This is a two-hour lecture for helping nurses to reduce stress and increase work satisfaction using mindfulness. You will be introduced to 5 simple and effective mindfulness-based exercises from the MINDFULGym program https://www.mindfulgymalaysia.com/

1. Psychiatrist & Mindfulness-Based Therapist, Sunway Medical Centre;
President of Malaysia Association for Mindfulness Practice & Research (MMPR)
By Dr. Phang Cheng Kar (M.D.)
1

2. The MINDFULGym program is supported by
8 local research in Malaysia for reducing stress and
improving happiness. In this presentation, you will
learn 5 exercises to help you cope with stress
2

3. 1. ABC of Stress in Nurses
2. Introduction to Mindfulness
3. Mindful Body Stretching
4. Mindful Breathing
5. NOWING The Present Moment
6. Gratitude Workout: Google-WWW-Yahoo
7. Loving Kindness (Rasa Sayang)
8. A Mindful Nursing Day
9. MINDFULGym Nurse Website
10. Q & A

4. STRESS
“Stress” is a general term that we use to refer to the tension that
arises when we can’t cope with the demands or challenges in life

5. Signs & symptoms of stress…
Thought Feeling
Body Behavior
STRESS
To know our stress level, we need to be aware of our signature or typical
stress symptoms which can be classified into four categories

6. Examples of typical stress symptoms?
“I’m useless”
“Nobody
likes me”
“I’m a burden
to others”
“I’m going
crazy”
“What if…!!!”
Sad
Fear
Worry
Angry
Impatient
Heart
beating
quickly
Breathing
rapidly
Muscle
aches
Easily tired
Gastric pain
Eat a lot
Keep quite
Drive
recklessly
Sleep all
the time
Smoke a lot
THOUGHT FEELING BODY BEHAVIOR

7. Is STRESS Good or Bad?
The figure shows the Yerkes Dodson curve. When our stress level (X axis) is too low,
performance (Y axis) is no good, e.g. lack of motivation to study. On the other hand,
when it’s too much, performance is also affected, e.g. nervousness impairs memory that
is crucial for learning. We need OPTIMAL stress – a.k.a. “eustress” (good stress) for
good performance. MINDFULGym NURSE is useful for reducing excessive stress…
Imagefromhttp://secretgeek.net/ydlaw.asp

8. Mindfulness – ICU Nurses, Serdang Hospital
Hee, K.L, Subramanian, P., Rahmat, N., & Phang, C.K. (2014). The Effect of Mindfulness Training Programme on
Reducing Stress and Promoting Well-being among Nurses in Critical Care Units. Australian Journal of Advance
Nursing, 31(3), 22–31.

9. Author & Year Sample Size. Study Design Interventions Outcome
(Cohen-Katz et al.,
2005)
(USA)
Healthcare professional,
90% nurses
Treatment (n=12),
Control
(n= 13)
Randomized
control study
(A pilot study)
8-week MBSR
For 2.5 hour/session
Control group: wait list
Reduced emotional exhaustion, feelings of
lack of personal achievement, and in
depersonalization, and increase in MAAS.
(Mackenzie et al.,
2006)
(Canada)
Treatment (n=16),
Control
(n=14)
Randomized
control study
(A pilot study)
4-weeks MBSR for 30-
minute/session
Control group: wait list
The relaxation and life satisfaction were
significantly increased, and the burnout was
significantly decreased. So, they found
mindfulness is helpful to practice for nurses
to reduce stress.
(Pipe et al., 2009)
(USA)
Treatment (n=15),
Control
(n=17)
Randomized
controlled trial
(A pilot study)
4-weeks MBSR for 2-hour
session
Control group: leadership course
Significantly reduction in stress symptoms
compared to control group.
(Ando et al., 2011)
(JAPAN)
28 nurses
Intervention (n=15),
Control (n=13)
Quasi-
experimental
with control
group
Modified version MBSR; 2
sessions for 30-60 minutes, and
Home with a CD.
Control group: no intervention
The finding was a significant reduction in
the General Health Questionnaire rates, and
rise in the Sense Of Coherence scores in the
mindfulness group compared with the
control group.
(Bazarko et al.,
2013)
(USA)
(n=41),
(n=36) complete the
study
Non-controlled
pre-post
intervention
(A pilot study)
Telephonic
Sessions;
(t-MBSR)
8-week
1.5-hour group teleconference
Calls
Improvement in general health; reduce
stress, and lowered work burnout.
(Hee Kim et al.,
2014)
(Malaysia)
(n=41) nurses, and
(n=37) who complete the
study
A single-group
pre-post study
design
MINDFULGym; 5 weeks; for
2-hours/session
Levels of perceived stress, stress, anxiety,
depression decreased significantly.
Levels of mindfulness and subjective
happiness increased significantly.

