Evaluation of easy-to-implement anti-stress interventions in a series of N-of-1 trials: study protocol of the anti-stress intervention among physicians study.
Valentin Max Vetter, Tobias Kurth, Stefan Konigorski
Frontiers in Psychiatry 2024 DOI: 10.3389/fpsyt.2024.1420097 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Series of N-of-1 trials Peer reviewed |
|---|---|
| Population | Physicians in residence in Germany |
| Intervention | box breathing |
| Duration | 4 weeks (two two-week cycles of AB or BA) |
| Topics | Breathwork Meditation |
| Keywords | N-of-1 trial Anti-stress intervention Box-breathing Physicians Work-related stress |
| Citations | 4 |
| Registration | NCT05745545 |
| Key findings | The study protocol describes a planned evaluation of the intervention effect of short daily breathwork or mindfulness exercises on perceived stress in physicians in residence. |
Abstract
Adverse effects of chronically high levels of stress on physical and mental health are well established. In physicians, the effects of elevated stress levels exceed the individual level and include treatment errors and reduced quality of patient-doctor relationships. Breathing and mindfulness-based exercises have been shown to reduce stress and could serve as an immediate and easy-to-implement anti-stress intervention among physicians. Due to the heterogeneity of their effect on stress, we aim to evaluate the intervention effect of performing a short daily breathwork-based or mindfulness-based intervention on the everyday level of perceived stress in physicians in residence in Germany in a series of N-of-1 trials. Study participants will choose between two short interventions, box breathing, and one guided more complex mindfulness-based breathing exercise. Each participant subsequently will be randomly allocated to a sequence of 1-week intervention (A) and control (B, everyday life) phases. Each N-of-1 trial consists of two two-week cycles (AB or BA), resulting in a total trial duration of 4 weeks (ABAB or BABA). Perceived levels of stress will be assessed daily via the StudyU App on the participant's smartphone. Additionally, participants will be asked to complete a questionnaire at baseline and three months after completion of the study that contains questions about basic participant characteristics, lifestyle factors, individual living situations, and validated psychological questionnaires. Intervention effects will be estimated by Bayesian multi-level random effects models on the individual and population level. This study contributes to the development of short-term solutions to reduce work-related stress for physicians in residence. This is expected to benefit the individual and increase the quality of overall healthcare due to a reduction in treatment errors and an increase in the quality of doctor-patient relationships. ClinicalTrials.gov, identifier NCT05745545.
Comparable studies
Other non-randomized and open-label trials on breathwork, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Effects of Shambhavi Mahamudra Kriya , a Multicomponent Breath-Based Yogic Practice ( Pranayama ), on Perceived Stress and General Well-Being Adults (mean age 43 years) participating in a 3-day retreat | 2017 | Pre-post intervention study | n = 142 |
| A multiday outdoor festival combining breathwork and cold water immersion is associated with reduced trait anxiety in a naturalistic pre-post study Attendees of the 3-day Festival du Froid (France, 2024) who provided complete paired... | 2026 | Naturalistic uncontrolled pre-post study | n = 19 |
| Effects of Mindfulness and Holotropic Breathwork on the Rehabilitation of Adolescents Who Use Psychoactive Substances: A Pilot Study Female adolescents aged 15–18 admitted to Fundación Grupo de Apoyo for rehabilitation... | 2023 | Pilot study with mixed methods exploratory design | n = 18 |
| EFFECT OF MINDFULNESS MEDITATION & PRANAYAMA ON PATIENTS WITH CHRONIC DEPRESSION Adults aged 18–54 with chronic depression (12 men, 12 women) | 2025 | Structured intervention study (pre-post, no control group) | n = 24 |
| Effects of the Brief Simha Kriya Breathing Practice for Health Care Workers During the COVID-19 Pandemic. Health care workers at a large major cancer center in the southern United States | 2024 | Prospective single-arm trial | n = 100 |
Citations in the library
Cites 7
- Mindfulness Interventions Annual Review of Psychology September 30, 2016
- Brief structured respiration practices enhance mood and reduce physiological arousal Cell Reports Medicine 2023
- The effect of mindfulness‐based interventions on reducing stress in future health professionals: A systematic review and meta‐analysis of randomized controlled trials Applied Psychology: Health and Well-Being August 1, 2023
- Mindfulness enhances cognitive functioning: a meta-analysis of 111 randomized controlled trials. Health Psychology Review June 2024
- Protocol for randomized personalized trial for stress management compared to standard of care. Frontiers in Psychology September 19, 2023
and 2 more in the library