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Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (11): 1233-1239.doi: 10.3736/jcim20121106

• Original Clinical Research • Previous Articles     Next Articles

Qigong therapy for physiotherapists suffering from burnout: a preliminary study

Pedro Saganha João1,Doenitz Christoph1,2,3,Greten Tobias2,3,Efferth Thomas4,J. Greten Henry1,2,3()   

  1. 1. Institute of Biomedical Sciences, University of Porto, 4099-030 Porto, Portugal
    2. German Society of Traditional Chinese Medicine, 69126 Heidelberg, Germany
    3. Heidelberg School of Chinese Medicine, 69126 Heidelberg, Germany
    4. Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, University of Mainz, 55099 Mainz, Germany
  • Received:2012-05-25 Accepted:2012-05-29 Online:2012-11-20 Published:2018-11-15

Objective: The study was carried out in order to evaluate the prevalence of burnout in physiotherapists, and to assess whether “White Ball” Qigong exercises may be effective in burnout. This was aimed to provide preliminary data for the preparation and development of a larger study.

Methods: Physiotherapists completed a demographic questionnaire and the Maslach Burnout Inventory (MBI) questionnaire. For the intervention and the control groups, the authors selected those physiotherapists with the highest levels of burnout on the most important subscale. The intervention group (eight physiotherapists) performed a specific qigong intervention as developed by the Heidelberg School of Chinese Medicine; the control group consisted of eight physiotherapists on a waiting list. At the end of a three-week period of treatment or waiting list, both groups repeated the MBI for the comparison of results.

Results: Of 106 physiotherapists (36 males and 70 females) assessed by the MBI, Emotional Exhaustion subscale was seen in 52 (49.1%), Depersonalization subscale in 36 (33.9%), and Burnout in the Personal Accomplishment subscale in 33 (31.2%), of whom 4 (3.8%) suffered to a severe degree and 29 (27.4%) moderately. Within the study group qigong lowered the mean values of Emotional Exhaustion subscale from 38.0 to 31.4, whereas in the control group the values rose from 33.9 to 37.9. The differences between the two groups were statistically significant (P= 0.023). Qigong lowered the mean value of Depersonalization subscale from 10.8 to 6.8. In controls the value rose from 7.3 to 10.6. The difference between the two groups was statistically significant (P= 0.013). The mean values of Personal Accomplishment subscale decreased in both groups: from 35.4 to 33.9 in the intervention group, and from 37.5 to 37.1 in the control group. The difference between the two groups was not statistically significant.

Conclusion: The effects of “White Ball” Qigong on burnout symptoms are measurable by the MBI. The results are compatible with the thesis that this type of qigong is an effective tool for the self-management of burnout. It is easy to integrate into a daily routine as it takes only 2×5 min per day. On the basis of this evaluation, a study design can now be developed on a larger scale with appropriate blinding, follow-up testing and adequate controls.

Key words: qigong, burnout, professional, physical therapy modalities, biofeedback, pilot projects

Figure 1

Recruitment flow chart"

"

Index Total (n=106) Men (n=36) Women (n=70)
Age (mean±standard deviation, years) 28.2±4.6 28.3±4.3 28.2±4.8
Schooling years (mean±standard deviation) 16.0±0.7 15.8±0.6 16.1±0.8
Academic Degree (n (%)) 1 1 1
Doctorate degree 4 (3.8) 0 (0) 4 (6.0)
Master's degree 7 (6.6) 1 (3.0) 6 (9.0)
Licenciatura degree (4 years) 78 (73.6)
26 (72.0)
52 (74.0)
Bacharel degree (3 years) 7 (6.6) 4 (11.0) 3 (4.0)
Clinical internship 10 (9.4) 5 (14.0) 5 (7.0)
Marital status (n (%)) 1 1 1
Single 80 (75.5) 26 (72.0) 54 (77.0)
Married 24 (22.6) 9 (25.0) 15 (21.0)
Divorced 2 (1.9) 1 (3.0) 1 (2.0)

"

Index Total (n=106) Men (n=36) Women (n=70)
Years of experience (mean±standard deviation) 4.9±4.4 4.5±4.3 5.1±4.5
Type of employment relationship (n (%)) 1 1 1
Permanent 39 (36.8) 11 (31.0) 28 (40.0)
Fixed-term contract 16 (15.1) 2 (5.0) 14 (20.0)
Self-employment 34 (32.1) 15 (42.0) 19 (27.0)
Clinical internship 17 (16) 8 (22.0) 9 (13.0)
Work days per week (mean±standard deviation) 5.2±0.7 5.4±1.0 5.1±0.4
Work hours per day (mean±standard deviation) 7.5±1.7 7.6±2.0 7.5±1.6
Patients per hour (mean±standard deviation) 4.1±1.5 4.3±1.5 4.0±1.5

