title: Building Resiliency in a Palliative Care Team: A Pilot Study.
abstract: BACKGROUND
  Palliative care clinicians (PCCs) are vulnerable to burnout as a result of chronic stress related to working with seriously ill patients. Burnout can lead to absenteeism, ineffective communication, medical errors, and job turnover. Interventions that promote better coping with stress are needed in this population.
  
  
  OBJECTIVE
  This pilot study tested the feasibility of the Relaxation Response Resiliency Program for Palliative Care Clinicians, a program targeted to decrease stress and increase resiliency, in a multidisciplinary cohort of PCCs (N = 16) at a major academic medical center.
  
  
  METHODS
  A physician delivered the intervention over two months in five sessions (12 hours total). Data were collected the week before the program start and two months after completion. The main outcome was feasibility of the program. Changes in perceived stress, positive and negative affect, perspective taking, optimism, satisfaction with life, and self-efficacy were examined using nonparametric statistical tests. Effect size was quantified using Cohen's d.
  
  
  RESULTS
  The intervention was feasible; all participants attended at least four of the five sessions, and there was no attrition. After the intervention, participants showed reductions in perceived stress and improvements in perspective taking.
  
  
  CONCLUSIONS
  Our findings suggest that a novel team-based resiliency intervention based on elicitation of the relaxation response was feasible and may help promote resiliency and protect against the negative consequences of stress for PCCs.
authors.affiliation: Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. Electronic address: dmehta@mgh.harvard.edu.
authors.forename: Darshan H
authors.initials: DH
authors.lastname: Mehta
authors.affiliation: Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Giselle K
authors.initials: GK
authors.lastname: Perez
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Traeger
authors.affiliation: Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.affiliation: Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Roberta E
authors.initials: RE
authors.lastname: Goldman
authors.affiliation: Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Haime
authors.affiliation: Division of Palliative Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Eva H
authors.initials: EH
authors.lastname: Chittenden
authors.affiliation: Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Denninger
authors.affiliation: Division of Palliative Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Jackson
mesh_terms: D000046:Academic Medical Centers / Q000379:methods; D000328:Adult; D001364:Awareness; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods* / Q000523:psychology*; D010348:Patient Care Team; D010865:Pilot Projects; D012064:Relaxation Therapy / Q000379:methods*; D055500:Resilience, Psychological; D013315:Stress, Psychological / Q000517:prevention & control
keywords: Palliative care providers; group intervention; health care provider wellness; mind-body therapies; relaxation response; resiliency; stress