An on-the-job mindfulness-based intervention for pediatric ICU nurses: a pilot

Chaplain care for health care colleagues: a scoping review

In addition to supporting patients and their loved ones at critical times, chaplains have long understood that caring for their health care colleagues is an important part of their practice. The Covid-19 pandemic prompted conversations among chaplains about how best to address the stress they were observing in health care workers. Our team conducted a scoping review in PubMed and CINAHL of peer reviewed literature describing chaplaincy care for health care workers. We started with 364 unique articles and found 59 that met criteria for the review. Five themes surfaced in analysis of these articles, with two themes emerging as most important: (1) descriptions of care for staff as part of the chaplain's role, especially when staff are making difficult decisions and (2) reports of the effects of chaplain care for staff, both indirect and direct. We discovered that research was limited, and more research is needed regarding chaplain care for health care colleagues.

Developing Self-Compassion in Healthcare Professionals Utilising a Brief Online Intervention: A Randomised Waitlist Control Trial

(1) Background: The level of stress experienced by staff in the healthcare sector is highly prevalent and well documented. Self-compassion may support the health and wellbeing of individuals and enable them to stay well at work. This study aimed to understand whether a brief, online, self-guided, novel intervention improved the health and wellbeing of healthcare professionals. (2) Methods: In a parallel randomised controlled trial, a volunteer sample of healthcare professionals were assigned to an intervention group (n = 110) or a waitlist control group (n = 80). Measures of self-compassion, mental wellbeing, stress and burnout were collected by an online questionnaire at baseline, post-programme and, for the intervention group, at follow-up. (3) Results: This intervention appeared to be effective in increasing self-compassion and mental health and decreasing stress and burnout. Significant group effects and significant time × group interactions for overall self-compassion [F (2, 183) = 32.72, p < 0.001; effect size ηp2 = 0.226], mental wellbeing [F (2, 212) = 17.46, p < 0.001; effect size ηp2 = 0.135], perceived stress [F (2, 205) = 5.42, p = 0.006; effect size ηp2 = 0.46], personal burnout [F (2, 224) = 7.57, p = 0.001; effect size ηp2 = 0.063] and work burnout [F (2, 208) = 7.39, p = 0.001; effect size ηp2 = 0.062] were found. (4) Conclusions: This study shows promise that an affordable and scalable intervention can be effective for busy healthcare professionals operating in a significantly challenging environment.

The Impact of Loving-Kindness Meditation on Job-Related Burnout of Nurses Working in Neonatal Intensive Care Unit: A Randomized Clinical Trial Study

Job-related burnout is one health outcome in nurses working in neonatal intensive care units (NICUs) due to the heavy workload, which results in negative physical and psychological consequences. One newly introduced approach to improve coping is loving-kindness meditation (LKM). Some studies have shown the effectiveness of the LKM on the mental health of nurses, though more evidence is required to support them. This study aimed to investigate the effectiveness of the LKM on job-related burnout of nurses working in NICU. This clustered controlled randomized clinical trial assessed job-related burnout before and after a month of practicing LKM guided through a virtual method. A total of 66 eligible NICU nurses from 2 referral children hospitals in Tehran were randomly assigned to 2 control (n = 33) and intervention (n = 33) groups. The intervention was performed 3 times a week for 1 month in the form of 20-minute audio files of LKM for the intervention group, and educational files on mental health during the COVID-19 pandemic were sent to the control group. The instruments used in this study were the demographic information questionnaire and the Maslach Burnout Inventory, which participants completed before and after the intervention. The mean difference in the overall scores of burnout before and after the intervention in the intervention group was significantly reduced (P = .003), but no significant difference was observed in the control group (P = .018). These findings support the benefit of LKM in NICU nurses in reducing burnout.

Variations in the Five Facets of Mindfulness in Italian Oncology Nurses according to Sex, Work Experience in Oncology, and Shift Work

BACKGROUND

Oncology nurses support cancer patients in meeting their self-care needs, often neglecting their own emotions and self-care needs. This study aims to investigate the variations in the five facets of holistic mindfulness among Italian oncology nurses based on gender, work experience in oncology, and shift work.

METHOD

A cross-sectional study was carried out in 2023 amongst all registered nurses who were employed in an oncology setting and working in Italy.

RESULTS

There were no significant differences in all five facets of holistic mindfulness (p ≥ 0.05) according to gender, work experience in the oncology field, and shift work.

CONCLUSION

Could holistic mindfulness be defined as an intrinsic individual characteristic? Surely, more insights will be necessary to better define the holistic trend in oncology nursing.

The influence of socio-cognitive mindfulness, moral sensitivity and dementia communication behaviors on dementia nursing performance of nurses in long-term care hospitals: a cross-sectional study

BACKGROUND

By incorporating socio-cognitive mindfulness which has been under-examined in the nursing field, this study investigated the relationships between socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance of nurses in long-term care hospitals. This study also examined the factors influencing nurses' dementia nursing performance.

METHODS

A cross-sectional study was conducted with 209 nurses from long-term care hospitals in Korea. Data were collected between August 1 and August 31, 2022. Participants completed the questionnaire assessing their socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance. Pearson's correlation and hierarchical multiple regression analysis were performed for data analysis.

RESULTS

Dementia nursing performance of the nurses in long-term care hospitals was positively related to their socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors. Furthermore, nurses' dementia communication behaviors, moral sensitivity, and total clinical career, in that order, were found to be the factors influencing their dementia nursing performance.

CONCLUSION

The findings indicate that the higher socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors, the higher dementia nursing performance, and that higher dementia nursing performance is associated with better dementia communication behaviors, greater moral sensitivity, and more extensive clinical experiences. This study provides a foundation for developing effective interventions to enhance dementia nursing performance in the future. To improve dementia nursing performance of nurses in long-term care hospitals, it is necessary to improve dementia communication behaviors and moral sensitivity, and prepare multilateral countermeasures to maintain nurses' clinical careers.

Moderators and mediators of effects of interventions to reduce stress in hospital employees: A systematic review

This systematic review examines moderators and mediators tested in evaluations of stress management interventions for hospital employees to determine their significance for intervention outcomes. To be included, studies had to comprise a moderator or mediator analysis and a quantitative assessment of stress or mental well-being, and to be published in English or German language. Five databases (APA PsycInfo, APA PsycArticles, Embase, Medline, and Web of Science) were searched. Moderators and mediators were categorised thematically and examined using effect direction plots. Study quality was assessed using RoB 2 and ROBINS-I. In fifteen included studies, 22 moderators and ten mediators were identified. Moderators and mediators were categorised into individual psychological factors (14), socio-economic status (6), work situation (5), intervention (3), and duration of employment (3). Two moderators (perceived stressfulness of residency, job control) had a positive, two a negative impact (spirituality, socially desirable responding). One moderator (years of professional experience) had a positive and negative impact. Three moderators measured on categorical scales (gender, profession, and shiftwork) also had effects, favouring women, physicians and night-shift employees. Five mediators (adherence to intervention, mindfulness, non-reactivity to inner experience, total observing, and self-compassion) had a positive impact, while three (isolation, over-identification, psychological inflexibility) had a negative impact. In conclusion, effects of interventions were predominantly driven by individual psychological factors, while the role of other variables seems to be limited. Interventions focussing on primary or tertiary prevention were rare. Also processes through which organisational-level interventions can be most effective have been hardly investigated. Larger and methodologically robust studies are needed to better understand causal pathways and optimise matching of interventions to target groups.

