Proposing A Workplace Meditation Model Based On Evidence-Based Programs: An Integrative Review

Abstract

Workplace Meditation (WM) practices, focusing on ameliorating occupational-stress, are becoming increasingly popular in organizations. Nevertheless, scientific research is scarce and effective evidence-based programs (EBP) to replicate are hard to find. In this sense, the purpose of this study was to perform a systematic review on WM EBP and to propose a model for interventions using meditation in the workplace, based on the tested programs found in the databases explored and which have proven their efficacy. A systematic integrative review on WM EBP for occupational-stress was conducted using Ebsco, Scielo and Google Scholar databases. Journal articles and book chapters from all countries, years and languages (those understood by the authors) with WM EBP were included. Articles without EBP, books, thesis, repeated, paid, journalistic articles and conference papers were excluded. After applying specific criteria to the 86 publications retrieved, 9 were included for the review. From the 9 publications, 11 programs were extracted, analysed and included in the review. The programs covered before and after measures (4); randomized controlled trial (6); and mixed methods (1). EBP included meditation in workplace; audio self-guided meditations; vipassana meditation; yoga; mindfulness-based stress reduction program; flow meditation and other mixed techniques. Findings report improvements in sleep quality and duration, self-perception work engagement and resilience, and quality of life, as well as reduction of stress, anxiety, depression, fatigue, and respiration rates. Regardless of the types of programs, Workplace Meditation practices have proven their efficacy in several constructs related with occupational stress. We conclude by presenting an integrated WM model, easy to replicate by organizations focused on intervening in occupational stress.

Keywords: Meditationworkplaceevidence-based programs

Introduction

Professionals’ psychological lack of health has an impact in organizations and high long term costs, estimated recently to incur about €212 million per year in large companies (Mateus, 2018). One of the health risk factors is the workers’ stress levels.

“Work-related stress, depression or anxiety is defined as a harmful reaction people have to undue pressures and demands placed on them at work” (Health and Safety Executive, 2017, p. 3). Stress is a state “which is accompanied by physical, psychological or social complaints or dysfunctions and which results from individuals feeling unable to bridge a gap with the requirements or expectations placed on them” (Eurofound, 2010, p. 5). According to the Work Stress Report by the European Foundation for the Improvement of Living and Working Conditions (Eurofound, 2010), 22% of European workers reported suffering from stress, lower back ache, muscular pain and fatigue and about a quarter are exposed to job strain. On top of that, Eurofound states that work-related stress has been associated with a number of other ill-health outcomes, such as cardiovascular disease, musculoskeletal disorders, particularly back problems and neck-shoulder-arm-wrist-hand problems, repetitive strain injuries as well as absenteeism and presenteeism (the practice of attending work even when employees feel too ill to be able to work effectively). According to the National Epidemiological Study for Mental Health (Nova Medical School, 2013), a study done by the World Mental Health Surveys Initiative, in Portugal, in particular, it is estimated that in average 2 out of 10 workers have psychological issues and skip work. Furthermore, the same study shows that Portugal has the second highest prevalence on psychiatric disorders at the European level, with anxiety disorders present in 16.5% of the population.

Although legislation and classical stress programs and directives have their role, as Eurofound (2010) states, new approaches are needed.

The American Psychological Association (APA) presents coping strategies to overcome this stress at work: (i) track your stressors; (ii) develop healthy responses; (iii) establish boundaries; (iv) take time to recharge, (v) learn how to relax, (vi) talk to your supervisor (vii) get support (American Psychological Association, n.d.) . In the context of ‘Learn to relax’, APA defends “ techniques such as meditation, deep breathing exercises and mindfulness (a state in which you actively observe present experiences and thoughts without judging them) can help melt away stress”. (American Psychological Association, n.d., para.11)

When approaching workplace-meditation programs, there a number of schools, styles and approaches, several mindfulness techniques, including both formal and informal practices with Mind/Body focus and/or integration. Although, the concept of mindfulness has its origins in ancient Eastern spiritual traditions, meditation and yogic practices have only recently been adopted in several scientific interventions. Mindfulness entails paying attention to the present moment with awareness and without judgment (Kabat-Zinn, 2003).

