title: Enhancing Clinicians' Well-Being and Patient-Centered Care Through Mindfulness.
abstract: BACKGROUND
  Mindful clinicians are resilient and more likely to provide patient-centered care. We aimed to enhance clinicians' well-being by offering a Mindfulness-Based Stress Reduction (MBSR) course that teaches mindfulness and stress management and then determine whether this impacted their subsequent medical encounters.
  
  
  METHODS
  In a longitudinal cohort study with 27 clinicians, MBSR was taught by a certified instructor. Pre-MBSR and post-MBSR online questionnaires assessed burnout, depression, stress, meaningfulness, and mindfulness. Patients independently rated their clinicians using the Rochester Communication Rating Scale (RCRS) after a clinical encounter before and after their clinician took the MBSR course. Nine medical doctors audiorecorded the consultations before and after MBSR; the tapes were coded and analyzed by an independent team using the Roter interaction analyses system.
  
  
  RESULTS
  Significant reductions in stress and burnout were found, and increases in mindfulness and meaningfulness. The decrease in stress was correlated with less judgmental attitudes and less reactivity-facets of mindfulness. The decrease in emotional exhaustion was correlated with more acting with awareness and less judgmental attitudes-facets of mindfulness. Patients' perceptions of the clinical encounter suggested that patient-centered care improved after MBSR. Decreased depersonalization was significantly associated with the RCRS subscale, "understanding of the patient's experience of illness." At both time points, doctors dominated the exchange and were patient-centered.
  
  
  CONCLUSIONS
  Mindfulness has a direct and positive impact on clinicians' well-being. When clinicians' experienced less depersonalization, their patients reported being better understood.
authors.affiliation: Dr. Dobkin: Associate Professor, Department of Medicine, Programs in Whole Person Care, McGill University, Montreal, Quebec, Canada. Dr. Bernardi: Postdoctoral Fellow, Department of Psychology, McGill University, Montreal, Quebec, Canada. Dr. Bagnis: Professor, Department of Nephrology, Groupe Hospitalier Pitié-Salpêtrière et Chaire de Recherche en Education Thérapeutique du Patient, Université Pierre et Marie Curie, Paris, France.
authors.forename: Patricia Lynn
authors.initials: PL
authors.lastname: Dobkin
authors.forename: Nicolò Francesco
authors.initials: NF
authors.lastname: Bernardi
authors.forename: Corinne Isnard
authors.initials: CI
authors.lastname: Bagnis
mesh_terms: D000223:Adaptation, Psychological; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D064866:Mindfulness; D018802:Patient-Centered Care / Q000379:methods* / Q000592:standards*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires