This assignment will require you to take the PICO, 5 research articles and place them in a table for analysis. You will critique each article and identify the most important parts of the research, analysis, and findings.
Then you will summarize the articles by grading the research, and identifying gaps in the literature as well as possible interventions (see grading rubric and examples).
Instructions:
1. Identify your PICO or research question of interest
2. Gather 5 research articles on your topic: be sure to save them and submit them along with the matrix; please make sure they are PDF documents.
3. Do not use clinical guidelines or Cochran Reviews, abstracts, future research reports or poster presentations. You can search for research only by indicating “research” when you do an advanced search. If you can’t answer a lot of the questions, it is probably not a research article.
4. We do not recommend that you use more than one qualitative research article or systematic review or meta analysis. These are harder to evaluate because they have so much more information in them. Remember it is not individuals in these studies- it is the articles. Use the reference list in the systematic reviews or meta analyses to find individual studies that may be easier to understand and use.
5. Review sample matrices and summaries ATTACHED
6. Use matrix table- one for each article and critique the parts of the article using the rubric-(RUBRIC IS ATTACHED)
7. Be sure to identify the evaluation tool used to grade the evidence such as (See below for grading the evidence tools)
8. Identify where there are issues with the articles and what gaps were not addressed with the research; be prepared this may change the way you look at your topic or may result in a slightly different direction for your area of interest. This is ok- that is what you want to accomplish with this assignment. It will really assist you as you move forward with your project.
9. For this assignment you will turn in the matrix tables, summary, references and pdf copies of your 5 articles.
10. Key definitions:
1. Level of evidence: the process used to evaluate the level of evidence of your articles- such as Jones Hopkins, Cincinnati Children’s evaluation etc,
2. Evaluation tool: use the method and describe how you arrived at the scoring or knowing that the article included all content it needed to- such as CASP;
3. Instrument: What type of instrument or tool was used in the article? This could be a depression screening tool, Nurse satisfaction tool etc. Describe the instrument- how many questions, reliability- consistency with test-retest, Cronbach Alpha, inter-rater reliablity; validity with content validity, face validity
Links to critical appraisal tools to evaluate research quality: Joanna Briggs Institute (joannabriggs.org) https://jbi.global/critical-appraisal-tools
CASP checklists https://casp-uk.net/casp-tools-checklists/
Mixed Method appraisal checklist McGill: http://mixedmethodsappraisaltoolpublic.pbworks.com/w/page/24607821/FrontPage
Cincinnati Children’s Hospital Medical Center Legend tools- very helpful: https://www.cincinnatichildrens.org/research/divisions/j/anderson-center/evidence-based-care/legend
Johns Hopkins EBP Models and Tools: https://www.hopkinsmedicine.org/evidence-based-practice/ijhn_2017_ebp.html
1. PICO Format
• P = Nurses in an inpatient hospital experiencing burnout
• I = Using a mindfulness-based program
• C = no intervention at all
• O = To reduce nurse burnout
• T = within a 6-month period
MY PICOT QUESTION: For nurses in an inpatient hospital experiencing burnout, does the introduction and usage of a mindfulness-based program versus no intervention at all reduce their burnout within 6 months?
ARTICLES
Please use 5 out the following articles: all the articles are attached.
1. The Effects of Mindfulness Meditation on Stress and Burnout in Nurses
Alyssa A. Green, BSN, RN Elizabeth V. Kinchen, PhD, RN, AHN-BC
2. Exploring a social work lead mindfulness-based intervention to address burnout among inpatient psychiatric nurses: a pilot study
Donna M. Wampole DSWa and Sara Bressi PhD, LSW
3. The Mediating Roles of Affect and Coping Strategy in the Relationship Between Trait Mindfulness and Burnout Among French Healthcare Professionals.
