Occupational Health & Wellbeing for Mindful -myassignmenthelp

Question: Discuss about theOccupational Health Wellbeingfor Mindful Intervention Answer: Importance of practice: Mindful intervention is useful in providing greater attention to healthcare strategies and increasing awareness of the ongoing healthcare strategies. Mindful intervention has several benefits including improving quality and vibrancy of the current medical practice. Abundant scientific reports are available for the usefulness of mindfulness in improving mental and physical health. Mindfulness interventions are useful in improving cognitive, affective, and interpersonal outcomes. Mindfulness intervention is helpful in reducing pain, stress and anxiety in the patients. It is also helpful in providing wellness and quality-of -life of the patient. Mindfulness interventions incorporate nonjudgmental experience of the current knowledge which provides positive outcome for mental and physical health. Mindfulness intervention based on the theory that most of the people give attention to future and think about the past. Both these aspects give stress to the individual. In such scenario, mindful ness intervention is helpful in reducing pain and anxiety and improving well-being. Mindful intervention has significant application in the occupational therapy like physical rehabilitation from pain. Mindful intervention has critical role in the occupation intervention because there should be integration of mind and body in the occupational therapy. Mindful intervention improves occupational engagement and it is related to the state of timelessness within the ideal expertise or experience of the activity engagement[1]. Mindfulness itself is an occupation and it is useful in improving experiences of the occupational practice. Thinking about the experiences of the illness in pain, would be helpful in understanding importance of mindfulness in pain management. In chronic illness like musculoskeletal pain, there would be loss of control, uncertainty and frequent change in the physical and psychological aspects of the patient. Mindfulness intervention is helpful in stabilizing all these aspects. Chromic pain is always accompanied with negative emotional aspects of the patient and family members. Mindfulness intervention is helpful in stabilizing emotional instability. In patients with chronic pain, there may be sleeplessness, weakness, discomfort, loss of functional abilities and inability to carry out activities of daily living. However, all these disabilities can not be treated by occupational rehabilitation. In such scenario, mindfulness intervention would be helpful for providing holistic care to the patient. Mindfulness can be applicable to different circumstances. Mindfulness intervention is useful in controlling emotions and sensations[2]. Theoretical background: Mindfulness intervention is mainly applied to nonjudgemental current-focused awareness to the complete experience in a stepwise manner. Mindfulness is a self-centred practice, however it exhibits presence in the world. In actual mindfulness practice, focus should be towards breath, body sensations, feelings and thoughts. Along with focusing on awareness of current moment, mindfulness intervention focuses on the attitude for giving attention, patience, sincerity, inquisitiveness and compassion. Discussion and inquiry in the process of mindfulness intervention are helpful in self-discovery and personal growth. Application of mindfulness interventions are gaining importance in the healthcare with the development of newer protocols, applicability of the mindfulness to varied populations and varied symptoms. There is abundant evidence available for the occupational health workers working in the areas of mental and physical health. It is well established that mindfulness is beneficial for the mental health people in improving quality of their life. Mindfulness techniques are directed towards the needs of individual patients. Goals of mindfulness in occupational therapy should be occupational engagement, reduced anxiety and alertness of physical sensations. Mindfulness intervention is similar to the generally accepted awareness-based interventions. Mindfulness intervention helps to tolerate unpleasant symptoms and it would be helpful in the liberation from the painful condition. Basically, mindfulness intervention not only gives training to relieve pain but also incorporates practice to relieve pain. Mindfulness practice gives patient new attitude and perspective to look towards illness and eliminate fear and distress due to illness. Mindfulness intervention deals with the decrease in the physical symptoms of the disease and increase in the broad psychological positive outcomes[3],[4]. Some recommended best practices: Mindfulness-Based Stress Reduction (MSBR) involves the meditation for 2 hours a week for 8 weeks. MSBR proved useful in the improving characteristic based mindfulness of the participants. Activities covered under MSBR include body scans, mindful yoga, mindful meditation and awareness of the stress management and health. MSBR is beneficial in giving attention to different parts of the body and current sensations. MSBR studies established that mindful practices learned by the patients can also be applied in the daily lives. Thus, mindfulness can emerge as a new occupation for the participants. Studies conducted on the occupational therapy for mindfulness varied in terms of duration of treatment and frequency of sessions of treatment[5],[6]. Acceptance and Commitment Therapy (ACT) is another therapy which deals with the psychological interventiosns of clinical behavioural analysis and mindfulness procedures. Main goals of these ACT studies are to improve psychological flexibility and in volvement in therapy by accepting painful condition and other psychological experiences[7]. Empirical research: Different occupational therapies were conducted for targeting musculoskeletal and pain disorders using mindfulness interventions. These studies include chronic pain, work related musculoskeletal injury and knee injury. Out of these studies in three studies, significant reduction in the pain was observed in mindfulness intervention group as compared to the control group[8]. In one study, reduction in pain was observed over time however this reduction in pain was not significant as compared to the control group[9]. In one study, mobile phone application was used for mindful intervention. Though, in this study number of participants were less, it was concluded that mindfulness interventions are useful in reducing pain. Along with the usefulness of these mindfulness interventions in primary outcome like pain reduction, these mindfulness interventions are also useful in the secondary outcomes. These secondary outcomes include, augmented acceptance of pain, ease of functioning with pain an d reduced distress and anxiety due to pain[10]. Study was also conducted on people with work related musculoskeletal disorders. In this study, outcomes were based on the trait-level mindfulness of patients. In this