Supporting staff: The role of health care chaplains

The aim of this study was to describe the range of spiritual care activities in support of clinical colleagues at a subset of U.S. hospitals. A descriptive cross-sectional design using a 76-item Zoom/telephone guided survey containing a subset of staff care questions was employed. Data were provided by directors/managers responsible for spiritual care services at the 2020-2021 U.S. News & World Report top hospitals. Results identified staff support as an important chaplaincy function at both organizational and spiritual care department levels. Staff chaplains at over half of the hospitals spend an estimated 10-30% of their time on staff care, with chaplains in five hospitals spending greater than 30%. The most frequently reported activities were religiously associated, such as blessings and rituals for hospital events. Additionally, chaplains actively support staff during critical events such as patient deaths and through organizational protocols such as code lavender and critical incident debriefings. Chaplain support for staff most commonly grew out of personal relationships or referrals from clinical managers. Future research opportunities in this area include systematic data collection for chaplains' specific staff support activities as well as efforts to investigate the impact of those activities on patient experience.

Implementing Brief Mindfulness-Based Interventions to Reduce Compassion Fatigue

BACKGROUND

Nurses in surgical-trauma units are susceptible to compassion fatigue due to work-related stressors. Mitigating and preventing compassion fatigue are critical to supporting the health and well-being of surgical-trauma nurses.

LOCAL PROBLEM

During the COVID-19 pandemic, a surgical-trauma unit was converted to a designated COVID-19 unit. Nurses verbalized feelings of burnout and stress during the pandemic and did not have a mechanism to cope with work-related stress. This project evaluated the impact of brief mindfulness-based interventions on compassion fatigue.

METHODS

From February 2021 to March 2022, mindfulness champions led 5 minutes of mindfulness-based interventions, including meditation, deep breathing, and self-compassion exercises, during shift huddles. The Professional Quality of Life, version 5, questionnaire was used to evaluate preintervention and postintervention burnout, secondary traumatic stress, and compassion satisfaction. Paired-sample t tests were used to evaluate the results.

RESULTS

Twenty-nine of 34 nurses responded (85% response rate) with matched preintervention and postintervention questionnaires. All subscale scores showed significant improvement after intervention. The mean burnout subscale score decreased by 9.35% (P = .003), mean secondary traumatic stress subscale score decreased by 11.89% (P = .005), and mean compassion satisfaction subscale score increased by 6.44% (P = .03) after intervention.

DISCUSSION

After implementing brief mindfulness-based interventions in shift huddles, nurses reported reductions in elements of compassion fatigue (burnout and secondary traumatic stress). Nurses reported that adding brief mindfulness-based interventions to shift huddles helped them cope with work-related stress.

CONCLUSIONS

Brief mindfulness-based interventions can improve nurses' compassion satisfaction while reducing compassion fatigue measurements.

Empathy, sympathy, and altruism-An evident triad based on compassion. A theoretical model for caring

BACKGROUND

Based on existing confusion and a suggested contradiction regarding empathy and compassion in relation to caring science as well as in clinical health care.

AIM

The aim of the study was to find a knowledge base for the development of clinical caring science for, empathy, sympathy altruism, and compassion and their mutual relationship.

DESIGN

A theoretical paper.

RESULTS

The text discusses the different concepts separately, considering their history, research, obstacles, and bias and then brings them together in a concept model. The conclusion shows that empathy, sympathy, and altruism have no contradictions. Instead, they together form an evident triad based on compassion. Compassion is a prerequisite and a basis for the others to work. In clinical application, empathy is metaphorically a quality coming from the head, sympathy from the heart and altruism from the hand, merged in an attitude of compassion as a motif to care. The paper also reflects on the possibilities to increase and develop a compassionate mood and capacity by education and training.

Effects of a brief interpersonal mindfulness program embedded in a psychiatric nursing practicum: A controlled pilot study

BACKGROUND

Nursing school is a stressful environment that demands high performance both professionally and academically. Interpersonal mindfulness training has shown promise for its stress-reducing capacity in other contexts; however, few descriptions or tests of this method in nursing training settings exist in the literature.

PURPOSE

This pilot study examined effects of a brief interpersonal mindfulness program embedded in a 4-week psychiatric nursing practicum in Thailand.

METHODS

Mixed methods were used with 31 fourth-year nursing students to measure changes in mindfulness and assess their experiences of the program's impact. The control and experimental groups received the same clinical training, but the experimental group was also trained to practice interpersonal mindfulness throughout the course.

FINDINGS

The experimental group reported statistically significantly greater increases in Observing, Describing, and Non-reacting subscale scores, and in scores for the overall Five-Facet Mindfulness questionnaire, Thai version, than the control group (p < .05, Cohen's d = 0.83-0.95, large effect sizes). Group interviews revealed themes: initial challenges to mindfulness practice, experiences of becoming more mindful, intrapersonal benefits, and consequences of mindfulness on interpersonal skills.

CONCLUSION

Overall, an interpersonal mindfulness program embedded in a psychiatric nursing practicum was effective. Further studies are required to address limitations of the present study.

Individual-level interventions for reducing occupational stress in healthcare workers

BACKGROUND

Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions.  OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms.  SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022.

SELECTION CRITERIA

We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms.  DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour);  2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise);  3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above.  The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended).  MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised.  The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants.  Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention  Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention.  A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type  Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar.

AUTHORS' CONCLUSIONS

Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.

Anxiety and sleep quality among front-line nurses treating first wave COVID-19 in China: The mediating role of mindfulness

AIM

To explore anxiety, sleep quality, and mindfulness of frontline nurses at the initial epicenter of the pandemic, to examine the mediating effects of mindfulness.

BACKGROUND

COVID-19 was first identified in Wuhan, China in January 2020. Nurses were at the forefront of care and treatment across hospitals in response to the pandemic.

METHODS

Single site cross-sectional survey conducted in Wuhan province (China) between March and April in 2020. Quantitative analysis of survey data from N118 nurses working in the frontline COVID response. Questionnaires included: The general information questionnaire, the Self-Anxiety Scale, the Short Inventory of Mindfulness, and the Pittsburgh Sleep Quality Index.

RESULTS

Front-line nurses' anxiety was positively associated with sleep quality and mindfulness was negatively associated with anxiety and sleep quality. Mindfulness had a mediating role on anxiety and sleep quality, with intermediary adjustment effects (ES = 0.136, 95 % CI 0.02 to 0.26), accounting for 21.9 % of the total effect ratio.