Mathilde Sauvain-Sabé, Anne Congard, Jean-Luc Kop, Catherine Weismann-Arcache, and Arnaud Villieux Online First Publication, February 10, 2022. http://dx.doi.org/10.1037/cbs0000312
4. Does self-compassion mitigate the relationship between burnout and barriers to compassion? A cross-sectional quantitative study of 799 nurses
Vinayak Deva , Antonio T. Fernando IIIa , Anecita Gigi Limb , Nathan S. Consedine
5. The relationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources
Elisabeth Diehl, Sandra Rieger, Stephan Letzel, Anja Schablon, Albert Nienhaus, Luis Carlos Escobar Pinzon, Pavel DietzID
6. COMPASSION-ORIENTED MINDFULNESS-BASED PROGRAM AND HEALTH PROFESSIONALS A Single-Centered Pilot Study on Burnout
ANNA MARCONI, MARIA ANTONIETTA BÀLZOLA, RAMONA GATTO, ANNALISA SORESINI, DIANA MABILIA & STEFANO POLETTI*
7. The importance of formal versus informal mindfulness practice for enhancing psychological wellbeing and study engagement in a medical student cohort with a 5-week mindfulness-based lifestyle program
Naomi Kakoschke, Craig Hassed, Richard Chambers, Kevin Lee
8. The Effects of Mindfulness-based Stress Reduction on Nurse Stress and Burnout A Qualitative and Quantitative Study, Part III
• Joanne Cohen-Katz, PhD • Susan Wiley, MD • Terry Capuano, MSN, MBA • Debra M. Baker, MA • Lynn Deitrick, PhD U Shauna Shapiro, PhDDNP 618 Article Matrix and Analysis
Student Name __________________________________
PICO Question ___________________________________________________________________
Search process :
Search terms:
Data bases:
Total number of articles obtained from search results: N=
Number of articles initially excluded based on abstract reading: N=
Number of articles reviewed: N=
Number of articles excluded based on criteria: N=
Inclusion Criteria:
Exclusion Criteria:
Number of systematic reviews or meta analyses used in Matrix- N =
Repeat this table – one for each article you are review. DO NOT double space in the table
The matrix and analysis assignment to submit consists of : 1). introduction describing the search process for this topic, 2). the review table (1 for each article = 5), 3). summary analysis, 4). reference page and 5). PDF copies of the articles – list by 1st author name as attachments
Author, year; Credentials Article #1
If credentials not identified- just state here, or identify place of employment
Article Focus/Title
Research Design/Intervention (describe intervention)
Level of Evidence and model used to grade evidence
Evaluation Tool (CASP or others- identify tool used)
Sample/# of subjects, how recruited, power analysis?
Data Collection procedure
Instruments and
Reliability/validity
of instruments
Data Analysis- id statistics, LOM, findings
Results
Discussion/
Significance of findings
Reliability and Validity of study, limitations
Helpful/Reliable
Compared to other articles
Author, year; Credentials Article #1
If credentials not identified- just state here, or identify place of employment
Article Focus/Title
Research Design/Intervention (describe intervention)
Level of Evidence and model used to grade evidence
Evaluation Tool (CASP or others- identify tool used)
Sample/# of subjects, how recruited, power analysis?
Data Collection procedure
Instruments and
Reliability/validity
of instruments
Data Analysis- id statistics, LOM, findings
Results
Discussion/
Significance of findings
Reliability and Validity of study, limitations
Helpful/Reliable
Compared to other articles
Author, year; Credentials Article #1
If credentials not identified- just state here, or identify place of employment
Article Focus/Title
Research Design/Intervention (describe intervention)
Level of Evidence and model used to grade evidence
Evaluation Tool (CASP or others- identify tool used)
Sample/# of subjects, how recruited, power analysis?
