Yoga and stress management in professional ethics

Many yoga benefits are physical, ranging from increased strength and flexibility to lower blood pressure. But a regular yoga practice also provides a variety of mental health benefits, such as stress relief and improved well-being, while increasing spirituality at the same time.

Certain poses can be done just about anywhere, and a yoga session can go for hours or minutes depending on your schedule. Enjoy the many benefits of yoga by engaging in this practice in a way that fits your lifestyle best.

Yoga derives its name from the word “yoke,” which means to bring together. And it does just that—bringing together the mind, body, and spirit. Whether you use it for spiritual transformation, stress management, or physical well-being, yoga’s benefits are numerous.

What Is Yoga?

The practice of yoga involves stretching the body and forming different poses while keeping your breath slow and controlled. This helps the body become both relaxed and energized at the same time.

Dating back over 5,000 years, yoga is considered by many to be the oldest defined practice of self-development. The methods of classical yoga include ethical disciplines, physical postures, breathing control, and meditation.

While it was first practiced in India, yoga has now become popular all over the world. Many companies understand the benefits of yoga in the workplace, recognizing that relaxed workers are healthier and more creative. Thus, they are sponsoring yoga fitness programs. 

There are various styles of yoga, some moving through poses more quickly (almost like an aerobic workout) and others that focus on relaxing slowly and deeply into each pose. Some have a more spiritual angle while others are used purely as a form of exercise.

13 Yoga Benefits for the Mind and Body

The benefits of practicing yoga are numerous, promoting health in both the mind and body. Some of the most-recognized yoga benefits include:

Yoga’s benefits are so numerous, it gives a high payoff for the amount of effort involved.

Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares how physical activity can boost your mental strength. Click below to listen now.

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Yoga for Stress Relief

A little yoga in the morning, at night, or even during a lunch break can reduce stress. There are multiple ways that yoga works to lower stress levels. Studies show that yoga targets stress by lifting mood, allowing for increased mindfulness, and increasing self-compassion.

By improving mood, allowing us to focus on the present moment, and encouraging us to give ourselves a break, yoga is an effective stress reliever. Many popular techniques used to reduce stress are derived from yoga, such as:

  • Controlled breathing
  • Meditation
  • Physical movement
  • Mental imagery
  • Stretching

Yoga combines several techniques used for stress reduction, so it provides the combined benefits of breathing exercises, stretching exercises, fitness programs, meditation practice, and guided imagery in one technique.

For those with physical limitations that may prevent a yoga practice, simple breathing exercises, meditation, or guided imagery might be a preferable option and provide similar benefits.

You can also look for chair yoga, yin yoga, and restorative yoga, all of which provide relaxation and movement but are not physically challenging.

How to Start Enjoying the Benefits of Yoga

You’ll see more benefits if you practice yoga regularly, so choose a time each day to get on your mat. For people with certain physical limitations, chair yoga can be a good option. Some people feel self-conscious doing some of the poses. This is normal. Over time, your confidence will increase.

If you want to enjoy yoga benefits on a limited budget, it is possible to learn from a book or video. Another option is to look for a studio that offers donation-based classes. Online yoga classes may also be more financially accessible.

If you can, though, try taking a class in person. Yoga classes can be wonderful for beginners. You are surrounded by people of all levels of expertise and ability, and you will have someone talking you through the process and helping you to learn the correct form.

Aside from taking a class, there are several useful apps that can help you with yoga. Many provide tips to help you learn everything you need to know to make the practice a regular part of your life, enabling you to enjoy yoga’s benefits for years to come. 

A Word From Verywell

The list of yoga benefits is long. One of the most notable is using yoga for stress relief. That said, this practice isn’t for everyone. So, if the physical practice isn’t possible or enjoyable for you, you may want to consider other options for boosting your mental and physical health.

That are many mental health strategies focused on self-improvement and many options for reducing stress. Find what works for your mind and body and do that.

The aim of this study is to analyze and summarize all the current knowledge concerning yoga as an effective technique for the prevention and management of stress and burnout among healthcare workers.

In some cases, yoga programs have been readapted to meet the needs of the work environment as being structured in less time-invasive sessions to be held in the workplace, in association with daily meditation to be carried out individually at home [ 15 ]. The clinical trials have highlighted significant efficacy in stress management, the reduction of burnout and in overall improvement of quality of life (QoL).

This pattern has captured the attention of healthcare managers who are now seeking solutions to these problems [ 9 ]. Burnout and stress impact the physical and mental health of the individual and compromise the quality of care as they generate dissatisfaction, anxiety and an increased risk for patients [ 10 12 ].

Most of the published literature regarding this topic focuses on the nursing category as it represents the most prominent group of healthcare providers and effectively combines the main health problems: Both psychological and physical stress [ 5 7 ]. Other professionals, such as surgeons and dentists have exhibited similar issues: These must be added to the numerous working hours they spend in stationary and incorrect posture from which musculoskeletal conditions such as back pain, neck or shoulder strain, headache and carpal tunnel syndrome derivate [ 8 ].