CONCLUSIONS

Anxiety causes a reduction in sleep quality and mindfulness can help with anxiety. Mindfulness strategies may help during periods of higher anxiety in the workplace; however, other factors must be considered. Further research is required on strategies for assisting nurses during periods of extreme anxiety.

Mediating effects of emotion regulation between socio-cognitive mindfulness and empathy in nurses: a cross-sectional study

Background

Acknowledging the under-examined research of socio-cognitive mindfulness and Gross’s emotion regulation strategies in nursing, this study investigated the relationships between socio-cognitive mindfulness, emotion regulation (i.e., reappraisal and suppression), and empathy among nurses. It also explored the mediating effects of emotion regulation.

Methods

A cross-sectional quantitative study was conducted in a sample of 245 nurses from two university hospitals in South Korea. Convenience sampling was used to collect data between August 3 and September 29, 2020. Participants completed the questionnaire measuring their socio-cognitive mindfulness, emotion regulation, and empathy. Structural equation modeling and path analysis were conducted for data analysis.

Results

Socio-cognitive mindfulness positively influenced emotion regulation of reappraisal (β = 0.404, p < 0.01) and empathy (β = 0.402, p < 0.01), but negatively influenced emotion regulation of suppression (β = −0.149, p < 0.05). Reappraisal positively influenced empathy (β = 0.341, p < 0.01), whereas suppression negatively influenced empathy (β = −0.127, p < 0.05). Importantly, emotion regulation of reappraisal mediated the association between socio-cognitive mindfulness and empathy (a X b = 0.107, p < 0.01).

Conclusion

The findings indicate that socio-cognitive mindfulness is effective in improving empathy among nurses by enhancing reappraisal. This study can provide a foundation for developing socio-cognitive mindfulness or emotion regulation programs to improve empathy among nurses, which would ultimately lead to better nursing performance by increasing patient satisfaction.

Brief mindful coloring for stress reduction in nurses working in a Hong Kong hospital during COVID-19 pandemic: A randomized controlled trial

BACKGROUND

Effective interventions to promote well-being at work are required to reduce the prevalence and consequences of stress and burnout especially during the COVID-19 pandemic. This study determined the effects of mindful coloring on perceived stress levels, mental well-being, burnout, and state and trait mindfulness levels for nurses during COVID-19.

METHODS

This was a single-center, two-armed, parallel, superiority, blinded randomized controlled trial. Seventy-seven participants were randomly allocated (by computer-generated sequence) to either mindful coloring (n = 39) or waitlist control groups (n = 38). Twenty-seven nurses in the mindful coloring group and 32 in the control group were included in the full compliance per protocol analysis. The mindful coloring intervention included participants viewing a 3-minutes instructional video and coloring mandalas for at least 5 working days or 100 minutes in total during a 10-day period. Participants in both groups completed the Perceived Stress Scale (total score 0-40), short Warwick-Edinburgh Mental Well-being Scale (total score 7-35), Maslach Burnout Inventory-Human Services Survey for Medical Personnel (3 subscales), Five Facets Mindfulness Questionnaire-Short Form (total score 24-120) and Mindful Attention Awareness Scale-State version (total score 0-30) instruments. The primary outcome was the perceived stress level.

RESULTS

Baseline prevalence of moderate to high perceived stress level was high (79.2%). There was a large mindful coloring effect on reducing mean perceived stress levels (Mean difference [MD] in change between groups -3.0, 95% CI: -5.0 to -1.00; Cohen's d = 0.80). Mindful coloring may lead to a small improvement in mental well-being level (P = .08), with an improvement found in the intervention group (MD 0.9, 95% CI 0.0-1.8, P = .04) through enhanced state mindfulness (P < .001). There were no effects on changing burnout subscales or trait mindfulness levels. No adverse reactions were reported.

CONCLUSION

Coloring mandalas may be an effective low-cost brief intervention to reduce perceived stress levels through enhancing state mindfulness and it may promote mental well-being. Hospitals may promote or provide mindful coloring as a self-care and stress-relief practice for nurses during their off hours or work breaks.

Implementing a Protocol to Address Risk for Burnout Among Mental Health Professionals

BACKGROUND

The magnitude for potential burnout is enormous. The Centers for Disease Control and Prevention, Center for Addiction and Mental Health, and Substance Abuse and Mental Health Services Administration reported diagnoses of psychiatric and substance use disorders are at an all-time high for physicians, psychiatrists, nurses, social workers, and psychologists.

OBJECTIVE

Reduce the potential for burnout among outpatient mental health clinicians and staff.

METHOD

Develop an agency wellness protocol utilizing evidence-based interventions to reduce the potential for clinician and staff burnout.

RESULTS

Survey data indicated low to moderate levels of burnout and depersonalization. Staff and clinician recommendations provided during feedback sessions were incorporated with evidence-based interventions to establish a wellness protocol.

CONCLUSION

Implementing evidence-based interventions in a wellness protocol may reduce the potential for clinician and staff burnout.

Health Promotion for Outpatient Careworkers in Germany

Due to ongoing demographic changes, the need for care is increasing in Germany. The number of outpatient care services is also rising, and with it, the number of employees in outpatient care, who are also continuously becoming older. Workplace health promotion (WHP) becomes relevant in this context, as it can reduce negative strain reactions and promote employees’ health. The aim of this study was (1) to reveal implemented WHP interventions in German outpatient care services; (2) to examine the potential challenges regarding a successful implementation of WHP measures; and (3) to illuminate further requests and needs experienced by outpatient careworkers. In qualitative field research, 30 semi-structured individual interviews were conducted with German caregivers, using the problem-centered interview method. The collected data were deductively and inductively evaluated and interpreted, using qualitative content analysis according to Mayring. Outpatient caregivers reported various WHP measures known from their workplaces, such as the provision of fruit baskets, programmes to increase physical activity, or a subsidy for a personal gym. They further reported WHP, such as back training, known from other care services. However, the respondents spoke of the challenges regarding the implementation or the use of WHP interventions in general. The most frequently named barriers were a lack of time after work and interventions that were only offered in their leisure time. In the same course, the participants still needed offers to increase physical activity, joint activities, or relaxation techniques. However, respondents highlighted that they preferred the interventions to take place during working hours. This way, they would also be more likely to take advantage of the interventions. The results of this study provide an insight into various WHP measures that already exist, or that are desirable for implementation with regard to caregivers’ needs. Subjectively perceived challenges for a successful implementation of WHP measures represent the importance of adjustments in the work organization of caregivers. It becomes clear that WHP is not yet established in the ambulant care sector, although it appears to be imperative for keeping caregivers healthy. Considering the different needs of employees, the results can provide a basis for the development of needs-based health promotion measures for caregivers.

