Professional Quality of Life and Turnover Intention in Forensic Nurse Program Coordinators: Implications to Forensic Nurse Workforce Development

BACKGROUND

Significant barriers to forensic nurse workforce development exist, affecting patient care access. Retention of forensic nurses is a persistent problem, and turnover of forensic nurses can be attributed to many factors related to professional quality of life, including compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS).

PURPOSE

The aim of this study was to identify the effect of an educational session on the topic of professional quality of life and strategies for mitigating the impact of stressors within the forensic nurse role on Professional Quality of Life Scale-5 and Turnover Intention Scale-6.

METHODS

A convenience sample of forensic nurse program coordinators was surveyed using a pretest-posttest quasi-experimental survey design. Correlation between professional quality of life indicators and turnover intention was explored.

RESULTS

Cohort ( n = 38) preintervention CS levels were average to high (mean = 41.42), BO levels were average to low (mean = 22.53), and STS levels were average to low (mean = 22.89). Statistically significant positive correlations were noted between each Professional Quality of Life Scale indicator and turnover intention (CS: r = 0.59, p < 0.0001; BO: r = 0.98, p < 0.0000; STS: r = 0.67, p < 0.0000). A statistically significant decrease in BO level (α = 0.05, p = 0.0454) was noted postintervention.

IMPLICATIONS

BO and STS had a strong positive correlation to turnover intention. BO levels decreased to a significant degree when reassessed 3 months after the educational intervention. Increased awareness of the impact of CS, BO, and STS could decrease BO in forensic nurses with potential reduction in turnover.

Socio-cognitive mindfulness in nursing: A scoping review

BACKGROUND

While research on meditative mindfulness in nursing is abundant, research on socio-cognitive mindfulness is in its early stages despite its potential advantages to nursing practice and nursing education. This study introduces the under-examined concept of socio-cognitive mindfulness to the nursing field.

OBJECTIVE

To identify what is known in the research field of socio-cognitive mindfulness in nursing. Specific aims were to identify the effects of socio-cognitive mindfulness on nurses and nursing students, and the application of socio-cognitive mindfulness interventions and their effectiveness in nursing.

DESIGN

A scoping review following the Arksey and O'Malley framework.

METHODS

An electronic search of PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, ERIC, and ProQuest databases was conducted. The search included full-text papers published in peer-reviewed journals in English. The included studies were independently examined by the two authors to ensure the thorough inclusion of relevant research by screening of titles and abstracts and screening of full-texts. The selected papers were categorized based on the specific objectives of the review.

RESULTS

Out of 5,798 papers, six quantitative studies and one mixed method study were included in the review. Among the seven studies, two studies investigated the effects of socio-cognitive mindfulness on nurses, four examined the effects of socio-cognitive mindfulness on nursing students, and one conducted an intervention study applying socio-cognitive mindfulness and identified its effects on nurses. The findings revealed several benefits of applying socio-cognitive mindfulness to nursing practice and nursing education. Specifically, socio-cognitive mindfulness enhanced nurses' and nursing students' positive emotions and effective emotion regulation, which would positively influence nurses' nursing performance as well as students' academic outcomes and quality of college life.

CONCLUSIONS

This study raises researchers' awareness of the significance of socio-cognitive mindfulness in nursing, and strongly recommends applying socio-cognitive mindfulness to nursing practice and nursing education and evaluating its effects.

Leaders' emotional labour and abusive supervision: The moderating role of mindfulness

In this study, we examine how leaders' emotional labour strategies (surface acting and deep acting) deplete leaders' self-control resources to predict abusive supervision, in addition to the moderating role of leader mindfulness. Integrating ego-depletion theory and emotion regulation theory, we hypothesise that deep acting and surface acting predict higher levels of abusive supervision, which is mediated by reduced self-control. Furthermore, we predict that leaders' trait mindfulness moderates the relationship between emotional labour and self-control on abusive supervision. Results from a three-wave study of leader-follower dyads supported mediation hypotheses; both deep and surface acting predicted abusive supervision, which is mediated by reduced self-control. Our moderated mediation hypotheses were supported for deep acting but not surface acting. This research contributes to the literature by demonstrating the depleting nature of emotional labour in leadership and the importance of leader mindfulness as a boundary condition that can make deep acting less harmful for leader behaviour.

Effective interventions to reduce burnout in nurses: A meta-analysis

BACKGROUND

To examine the effectiveness of interventions to ameliorate burnout, secondary traumatic stress, and emotional exhaustion in nurses and midwives. The systematic review was completed with all available studies that reported data on the effect of interventions that targeted burnout using the outcome measures of the Professional Quality of Life scale (ProQOL), or the Maslach Burnout Inventory (MBI).

METHODS

We used a systematic review methodology, which included a meta-analysis. A total of 2103 articles resulted from the systematic search; 688 were removed as duplicates, and 1415 articles were reviewed by the title and abstract, of which 255 were eligible for full-text screening. Only 66 met the inclusion criteria and were included in the analysis. The final meta-analysis consisted of 33 reports divided into 12 studies for ProQOL and 21 studies for the MBI.

RESULTS

The results provide an overall effect in studies using the ProQOL measurement was Z = 2.07 (P = 0.04) and a positive improvement mean difference of 9.32. The overall effect in studies using MBI was Z = 3.13 (P = 0.002) and a positive improvement mean difference of 6.58.

CONCLUSIONS

Whilst most studies indicated a positive difference, the most effective interventions included clinical supervision or activities that addressed the personal physical and mental well-being of nurses. Less effective interventions were managerial interventions or ones that used a strictly educational approach.

