathing and Walking (n 1⁄4 129); most (68%) participants who took 1 module took all 3 modules. There were no differences in participation in any module by gender, trainee status, or profession. Completing modules was associated with small but significant improvements on the Cognitive and Aff...
Background. There is increasing interest in brief, online training in mind-body skills to improve resilience in health professionals. Methods. We analyzed data from an online training program in focused attention meditation. Resilience,... more
Background. There is increasing interest in brief, online training in mind-body skills to improve resilience in health professionals. Methods. We analyzed data from an online training program in focused attention meditation. Resilience, relaxation, stress, positive and negative affect, and flourishing were measured before and after training using standardized scales. Results. The 379 participants included nurses (31%), physicians (21%), social workers and psychologists (10%), and others (38%). At baseline, participants reported high levels of stress (mean 16.7 compared with population norms of 12-14). Completing modules was associated with small but significant improvements in relaxation, resilience, stress, positive and negative affect, and flourishing (P <. 01 for all) Conclusion. Online focused attention meditation training reaches diverse health professionals and is associated with improvements in relaxation, resilience, stress, affect, and flourishing. Additional research is...
This guide for parents discusses some common problems seen in a pediatrician's office, reviewing alternate methods of treatment that include herbal science, homeopathy, acupuncture, and chiropractic methods. The book begins with an... more
This guide for parents discusses some common problems seen in a pediatrician's office, reviewing alternate methods of treatment that include herbal science, homeopathy, acupuncture, and chiropractic methods. The book begins with an explanation of the various therapies available for the treatment of children. Each subsequent chapter deals with an explanation of a particular ailment followed by medications, herbs, and nutritional supplements (biochemical therapies) used for treatment. This section is followed by a description of lifestyle therapies (nutritional, environmental, and mind-body methods), biomechanical therapies (massage, chiropractic methods, and surgery), and bioenergetic therapies (acupuncture and homeopathy) that can be applied to that illness. The chapters cover acne, allergies, asthma, enuresis, burns, varicella, colds, colic, conjunctivitis, constipation, cough, cradle cap, diaper rash, diarrhea, otitis media, eczema, fever, headache, hyperactivity, jaundice, tinea, sleep problems, sore throats, vomiting and nausea, and warts. The presentation of the various treatments available is done in a balanced manner,
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Healing Touch (HT) is a biofield therapy used to enhance well-being. We conducted a pilot study to assess its effects in pediatric oncology patients. We enrolled patients in the continuation or consolidation phase of therapy. Patients or... more
Healing Touch (HT) is a biofield therapy used to enhance well-being. We conducted a pilot study to assess its effects in pediatric oncology patients. We enrolled patients in the continuation or consolidation phase of therapy. Patients or their parent completed simple visual analogue scales (VASs; 0-10) for relaxation, vitality, overall well-being, stress, anxiety, and depression before and after a 20-minute period of rest and a standardized HT treatment. Patients' heart rates were monitored and later analyzed for heart rate variability (HRV) characteristics. Of the nine patients, all completed VASs and six had usable HRV data. The average age was 9 years. VAS scores for stress decreased significantly more for HT treatment than for rest (HT: 4.4-1.7; rest: 2.3-2.3; p = .03). The HRV characteristic of total power was significantly lower during HT than for rest (HT 599 +/- 221; rest: 857 +/- 155; p = .048), and sympathetic activity was somewhat but not significantly lower (HT: 312 ...
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Background. Patient demand and clinician interest have driven professional training in integrative therapies, but few rigorous evaluations have been published. Methods. This project evaluated the proof of concept of training in... more
Background. Patient demand and clinician interest have driven professional training in integrative therapies, but few rigorous evaluations have been published. Methods. This project evaluated the proof of concept of training in acupressure, guided imagery, massage, and Reiki on clinicians’ sense of self-efficacy in providing nondrug therapies, self-confidence in providing compassionate care, and engagement with work. Results. Three out of 4 topics met minimum enrollment numbers; 22 of 24 participants completed follow-up as well as pretraining surveys. All would recommend the training to others and planned changes in personal and professional care. There were significant improvements in self-efficacy in using nondrug therapies, confidence in providing compassionate care, and unplanned absenteeism ( P < .05 for each). Conclusion. Training in integrative therapies is feasible and associated with significant improvements in clinicians’ sense of self-efficacy, confidence in providing ...