Data Collection procedure
Instruments and
Reliability/validity
of instruments
Data Analysis- id statistics, LOM, findings
Results
Discussion/
Significance of findings
Reliability and ValidityDNP 816 Matrix and Summary Rubric
Element
7.5 points
5 points
3.5 points
2 points
Source information and quality
(7.5 points)
All key elements are present: Author credentials listed, article is less than 5 years old, and publication is peer reviewed/
scholarly, article is based on research and relates to the chosen topic of concern; is a primary source
Two key elements are present: Author credentials listed, article is less than 5 years old, ad publication is peer reviewed/
scholarly, article is based on research and relates to the chosen topic of concern but is a secondary source
One key element is listed: Author credentials listed, article is less than 5 years old, ad publication is peer reviewed/
scholarly, the articles only partially relate to the chosen topic of concern or is a secondary source
Missing key elements: Author credentials listed, article is more than 5 years old, and publication is peer reviewed/
scholarly, the article has little or nothing to do with the topic of concern and is a secondary source. The article is not research.
Research Design and interventions described (.7.5 points)
See Polit/Beck pp. 18, 210), (pp. 17, 201 in 11th ed.)
All key elements are present: appropriate research design identified, thorough description of intervention, justification for not using a different research design, longitudinal or prospective, or causal intent. Identifies IV and DV if appropriate
Elements are covered but not in enough depth: appropriate research design identified, thorough description of intervention, justification for not using a different research design, longitudinal or prospective, or causal intent. Identifies IV and DV
Missing elements in this category- research design or intervention: appropriate research design identified, thorough description of intervention, justification for not using a different research design, longitudinal or prospective, or causal intent. Identifies IV and DV
Missing key elements: does not identify the correct research design, no description of the intervention (if present), does not identify IV or DV (if appropriate)
Level of Evidence and model used to grade evidence and Evaluation tool used (CASP or others) (7.5 points)
See Polit/Beck p. 35 (p. 36-37 in 11th ed)
Key elements addressed: What was the strength of the evidence in support of your research topic- what model was used to grade the evidence? What evaluation tool was used to assess the evidence?
Key elements are not well described but are present:
Strength of evidence, model used to grade the evidence and evaluation tool used.
Missing elements in this category: Includes some information but it missing content related to grading the evidence, model use or evaluation tool.
Does not include the level of evidence and model used to grade it. Does not use an evaluation tool to assess design
1
Article Matrix and Analysis
Used with Permission
College of Health and Human Services-School of Nursing, Northern Kentucky University
DNP 816: Analysis and Application of Health Data for APRN Practice
September 20, 2020
Article Matrix and Analysis
Student Name: XXXXXX
PICO Question: In patients with hypertension (P), what is the effect of education about hypertension and medications (I) in comparison to no education (C), on compliance with following medication regimens (O) within three months of the first prescription (T).
Search process: Data base search was done using Northern Kentucky University library. Boolean phrases were used. Articles were assessed based on abstract and criteria listed below until five articles were left.
Search terms: hypertension OR high blood pressure AND education OR educational (must be in title) AND medication adherence OR medication compliance
Data bases: CINAHL Complete, Gale Academic OneFile
Total number of articles obtained from search results: N=29/ N=18 N= 33
Number of articles initially excluded based on abstract reading: N=1/N=4
Number of articles reviewed: N= 3/N=6
Number of articles excluded based on criteria: N=20/N=8 N=20
Inclusion Criteria: Full text only, English, Article within the past five years, Peer reviewed
Exclusion Criteria: Article published before 2015, No full text link, Language other than English, Not peer reviewed, Duplicate article, Non-research article
Studies included in systematic review or meta-analysis- N = 0
Author, year; Credentials Article #1
Aghakhani, N. (PhD), Parizad, N. (PhD), Soltani, B. (MSN), Khademvatan, K. (MD), & Rahimi, Z. (MSN) (2019)
Article Focus/Title
The effect of the blended education program on treatment concordance of patients with hypertension: A single-blinded randomized, control trial
Research Design/Intervention
Randomized control trial, single-blind. The intervention was education that was blended in style between face-to-face education and online education.