The term “burnout” is usually referred to helping professions. It indicates a prolonged exposure to physical and psychological stress that results in deterioration of the emotional functioning of the individual and in a difficulty of adaptation to their professional commitments [ 4 ].

The same selection strategy was used for data extraction: two different reviewers collected the data and any disagreement was resolved by a consensus session. The following information were gathered: Author; study design (observational study or clinical trial); year of publication; country; outcomes; quality score. After analyzing the full-text, the main identified target populations were medical specialists, mental healthcare providers, nurses and dentists.

Search results found in both databases (PubMed and Scopus) were uploaded for screening into JabRef 3.8.1. A first selection was performed by filtering duplicates and subsequently, a title and abstract screening was conducted. All potentially relevant articles were then independently reviewed for full text and assessed for eligibility. Studies were included if they addressed the question of yoga used to manage stress and reduce physical pathologies in healthcare professionals. No restriction of year of publication or language was applied during the study selection. Any disagreement between the reviewers was resolved through a consensus session with a third reviewer. Figure 1 shows the flowchart of the selection of articles.

This systematic review was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria [ 16 ]. Two electronic databases were examined: Medline (PubMed) and Scopus. The following search algorithm was applied: “yoga AND stress management AND health professional”. In February 2017, eligible studies were selected through a multi-step approach (title reading, abstract and full-text assessment) by two independent researchers.

Fang and Li’s clinical trial examines a population of 120 nurses randomized into two groups: one group followed a yoga program, while the other group followed no program. A six-month follow-up analysis shows that the yoga group reports reductions in stress levels (χ2 = 16.449;= 0.001) Change using “χ2” [ 6 ]. The study of Alexander et al., conducted on a nurse population involved in an eight-week yoga program, also shows higher levels of self-care compared to a population who did not participate [ 5 ]. Riley’s work, in addition to giving an estimate of how yoga can improve the physical and psychological health status of staff, estimates how yoga programs are more effective than cognitive training programs in determining a better mental well-being and a reduction of stress-related consequences [ 19 ]. Finally, Bond et al. carried out a trial focused on medical students that were involved in an 11-week mind–body course: Statistically significant improvements were recorded in self-regulation values, which rose from 3.49 to 3.58 (= 0.003), and in self-compassion values, which arose from 2.88 to 3.25 (= 0.04). The perceived stress scores decreased from 1.55 to 1.48, and empathy levels increased from 5.64 to 5.80, however these values were not statistically significant (= 0.70 and= 0.30, respectively) [ 1 ].

Moreover, clinical trials are useful in establishing the evidence of a greater effectiveness of this innovative approach and can highlight the potential of such disciplines by comparing them to normal cognitive trainings.

From the scientific literature review it was seen that health professionals are receptive to this matter and perceive demanding workloads, intense care provision, conflicting expectations, patient management and family expectations as stressful factors that inevitably negatively affect their own health [ 3 ]. These elements are especially highlighted by some professional categories such as palliative care clinicians who are exposed to severe stress in their particularly challenging area of work. As an alternative to conventional cognitive training, healthcare workers recognize mind–body skills as important tools that can help them in managing their work activities [ 3 ]. Nurses for example, the largest group of healthcare professionals, are exposed to both physical and psychological stressors. In an anonymous survey conducted by Kemper et al., 50% of respondents were shown to have great expectations in mind–body training aimed at reducing anxiety, gaining serenity and a greater psychic well-being. About 99% of respondents reported having tried a mind–body practice in the 12 months prior to the study and among these 34% declared participation in meditation activities such as yoga, chi or qigong [ 20 ]. Conversely, in the category of dental hygienists references to yoga were more focused on solving problems related to low backpain and neck pain [ 8 ].

It is recognized that the daily practice of simple exercises strengthens the body and helps individuals to manage the burdens of life, work and interpersonal relationships [ 44 ]. Until a couple of decades ago, the term “meditation” was absent from medical textbooks and scientific articles. However, this approach is now becoming widely acknowledged. The examined scientific literature dealt mainly with the possibility of using meditation techniques—yoga in particular—to manage physical and mental stress, and their use has recently been hypothesized as a possible answer to work-related issues of healthcare workers [ 38 ].

The discipline of yoga was originally defined as confined within a predominantly spiritual and meditative field. It evolved over time and assumed a more multifaceted nature of mixed techniques that combine mental with physical well-being [ 38 ]. This integrated approach guarantees holistic benefits for the individual. Firstly, aerobic and anaerobic exercises improve the musculoskeletal structure, the insulin circuit, the hormone system, and the metabolism [ 39 41 ]. Furthermore, the benefits achieved from sports or gymnastic exercise are enhanced by the association with meditation activities and psychoanalytic techniques that help to induce relaxation and self-awareness; this technique helps to improve cognitive flexibility and increase attention, acceptance and control of emotional reactions [ 42 43 ].

Starting from their university training, medical and nursing students are exposed to heavy workloads, excessive stress and a competitive atmosphere [ 35 36 ]. These factors can negatively affect their future professional lives [ 1 2 ]. For this reason, it is necessary to identify an effective approach offering targeted solutions for stress management and contributing to achieving a healthy condition for these professional categories [ 37 ].