"Room to Reflect": A Pilot Workplace Resiliency Intervention for Nurses

Rising workload demands for nurses necessitate the implementation of easily accessible and innovative clinician well-being resources on health care units. This pre/post pilot study sought to measure the impact of a mobile workplace intervention, “Room to Reflect” on staff nurse and nurse manager resilience. A mobile toolbox with a sound machine, Virtual Reality headset, and associated Quick Response code audio/video offerings, and a paper Pocket Guide of mindful restoration practices were provided to 7 health care units for a 3 month period. Pre/post questionnaires assessed perceived resilience using the Connor-Davidson Resilience scale, and intervention feasibility (ease of use), accessibility (spaces used), and effectiveness (restoration). Data analysis consisted of descriptive statistics, paired and independent samples t-tests, and Wilcoxon Signed Rank tests. From the pre (n = 97) to post (n = 57) intervention period, there was a significant difference in resilience for Clinician 3 staff nurses. A mean increase in resilience was noted among nurse managers following participation in the intervention, z = −2.03, p < 0.05. The Pocket Guide was the easiest offering to use, while VR offerings were accessed the most through Quick Response code. Space and time were the most common barriers to Room to Reflect use. Staff nurses felt supported by managers to use the program, and managers perceived that the program improved nurse job satisfaction.

Emergency Department Nurses' Experiences of a Mindfulness Training Intervention: A Phenomenological Exploration

Purpose: The purpose of this study was to explore emergency care nurses' experiences of an intervention to increase compassion and empathy and reduce stress through individual mindfulness training delivered via workshops and a smartphone application. We also explored how the nurses felt about the practical and technical aspects of the intervention. Design: Qualitative interview study. Method: Individual interviews were conducted with eight of the 56 participants in the intervention study and used phenomenological analysis to illuminate how they made sense of their lived experiences of mindfulness training. Findings: Three themes illuminated the nurses' experiences: becoming aware, changing through mindfulness, and gaining the tools for mindfulness through workshops and the mobile application. The first two themes expressed personal experiences, whereas the third expressed experiences of the practical and technical aspects of the intervention. Most nurses found the mobile application easy to use and effective. Conclusions: Emergency care nurses can feel that the awareness and changes that come with mindfulness training benefit them, their colleagues, and the patients for whom they care. The findings also provide insights into the challenges of practicing mindfulness in a busy emergency care setting and into the practical aspects of using a smartphone application to train mindfulness.

Effects of Classical Music Virtual Reality on Pediatric Healthcare Worker Compassion Fatigue

OBJECTIVE

The aim of this study was to explore the impact of classical music virtual reality (VR) on burnout, secondary traumatic stress, anxiety, and capacity for developing caring relationships with patients among healthcare workers (HCWs).

BACKGROUND

COVID-19 accentuated the importance of promoting the well-being of frontline workers. Efforts to address the mental health needs of HCWs are likely to positively impact patient outcomes.

METHODS

Healthcare workers completed 3 sessions of VR. A Wilcoxon rank-sum test was used to compare premeasure versus postmeasure on the Professional Quality of Life (ProQOL), State Trait Anxiety Inventory, and Caring Ability Inventory. Analysis of variance was performed to identify associations between the intervention and differences in scores for each ProQOL domain. Bonferroni correction adjusted for multiple comparisons. Fisher's t test was used for categorical analysis.

RESULTS

Seventy-one HCWs completed the study. There was a significant reduction in burnout after the experience, compared with baseline.

CONCLUSIONS

This study provides evidence that classical music VR may reduce burnout in HCWs.

5-min mindfulness audio induction alleviates psychological distress and sleep disorders in patients with COVID-19

BACKGROUND

Mindfulness meditation is beneficial to mitigate the negative effects of the coronavirus disease 2019 (COVID-19) pandemic in the general population, but no study examined such meditation in the COVID-19 patients themselves.

AIM

To explore the short-term efficacy of mindfulness meditation in alleviating psychological distress and sleep disorders in patients with COVID-19.

METHODS

This prospective study enrolled patients with mild COVID-19 treated at Wuhan Fangcang Hospital in February 2020. The patients were voluntarily divided into either a mindfulness or a conventional intervention group. The patients were evaluated before/after the intervention using the Short Inventory of Mindfulness Capability (SMI-C), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI).

RESULTS

Seventy-five participants were enrolled in this study, with 43 and 32 in the mindfulness and conventional groups, respectively. Before the intervention, there were no differences in SMI-C, HADS, or PSQI scores between the two groups. After the 2-wk intervention, the mindfulness level (from 30.16 ± 5.58 to 35.23 ± 5.95, P < 0.001) and sleep quality (from 12.85 ± 3.06 to 9.44 ± 3.86, P < 0.001) were significantly increased in the mindfulness group. There were no differences in the conventional group. After the intervention, the mindfulness level (35.23 ± 5.95 vs 31.17 ± 6.50, P = 0.006) and sleep quality (9.44 ± 3.86 vs 11.87 ± 4.06, P = 0.011) were significantly higher in the mindfulness group than in the conventional group. Depression decreased in the mindfulness group (from 14.15 ± 3.21 to 12.50 ± 4.01, P = 0.038), but there was no difference between the two groups.

CONCLUSION

Short-term mindfulness meditation can increase the mindfulness level, improve the sleep quality, and decrease the depression of patients with COVID-19.

The Effect of a Mindfulness-Based Intervention on Nurses in Kelantan, Malaysia

Background

Among healthcare workers, nurses have a particularly high risk of stress. Stressful conditions in the workplace increase the possibility of burnout and psychological distress. Short mindfulness-based interventions can help to decrease stress, anxiety and depression. This study aimed to explore the effectiveness of a mindfulness-based intervention in reducing perceived stress, anxiety and depression among public teaching hospital staff nurses.

Methods

Thirty-five nurses from various specialities were recruited from Hospital Universiti Sains Malaysia (HUSM). The intervention comprised a 1-day brief mindfulness-based intervention workshop and 1 h group practice session each month for 3 months together with daily follow-up via WhatsApp group. All the participants completed a self-administered sociodemographic questionnaire validated for use in a Malay population. The Depression, Anxiety and Stress Scale 21 (DASS 21) and Perceived Stress Scale 10 (PSS 10) were used to measure perceived stress, anxiety and depression before the intervention, and 3 months later upon completion of the intervention.

Results

There was a statistically significant reduction in the scores for stress perception (95% confidence interval [CI]: 0.06, 2.92; P = 0.04) and anxiety (95% CI: 0.06, 2.34; P = 0.04) post-intervention.

Conclusion

A brief mindfulness-based intervention was effective in reducing perceived stress and anxiety among nurses.

Mindfulness for Outpatient Oncology Nurses: A Pilot Study

This prospective pre-/posttest pilot studied a mindfulness-based stress reduction (MBSR) intervention first, to reduce self-reported stress and improve compassion satisfaction; and second, to reduce physiological indices of stress. Even small interventions of MBSR before a shift effectively reduces the physiological indices of stress and may help reduce compassion fatigue and burnout in nurses.