Level of Evidence
Level I (Dearholt et al., 2012)
Sample/# of subjects
Patients age 20-65, hypertension diagnosis, blood pressure greater than 140/90 but less than 180/110, agree to participate in the study, able to read and write, able to receive emails and texts, no severe underlying disease (ex. Kidney disease or heart problems) that could impact the study. Total number of participants – 60
Evaluation Tool
CASP for randomized control trial Score 11/11
Data Collection procedure
Questionnaires/tests were administered and scored; control and intervention group received respective education; two weeks after education programs were finished, the same questionnaire/test was administered and scored
Type of Instrument
Questionnaire/test that included demographic information and questions addressing treatment in three dimensions; dietary adherence, compliance to medication regimen, and physical activity plan, the questionnaire 2
Article Matrix and Analysis
Student Name: Used with Permission
College of Health and Human Services-School of Nursing, Northern Kentucky University
DNP 816: Analysis & Application of Health Data for ANP
Dr. Faculty Name
September 20, 2020
Article Matrix and Analysis
Student Name: XXXXX
PICO Question: In adult patients with diabetes (P), how does strict glucose monitoring and treatment regimens (I), when compared to decreased compliance to home treatment i.e. routine glucose monitoring, medication adherence and nutritional changes (C), affect and influence patient quality of life through improvement in treatment education and expectations (O) over one year (T)?
Search process: I utilized the NKU online library to search for articles. The data bases included CINHAL and MEDLINE PLUS. These are peer-reviewed, current and reputable search engines that provided the most accurate and reliable articles for the assignment.
Search terms: Patients with diabetes AND adherence OR compliance to treatment OR management; noncompliance OR nonadherence in diabetic treatment AND effects on quality of life; compliance to diabetic treatment AND management AND importance OR significance
Data bases: CINHAL COMPLETE and MEDLINE
Total number of articles obtained from search results: N=11,568
Number of articles initially excluded based on abstract reading: N=37 (out of first 100 relevant)
Number of articles reviewed: N=9
Number of articles excluded based on criteria: N=7,868
Inclusion Criteria: Must be in English, full text only, research or review article, published in 2013 or later, peer-reviewed articles, include adults as the subject, be discovered in a reputable database
Exclusion Criteria: Article published prior to 2013, language other than English, no full text link, obtained from a non-reputable source
Number of systematic review or meta-analysis used in Matrix: N =0
Repeat this table – one for each article you are reviewing.
The matrix and analysis assignment to submit consists of : 1). introduction describing the search process for this topic, 2). the review table (1 for each article = 5), 3). summary analysis, 4). reference page and 5). 5 PDF copies of the articles
Author, year; Credentials Article #1
Mirahmadizadeh, A. Delam, H. Seif, M. et al. (2019). All authors had a doctorate degree with one holding a masters. Published in the International Journal of Molecular Sciences.