Maslach, Professor of psychology at the University of California, Berkeley is considered one of the most important scientists regarding the burnout phenomenon, which he defines as “an emotional depletion syndrome, a depersonalization, and a reduction in personal abilities” that may arise in subjects whose professions “are concerned with the people” [ 34 ].

Due to their exposure to high stress levels, healthcare professionals often experience severe anxiety conditions that may lead to psycho-emotional disruption and ultimately result in burnout [ 30 ]. The psychologist Freudenberger coined the term “burnout” to describe the symptoms of professional exhaustion [ 31 ]. This word indicates the psycho-physical depletion of healthcare providers who gradually lose the ability to adapt to daily stress within the workplace [ 32 ]. The subject presents a combination of anxiety and distress, and consequently becomes unstable and neurotic [ 33 ].

Likewise, nurses are often exposed to physical stress resulting from lifting and moving heavy weights, which can lead to physical injury as backpain or herniated disc and that can interfere with their professional life [ 20 ].

Dental hygienists represent a relevant example of this issue as they often experience neck and back pain, eye problems, muscle tension, headaches or carpal tunnel syndrome. These medical conditions are caused by poor posture, demanding schedules and long working hours, which can have a substantial negative impact on the physical well-being of the person and afflict the quality of professional life and job satisfaction [ 8 ].

Work-related issues can be physical or affect the subject’s emotional network [ 22 ]. In the first situation the musculoskeletal apparatus is put under pressure. In the workplace there are situations that create a bio-mechanical overload, muscle tension and fatigue [ 25 ]. A stationary and inappropriate posture, the effects of repetitive tasks that require an accurate “execution” and that limit normal movement can be the cause of a physical injury [ 26 ]. Consequently, chronic degenerative diseases of the spine, neck and upper limbs affecting doctors, surgeons, dentists and nurses are frequent in the healthcare sector [ 27 29 ].

Operating within a difficult setting, healthcare workers run into many stressful events that can compromise their state of health [ 22 ]. Often, as a consequence of the demand to maximize performance and productivity at work, health professionals’ needs to release emotional and physical tensions are ignored [ 23 ]. This inevitably results in serious issues affecting their health [ 24 ].

The quality assessment of clinical trials presented scores between a minimum of 1/5 and a maximum of 5/5. The average score was 1/5, which indicates an overall low quality of the studies. These data might be related to the difficulty in applying the parameters of this evaluation scale to these type of interventions (for instance, the difficulty of administering a yoga session to a blind population). The quality assessment for observational studies gave a minimum score of 5/9 and a maximum score of 8/9; the recorded average score of 6.5/9 indicates an overall good quality of the included observational studies.

After duplicates were eliminated, 26 potentially relevant studies were identified. Following the screening of titles and abstracts, 15 studies were excluded as they did not meet the inclusion criteria. Ultimately, eleven articles were included in the review. Among these, seven were clinical trials and four were observational studies. Table 1 and Table 2 summarize the characteristics of the included studies. Three articles focused on the nurse population, six articles on medical specialists and two articles on dentists. Ten studies were conducted in the USA and just one was conducted in China.

4. Discussion

Increasing the use of yoga and meditation can provide a valid help to the healthcare workers in achieving a stable psycho-physical well-being that enhances their value within their work environment. This is mainly through simple meditation exercises which do not require a specific environment and can even be performed in any workplace setting [ 45 ]. The yoga program discussed in the study of Klatt et al. emphasizes the advantages of an activity that prove to be feasible and adaptable to the working environment [ 15 ]. Furthermore, the implementation of an individualized approach could guarantee an effective impact on the specific health needs of the employees. Programs such as Mindfulness in Motion (MIM) are delivered within the workplace and structured in short sessions that do not impact professional routine [ 15 ]. Alternatively, these yoga sessions could be organized alongside other activities such as art, music and writing. Along these lines, the Arts-in-Medicine program (AIM) described by Repar and Patton was devised. In addition, in this case, improvements were seen in the perceived levels of stress and overall well-being of individuals [ 7 ].

Within the scope of occupational medicine there are many interventions that can improve the psychological and physical well-being of healthcare workers, such as rescheduling working shifts or frequency and duration of breaks [ 46 ]. Nevertheless, the studies in this systematic review have shown an evident effectiveness of the yoga approach and suggest that a synergistic positive effect could be achieved when combining it with the other above-mentioned interventions [ 47 ].

The weaknesses of this analysis are undeniably related to the low numerical consistency of studies present in the literature and at the same time to the heterogeneity of the interventions that results in a difficulty to make any comparison. The studies included in this review are relatively recent: 2007 is the earliest year of publication and this highlights even more the innovation and the broad potential of this insight.

Alternatively, the strengths of this study are represented by the revolution that this type of approach brings for the management of healthcare workers as the costs for implementing them are low in comparison to the considerable projected costs of financial and welfare benefits. Healthcare administrators, who are called upon to offer efficient solutions to workers’ health issues, must acknowledge the importance of this simple and effective approach.

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