"

MBI subscale Total (n=106) Men (n=36) Women (n=70)
Emotional Exhaustion 1 1 1
Low (<16) 54 (50.9%) 18 (50.0%) 36 (51.4%)
Moderate (17-26) 29 (27.4%) 11 (30.6%) 18 (25.7%)
High (>27) 23 (21.7%) 7 (19.4%) 16 (22.9%)
Depersonalization 1 11 1
Low (<6) 70 (66.0%) 22 (61.1%) 48 (68.6%)
Moderate (7-12) 28 (26.5%) 11 (30.6%) 17 (24.3%)
High (>13) 8 (7.5%) 3 (8.3%) 5 (7.1%)
(Lack of) Personal Accomplishment 1 1 1
Low (“no burnout”) (>39) 73 (68.8%) 24 (66.7%) 49 (70.0%)
Moderate (32-38) 29 (27.4%) 10 (27.8%) 19 (27.1%)
High (“severe burnout”) (<31) 4 (3.8%) 2 (5.5%) 2 (2.9%)

"

MBI subscale Intervention group (n=8) Control group (n=8) P value between
the groups
First measure Second measure Pvalue First measure Second measure Pvalue
Emotional Exhaustion 38.0±7.3 31.4±12 0.141 33.9±4.1 37.9±3.5 0.011 0.023
Depersonalization 10.8±9.0 6.8±4.6 0.204 7.3±4.3 10.6±5.0 0.016 0.013
(Lack of) Personal
Accomplishment
35.4±10.4
33.9±6.4
0.310
37.5±2.7
37.1±3.0
0.573
0.187
[1] Santos MC, Barros L, Carolino E . Occupational stress and coping resources in physiotherapists: a survey of physiotherapists in three general hospitals. Physiotherapy. 2010; 96(4) : 303-310.
doi: 10.1016/j.physio.2010.03.001
[2] Ogiwara S, Hayashi H . Burnout amongst physiotherapists in Ishikawa Prefecture.[J] Phys Ther Sci. 2002 ; 14:7-13.
doi: 10.1589/jpts.14.7
[3] Pavlakis A, Raftopoulos V, Theodorou M . Burnout syndrome in Cypriot physiotherapists: a national survey. BMC Health Serv Res. 2010; 10:63.
doi: 10.1186/1472-6963-10-63 pmid: 20222948
[4] Pires S, Mateus R, Camara J. Sindrome de Burnout nos Profissionais de Saude de um Centro de Atendimento a Toxicodependentes. Revista Toxicodependencias IDT. 2004; 10(1): 15-23. German.
[5] Maslach C, Jackson SE . The measurement of experienced burnout.[J] Organ Behav. 1981; 2(2):99-113.
doi: 10.1002/job.4030020205
[6] Leiter MP, Maslach C . The impact of interpersonal environment on burnout and organizational commitment.[J] Organ Behav. 1988; 9(4):297-308.
doi: 10.1002/job.4030090402
[7] Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, Mooney CJ, Quill TE . Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009; 302(12):1284-1293.
doi: 10.1001/jama.2009.1384
[8] Li Calzi S, Farinelli M, Ercolani M, Alianti M, Manigrasso V, Taroni AM . Physical rehabilitation and burnout: different aspects of the syndrome and comparison between healthcare professionals involved. Eura Medicophys. 2006; 42(1) : 27-36.
[9] Campo MA, Weiser S, Koenig KL . Job strain in physical therapists. Phys Ther. 2009; 89(9):946-956
doi: 10.2522/ptj.20080322 pmid: 19608632
[10] Donohoe E, Nawawi A, Wilker L, Schindler T, Jette DU . Factors associated with burnout of physical therapists in Massachusetts rehabilitation hospitals. Phys Ther. 1993; 73(11) : 750-756.
doi: 10.1093/ptj/73.11.750
[11] Schuster ND, Nelson DL, Quisling C . Burnout among physical therapists. Phys Ther. 1984; 64(3):299-303.
doi: 10.2307/1510237 pmid: 6701199
[12] Deckard GJ, Present RM . Impact of role stress on physical therapists 5 emotional and physical well-being . Phys Ther. 1989; 69(9):713-718.
doi: 10.1097/00008526-198910000-00009 pmid: 2772034
[13] Hall AM, Ferreira PH, Maher CG, Latimer J, Ferreira ML . The influence of the therapist-patient relationship on treatment outcome in physical rehabilitation: a systematic review. Phys Ther. 2010; 90(8):1099-1110.