Article Focus/Title
Factors Affecting Insulin Compliance in Patients with Type 2 Diabetes in South Iran, 2017: We Are Faced with Insulin Phobia
Research Design/Intervention
Cross-sectional study : No intervention
Level of Evidence and model used to grade evidence
Level IV :Johns Hopkins
Sample/# of subjects, how recruited
Adults aged 30 years or greater who attended one of twelve diabetic clinics in ShiANNA MARCONI, MARIA ANTONIETTA BÀLZOLA, RAMONA GATTO,
ANNALISA SORESINI, DIANA MABILIA & STEFANO POLETTI*
COMPASSION-ORIENTED MINDFULNESS-BASED
PROGRAM AND HEALTH PROFESSIONALS
A Single-Centered Pilot Study on Burnout**
(Received: 15 November 2018; accepted: 15 June 2019)
This pre-post, single-centered study evaluates the effects of a compassion-oriented mindfulness-
based intervention on health professionals’ quality of life. The intervention was conducted in an
Italian general hospital in the province of Milan. Between 2014 and 2015, thirty-four health pro-
fessionals operating in the territorial psychiatric services followed an 18-week Compassion-Ori-
ented Mindfulness-based Program. The program involved the practice of mindfulness meditation
combined with a psycho-educational training. This pilot study analysed the impact of the interven-
tion on mood, quality of life, and burnout-related characteristics. Outcome measures included the
State-Trait Anxiety Inventory, the Beck Depression Inventory, the Maslach Burnout Inventory, the
Five Facets of Mindfulness Questionnaire, and the Professional Quality of Life Scale. After the
intervention, participants showed significantly decreased levels of depression, state anxiety, and
emotional exhaustion. We found that an overall beneficial effect of the Compassion-Oriented
Mindfulness-based Program existed in preventing burnout symptomatology. Non-evaluative and
mindful attention was shown to improve stress resilience and coping strategies while simultan –
eously reducing worry and rumination. These results suggest that a compassion-oriented mindful-
ness program could prevent the development of anxiety and depression traits.
Keywords: Health care professionals, mindfulness, compassion, burnout syndrome, prevention,
coping strategies
European Journal of Mental Health 14 (2019) 280–295
https://doi.org/10.5708/EJMH.14.2019.2.4
ISSN 1788-7119 © 2019 Semmelweis University Institute of Mental Health, Budapest
** Corresponding author: Stefano Poletti, Institut National Santé Et Recherche Médicale U1028, CRNL équipe
DYCOG, Bron, France; [email protected]
** Ethical approval: All procedures performed in studies involving human participants were in accordance with
the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declar –
ation and its later amendments or comparable ethical standards. This article does not contain any studies with
animals performed by any of the authors. Informed consent: Informed consent was obtained from all individual
participants included in the study.
1. Introduction
Health professionals often face high stress situations, experiencing the consequences
of attentive performances and intervention efficacy (CHESAK et al. 2015; SKOSNIK et
al. 2000): this may bring to work dissatisfaction and to the development of the
Burnout Syndrome (BLEGEN 1993; ROSENBERG & PACE 2006). Many studies show
how burnout syndrome, together with highExploring a social work lead mindfulness-based
intervention to address burnout among inpatient
psychiatric nurses: a pilot study
Donna M. Wampole DSWa and Sara Bressi PhD, LSWb
aSchool of Social Work, University of Southern Maine, Portland, USA; bBryn Mawr College, Graduate
School of Social Work and Social Research, Bryn Mawr, USA
ABSTRACT
Acute psychiatric nurses experience workplace stressors related
to organizational factors including staffing shortages, along
with interpersonal conflict with patients and colleagues. The
pilot study examined the experience of burnout among acute
care psychiatric nurses and the usefulness of a social work lead
mindfulness-based intervention for reducing burnout elements.
Findings indicated participants experienced emotional exhaus-
tion associated with their work, but also a significant degree of
personal accomplishment. Nurses identified the intervention as
having the potential to promote better emotional regulation in
the workplace and beyond. Social worker education on mind-
fulness techniques may represent an untapped resource for
improving the emotional wellness and effective patient care.
ARTICLE HISTORY
Received 5 May 2020
Revised 14 September 2020
Accepted 18 September 2020
KEYWORDS
Burnout; mindfulness;
nursing; inpatient;
psychiatric
Inpatient mental health units serve youth and adults with behavioral health
and substance abuse conditions experiencing a range of acute symptoms
including suicidality, mood dysregulation, and psychosis, as well as the psy-
chological and physical effects of the use of psychoactive substances.
Individuals diagnosed with a mental health disorder are also more likely to
have a history of trauma (Batelaan, 2016; Celik & Hocaoglu, 2015; Li et al.,
2015), and thus may exhibit and experience emotional and physical decom-
pensation in response to particular medical settings, such as inpatient units
(Batelaan, 2016; Celik & Hocaoglu, 2015; Li et al., 2015). Psychiatric nurses, as
part of an interdisciplinary inpatient treatment team, typically have the most
direct contact with patients and are tasked with monitoring patients’ progress
in treatment, dosing medications, facilitating milieu-based treatments, and
coordinating care in collaboration with unit social workers and physicians.