Psychosocial and psychological interventions' effectiveness among nurses in intensive care units caring for pediatric patients: A systematic review and meta-analysis

OBJECTIVE

This review aimed to evaluate the effectiveness of psychosocial and psychological interventions in nurses among intensive care units caring for pediatric patients.

METHODS

A literature search was performed in PubMed, EMBASE, CINAHL databases, using preferred reporting items for systematic reviews and meta-analysis guidelines. Study design, population characteristics, contents of the programs, measured outcomes, and results were systematically reviewed from 8 selected studies. To estimate the effect size, a meta-analysis of the studies was performed using the RevMan 5.3 program. The effect size used was the standardized mean difference.

RESULTS

Of 1,630 studies identified, 4 met the inclusion criteria, and 3 studies were used to estimate the effect size of psychosocial and psychological interventions. The primary outcome variable of these studies was stress. The effect of the intervention program on stress was also found to have no effect in individual studies, and the overall effect size was not statistically significant (standardized mean difference = -0.06; 95% confidence interval: -0.33, 0.20; Z = 0.48, p = 0.630). However, according to the individual literature included in this study, after the stress management program was applied as a group, a significant stress reduction was shown in the experimental group (p = 0.021).

CONCLUSIONS

These results show that psychosocial and psychological interventions were effective in stress management by a group approach. Therefore, it is necessary to develop psychosocial support interventions for stress management of nurses among intensive care units caring for pediatric patients more diversely.

The Relationships of End-of-life Care Stress with Compassionate Competence and Attitudes toward End-of-life Care among Pediatric Nurses

Purpose

This study aimed to provide basic data for developing interventions to relieve the end-of-life care stress experienced by pediatric nurses by examining the relationships of end-of-life care stress with compassionate competence and attitudes toward end-of-life care.

Methods

Data were collected via a survey that was conducted from September 10 to September 30, 2018 and administered to 113 nurses who had worked for more than 6 months in a pediatric unit at a tertiary hospital in Seoul, South Korea. The data were analyzed for frequency, percentage, mean, and standard deviation, and the independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 25.0.

Results

End-of-life care stress among pediatric nurses had a weak positive correlation (r=0.216, P<0.05) with compassionate competence and had no significant correlation with attitudes toward end-of-life care. Among the sub-factors of end-of-life care stress, psychological difficulties had a weak positive correlation with sensitivity (r=0.309, P<0.01) and communication (r=0.230, P<0.05), which are aspects of compassionate competence. Lack of knowledge about end-of-life care had a weak positive correlation with communication (r=0.209, P<0.05) as an aspect of compassionate competence.

Conclusion

To improve the quality of end-of-life care provided by pediatric nurses, it is necessary to improve their compassionate competence and reduce their end-of-life care stress by developing education and support programs tailored to the characteristics of children and specific communication methods.

The Impact of COVID-19: Nurses Occupational Stress and Strategies to Manage It

OBJECTIVE

The aim of this study was to explore the occupational stress perception of nurses and how they manage it during the COVID-19 pandemic.

BACKGROUND

The management of occupational stress is a key factor in promoting nurses' well-being.

METHODS

A descriptive cross-sectional study was conducted.

RESULTS

The top occupational stressors from the nurses' perspectives (N = 236) as measured by using an updated version of the Nursing Stress Scale (NSS) included wearing a face mask at all times in the hospital, unpredictable staffing and scheduling, not enough staff to adequately cover the unit, feeling helpless in the case a patient fails to improve, and being assigned to a COVID-19 patient. The mean stress score was 31.87. The updated NSS Cronbach's α was 0.92, and the interclass interclass correlation coefficient was 0.914.

CONCLUSION

Nurse administrators are in a strategic position to develop interventions (eg, open door policy, meetings, and employee assistance programs) to assist nurses in effectively managing stress.

Effectiveness of a One Day Self-Compassion Training for Pediatric Nurses' Resilience

BACKGROUND

Resilience is a critical skill for nurses and other healthcare professionals, especially during the COVID-19 pandemic, yet few nurses receive training that promotes emotional awareness and regulation, resilience, and self-compassion.

PURPOSE

The purpose of this study was to understand if attending a one-day workshop format of the Self Compassion for Healthcare Communities (SCHC) program would improve pediatric nurses' resilience, well-being, and professional quality of life.

DESIGN AND METHODS

Following a quasi-experimental design, pre, post, and follow-up surveys were acquired from 22 nurses who attended the training and 26 nurses who did not attend the training. In a linear mixed models regression analysis, changes in self-compassion, mindfulness, compassion, resilience, job engagement, professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress), depression, anxiety and stress were analyzed between groups.

RESULTS

Participants in the intervention exhibited significant increases in self-compassion, mindfulness, compassion to others, resilience and compassion satisfaction, and significant decreases in burnout, anxiety, and stress compared to the non-intervention group.

CONCLUSIONS

A one-day SCHC training program provides nurses with knowledge and skills to increase their resilience and support their emotional well-being and professional quality of life.

PRACTICE IMPLICATIONS

Nurses' schedules may hamper their ability to attend lengthy resilience trainings, yet the skills needed for resilience are crucial to decreasing burnout, empathy fatigue, and turnover. Offering an effective, one-day training provides an accessible alternative for nurses to gain knowledge and skills that increase resilience.

Effects of Holy Name Meditation on the Quality of Life of Hospital Middle Manager Nurses in Korea: A 6-Month Follow-Up

BACKGROUND

Nurses experience poor quality of life due to workload and role stress. In this study, a spirituality-based intervention was administered to nurse managers.

METHOD

A total of 45 nurse managers participated in the study; 24 were assigned to the experimental group, and 21 were assigned to a control group. The Holy Name Meditation Program was provided solely to the experimental group. Pretest, posttest 1 (5 weeks after the intervention), posttest 2 (12 weeks after the intervention), and posttest 3 (24 weeks after the intervention) data were gathered on seven variables, including spiritual well-being, spiritual needs, job satisfaction, leadership, burnout, depression, and self-efficacy.

RESULTS

The experimental group showed significant improvement in spiritual well-being (p < .001), spiritual needs (p = .029), and job satisfaction (p = .005) until the 24-week follow-up. Burnout (p < .001), depression and anxiety (p = .034), and self-efficacy (p = .024) showed significant improvement until the 12-week follow-up. Depression and anxiety (p = .053) showed decreasing tendency until the 24-week follow-up.

CONCLUSION

Evidence suggests this program promotes spiritual and psychosocial well-being of nurse managers. [J Contin Educ Nurs. 2020;51(5):215-224.].

The item network and domain network of burnout in Chinese nurses

Background

As a common social phenomenon, nurses’ occupational burnout has a high incidence rate, which seriously affects their mental health and nursing level. The current assessment mostly uses the total score model and explores the influence of external factors on burnout, while the correlation between burnout items or dimensions is less explored. Ignoring the correlation between the items or dimensions may result in a limited understanding of nurse occupational burnout. This paper explores the item and dimension network structure of the Maslach Burnout Inventory-General Survey (MBI-GS) in Chinese nurses, so as to gain a deeper understanding of this psychological construct and identify potential targets for clinical intervention.