Research Interests: Medicine()
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Mind-body practices that intentionally generate positive emotion could improve health professionals’ well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed... more
Mind-body practices that intentionally generate positive emotion could improve health professionals’ well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: ( a) Gratitude, ( b) Positive Word, and ( c) Loving-kindness/Compassion meditation. Paired t tests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff’s Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in...
Background. Online training is feasible, but the impact of brief mindfulness training on health professionals needs to be better understood. Methods. We analyzed data from health professionals and trainees who completed self-reflection... more
Background. Online training is feasible, but the impact of brief mindfulness training on health professionals needs to be better understood. Methods. We analyzed data from health professionals and trainees who completed self-reflection exercises embedded in online mindfulness training between May 2014 and September, 2015; their changes in mindfulness were measured using standardized scales. Results. Participants included nurses (34%), physicians (24%), social workers and psychologists (10%), dietitians (8%), and others (25%); 85% were women, and 20% were trainees. The most popular module was Introduction to Mindfulness (n = 161), followed by Mindfulness in Daily Life (n = 146), and Mindful Breathing and Walking (n = 129); most (68%) participants who took 1 module took all 3 modules. There were no differences in participation in any module by gender, trainee status, or profession. Completing modules was associated with small but significant improvements on the Cognitive and Affective...
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Background. There is a high rate of burnout among health professionals, driving diverse attempts to promote resilience and well-being to counter this trend. The purpose of this project was to assess the dose-response relationship between... more
Background. There is a high rate of burnout among health professionals, driving diverse attempts to promote resilience and well-being to counter this trend. The purpose of this project was to assess the dose-response relationship between the number of hours of online mind-body skills training for health professionals and relevant outcomes a year later. Methods. Among 1438 registrants for online training (including up to 12 hours of training on mind-body practices) between December 2013 and November 2015, we analyzed responses from the first 10% who responded to an anonymous online survey between December 1, 2015 and February 1, 2016. Questions included the type and frequency of mind-body practice in the past 30 days and whether the online training had any impact on personal life or professional practice. Standardized measures were used to assess stress, mindfulness, confidence in providing compassionate care, and burnout. Results. The 149 respondents represented a variety of ages an...
Research Interests: Medicine()
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This study evaluated the feasibility and impact of brief online guided imagery training (up to 3 hours) for health professionals. Paired t tests were used to measure pre-to-post-training changes in stress (Perceived Stress Scale,),... more
This study evaluated the feasibility and impact of brief online guided imagery training (up to 3 hours) for health professionals. Paired t tests were used to measure pre-to-post-training changes in stress (Perceived Stress Scale,), anxiety (Patient Reported Outcomes Measurement Information System–Anxiety Scale), empathy (Empathic Concern Scale, and Perspective-taking Scale), and self-efficacy (Self-Efficacy in providing Non-Drug Therapies Scale). Online guided imagery training attracted diverse health professionals and trainees (n = 273; 14% trainees; 34% registered nurses, 20% physicians, 14% social workers, 5% registered dititians, and 27% others). Participants reported small but significant pre-to-post-module improvements in stress (17.8 to 13.5), anxiety ( T-scores 56.4 to 54.3), empathy (both empathic concern, 29.8 to 30.7, and perspective taking, 28.0 to 29.4), and self-efficacy in providing nondrug therapies for common symptoms (58.5 to 77.0) ( P < .001 for all). Future st...
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BACKGROUND: We aimed to describe the national epidemiology of burnout in pediatric residents. METHODS: We conducted surveys of residents at 34 programs in 2016, 43 programs in 2017, and 49 programs in 2018. Survey items included the... more
BACKGROUND: We aimed to describe the national epidemiology of burnout in pediatric residents. METHODS: We conducted surveys of residents at 34 programs in 2016, 43 programs in 2017, and 49 programs in 2018. Survey items included the Maslach Burnout Inventory, demographics, program characteristics, personal qualities, experiences, and satisfaction with support, work-life balance, and learning environment. Analyses included cross-sectional comparisons and cross-sectional and longitudinal regression. RESULTS: More than 60% of eligible residents participated; burnout rates were >50% in all years and not consistently associated with any demographic or residency characteristics. Cross-sectional associations were significant between burnout and stress, sleepiness, quality of life, mindfulness, self-compassion, empathy, confidence in providing compassionate care (CCC), being on a high-acuity rotation, recent major medical error, recent time off, satisfaction with support and career choic...