One of the first and rigorously studied group applications of mindfulness is Kabat-Zinn’s Mindfulness-Based Stress Reduction (MBSR), in which MBSR groups meet for 8 weekly 1.5 to 2.5 hour sessions and members were encouraged to practice MBSR outside of group for 45 minutes 6 days per week (Newsome, Waldo, & Gruszka, 2012). MBSR for health care professionals showed that levels of stress decreased while quality of life and levels of self-compassion increased among the participants (Shapiro, Astin, Bishop, & Cordova, 2005). Over the past decades, studies regarding Mindfulness Based Intervention (MBI) have found impressive reductions in psychological morbidity and pain, mitigation of stress and enhanced emotional well-being (Bishop Scott et al., 2006; Karasek, 1979). In general, “most studies found that MBI was effective for psychological distress, stress and burnout” (Huang, Li, Huang, & Tang, 2015, p. 3).

Problem Statement

Workplace Meditation (WM) practices, focusing on ameliorating occupational-stress, are becoming increasingly popular in organizations worldwide. Nevertheless, scientific research is scarce, effective evidence-based programs to replicate are hard to find, and a complete, eclectically, low-cost, effective WM model to present to organizations is non-existent.

Research Questions

The research questions (RQs) which oriented this research were:

RQ1: Which publications describes meditation or mindfulness evidence-based programs in the workplace?

RQ2: What benefits or consequences were found in these evidence-based programs?

RQ3: Which of the evidence-based programs might be an integrative and effective meditation approach to propose to organizations?

Purpose of the Study

The purpose of this study is to perform a systematic review on evidence-based programs of Workplace Meditation and to propose a model for interventions using meditation in the workplace, based on the tested programs which have proven their efficacy. This review covered any form of meditation (focusing on the present approaches), disregarding any religious variables.

Research Methods

Following methodological instructions by Callahan (2010) and Torraco (2005), an integrative literature review (ILR) was conducted. An ILR is “a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated”(Torraco, 2005, p. 356).

Procedure

Research was conducted in two stages; the first was on 20 (First Phase) and the second was on 24 May 2017 (Second Phase) using three different databases. Keywords used for the search were “Meditation”, “Mindfulness”, “Workplace” and “Occupational Stress” in the title, abstract and keywords, from all countries and all languages.

AB meditation programs OR AB meditação OR AB mindfulness AND AB (occupational stress OR workplace stress OR job stress) OR AB stress ocupacional OR AB meditacion.

First Phase

On 20 May 2017, researchers searched Ebsco and Scopus database with the keywords above for peer-reviewed journal articles. The search generated 40 peer-review papers, and the team began the analysis. Unfortunately, after applying inclusion and exclusion criteria (described in 5.2 below), no article was found to be suitable.

Second Phase

Due to the results of the first phase, a second phase was put in motion on 24 May 2017, using the same keywords. Using Scielo database and Google Schoolar, the research team no longer configured the search for indexed journals or peer-reviewed papers, in order to widen the search. 17 publications were retrieved from the Scielo database retrieved and 29 from Google Scholar.

Inclusion and exclusion criteria

The inclusion criteria were: (i) all publications, from all countries and all languages and (ii) Evidence-Based Research which showed data on meditation or mindfulness in the workplace to address stress at work.

The following were excluded from the retrieved publications: repeated references, books and thesis, payed articles, journalistic articles, conference papers and articles that did not present evidence-based programs of meditation in the workplace.

Data Analysis

Initially, 86 publications were retrieved from three different databases (Ebsco, Scielo and Google Scholar) but after applying exclusion and inclusion criteria, 9 publications were finally selected to be included in this review.

Findings

As mentioned earlier, 9 publications were included in this review: 6 from Google scholar and 3 from Scielo Database (Table 1 .)

RQ1: Which publications describes meditation or mindfulness evidence-based programs in the workplace

Because an integrative review should synthesize the presentation of the literature (Callahan, 2010) findings are presented in Table 01 . A summary of all publications pertinent to answering RQ 1 is presented. The 9 selected publications describe meditation or mindfulness evidence-based programs in the workplace, from all over the world, using diverse strategies related to meditative practices and research design.

Table 1 -
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RQ2: What benefits or consequences were found in these evidence-based programs?

The benefits or consequences found in these evidence-based programs (presented previously in Table 01 ) were listed, analysed and categorized into 4 types (Table 02 ): (i) mindfulness; (ii) physical (iii) psychological and (iv) work related experience. Mindfulness effects refers to improvements in body sensations. Psychological effects refers to effect on psychological constructs and perception of reality and self. Finally, work related experience included factors that affect work performance.

