Nurse Burnout Group Versus Individual Mindfulness Interventions: A Systematic Review
Background: Nurses are prone to burnout due to the physically and emotionally taxing characteristics of the job and the high workloads required. This has been particularly apparent in the context of COVID-19. In New Zealand, almost 50% of nurses have reported experiencing work-related burnout, although this is a worldwide phenomenon. Mindfulness-based interventions have been proven to mitigate burnout and foster resilience in healthcare professionals. The aim of this study was to determine whether mindfulness interventions for burnt out nurses are better implemented in a group or individual format.
Methods: A systematic review was chosen to investigate this question and the PRISMA systematic review guidelines were followed. The databases used to search for articles on this topic were CINAHL, Medline, EMCare, PsycINFO, Scopus and Science Direct databases. The searches occurred in September 2022 and included studies from 2012 to 2022. Studies were included if they treated burnout symptoms in nurses with mindfulness-based interventions. Studies had to be quasi-experimental, randomised control trials, non-randomised control trials and pilot studies that included pre- and post-burnout measurements. The study quality was assessed using the RoB2 and ROBINS-I tools.
Results: Seven studies met the inclusion criteria and were included. Two were randomised control trials, one was a non-randomised control study, three were a quasi-experimental study, and one was a mixed method study some of which were pilot studies. The seven studies used the Maslach Burnout Inventory, the Copenhagen Burnout Inventory, and the ProQOL scale. They used a mix of mindfulness-based interventions such as, mindfulness-based yoga, abbreviated mindfulness-based stress reduction (MBSR) intervention, and Mindful Living with Stress intervention and the Community Resilience Model mindfulness-based intervention. Five interventions used a group format and two an individual one. Both formats showed statistically significant improvements in burnout.
Discussion: Findings showed that group and individual-format mindfulness interventions were both effective in improving burnout in nurses. Only one study specified the reasoning of using a group format, the other studies did not. It did not appear to be an important consideration although it is possible that aspects of both could have affected the outcome of the interventions. In the group format, coordination of groups appeared to be a barrier to engagement, but peer support may have been a beneficial aspect. In the individual format, participants reported liking the flexibility and brevity of practice.
In conclusion, all studies showed an improvement in burnout scores, although not all were statistically significant. Overall, there was not enough evidence and the evidence included was varying in quality. Thus, it was impossible to conclude which format better supported an improvement in burnout for nurses. Therefore, further research is needed to further our understanding of the treatment of burnout for nurses.