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© 2006 Kemper et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses /by/2.0), which permits unrestricted use,... more
© 2006 Kemper et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses /by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, ...
Research Interests: Complementary and Alternative Medicine, Medicine, Herbal Medicine, Humans, Female, and 15 moreMale, Communication Skill, Complementary, Dietary Supplements, Health Professionals, Cost effectiveness, Middle Aged, Adult, And, Cross Section, Dietary Supplement, Cross Sectional Studies, Logistic Models, Health Personnel, and Health Care Surveys
This paper reports on the differences between attitudes towards technology and student retention in a Web-based healthcare continuing education course that was delivered using both the push and pull technologies. Including nearly 1500... more
This paper reports on the differences between attitudes towards technology and student retention in a Web-based healthcare continuing education course that was delivered using both the push and pull technologies. Including nearly 1500 participants the course lasted for about 4 months and the results indicate that overall retention rate was at 64% with no significant difference between retention based on the mode of delivery. There were differences in attitudes towards computers and self-reported computer proficiency between the completers and non-completers with the completers reporting a lower comfort level with computers as well as lower proficiency.
Herbs and other dietary supplements (H/DS) are frequently used by the public. They have significant health implications, yet little is known about health professionals' knowledge, attitudes, or clinical practices related to H/DS.... more
Herbs and other dietary supplements (H/DS) are frequently used by the public. They have significant health implications, yet little is known about health professionals' knowledge, attitudes, or clinical practices related to H/DS. Cross-sectional survey of clinicians prior to participation in an Internet-based educational program on herbs and dietary supplements. The 537 participants included 111 physicians (MD), 30 advanced practice nurses (RN), 46 pharmacists (PharmD), and 350 dietitians (RD). In addition to demographic information, participants were asked about their knowledge, attitudes, and practices related to H/DS. Most participants were involved in direct patient care (85%), in practice or on faculty (84%), and from outside our local institutions (76%); 66% reported receiving professional education about H/DS in the past year. There were statistically significant differences between professional groups, with RDs scoring better than others, but even their average scores we...
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Research Interests: Program Evaluation, Communication, Distance Education, Curriculum, Herbal Medicine, and 15 moreContinuing Medical Education, Prospective studies, Humans, Computer Assisted Instruction, Female, Male, Behavior change, Dietary Supplements, Middle Aged, Adult, Public health systems and services research, Curriculum and Pedagogy, Clinical Competence, Dietary Supplement, and Internet
Healing Touch (HT) is a biofield therapy used to enhance well-being. We conducted a pilot study to assess its effects in pediatric oncology patients. We enrolled patients in the continuation or consolidation phase of therapy. Patients or... more
Healing Touch (HT) is a biofield therapy used to enhance well-being. We conducted a pilot study to assess its effects in pediatric oncology patients. We enrolled patients in the continuation or consolidation phase of therapy. Patients or their parent completed simple visual analogue scales (VASs; 0-10) for relaxation, vitality, overall well-being, stress, anxiety, and depression before and after a 20-minute period of rest and a standardized HT treatment. Patients' heart rates were monitored and later analyzed for heart rate variability (HRV) characteristics. Of the nine patients, all completed VASs and six had usable HRV data. The average age was 9 years. VAS scores for stress decreased significantly more for HT treatment than for rest (HT: 4.4-1.7; rest: 2.3-2.3; p = .03). The HRV characteristic of total power was significantly lower during HT than for rest (HT 599 +/- 221; rest: 857 +/- 155; p = .048), and sympathetic activity was somewhat but not significantly lower (HT: 312 ...