10. Author & Year Sample Size. Study Design Interventions Outcome
(Horner et al.,
2014)
(USA)
(n=43)
About 60% of them
attended five or more
classes.
The quasi-
experimental
research study,
the similar
nursing unit
served as the
control group.
(A pilot study)
10-week mindfulness training
program for 30-minute/session
The similar nursing unit served
as the control group; Without
intervention
There were improvements in the levels of
mindfulness, burnout, stress, and in patient
satisfaction in the experimental group,
while the control group remained the same.
(Gauthier et al.,
2015)
(USA)
(n=38) pediatric ICU
nurses
Quasi-
experiment
(A pilot study)
5-minute mindfulness before
each shift for a month
Mindfulness provides support for the job,
self-care and stress reduction.
(dos Santos et al.,
2016)
(Brazil)
(n=13) nurses Pre-post
intervention (A
pilot study)
6-week Stress Reduction
Program (SRP) was based on
MBSR
for 60-minute/session
The results revealed a significant reduction
of stress, depression, anxiety, and burnout.
(Duarte & Pinto-
Gouveia, 2016)
(Portugal)
Intervention group
(n =45), and a control
group (wait-list)
(n =48).
Non-
randomized
controlled
study
6-week MBSR
for 2-hours/session
Controlled study: waiting list
It was found significant reductions in
stress, burnout, compassion fatigue, and
experiential avoidance, and development in
compassion, mindfulness, and life
satisfaction.
(Duarte & Pinto-
Gouveia, 2017)
(Portugal)
(n=94) Quasi-
experiment
6-week MBSR
for 2-hours/session
Reduction in compassion fatigue, burnout,
stress, and depression.
(Wylde et al., 2017)
(USA)
Traditionally Delivered
Mindfulness (n=49),
Smartphone Delivered
Mindfulness (n=46)
Non-
randomized
controlled
study
Traditionally delivered
Mindfulness; 4-Weeks for 30-
minutes/session; Smartphone
delivered Mindfulness
Smartphone mindfulness may contribute
further profits for nurses than traditional
mindfulness.

11. 1. ABC of Stress in Nurses
2. Introduction to Mindfulness
3. Mindful Body Stretching
4. Mindful Breathing
5. NOWING The Present Moment
6. Gratitude Workout: Google-WWW-Yahoo
7. Loving Kindness (Rasa Sayang)
8. A Mindful Nursing Day
9. MINDFULGym Nurse Website
10. Q & A

12. “Mindfulness” is now a very popular
concept for self-help & wellness

13. Mindfulness means
Remembering to
PAY ATTENTION
to the PRESENT MOMENT
with an attitude of Kindness,
a Beginner’s Mind & Wisdom
Dr. Zhen-Phang, MINDFULGym
What is Mindfulness?

14. Teacher says pay attention!
MINDFULGym will teach you
HOW to pay attention…

15. Mindfulness was first introduced into medicine as MBSR by Emeritus Professor
Dr. Jon Kabat-Zinn in the 1970s at the University of Massachusetts Medical Centre
for stress reduction in patients with physical disorders, e.g. chronic pain & psoriasis
MBSR –
Mindfulness-based Stress
Reduction Program

17. 1. ABC of Stress in Nurses
2. Introduction to Mindfulness
3. Mindful Body Stretching
4. Mindful Breathing
5. NOWING The Present Moment
6. Gratitude Workout: Google-WWW-Yahoo
7. Loving Kindness (Rasa Sayang)
8. A Mindful Nursing Day
9. MINDFULGym Nurse Website
10. Q & A

18. Teknik1:
MINDFUL BODY STRETCHING
ReganganKetarasedar

19. 7/8/2018 copyright (your organization) 2003 19
Mindful Body Stretching:
Tortoise!

20. 7/8/2018 copyright (your organization) 2003 20
Mindful Body Stretching:
Superman!

