111 Mindfulness-Based Stress Reduction for Elementary School Teachers: A Qualitative study Limitations and future directions Unfortunately COVID-19 resulted in a number of adaptations to the study. At first, we had to use video conferencing for conducting the interviews, which sometimes made it difficult because of, for example, faltering connections that limited spontaneous interactions. Secondly, parents were no longer allowed to enter the school, and teachers often worked in small ‘bubbles’ to limit infections. This may explain why none or a few experiences regarding to the effect on contact with parents or colleagues were exchanged during the interviews. A third limitation could be time difference between the focus groups, where a topic list has been used during the interviews 16 weeks after MBSR and the last session groups in which only the starting question of the topic list was used. Despite these differences all codes from the focus groups resurfaced in the last session-group. The 23 remaining codes only related to the last session interviews. Insight and awareness were discussed in more detail and could be explained by the difference in time between the last session of MBSR and the time of the focus group interviews because the first step in effects can be seen in changes in insight and awareness which overtime may lead to changes in behaviour. Because our study indicates that MBSR can make a valuable contribution to the functioning of teachers and their classroom climate quality, these findings may be important for academic training of elementary school teachers nationwide so that they acquire these skills during their education. It is not only important for their professional actions or skills, but can also contribute to personal well-being, as teachers often experience a high level of stress. These findings may contribute to the call of the World Health Organization (WHO) that stress will be the number one cause of disease by 2030 (WHO, December 2011). MBSR could possibly contribute to an adequate response to this worrying development, especially within de educational sector. Another recommendation might be to use mindfulness teachers with an educational background in primary education. Teachers in this study indicated that accessibility of MBSR was facilitated by the educational background of the trainer. In terms of future research, quantitative research on the effectiveness of MBSR for elementary school teachers is needed to complement these qualitative findings. An RCT investigating the effectiveness of MBSR in this population is currently underway (Lensen et al., 2024). This qualitative study might help, however, to use questionnaires in this type of research that are better aligned with the experiences of participants themselves. For example, both professional and personal aspects should be considered as well as the effect on pupils. This study provides indications for the functioning mechanisms. Mediation effects should be examined to test these potential working mechanisms. This study suggests that the standard MBSR program can be a valuable contribution to elementary school teachers’ professional and personal functioning and their classroom climate quality. However, more quantitative research on the effectiveness and possible working mechanisms of MBSR for elementary school teachers is recommended. 6
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