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Whatever the reason for choosing CAM, the most commonly used therapies are herbs and other dietary supplements. Whether they are purified or raw, synthetic or natural, modern or ancient, herbs and supplements work biochemically—just as... more
Whatever the reason for choosing CAM, the most commonly used therapies are herbs and other dietary supplements. Whether they are purified or raw, synthetic or natural, modern or ancient, herbs and supplements work biochemically—just as standard medications do. ...
e24047 Background: Surveys suggest up to 87% of patients with cancer use complementary and integrative (CIM) therapies such as herbal medicine, acupuncture, massage and mind-body practices. These therapies may assist with symptoms of... more
e24047 Background: Surveys suggest up to 87% of patients with cancer use complementary and integrative (CIM) therapies such as herbal medicine, acupuncture, massage and mind-body practices. These therapies may assist with symptoms of pain, nausea and anxiety. However, several studies have demonstrated that many clinicians do not inquire about CIM use, which may be due to lack of education and/or limited evidence-based data. We sought to explore the perspectives of clinicians at an academic comprehensive cancer center on the use of CIM therapies. Methods: Physicians and advanced practice providers (APPs) who practice medical oncology, hematology, radiation oncology, surgical oncology and neuro-oncology in a Midwest tertiary comprehensive cancer center were asked to participate in a 9-question online survey which inquired about their personal knowledge and recommendation for 21 different CIM therapies (not all are offered at the cancer center). Responses were summarized using descript...
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The authors wish to make the following corrections to their paper [...]
Research Interests: Children()
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Pediatric integrative medicine (PIM) is of significant interest to patients, with 12% of the general pediatric population and up to 80% of children with chronic conditions using PIM approaches. The field of PIM has evolved over the past... more
Pediatric integrative medicine (PIM) is of significant interest to patients, with 12% of the general pediatric population and up to 80% of children with chronic conditions using PIM approaches. The field of PIM has evolved over the past 25 years, approaching child health with a number of guiding principles: preventive, context-centered, relationship-based, personalized, participatory, and ecologically sustainable. This manuscript reviews important time points for the field of PIM and reports on a series of meetings of PIM leaders, aimed at assessing the state of the field and planning for its future. Efforts in the first decade of the 2000s led to increased visibility in academic and professional pediatric organizations and through international listservs, designed to link those interested in and practicing PIM, all of which continue to flourish. The PIM leadership summits in recent years resulted in specific goals to advance PIM further in the following key areas: research, clinica...
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Research Interests: Explore()
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Context: Herbs and other dietary supplements (H/DS) are frequently used by the public. They have significant health implications, yet little is known about health professionals' knowledge, attitudes, or clinical practices related to H/DS.... more
Context: Herbs and other dietary supplements (H/DS) are frequently used by the public. They have significant health implications, yet little is known about health professionals' knowledge, attitudes, or clinical practices related to H/DS. Design: Cross-sectional survey of clinicians prior to participation in an Internet-based educational program on herbs and dietary supplements. Participants: The 537 participants included 111 physicians (MD), 30 advanced practice nurses (RN), 46 pharmacists (PharmD), and 350 dietitians (RD). In addition to demographic information, participants were asked about their knowledge, attitudes, and practices related to H/DS. Results: Most participants were involved in direct patient care (85%), in practice or on faculty (84%), and from outside our local institutions (76%); 66% reported receiving professional education about H/DS in the past year. There were statistically significant differences between professional groups, with RDs scoring better than others, but even their average scores were less than 60% of possible. The average score on knowledge questions was 10/20; the average confidence score was 4 out of 10 possible, and the average communication score was 1.4 out of 4 possible. Most respondents knew the most common clinical uses of echinacea and St. John's wort, and felt confident that they knew more than their colleagues about H/DS. Key deficits were in knowledge about adverse effects, confidence in reporting side effects, routinely communicating with patients about H/DS, and recording H/DS information in the medical record. Conclusions: Despite significant interest and previous training in H/DS, these clinicians had substantial room for improvement in knowledge, attitudes, and clinical practices about H/DS. Educational interventions and institutional policies are needed to improve the quality of patient care regarding H/DS, and such interventions should be rigorously evaluated to ensure that continuous improvements occur.
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Whatever the reason for choosing CAM, the most commonly used therapies are herbs and other dietary supplements. Whether they are purified or raw, synthetic or natural, modern or ancient, herbs and supplements work biochemically—just as... more
Whatever the reason for choosing CAM, the most commonly used therapies are herbs and other dietary supplements. Whether they are purified or raw, synthetic or natural, modern or ancient, herbs and supplements work biochemically—just as standard medications do. ...