This direct care is provided to distressed patients within units besieged by
nurse staffing shortages and increasing administrative demands which prior
literature has related to diminished quality of care and decreased job satisfac-
tion (APNA, 2012; Aiken et al., 2002; Hanrahan et al., 2010). The emotional
CONTACT Donna M. Wampole [email protected] School of Social Work, University of Southern
Maine, Portland 04104, USA
SOCIAL WORK IN HEALTH CARE
2020, VOL. 59, NO. 8, 615–630
https://doi.org/10.1080/00981389.2020.1827123
© 2020 Taylor & Francis Group, LLC
http://www.tandfonline.com
https://crossmark.crossref.org/dialog/?doi=10Contents lists available at ScienceDirect
International Journal of Nursing Studies
journal homepage: www.elsevier.com/locate/ijns
Does self-compassion mitigate the relationship between burnout and
barriers to compassion? A cross-sectional quantitative study of 799 nurses
Vinayak Deva, Antonio T. Fernando IIIa, Anecita Gigi Limb, Nathan S. Consedinea,⁎
a Department of Psychological Medicine, University of Auckland, New Zealand
b School of Nursing, University of Auckland, New Zealand
A R T I C L E I N F O
Keywords:
Burnout
Compassion
Self-compassion
Barriers
Nursing
Compassion-fatigue
Resiliency
A B S T R A C T
Background: Burnout has numerous negative consequences for nurses, potentially impairing their ability to
deliver compassionate patient care. However, the association between burnout and compassion and, more
specifically, barriers to compassion in medicine is unclear. This article evaluates the associations between
burnout and barriers to compassion and examines whether dispositional self-compassion might mitigate this
association.
Hypothesis: Consistent with prior work, the authors expected greater burnout to predict greater barriers to
compassion. We also expected self-compassion – the ability to be kind to the self during times of distress – to
weaken the association between burnout and barriers to compassion among nurses.
Methods: Registered nurses working in New Zealand medical contexts were recruited using non-random con-
venience sampling. Following consent, 799 valid participants completed a cross-sectional survey including the
Copenhagen Burnout Inventory, the Barriers to Physician Compassion scale, and a measure of dispositional self-
compassion.
Results: As expected, greater burnout predicted greater barriers to compassion while self-compassion predicted
fewer barriers. However, self-compassion mitigated the association between burnout and burnout related bar-
riers to compassion (but not other barriers). The interaction suggested that suggested that the association was
stronger (rather than weaker) among those with greater self-compassion.
Discussion: Understanding the lack of compassion and the effects of burnout in patient care are priorities in
health. This report extends evidence on the association between burnout and compassion-fatigue to show that
burnout also predicts the experience of specific barriers to compassion. While self-compassion predicted lower
burnout and barriers, it may not necessarily reduce the extent to which burnout contributes to the experience of
barriers to compassion in medicine. Implications for understanding how burnout manifests in barriers to clinical
compassion, interventions and professional training, and future directions in nursing are discussed.
What is already known about the topic?
• Burnout is widespread among nurses and thought to have numerous
negative correlates, including those related to their ability to deliver
compassionate care.
• Prior researchers have typically linkedRESEARCH ARTICLE
The relationship between workload and
burnout among nurses: The buffering role of
personal, social and organisational resources
Elisabeth Diehl1, Sandra Rieger1, Stephan Letzel1, Anja Schablon2, Albert Nienhaus2,3,
Luis Carlos Escobar Pinzon1,4‡, Pavel DietzID
1‡*
1 Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes
Gutenberg University Mainz, Mainz, Germany, 2 Institute for Health Services Research in Dermatology and
Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 3 Department for
Occupational Medicine, Hazardous Substances and Health Science, Institution for Accident Insurance and
Prevention in the Health and Welfare Services (BGW), Hamburg, Germany, 4 Federal Institute for
Occupational Safety and Health (BAuA), Berlin, Germany
‡ These authors are joint senior authors on this work.
