Introduction
This February we´re starting an exciting project in Badalona, Spain, at the primary care health center (CAP apenins-Montigalà). The objective of this project is to assess the reduction of the level of burnout and improve the work engagement of primary care workers with the intervention of individual mindfulness sessions in an immersive virtual reality environment using virtual reality (VR) glasses. A reduction in the level of Burnout and an improvement in the level of work engagement are expected at the end of the meditation sessions. The practice of meditation should give the subjects a sense of well-being and the opportunity to face the demand for care with a new, more positive perspective, gaining a better ability to self-regulate their own emotions. The mental health of our primary care workers is affected due to the workload, the demand for care and the difficult socio-economic situation of the local population. Currently this panorama has worsened with the negative emotional charge resulting from the Sars covid-19 pandemic [1,2]. When these working conditions and the demands of a complex work environment endure over time, they are likely to cause an imbalance between the work demands and the personal resources. This can lead to developing symptoms such as exhaustion, fatigue, job dissatisfaction, chronic stress, etc. That situation causes a poor quality of care provided to the patient, an increase in errors and a negative work environment [2].
The burnout syndrome (BO) among health workers has been well known for years and has only been accentuated recently. It is directly related to another concept called “work engagement” (WE), which would be the level of work commitment of each person. Some recent studies highlight the high BO of Primary Care (PA) workers. In the PA centers of Asturias it has been found that more than one in 2 doctors are burned out [3]. Therapies with guided meditation, especially with the mindfulness technique, have already been validated as a tool to improve mental health and promote the well-being of professionals, mainly in jobs with a high stress load such as primary care [4]. The scientific evidence of the mindfulness meditation technique is reported in various studies and reviews that support that it´s effective in reducing burnout [5]. Mindfulness is a meditation technique that consists of observing the present moment. The goal of mindfulness is to achieve a deep state of consciousness free of judgments about our sensations, feelings or thoughts, paying attention to what happens inside us at all times. With this new personal tool, one will be able to face adverse emotional events with more peace of mind, generating a sense of balance and well-being. Ultimately these personal changes and self-awareness in clinical practice reduce symptoms of stress and burnout and increase well-being and compassion among physicians and patients [6,7].
In recent years we have seen an accelerated advance of technology related to virtual reality. The medical and healthcare field is one of the fastest growing in the use of these new tools. In many organizations it has become a very important resource to address and improve the quality of the work environment [8]. Virtual reality (VR) is a simulated experience that can be similar to or completely different from the real world. The Virtual reality environment provides an immersive experience that allows the user to interact with scenarios and objects that simulate reality, thanks to the use of advanced computer technology. Virtual reality (VR) helps capture participants’ attention and offers users the illusion of “being there” in the 3D computer-generated environment. This immersion in the session transports conscious attention to an environment created to facilitate relaxation, which can be very useful especially for people with difficulty in concentrating attention [9].
Methodology
The intervention consists of individual mindfulness therapy sessions, once a week, for 8 weeks. The sessions are conducted in a virtual 3D environment using the VR glasses, supervised by the researchers. Specific questionnaires will be passed to measure the variables at the beginning and end of the study:
a) Maslach Burnout Inventory (MBI) [10,11].
b) Utrecht Work Engagement Scale (UWES) [12-15].
The sessions will be held in a new space we’re calling our
Immersion room (see photo below), where the participants will
be accompanied and assisted to wear the glasses and access the
simulation. The environment is composed of an immersive virtual
scenario in nature in the format of an island. The participant enters
the built-in environment as a generic avatar (Figure 1). Upon arrival
the users will find two teleportation buttons that will take them to
one of the two predefined stations for the meditation. They can
choose to follow the guided meditation facing the beach with sound
from the waves, or by the river and mountains with a waterfall.