study, improvement in the quality of life of the patients with work related musculoskeletal disorders was observed. This outcome was used in the prediction of time until return to work for all the patients[11]. Combination of the traditional rehabilitation therapy and mindfulness intervention proved helpful in the improving rehabilitation process and augmented engagement in the therapy. Integration of mindfulness intervention and physical rehabilitation are proved clinically useful and well accepted by the patients. Integration of mindfulness and physical rehabilitation are helpful reducing pain and maintaining normal functioning despite pain[12]. Evaluation of practice: Evaluation of the outcome of pain intervention should be done in general and specific way. In general evaluation, temperature and general appearance should be evaluated. For evaluating origin of pain, patients should undergo spinal and neurological examination. If there is no pain of spinal and neurological origin, patient should be assessed for localized or referred pain. In spinal examination, inspection of back and neck should be done for deformity and erythema. Spine and paravertebral muscles should be assessed by palpation for tenderness and muscle spasm. Gross motion of the patient with pain should be evaluated. Acceptance of the pain for performing routine activities should be performed by observing motion in pain and asking questions about acceptance of pain. Shoulder and hip examination should be performed in patients with neck and lower back pain respectively. Neurological examination should be performed for sensation and reflexes. In mindfulness intervention of musculoskel etal pain, outcome should be evaluated in both physical and psychological aspects. Psychological aspects include assessment of pain unpleasantness score, acceptance of pain, psychological flexibility, self-compassion and mental score for stress reduction. Pain unpleasantness scores should be assessed to understand the difference between control group and mindful intervention. Laboratory tests and neuroimaging studies also should be evaluated in mindfulness intervention of musculoskeletal pain. Analogue scale (VAS) and numeric rating scale (NRS) should be used for assessing pain in patients with musculoskeletal pain[13]. Description of practice: Mindfulness programme like MSBR should be applied one session per for 8 weeks. In addition to this, there should be daily 30 45-minute practice according to the instructions at home. This programme incorporates, explanation of techniques, practicing of techniques and session for feedback and experience sharing. There should not be any mindfulness intervention in control group. However, control group should receive routine occupational intervention for musculoskeletal pain. This 8 week programme should be scheduled in systematic manner. In first week, there should be introductory session, conceptual framework, rational behind intervention in pain management, fundamentals of mindfulness intervention and explanation of schedule for forthcoming weeks. In second week, there should be explanation of breathing in mindfulness in pain reduction. There should be explanation of two breathing techniques. One should be breathing by formal sitting and another should be anytime and anywhere. Provi sion also should be made in the form Mp3 cd for performing breathing at home. At home, breathing should be performed for 10- 15 minutes daily. In third week, there should be explanation of effectiveness of sitting meditation on pain management. Explanation of practice and procedure for sitting meditation. There should be provision of Mp3 cd for practicing sitting meditation at home. Sitting meditation should be performed at home for 15 20 minutes. In fourth week, there should be explanation of the body scan technique, its usefulness and rational in pain management. Mp3 cd should be provided for body scan practice at home for 20 25 minutes daily. In week 5, there should be advanced body scan technique. In week 6, there should be walking meditation for management of pain. In week 7, there should be elucidation of mindfulness intervention in reduction of pain. There should be instruction about mindful living and exercise. In week 8, there should be summary of all the sessions, feedba ck from the participants and evaluation[14],[15]. Future questions: More validation should be done for the application of mindfulness in the physical disorders like pain management. More focus should be on the evidence based occupational therapies. There is availability of established mindfulness protocols. These protocols should be integrated with occupational rehabilitation for pain management. High quality research should be carried out to address limitations of the current studies. Most of the studies of mindfulness in physical rehabilitation like pain management should be carried out in large number of participants. Most of the existing studies are carried out on the limited number of patients. Hence, most of the results are positive for the mindfulness intervention in physical rehabilitation. Randomised trials incorporating large number of population would be helpful in identifying drawbacks of the mindfulness intervention. It would be helpful in the getting substantial data out of the study. Same protocol for the mindfulness intervention shoul d be applied in different geographic regions, and in different socio-economic classes to get validity of the protocol. Physical diagnosis should also be incorporated in the interventions and it should be carried out in the randomized trials. Training should be provided to the occupation therapist for the carrying out mindful interventions. Mindfulness interventions should be incorporated in the professional curricula of occupational therapist. Continuing education programme and other professional training should be provided to occupational therapist. There should be more development and validation of the clinical practices for integration of mindfulness intervention in occupational therapy. Cost effective methods should be developed for the integration of mindfulness in occupational therapy[16]. Bibliography: Brown, K. W., Creswell, D., and Ryan, R. M (2015). Handbook of Mindfulness: Theory, Research, and Practice. Guilford Publications. Block-Lerner, J., and LeeAnn, C. (2016). The Mindfulness-Informed Educator: Building Acceptance and Psychological Flexibility in Higher Education. Routledge. Cook-Cottone, C. P. (2017). Mindfulness and Yoga in Schools: A Guide for Teachers and Practitioners. Springer Publishing Company. Early, M. B. (2013). Physical Dysfunction Practice Skills for the Occupational Therapy Assistant. Elsevier Health Sciences. Evetts, C. L., and Peloquin, S. M. (2017). Mindful Crafts as Therapy: Engaging More Than Hands. F.A. Davis. Goodacre, L., and McArthur, M. (2013). Rheumatology Practice in Occupational Therapy: Promoting Lifestyle Management. John Wiley Sons. McCown, D., Reibel, D. K., and Micozzi, M. S. (2010). Teaching Mindfulness: A Practical Guide for Clinicians and Educators. Springer Science Business Media.