* [email protected]
Abstract
Workload in the nursing profession is high, which is associated with poor health. Thus, it is
important to get a proper understanding of the working situation and to analyse factors
which might be able to mitigate the negative effects of such a high workload. In Germany,
many people with serious or life-threatening illnesses are treated in non-specialized pallia-
tive care settings such as nursing homes, hospitals and outpatient care. The purpose of the
present study was to investigate the buffering role of resources on the relationship between
workload and burnout among nurses. A nationwide cross-sectional survey was applied. The
questionnaire included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ)
(scale ‘quantitative demands’ measuring workload, scale ‘burnout’, various scales to
resources), the resilience questionnaire RS-13 and single self-developed questions. Bivari-
ate and moderator analyses were performed. Palliative care aspects, such as the ‘extent of
palliative care’, were incorporated to the analyses as covariates. 497 nurses participated.
Nurses who reported ‘workplace commitment’, a ‘good working team’ and ‘recognition from
supervisor’ conveyed a weaker association between ‘quantitative demands’ and ‘burnout’
than those who did not. On average, nurses spend 20% of their working time with palliative
care. Spending more time than this was associated with ‘burnout’. The results of our study
imply a buffering role of different resources on burnout. Additionally, the study reveals that
the ‘extent of palliative care’ may have an impact on nurse burnout, and should be consid-
ered in future studies.
PLOS ONE
PLOS ONE | https://doi.org/10.1371/journal.pone.0245798 January 22, 2021 1 / 17
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OPEN ACCESS
Citation: Diehl E, Rieger S, Letzel S, Schablon A,
Nienhaus A, Escobar Pinzon LC, et al. (2021) The
relationship between workload and burnout among
nurses: The buffering role of personal, social and
organisational resouCritical Review
The Effects of Mindfulness Meditation
on Stress and Burnout in Nurses
Alyssa A. Green, BSN, RN
Elizabeth V. Kinchen, PhD, RN, AHN-BC
University of Central Florida College of Nursing
Background: Occupational burnout related to stress in the workplace is experienced by nurses who are
regularly confronted with trauma, suffering, and high workloads. Burnout can negatively impact patient
care and have detrimental effects on nurses’ physical and mental health. Mindfulness-based stress reduc-
tion programs have been researched as a potential holistic intervention for reducing stress and burnout in
nurses through cultivating present awareness, emotional regulation, and positive thinking. Purpose: This
critical review of the literature explores current knowledge on the effectiveness of mindfulness meditation
on stress and burnout in nurses, examines gaps in the current literature, and provides recommendations
for future research on this topic.Methods: Search terms included mindfulness, meditation, mindfulness-
based stress reduction , occupational stress, stress, burnout, and nurs*. Peer-reviewed research directly
related to the impact of mindfulness-based stress reduction on nurses experiencing stress and/or
burnout was reviewed. Findings: Findings reveal evidence that mindfulness meditation is effective in
decreasing stress and burnout in nurses. Mindfulness-based interventions have been shown to signifi-
cantly decrease stress, improve all aspects of burnout, and increase self-compassion and compassion sat-
isfaction in practicing nurses. Conclusions: Mindfulness meditation has the potential to decrease
stress and burnout in nurses by decreasing self-judgment and overidentification with experience, and
by increasing resiliency, compassion, and emotional regulation.