Methods

A total of 493 Chinese nurses were recruited by cluster sampling. All participants were invited to complete the survey on symptoms of burnout. Network analysis was used to investigate the item network of MBI-GS. In addition, community detection was used to explore the communities of MBI-GS, and then network analysis was used to investigate the dimension network of MBI-GS based on the results of community detection. Regularized partial correlation and non-regularized partial correlation were used to describe the association between different nodes of the item network and dimension network, respectively. Expected influence and predictability were used to describe the relative importance and the controllability of nodes in both the item and dimension networks.

Results

In the item network, most of the strongly correlated edges were in the same dimension of emotional exhaustion (E), cynicism (C) and reduced professional efficacy (R), respectively. E5 (Item 5 of emotional exhaustion, the same below) “I feel burned out from my work”, C1 “I have become more callous toward work since I took this job”, and R3 “In my opinion, I am good at my job” had the highest expected influence (z-scores = 0.99, 0.81 and 0.94, respectively), indicating theirs highest importance in the network. E1 “I feel emotionally drained from my work” and E5 had the highest predictability (E1 = 0.74, E5 = 0.74). It shows that these two nodes can be interpreted by their internal neighbors to the greatest extent and have the highest controllability in the network. The spinglass algorithm and walktrap algorithm obtained exactly the same three communities, which are consistent with the original dimensions of MBI-GS. In the dimension network, the emotional exhaustion dimension was closely related to the cynicism dimension (weight = 0.65).

Conclusions

The network model is a useful tool to study burnout in Chinese nurses. This study explores the item and domain network structure of nurse burnout from the network perspective. By calculating the relevant indicators, we found that E5, C1, and R3 were the most central nodes in the item network and cynicism was the central node in the domain network, suggesting that interventions aimed at E5, C1, R3 and cynicism might decrease the overall burnout level of Chinese nurses to the greatest extent. This study provides potential targets and a new way of thinking for the intervention of nurse burnout, which can be explored and verified in clinical practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00670-8.

Burnout and spirituality among nurses: A scoping review

OBJECTIVE

To investigate the relationship between spirituality / religiousness and Burnout Syndrome in nurses, as well as to examine the current evidence for spiritual/religious interventions to alleviate their symptoms.

DATA SOURCES

A scoping review was conducted using CINAHL, SCOPUS, Web of Science, Pubmed databases, and grey literature, between January and July 2020.

STUDY SELECTION

Two researchers performed the searches with a 95% agreement rate for the inclusion and exclusion of the studies. Both quantitative and qualitative studies published in peer-reviewed journals, using Spanish, Portuguese or English language were included. Restriction on publication date was not applied.

DATA EXTRACTION

A total of 1143 articles were identified and 18 were included in the final analysis. Quality assessment was performed, following CONSORT, STROBE, PRISMA and COREQ guidelines. Finally, the following data were extracted: authors, year, country, study design and sample characteristics, purpose of the study, and major findings.

DATA SYNTHESIS

The results of the present review show that spirituality / religiousness is a common strategy used by nurses when coping with stress and burnout. Most studies reveal that spiritual and religious beliefs are correlated with lower levels of burnout, exhaustion and depersonalization in different settings. Nevertheless, two studies have not found any relationship and one study has found worse outcomes.

CONCLUSIONS

There is a lack of experimental studies trying to examine if spiritual interventions could modify burnout levels in clinical practice. Health managers should be aware of the spirituality / religiousness of their nurses and provide the appropriate spiritual support.

The effects of auricular acupressure on stress, anxiety, and depression of outpatient nurses in South Korea

BACKGROUND AND PURPOSE

Outpatient nursing is an occupation with high emotional labor and job stress. The purpose of this study was to examine the effects of auricular acupressure on stress, anxiety, and depression of outpatient nurses.

MATERIALS AND METHODS

The study design was a randomized controlled trial. Participants were 54 outpatient nurses, divided into an experimental (n = 28) and a control group (n = 26). Auricular acupressure using vaccaria seeds was administered to the experimental group, while placebo auricular acupressure using vaccaria seeds was administered to the placebo group. Sessions continued for 5 weeks. Outcome measurements included blood tests such as cortisol and serotonin.

RESULTS

There was a statistically significant difference in depression scores (t = 3.111, p = 0.002) and serotonin levels (t = 6.304, p < 0.001) between the experimental and placebo groups. Auricular acupressure decreased depression scores, and the depression-related physiological index, serotonin, also changed significantly.

CONCLUSION

Auricular acupressure using vaccaria seeds was effective in decreasing depression in outpatient nurses.

The Mindfulness and the Emotional Regulation Skills in Italian Nurses During the COVID-19 Pandemic: A Descriptive Survey-Correlational Study

Purpose: To analyze the differences in mindfulness level and emotional regulation skills, as cognitive reappraisal and expressive suppression subdimensions, according to sex and years of work experience in a sample of Italian nurses directly involved in the care of coronavirus disease 2019 (COVID-19) patients. Then, correlations were also performed in order to evidence relationships between the mindfulness tendency and the emotional regulation skills, both in cognitive reappraisal and expressive suppression, too. Design of study: Descriptive correlational study. Methods: In June 2020, an online questionnaire was administered. Data relating to sex and years of work experience, the Mindfulness Attention Awareness Scale (MAAS), and the Emotion Regulation Questionnaire (ERQ) in the cognitive reappraisal and expressive suppression subdimensions were collected. Findings: Two hundred nurses were enrolled. Males recorded higher MAAS values compared to females (p = .001). No significant differences were registered in the MAAS scores according to years of work experience and regarding the ERQ subscales according to sex and work of experience, too. Also, any correlations were reported between MAAS and ERQ subscales. Conclusions: Future training on the basic principles of mindfulness and Emotion Regulation were considered a priority in nurses to better self-modulate their own beings, particularly during the pandemic period.

The Association between Well-being Behaviors and Resilience in Health Care Workers

Engaging in well-being behaviors may promote resilience, which can protect against burnout. This descriptive, correlational analysis utilized baseline data from health care workers enrolled in the Web-based Implementation of the Science for Enhancing Resilience longitudinal study (N = 2,383). The study aimed to describe the association of (a) types of well-being behaviors (regular exercise, yoga, meditation, spent time with a close friend, vacation) and (b) total number of well-being behaviors with resilience (emotional thriving and emotional recovery), covarying for sociodemographic and professional characteristics. General linear model findings indicated that each well-being behavior was significantly associated with greater emotional thriving, while only exercise and spending time with friends were significantly related to greater emotional recovery. Emotional thriving and emotional recovery were also significantly higher among health care workers reporting more well-being behaviors. Engaging in well-being behaviors may be one part of the solution toward increasing resilience in health care workers that warrants further investigation.