Table 2 -
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RQ 3: Which of the evidence-based programs might be an integrative and effective meditation approach to propose to organizations?

An ILR should synthesize literature and offer something new, whether reframing an existing idea or constructing a new one, and should critically analyse existing literature (Callahan, 2010). Furthermore, the ILR should provide motivation for others to act on the work presented, whether through research or practice.

Organizations worldwide face diverse challenges: rapid advances in technology, increasing taxes, effects of globalization, all leading to high levels of occupational stress and so, to convince companies to implement meditation-based interventions, researchers and practitioners should provide irrefutable data and convincing arguments. In this regard, the main point of this work is to summarize and present, based on the literature review and, in our professional field experience, an effective, cost-friendly and diverse employee-friendly model, to organizations.

In Table 03 we present our model comprising several phases which we think are fundamental and are a merger of the literature review and good practices.

Table 3 -
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We were able to merge most of WM approaches existent in the literature in the model presented. Furthermore, one of the challenges of MBI at the moment is to extend the positive effect over a longer period (Huang et al., 2015), so we opted to use the online interventions has a way to achieve this goal, since several evidence-based programs found that there were no significant variations between online and in-person meditation settings.

Finally, we summarize several guidelines for good practices when implementing this model (all of which emerged from the review). Several principles must be met in order to implement this model with success: (i) engage workers form the beginning, executing a diagnostic of their physical and psychosocial needs, as effective programs should be tailored to job characteristics; (ii) use only voluntary workers; (iii) execute presential interventions within working and paid hours; (iv) when implementing the presential interventions, ensure that a ‘Please do not disturb room’ sign is outside the room; (v) eliminate all use of words like Buddhism and all spiritual references; (vi) choosing the facilitator is of most importance: the ideal profile comprises a psychologist with Mindfulness techniques experience, a meditation and yoga practitioner, since yoga has proven to be effective both in the publications in this review and others (Araújo, Fernandes, Mendes, Magalhães, & Martins, 2016). This professional should be updated with innovative teaching approaches, as discussed in other papers authored by us (Araújo & Fernandes, 2017) and a technological profile for app using; (vii) when poor mental health or psychopathological issues are detected in a participant, the facilitator should forward him/her to a professional psychologist (not the facilitator him/herself).

6. Conclusion

In this paper we presented an integrative workplace meditation program model with low cost investment, based on evidence-based programs from all over the world.

Limitations of this study include the languages authors were able to analyse. In this review, we only included papers in English, French, Portuguese and Spanish: certainly, there are many others from all Asiatic countries that report mindfulness and mediation programs at work but which could not be reviewed due to the language barrier. Furthermore, unfortunately, many scientific articles related to MBI and workplace stress can be accessed only for a fee, which posed a strong limitation, not only for review, but also for implementation for the simple reason that if people are not able to access these works, how can professionals implement successful interventions to reduce workplace stress worldwide? The whole effort to research and find effective interventions to eliminate workplace stress seems self-defeating if no one can access the work, unless they pay for it.

The ultimate goal for organisations, should be to reduce absence due to sickness related to stress and to increase the general well-being of the workforce, as this will guard against stress in the future and brings attendant benefits such as increased morale, reduced employee turnover and increased productivity (Eurofound, 2010). As also emphasised by Eurofound, maintaining the momentum in implementing stress reduction initiatives can also be problematic, as this requires dedication and continued financial commitment on the part of organisations. We hope our contribution of providing organizations with an effective, evidenced-based, integrative and low-cost model, publishing in an open access journal, will become sought after and implemented in order to overcome this ever-growing problem of occupational stress.

Acknowledgments

We would like to acknowledge the Centre for Studies in Education, Technologies and Health (CI&DETS) at the Polytechnic Institute of Viseu, Portugal for their support in conducting this research.

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18 December 2019

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Araújo, P., Fernandes*, R., Martins, E., & Mendes, F. (2019). Proposing A Workplace Meditation Model Based On Evidence-Based Programs: An Integrative Review. In Z. Bekirogullari, M. Y. Minas, R. X. Thambusamy, & C. Albuquerque (Eds.), Health and Health Psychology - icH&Hpsy 2018, vol 48. European Proceedings of Social and Behavioural Sciences (pp. 45-54). Future Academy. https://doi.org/10.15405/epsbs.2018.11.5