Mindfulness as an Intervention to Mitigate and Decrease Rates of Burnout in Registered Nurses: A Systematic Literature Review
The aim of this review is to explore the effects of mindfulness-based interventions on Registered Nurse's rate of burnout and stress. Particularly focusing on the mitigation and decrease of burnout. Burnout is a multifaceted, complex issue that has become engrained in the culture of nursing and a widespread epidemic. Burnout has detrimental effects for the quality of life of the nurse, patient outcomes, interprofessional collaboration, and nursing practice. A systematic literature review incorporating qualitative data and analyzing the quantitative data was conducted. Studies on the effects of mindfulness-based interventions for nurses relating to burnout published between January 2008 and May 2018 were identified through a systematic search in electronic databases: CINHAL, Cochrane, Embase, Medline, PsycInfo, and PubMed. Gray literature was searched through Scopus and clinical trials were explored through clincialtrials.gov. Data analysis was based on 8 data points that were extracted from the research. A total of 17 articles were selected for inclusion in the systematic literature review. There were several different types of studies including single group intervention study, randomized control trial interventions studies, mixed model, quasi-experimental studies with controls, and a non-randomized controlled comparison. All relied on self-reporting scales and questionnaire for quantitative pre-post intervention changes. Overall, the 10 of the 17 studies found that there was a statistically significant decrease in burnout rates and an increase in mindfulness post intervention. Several other factors improved in a number of studies such as quality of life, decreased stress, increased sense of personal accomplishment, and decreased emotional exhaustion. There were also indications of an improvement in the individual's holistic well-being (e.g. inner state of calmness, awareness and enthusiasm) relating to improved mindfulness levels in 12 of the studies. Based on the results of this systematic review, mindfulness may be considered a potentially effective intervention for decreasing nurse burnout and mitigating future burnout. This intervention could be useful in a number of contexts including on-site and off-site programs with institutional support. Future research should explore longitudinal outcomes of mindfulness practice, symptom focused outcome measures, and multi-modal studies.