Positive Emotion Skills Intervention to Address Burnout in Critical Care Nurses

Critical care nurses experience high levels of workplace stress, which can lead to burnout. Many medical centers have begun offering wellness programs to address burnout in their nursing staff; however, most of these programs focus on reducing negative states such as stress, depression, and anxiety. A growing body of evidence highlights the unique, independent role of positive emotion in promoting adaptive coping in the face of stress. This article describes a novel approach for preventing burnout in critical care nurses: an intervention that explicitly aims to increase positive emotion by teaching individuals empirically supported skills. This positive emotion skills intervention has been used successfully in other populations and can be tailored for critical care nurses. Also discussed are recommendations for addressing burnout in intensive care unit nurses at both the individual and organizational levels.

An Exploratory Study of a 3-Minute Mindfulness Intervention on Compassion Fatigue in Nurses

This study shows that breathing mindfully for 3 minutes over a period of 4 weeks, positively affects compassion fatigue in nurses. A nonrandomized, pre/postintervention study was conducted using a 3-minute attentional breathing intervention. Thirty-two nurses participated over 4 weeks. The intervention demonstrated statistically significant reductions in compassion fatigue measures.

Replenish at Work: An Integrative Program to Decrease Stress and Promote a Culture of Wellness in the Intensive Care Unit

Intensive care unit (ICU) nurses report some of the highest levels of stress and burnout because they are exposed to excessive workloads, end-of-life concerns, prolonged care, and ethical dilemmas. Supporting ICU staff through self-care and mindfulness programs is successful in improving stress and burnout and in promoting resilience. Addressing barriers to engaging in self-care practices and identifying unit-specific needs are important to consider when implementing wellness programs. Micro-restorative practices can alleviate immediate stress generated from patient care and provide a moment of peace in busy ICUs. Leadership and organizational support are vital in identifying the need for and promoting wellness programs.

Nurses' experiences of the effects of mindfulness training: A narrative review and qualitative meta-synthesis

OBJECTIVE

To explore nurses' experiences of the effects of undertaking mindfulness training.

DESIGN

Qualitative meta-synthesis.

DATA SOURCES

Qualitative literature from seven scientific databases: Pubmed, Cochran Library, Science Direct, EBSCO, Web of Science, Scopus and PsycINFO were searched.

REVIEW METHODS

The PRISMA flow diagram was used to report the phases of the literature search. The Critical Appraisal Skills Program (CASP) qualitative research checklist, and the Mixed-Methods Appraisal Tool (MMAT) for mixed method studies were used as appraisal framework. Data synthesis was conducted using Thematic synthesis. The review steps were guided by Adams, Chamberlain, & Giles, 2019 and Whittemore & Knafl, 2005.

RESULTS

4 qualitative studies and 3 mixed-methods studies were included in the review. Four interpretive themes were generated to show how nurses experience of the effects of mindfulness training: 1. Stress conceptualisation and management; 2. Nurses' valued aspects of mindfulness training strategies; 3. Self-care awareness and strategies; 4. Challenges of mindfulness training.

CONCLUSION

Conducting mindfulness-based interventions among nursing professionals helps to reduce work-related stress and has positive effects on work and life.

Favorable Outcomes From an In-person and Online Feasibility Mindful Moment Pilot Study

Long hours, inadequate staff, and increasingly complicated patients make nurses more vulnerable to increased levels of stress and burnout. Nurses skilled in exercising self-care practices are better equipped to manage complex clinical situations. The purpose of this pilot study was to evaluate the feasibility of short mindfulness sessions (Mindful Moment) practiced prior to a shift, available in person and online, on nurse burnout and perceived levels of stress. The 8-week Mindful Moment study consisted of 20-minute sessions delivered either in person or online that included yoga, self-reflection, and meditation. Nurse burnout was assessed using the Maslach Burnout Inventory at weeks 0, 4, and 8. Perceived stress was assessed using a visual analog scale before and after each Mindful Moment session. Descriptive statistics, pre/postintervention differences, and percent change calculations were used to evaluate study outcomes. Forty-seven nurses agreed to participate, with 20 nurses completing the study (43%). Participants were all female, aged 36.8 ± 9.8 years, with 12 ± 8.6 years of nursing experience. With respect to nurse burnout, there was a -31% change in emotional exhaustion (P = .079), a -31% change in depersonalization (P = .057), and a +10% change in personal accomplishment (P = .331). There were consistent reductions in nurses' perceived stress pre/post-Mindful Moment session, with percent changes ranging from -35% to 40%. Findings from this study suggest that practicing a brief Mindful Moment prior to the start of a shift is feasible and self-care interventions provide lower levels of burnout and perceived stress among this sample of nurses.

Staff-Care by Chaplains during COVID-19

The aim of this study was to understand how chaplains delivered spiritual care to staff during the Covid-19 pandemic. The researchers analyzed data collected from an International Survey of Chaplain Activity and Experience during Covid-19 (N = 1657). The findings revealed positive changes that emerged and new practices evolved around the use of technology as useful tools for maintaining contact with staff.

The effect of the yoga course on mindfulness and self-compassion among nursing students

PURPOSE

This study aimed to investigate the effect of yoga on mindfulness and self-compassion among nursing students.

DESIGN AND METHODS

The quasiexperimental single-group pretest-posttest design study conducted with 47 nursing students. The data were collected using a "personal data form," the "mindful attention awareness scale (MAAS)," and the "self-compassion scale (SCS)."

FINDINGS

While the mean score of the students from the "MAAS" was 60.51 (±11.35) in the pretest, it increased to 63.7 (±8.75) in the posttest (p < 0.05). While the mean score of the students from the SCS was 3.22 ± 0.69 in the pretest, it increased to 3.59 (±0.53) in the posttest (p < 0.05). A statistically significant relationship was found between mindfulness and SCS scores (r = 0.162).

PRACTICE IMPLICATIONS

After the yoga course, mindfulness and self-compassion of the students were found to be higher than it was before the lessons. The higher the mindfulness level of the students is, the higher the level of self-compassion is.

Exploring the Relationship Between Perceived Visual Access to Nature and Nurse Burnout

OBJECTIVE

This study aims to investigate the relationship between perceived visual access to nature views in nurse work and break environments and scores for subscales of Maslach Burnout Inventory among nurses.

BACKGROUND

Burnout is a severe problem among nurses. Literature shows a relationship between stress and burnout and between nature exposure and stress. However, the possible consequent relationship between connection to nature and nurse burnout needs further study.

METHODS

This cross-sectional study explored the relationship between the subscales (Emotional Exhaustion, Depersonalization, and Personal Accomplishment [EE, DP, and PA]) of the Maslach Burnout Inventory as "outcome variables" and perception of view duration, frequency of exposure to views, view content and artwork content as "explanatory variables" in a subset regression model. The study model also included organizational stressors, environmental design factors, unit type, workload, and personal factors as control variables. Fifty-one nurses working in six units in a large tertiary care hospital participated in the study.

RESULTS

Percentage of perceived nature views and organizational stressors were the top two best predictors correlating with EE (37% of the EE variance; p < .05). Percentage of perceived nature views, organizational stressors, and environmental design were the top three predictors correlating with DP (43% of variance for DP; p < .05). No significant relationship was found between study variables and PA.