Keywords: mindfulness meditation; MBSR; nursing; stress; burnout; occupational stress; stress
management; alternative/complementary therapies; health and wellness coaching; stress and coping
Chronic exposure to psychological stress resulting
from an imbalance between occupational demand
and an individual’s ability to cope is known as
“burnout” (Saeidi et al., 2020). A growing number
of health care professionals are finding themselves
unable to cope with high levels of stress, with
studies reporting that up to 70% of intensive care
unit (ICU) nurses and over 40% of hospital nurses
experience work-related burnout (Vahey et al.,
2004; van Mol et al., 2015).
Burnout is characterized by emotional exhaus-
tion, depersonalization, and decreased personal
accomplishment, and is often a gradual process
wherein the individual’s physical and emotional capa-
bilities are diminished after prolonged exposure to
stress in the workplace (Maslach & Jackson, 1981).
The high demands of the health care system are
often out of an individual nurse’s control, and
heavy workloads, lack of support, constrained
resources, the emotional nature of the job, and inad-
equate staffing are major contrFEATURES
The Effects of Mindfulness-based
Stress Reduction on Nurse Stress
and Burnout
A Qualitative and Quantitative Study, Part III
• Joanne Cohen-Katz, PhD • Susan Wiley, MD • Terry Capuano, MSN, MBA
• Debra M. Baker, MA • Lynn Deitrick, PhD U Shauna Shapiro, PhD
Part III of the study on mindfulness-based stress reduotion (MBSR) describes qualitative data and discusses the
implications of the findings. Study analysis revealed that nurses found MBSR helpful. Greater relaxation and
self-care and improvement in work and family relationships were among reported benefits. Challenges included
restlessness, physical pain, and dealing with difficult emotions. KEYWORDS: meditation, mindfuhess, nurse, stress,
stress tvanagement Holist Nurs Pract 2005,9{2):lH-S6
An 8-week mindfulness-based stress reduction
(MBSR) program, based on the University of
Massachusetts Medical Center program created by
Jon Kabat-Zinn,’ was offered to nurse professionals at
Lehigh Valley Hospital and Health Network
(LVHHN). The effects of MBSR on nurse stress and
burnout were studied and presented in a 3-part
series. Part I reported on the rationale for offering
MBSR to nurses and the process of developing and
implementing a program within the LVHHN
system.^ Part II of the series presented the quantitative
data analysis, reporting the effects of MBSR on
burnout, psychological distress, and mindfulness.-‘
This article, Part III, highlights qualitative data
analysis.
Qualitative methodology was chosen for data
collection and analysis in this phase of the project for
several reasons. First, the number of participants on
From the Lehigh Valley Hospital and Health Network, Allentown, Pa (Drs
Cohen-Katz, Wiley, and Deitrick, and Mss Capuano and Baker); and the
Santa Clara University, Calif (Dr Shapiro).
Corresponding author: Joanne Cohen-Katz, PhD, Lehigh Valley Hospital,
Department of Family Medicine, 17th & Chew Sts, Allentown, PA 18105
(e-mail: [email protected]).
Clarification: The authors of “The Effects of Mindfulness-based Stress Re-
duction on Nurse Stress and Burnout, Part II: A Quantitative and Qualitative
Study,” Holist Nurs Pract, 2005;19(l):26-35 were listed incorrectly. The
correct authors are as follows: Joanne Cohen-Katz, PhD, Susan Wiley, MD,
Terry Capuano, MSN, MBA, Debra M. Baker, MA, Sharon Kimmel, MHA,
PhD, and Shauna Shapiro, PhD.
whom we collected quantitative data was small
(Â — 25), suggesting that these measures should be
interpreted with caution and supplemented with other
types of analysis. Second, because almost no data
exist examining the impact of MBSR on nurse burnout
and stress, qualitative data allowed us to explore issues
in a more open-ended way and helped uncover areas to
be explored in future studies.
Third, literature on the nurse as healer, explored in
Part I,̂ suggested that many aspects of becoming a
healer are difficult to capture through existing
quantitative measures; for example, self-care,
self-awareness (wounded healer)
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