21. Mindful Body Stretching:
Push the ceiling!

22. Urut-Urut…Tepuk-Tepuk

23. Teknik2:
MINDFUL BREATHING
PernafasanKetarasedar

24. Slow, Deep & Mindful
Breathing – Qi Gong Style

27. Teknik3:
NOWING THE
PRESENT MOMENT
Latihan Tumpu & Tekun

28. MULTITASKING

29. What is Multitasking?

30. Multitasking, Mindlessness & Mistakes

31. Multitasking, Mindlessness & Mistakes

32. Multitasking, Mindlessness & Mistakes

33. NOW-INGThe Present Moment

34. Teknik 4:
GratitudeWorkout–
‘Google-WWW-Yahoo’
Latihan Kesyukuran
WOW-WOW-WOW

35. Bronze medalists are happier
than silver medalists because
they are more GRATEFUL

36. Try to ‘Google’ (search) for 3 WWW (What Went Well?)
everyday & ‘Yahoo’ (rejoice). In another words, deliberately try
to pay attention to things that went well in life, count blessings
or find things to appreciate. For examples…

39. Teknik 5:
LOVING-KINDNESS
Amalan‘RasaSayang’

40. 1. When is the most
important time?
2. Who is the most
important person?
3. What is the most
important thing to do?

41. Rasa sayang eh,
Rasa sayang, sayang eh
Eh, may I, may you, may all be
happy, Happy, HAPPY – Yeahh 

42. Saya doakan/ucapkan…
SIHAT
SELAMAT
SEJAHTERA

43. 1. Mindful Body Stretching
(Regangan Ketarasedar)
2. Mindful Breathing
(Pernafasan Ketarasedar)
3. NOWING The Present Moment
(Latihan Tumpu & Tekun)
4. Gratitude Workout: ‘Google-WWW-Yahoo’
(Latihan Kesyukuran)
5. Loving-Kindness (Rasa Sayang)
(Amalan ‘Rasa Sayang’)

44. 1. ABC of Stress in Nurses
2. Introduction to Mindfulness
3. Mindful Body Stretching
4. Mindful Breathing
5. NOWING The Present Moment
6. Gratitude Workout: Google-WWW-Yahoo
7. Loving Kindness (Rasa Sayang)
8. A Mindful Nursing Day
9. MINDFULGym Nurse Website
10. Q & A

45. How to practice? Suggestion…
• Before work – Mindful Body Stretching
• During work (every 2-3 hours) – Mindful Breathing
• When you are tired and need to focus on nursing
procedures – NOWING The Present Moment
• After work – sing ‘Rasa Sayang’ and wish everyone
safe, healthy, and happy
• Weekend or off days – write Gratitude Workout
diary

46. https://pckar39011.wixsite.com/mindfulgym-nurse/copy-of-a-mindful-day

47. 1. ABC of Stress in Nurses
2. Introduction to Mindfulness
3. Mindful Body Stretching
4. Mindful Breathing
5. NOWING The Present Moment
6. Gratitude Workout: Google-WWW-Yahoo
7. Loving Kindness (Rasa Sayang)
8. A Mindful Nursing Day
9. MINDFULGym Nurse Website
10. Q & A

48. For more information:
https://pckar39011.wixsite.com/mindfulgym-nurse

49. Dr. Phang Cheng Kar
pckar39011@gmail.com
https://www.mindfulgymalaysia.com/

50. Soalan Quiz 1
• Namakan 3 tanda-tanda
stress yang anda kerap alami

51. Soalan Quiz 2
• Namakan orang yang
memperkenalkan program
ketarasedar/mindfulness
sekular pertama (MBSR)
di dunia

52. Soalan Quiz 3
• Namakan program
ketarasedar (mindfulness)
buatan Malaysia yang
diperkenalkan oleh
Dr. Phang

53. Soalan Quiz 4
• Berikan takrifan
Ketarasedar (Mindfulness)
dalam program
MINDFULGym

54. Soalan Quiz 5
• Namakan 3 teknik
Ketarasedar yang anda telah
belajar dalam program
MINDFULGym Nurse

55. Soalan Quiz 6
• ‘Google’ & nyatakan 3
benda yang anda WW-
WW-WW/YAH
(bersyukur)

56. Soalan Quiz 7
• Nyanyikan lagu ‘Rasa
Sayang’ versi MINDFULGym
untuk amalan
sayang dan mesra