The visual environment and guided meditation will be created by
Dr Ferrer using Blender and Unity software, then uploaded to an
immersive online system. As from the 21st of February 2022 we
have finally started our guided sessions and so far the feedback
from the users is all positive. We´re hopeful that this project will
help our workers to find a healthier way to live the work demands
and stressful situations. I hope by sharing the idea of the project
more people will be interested and encouraged to start innovative
local projects.
References
- Martín Quintero G. Evaluation of emotional processing in health professionals who present burnout syndrome.
- García Iglesias JJ, Gómez Salgado J, Fagundo Rivera J, Romero Martín M, Ortega Moreno M, et al. (2021) Factores Predictores De Los Niveles De Burnout Y Work Engagement En Médicos Y Enfermeras: Una Revisión Sistemática 95: 5.
- Delgado SY, Faza VG, Calvo AS, Gil PS, Gómez LG, et al. (2020) Relationship between emotional intelligence and burnout in Primary Care physicians. Family Medicine. SEMERGEN 46(7): 472-478.
- Francy Cantor Cruz, Jorge McDouall-Lombana, Aldemar Parra, Lucia Martin-Benito, Natalia Paternina Quesada, et al. (2021) Cuidado de la salud mental del personal de salud durante COVID-19: recomendaciones basadas en evidencia y consenso de expertosMental Health Care of Health Workers During Covid-19: Recommendations Based on Evidence and Expert Consensus 50(3): 225-231.
- Salvado M, Marques DL, Pires IM, Silva NM (2021) Mindfulness-Based Interventions to Reduce Burnout in Primary Healthcare Professionals: A Systematic Review and Meta-Analysis. Healthcare (Basel) 9(10): 1342.
- Schroeder DA, Stephens E, Colgan D, Hunsinger M, Rubin D, et al. (2016) A Brief Mindfulness-Based Intervention for Primary Care Physicians: A Pilot Randomized Controlled Trial. Am J Lifestyle Med 12(1): 83-91.
- Del Mar Molero Jurado M, Pérez-Fuentes MDC, Barragán Martín AB, Soriano Sánchez JG, Oropesa Ruiz NF, et al. (2020) Mindfulness in Family Caregivers of Persons with Dementia: Systematic Review and Meta-Analysis. Healthcare 8(3):
- Weitzman RE, Wong K, Worrall DM, Park C, McKee S, et al. (2021) Incorporating Virtual Reality to Improve Otolaryngology Resident Wellness: One Institution's The Laryngoscope 131(9): 1972-1976.
- Navarro-Haro MV, LoÂpez-del-Hoyo Y, Campos D, Linehan MM, Hoffman HG, et (2017) Meditation experts try Virtual Reality Mindfulness: A pilot study evaluation of the feasibility and acceptability of Virtual Reality to facilitate mindfulness practice in people attending a Mindfulness conference. PLoS ONE 12 (11): e0187777.
- Cañadas-de la Fuente GA, San Luis C, Lozano LM, Vargas C, García I, et al. (2014) Evidence of factorial validity of the Maslach Burnout Inventory and study of burnout levels in health professionals. Latin American Journal of Psychology 46(1): 44-52.
- Hernández Vargas CI, Llorens S, Rodríguez-Sánchez A. Burnout in health personnel: validation of the MBI scale in Mexico.
- Seppälä P, Mauno S, Feldt T, Hakanen J, Kinnunen U, et al. (2009) The construct validity of the Utrecht Work Engagement Scale: Multisample and longitudinal evidence. Journal of Happiness studies 10(4): 459.
- Torabinia M, Mahmoudi S, Dolatshahi M, Abyaz MR (2017) Measuring engagement in nurses: the psychometric properties of the Persian version of Utrecht Work Engagement Scale. Medical journal of the Islamic Republic of Iran 31: 15.
- (2011) UWES - UTRECHT WORK ENGAGEMENT SCALE, Escala Utrecht de Engagement en el Trabajo. ©Occupational Health Psychology Unit Utrecht University.
- Schaufeli WB (2011) Work engagement: A key concept of a positive occupational health psychology. 22(3): 187-200.