doi: 10.2522/ptj.20090245
[14] Stubbs B, Winstanley S, Alderman N, Birkett-Swan L . The risk of assault to physiotherapists : beyond zero tolerance? Physiotherapy. 2009; 95(2):134-139.
doi: 10.1016/j.physio.2008.12.005 pmid: 19627695
[15] Fjellman-Wiklund A, Stenlund T, Steinholtz K, Ahlgren C . Take charge: Patients’ experiences during participation in a rehabilitation programme for burnout.[J] Rehabil Med. 2010; 42(5):475-481.
doi: 10.2340/16501977-0534
[16] Greten HJ. . Understanding TCM. Heidelberg : Heidelberg School Editions. 2007 : 1-145.
[17] Sertel S, Greten HJ, Kraemer HJ, Efferth T, Plinkert PK, Baumann I . Evaluation of quality of life in patients treated with Traditional Chinese Medicine. The Open Otorhinolaryngol J. 2010; 4:62-67.
doi: 10.2174/1874428101004010062
[18] Tsang HW, Cheung L, Lak DC . Qigong as a psychosocial intervention for depressed elderly with chronic physical illnesses. Int[J] Geriatr Psychiatry. 2002 ; 17(12):1146-1154.
doi: 10.1002/(ISSN)1099-1166
[19] Skoglund L, Jansson E . Qigong reduces stress in computer operators. Complement Ther Clin Pract. 2007 ; 13(2):78-84.
doi: 10.1016/j.ctcp.2006.09.003 pmid: 17400142
[20] Greten HJ . Handbuch des funktionell therapeutischen Qigong I: Diagnosengerechte ubungspraxis. Heidelberg: Heidelberg School of Chinese Medicine. 2009. German.
[21] Johnson JA . Chinese medical qigong therapy: a comprehensive clinical Text. Pacific Grove: The International Institute of Medical Qigong. 2000.
[22] Lin S . Research leading to a systems/cellular/molecular model for the benefits of Qigong and Tai Chi on health and healing. In Theses: Scientific and Skill Papers on Qigong, published in coordination with The World Qigong Forum 2007 and 10th World Congress on Qigong and Traditional Chinese Medicine, Tokyo, 2007: 3-8.
[23] Matos LC, Goncalves MJ, Silva AR, Mendes JG, Machado JP, Greten HJ. Assessment of Qigong-related effects by infrared thermography: a case study. J Chin Integr Med. 2012; 10(6):663-666. English with abstract in Chinese.
Matos LC, Goncalves MJ, Silva AR, Mendes JG, Machado JP, Greten HJ. 使用温度记录法衡量气功的治疗效应. 中西医结合学报. 2012; 10(6):663-666.
[24] Li M, Chen K, Mo Z. Use of qigong therapy in the detoxification of heroin addicts. Altern Ther Health Med. 2002; 8(1): 50- 54, 56-59.
doi: 10.1016/S0531-5131(02)00423-5 pmid: 11795622
[25] Dorcas A, Yung P . Qigong: harmonising the breath, the body and the mind. Complement Ther Nurs Midwifery. 2003; 9(4):198-202.
doi: 10.1016/S1353-6117(03)00053-2 pmid: 14556769
[26] Chen K, Yeung R . Exploratory studies of Qigong therapy for cancer in China. Integr Cancer Ther. 2002 ; 1(4):345-370.
doi: 10.1177/1534735402238187 pmid: 14664729
[27] Sander KM . Medical applications of qigong. Altern Ther Health Med. 1996; 2(1):40-46.
[28] Balogun JA, Titiloye V, Balogun A, Oyeyemi A, Katz J . Prevalence and determinants of burnout among physical and occupational therapists.[J] Allied Health. 2002 ; 31(3):131-139.
pmid: 12227263
[29] Serrano Gisbert MF, de Los Fayos EJ, Hidalgo Montesinos MD. Burnout in Spanish physiotherapists. Psicothema. 2008; 20(3): 361-368. Spanish.
pmid: 18674428
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