Mindfulness Based Stress Reduction and Workplace Burnout: A Literature Review
Background: Burnout is a significant issue in the healthcare workplace (Aiken et al. 2002) Nurse burnout leads to negative effects that impact the overall health of the nurse with the potential of producing chronic physical and mental health conditions (Asuero et al. 2014) In addition to the nurse's own compromised health, nurse burnout can adversely influence the quality of patient care provided (Poghosyan et al. 2010) and the engagement of the nurse in providing empathetic and compassionate care to patients due to compassion fatigue, which facilitates a decline in motivation and helping patients achieve their healthcare goals (Mahon et al. 2017) Nurse burnout has also been found to impact job satisfaction (Aiken et al. 2002) which could negatively impact healthcare organizations due to decreased nurse retention rates. Mindfulness Based Stress Reduction (MBSR) has been introduced as an intervention that brings about awareness and attentiveness to an experience (Halm, 2017) MSBR training enables the user to learn strategies that are aimed at decreasing anxiety and stress resulting in ultimately, a decrease in burnout rate (Halm, 2017; Smith, 2014) MSBR helps the user focus on the present moment by implementing healthier ways to respond to stressors. Within the framework of MSBR, the user becomes amenable to purposefully accepting the present moment. Attentiveness of the present moment cultivates alleviation of stress through emotional adaptation (Halm, 2017) MSBR promotes self awareness by embracing the raw emotion and experience for its accurate significance without judgement in the moments as they occur. Objective: To evaluate the PICO question: Do healthcare workers who practice mindfulness based stress reduction (MSBR) in the workplace report a lesser rate of burnout as compared to healthcare workers who do not employ MSBR? Methods: A review of the literature was conducted to explore current evidence on the impact of MBSR on healthcare worker burnout. The search strategy involved collecting research articles from the following databases: Cumulative Index to Nursing and Allied Heath Literature (CINHAL) SUMSearch, and PubMed. The following search terms were used: "mindfulness AND burnout" "mindfulness based stress reduction AND nurse" "healthcare worker AND burnout" "workplace" with a date limit of the past 5 years. Research studies that included nurses and MBSR or a similar mindfulness technique were included. Findings: Of the six research studies included, 1 was a randomized controlled trial (Asuero et al. 2014) 2 were quasi experimental designs (Duarte Pinto Gouveia, 2016; Mahon et al. 2017) and 3 used nonexperimental designs (dos Santos et al, 2016; Vaclavik et al. 2018; Westphal et al. 2015) Interventions varied in duration from 6 to 8 weeks. Most mindfulness courses were held weekly with the weekly sessions ranging from 1 to 2.5 hours in length. One study provided the intervention several days during the week within a 6 week period (dos Santos et al, 2016) Additionally participants in several studies were instructed to practice mindfulness principals throughout the week. The MBSR related outcomes evaluated included burnout (Asuero et al. 2014; dos Santos et al, 2016; Duarte Pinto Gouveia, 2016; Westphal et al. 2015) stress (dos Santos et al, 2016; Mahon et al. 2017) distress (Vaclavik et al. 2018) anxiety (dos Santos et al, 2016; Westphal et al. 2015) depression (dos Santos et al, 2016; Westphal et al. 2015) and compassion/compassion fatigue (Duarte PintoGouveia, 2016; Mahon et al. 2017) The collaborative findings demonstrated favor for the incorporation of MSBR in the workplace to decrease healthcare worker burnout. Components of MSBR such as mindfulness meditation and self compassion training provided the tools necessary to enhance nurses' compassion, increase engagement, and reduce perceived stress. These findings highlight the fact that nurses have a high level of job related stressors that can lead to negative physical and mental health and subsequent burnout. MSBR is a practical tool that can be provided to staff to effectively reduce stress, improve overall well being, and decrease burnout among nurses. The literature review revealed that the majority of participants receiving the MBSR intervention reported an increase in both physiologic and psychologic well being, an increase in compassion, improved clinical outcomes, increase in work satisfaction, as well as an improvement in overall life satisfaction after completion and implementation of MSBR (see Table 1) An evidence grid of the literature review findings will be presented. Conclusions: The evidence supports the effectiveness of MBSR in reducing burnout. All studies supported the use of a mindfulness based program for the reduction or prevention of healthcare professional burnout or stress. Additional benefits of MBSR included decreased depression, decrease in anxiety, decrease of distress, and increased compassion fatigue. Title: Mindfulness Based Stress Reduction and Workplace Burnout: A Literature Review