CONCLUSIONS

The results of this study recommend perceiving nature views as an independent or integrated intervention to meditation and relaxation techniques. From a design standpoint, this study suggests that a unit and breakroom design with access to nature views could work as a consistent preventive intervention for burnout.

The Use of Mindfulness-Based Interventions to Mitigate Stress and Burnout in Nurses

Research indicates that mindfulness-based interventions can positively change how individuals perceive stress and burnout. Part of the responsibility of mitigating stress and burnout among nurses should be placed upon the organization; thus, nursing professional development practitioners are in a unique position to engage nurses in mindfulness-based practices. Therefore, a quality improvement project aimed to decrease perceived stress and/or burnout among nurses on three pilot units was implemented utilizing evidence-based mindfulness interventions.

The Nursing Stress Scale-Spanish Version: An Update to Its Psychometric Properties and Validation of a Short-form Version in Acute Care Hospital Settings

Stressful working conditions are correlated with a negative impact on the well-being of nurses, job satisfaction, quality of patient care and the health of the staff. The Nursing Stress Scale (NSS) has been shown to be a valid and reliable instrument to assess occupational stressors among nurses. This study updates the psychometric properties of the “NSS-Spanish version” and validates a short-form version. A cross-sectional design was carried out for this study. A reliability analysis and a confirmatory factor analysis and an exploratory factor analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing and criterion validity confirmed scale equivalence. A total of 2195 Registered Nurses and 1914 Licensed Practical Nurses were enrolled. The original 34-item scale obtained a good internal consistency but an unsatisfactory confirmatory and exploratory factor analysis. The short-form Nursing Stress Scale (11-items) obtained a good internal consistency for Registered Nurses (α = 0.83) and for Licensed Practical Nurses (α = 0.79). Both Nursing Stress Scales obtained a strong correlation for Registered Nurses (rho = 0.904) and for Licensed Practical Nurses (rho = 0.888). The 11-item version of the Nursing Stress Scale is a valid and reliable scale to assess stress perception among Registered Nurses and Licensed Practical Nurses. Its short-form nature improves the psychometric properties and the feasibility of the tool.

An evaluation of a mindfulness-based stress reduction intervention for critical care nursing staff: A quality improvement project

BACKGROUND

Critical care is a stressful workplace for nursing staff. Mindfulness-based stress reduction programmes are an emerging concept to manage stress in nursing, but little is known about the impact of such interventions, especially in critical care settings.

AIMS AND OBJECTIVES

A quality improvement initiative was introduced to explore the effects of a mindfulness-based stress reduction intervention on a cohort of critical care nurses in terms of quality of life, perceived stress, mindfulness awareness, and sickness and absence rates.

METHODS

A pre-/post-interventional design recruited nurses (n = 25) working within a critical care unit to undertake the intervention. Participants were asked to complete psychometric questionnaires at three time points, pre-course (0 months), immediately post-course (8 weeks), and at a follow-up point at month 4. Sickness and absence rates were analysed to detect differences pre- and post-course. Retention rates were ascertained by numbers of participants completing the psychometric tests.

FINDINGS

Overall, positive correlations were found when comparing pre-course vs 8-week mean scores of satisfaction with life (P < .001), reduced perceived stress (P < .001), and mindfulness awareness (P = .002). Bootstrap analysis of the data confirmed that positive outcome measures were more significant at the 4-month mark in reduced perceived stress and mindfulness awareness (P < .001) compared with the satisfaction with life scale (P = .41). There was no significant change in sickness rates pre- and post-intervention (P = .69). The retention rate was 70% at month 4.

CONCLUSIONS AND RECOMMENDATIONS

Mindfulness training is a feasible and accepted intervention that critical care nurses may benefit from in terms of quality of life, perceived stress, and mindfulness awareness. This has positive outcomes for staff and patients.

Mindful Mentors: Is a Longitudinal Mind-Body Skills Training Pilot Program Feasible for Pediatric Cardiology Staff?

Background

Stress and burnout among medical professionals are common and costly, placing professionals, organizations, and patients at risk.

Objectives

To determine feasibility and acceptability of a longitudinal mind-body skills training initiative to help staff decrease stress and burnout, improve well-being, and empower them to utilize basic mindfulness methods with coworkers, patients, and families.

Methods

Prospective cohort, mixed methods approach. Nurses, doctors, technicians, social workers, child life specialists were eligible to participate. The 12-month curriculum consisted of 16 hours of intensive education/practice over 2 days, with training in mindfulness skills, self-compassion, nonviolent communication, overcoming barriers to practice, and mindful listening/speaking, followed by monthly 1 hour booster/debriefing sessions.

Results

A total of 37 staff participated (RN = 18, MD = 5, Technician = 6, Social Worker = 3, Child life = 3, others = 2) in the initial training, and 24 (65%) completed the 3- and 12-month follow-up surveys. Compared with pretraining scores, there were significant improvements 3 to 12 months after the initial training in stress (P < .0001), distress (P ≤ .04), anxiety (P = .01), self-efficacy in providing non-drug therapies (P < .0001), mindfulness (P = .002), burnout (P < .0001), and confidence in providing compassionate care (P < .0001). In addition, 25 (67%) participants initiated projects incorporating what they learned into staff/patient wellness activities.

Conclusion

This longitudinal pilot program was feasible and was associated with improvements in measures of psychological well-being over the 12-month intervention. The innovative approach of training participants to teach basic techniques to coworkers and other staff can increase the impact of this program beyond any individual participant. Future research will investigate the aspects of implementation and potential effects on patient care and experience.

The Future of Shift Work: Circadian Biology Meets Personalised Medicine and Behavioural Science

Shift work is commonplace in modern societies, and shift workers are predisposed to the development of numerous chronic diseases. Disruptions to the circadian systems of shift workers are considered important contributors to the biological dysfunction these people frequently experience. Because of this, understanding how to alter shift work and zeitgeber (time cue) schedules to enhance circadian system function is likely to be key to improving the health of shift workers. While light exposure is the most important zeitgeber for the central clock in the circadian system, diet and exercise are plausible zeitgebers for circadian clocks in many tissues. We know little about how different zeitgebers interact and how to tailor zeitgeber schedules to the needs of individuals; however, in this review we share some guidelines to help shift workers adapt to their work schedules based on our current understanding of circadian biology. We focus in particular on the importance of diet timing and composition. Going forward, developments in phenotyping and "envirotyping" methods may be important to understanding how to optimise shift work. Non-invasive, multimodal, comprehensive phenotyping using multiple sources of time-stamped data may yield insights that are critical to the care of shift workers. Finally, the impact of these advances will be reduced without modifications to work environments to make it easier for shift workers to engage in behaviours conducive to their health. Integrating findings from behavioural science and ergonomics may help shift workers make healthier choices, thereby amplifying the beneficial effects of improved lifestyle prescriptions for these people.