Yoga breathing, meditation-based program improves physician well-being, lowers burnout
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Key takeaways:
- Sudarshan Kriya Yoga is an online program that can be learned in three, 90-minute sessions.
- Physicians in the Sudarshan Kriya Yoga group reported significantly less stress, depression and insomnia.
A Sudarshan Kriya Yoga online program led to significant improvements in wellness and decreased burnout among a cohort of international physicians, according to study results published in JAMA Network Open.
Researchers suggest that Sudarshan Kriya Yoga may be an effective, practical and safe approach to improve physician well-being.
Addressing burnout
“Physician burnout has a profound impact on patient care, with roots that go much deeper than everyday frustrations and point to systemic issues in health care,” Duygu Sag, PhD, immunologist at Izmir Biomedicine and Genome Center at Dokuz Eylul University Health Campus, Izmir, Turkey, told Healio. “Physician burnout costs the U.S. health care system approximately $4.6 billion annually in lost productivity; thus, health care systems worldwide are increasingly recognizing the importance of addressing physician burnout to ensure the sustainability and effectiveness of health care delivery. Preventive measures and interventions to address burnout are urgently needed to decrease costs and further improve health care systems.”
For this reason, Sag and colleagues conducted a randomized clinical trial to assess and compare a Sudarshan Kriya Yoga online program — consisting of gentle yoga stretches, unique rhythmic breathing techniques, meditation exercise and cognitive coping and stressor evaluation strategies — vs. a stress management education online program — consisting of a group discussion format that included video education resources that explained how to reduce psychological distress, including cognitive coping strategies — in reducing psychological distress and improving wellness among 129 physicians (89.2% women; mean age, 46.2 years) in Turkey, Germany and Dubai.
“Consistent with other reports on gender differences on the frequency of wellness practice use, our study had a higher number of female participants, which could be because distress and burnout has been found to be significantly higher in female workers compared with their male counterparts,” the researchers wrote. “This could lead to increased interest in seeking interventions designed to mitigate these symptoms.”
Researchers used a computer algorithm to randomly assign physicians 1:1 to the stress management education group (n = 63) or the Sudarshan Kriya Yoga group (n = 66).
Between Nov. 11, 2021, and March 14, 2022, physicians in both groups participated in 1.5 hours of group video conference call training for 3 consecutive days.
After the 3-day instruction period, participants in the stress management education group reviewed and applied notes from the training, then had a weekly 1-hour group-based online follow-up session. Those in the Sudarshan Kriya Yoga group practiced breathwork and mediation for approximately 30 minutes per day on their own after the 3-day instruction period, and participated in the 1-hour, weekly group-based online follow-up session.
Primary outcomes included measurements of stress, depression and insomnia with primary endpoint at 8 weeks. Secondary outcomes included anxiety, optimism, professional fulfillment, work exhaustion, interpersonal disengagement, overall burnout and self-reported professional errors.
Observed improvements
Results showed that compared with physicians in the stress management education group, those in the Sudarshan Kriya Yoga group reported significantly less stress post-training (difference, −6.8 points; 95% CI, −9.6 to −4.1) and post-intervention (difference, −6 points; 95% CI, −8.8 to −3.3).
Moreover, physicians in the Sudarshan Kriya Yoga group reported significantly less depression post-training (difference, −5.7 points; 95% CI, −8.6 to −2.8) and post-intervention (difference, −5.4 points; 95% CI, −8.3 to −2.5) as well as significant decreases in anxiety post-intervention.
Researchers also observed a significant decrease in insomnia from baseline to postintervention among those assigned Sudarshan Kriya Yoga (difference, −0.3 points; 95% CI, −2.3 to −1.7).
Of note, physicians in the Sudarshan Kriya Yoga group reported significant improvement in professional fulfillment and significant decreases in work exhaustion, interpersonal disengagement and burnout.
“Our data suggest that [Sudarshan Kriya Yoga] is effective in decreasing psychological distress and burnout on multiple parameters and may be a potential tool to mitigate burnout for female physicians,” the researchers wrote.
Researchers observed no effect on self-reported medical errors in either group.
Limitations of the study included the largely female population and the need to increase the percentage of male participants in future studies; the possibility that participants were self-selected among a group more motivated than an average cross-section of physicians and benefited more from the intervention; and researchers did not have the resources to examine objective measures (eg, daily measures of saliva cortisol, inflammatory cytokines, heart rate variability) to determine the association with the findings.
Future research
“Happy medical doctors mean happy patients and a healthy society,” Sag told Healio.
“Future studies are needed to better understand the physiological and psychological mechanisms underlying the effects of our findings.”
For more information:
Duygu Sag, PhD, can be reached at duygu.sag@ibg.edu.tr.
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