Structural Relationships between Socio-Cognitive Mindfulness, Everyday Creativity, and Clinical Competence in Nursing Students: Mediating Effects of Everyday Creativity

BACKGROUND

Incorporating socio-cognitive mindfulness, which has not received much attention from nursing researchers, this study investigated the structural relationships between socio-cognitive mindfulness, everyday creativity, and clinical competence among nursing students. This study also explored the mediating effect of everyday creativity.

METHODS

A cross-sectional study was performed with 222 nursing students in South Korea. Students completed the questionnaire evaluating their own socio-cognitive mindfulness, everyday creativity, and clinical competence. Data were analyzed using structural equation modeling and path analysis.

RESULTS

Socio-cognitive mindfulness positively influenced everyday creativity (β = 0.791, p < 0.01), and everyday creativity also positively influenced clinical competence (β = 0.470, p < 0.01). However, the relationship between socio-cognitive mindfulness and clinical competence was not significant. Importantly, everyday creativity fully mediated the relationship between socio-cognitive mindfulness and clinical competence (a × b = 0.372, p < 0.01).

CONCLUSIONS

The results indicate that socio-cognitive mindfulness effectively enhances nursing students' clinical competence by improving their everyday creativity. The mediating result highlights the significance of everyday creativity in nursing education, underscoring the necessity for training programs aimed at cultivating creativity. This research offers a basis for developing programs that concentrate on socio-cognitive mindfulness and everyday creativity, with the goal of enhancing the clinical competence of nursing students.

Feasibility of a Mindfulness Education Module for Nurses: An Evidence-Based Practice Project

Nurse burnout is a well-defined problem that has been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic and negatively affects nurses' mental health, nursing shortages, patient safety, and quality of care. Evidence shows that mindfulness is an effective strategy for managing stress and decreasing burnout among nurses. This article describes an evidence-based practice project that translated this evidence into practice via a vetted mindfulness educational intervention for nurses on a pulmonary medicine unit and a medical intensive care unit. The goal of this project was to assess the feasibility of this educational intervention, processes, and outcomes with the goal to extend the project hospital-wide. Preintervention levels of nurse burnout were assessed using the validated Copenhagen Burnout Inventory. For both units, personal and work-related burnout were in the moderate range and patient-related burnout was in the mild range. Postintervention surveys completed by participant nurses and the nurse managers of both units supported the feasibility of this education module. Future implementation of annual mindfulness education was supported through both participant and administrative feedback. [J Contin Educ Nurs. 2023;54(11):516-523.].

Effect of a Compassion Fatigue Resiliency Program on Nurse Managers' Professional Quality of Life, Stress, and Resilience: A Mixed-Methods Study

BACKGROUND

Compassion fatigue, stress, and burnout have an adverse impact on nurse managers.

PURPOSE

To evaluate the impact of a compassion fatigue resiliency program on nurse managers and to obtain their views of the program.

METHODS

This mixed-methods study was conducted with 16 nurse managers. The compassion fatigue resiliency program was implemented; compassion fatigue, compassion satisfaction, burnout, perceived stress, and resilience were assessed before and after implementation of the program.

RESULTS

The mean compassion fatigue and perceived stress scores of nurses decreased significantly after the intervention. Four themes were identified from qualitative analysis, including awareness, coping with stress, effective communication skills in team management, and recommendations.

CONCLUSIONS

The current study shows the training program reduced nurse managers' compassion fatigue and stress and enabled nurse managers to improve their coping skills and awareness.

The Impact of a Psychoeducational Group Program on the Mental Well-Being of Unit-Based Nurse Leaders: A Randomized Controlled Trial

This randomized controlled trial examined the impact of a psychoeducational group program on the mental well-being of unit-based nurse leaders, specifically nurse managers and assistant nurse managers. The program was developed around the themes of resilience, insight, self-compassion, and empowerment to fight burnout and enhance purposeful adaptive coping to reduce distress and improve mental wellbeing. The sample included 77 unit-based nurse leaders. Outcomes included post-traumatic growth, resilience, insight, self-compassion, empowerment, perceived stress, burnout, and job satisfaction. Paired samples t-tests and repeated measures ANOVA tests were conducted to compare outcomes at baseline to the follow-up timepoints of endpoint, one-month follow-up, three-month follow-up, and six-month follow-up. The intervention group participants showed significant improvement in post-traumatic growth between baseline and all follow-up timepoints compared to the waitlist control group. Among intervention group participants, there were also significant improvements in self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction, as well as significant reductions in perceived stress, burnout, and secondary traumatic stress. This study extends existing evidence that this psychoeducational group program can be an effective intervention for improving and protecting mental wellbeing. Among nurse leaders, it can reduce stress and burnout and improve post-traumatic growth, self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction.

Experiential Avoidance in Primary Care Providers: Psychometric Properties of the Brazilian "Acceptance and Action Questionnaire" (AAQ-II) and Its Criterion Validity on Mood Disorder-Related Psychological Distress

BACKGROUND

A sizeable proportion of Brazilian Primary Care (PC) providers suffer from common mental disorders, such as anxiety and depression. In an effort to cope with job-related distress, PC workers are likely to implement maladaptive strategies such as experiential avoidance (EA). The Acceptance and Action Questionnaire (AAQ-II) is a widely used instrument that evaluates EA but has shown questionable internal consistency in specific populations. This study assesses the psychometric properties of the AAQ-II among Brazilian PC providers, evaluates its convergence and divergence with self-criticism and mindfulness skills, and explores its criterion validity on anxiety and depressive symptoms.

METHODS

A cross-sectional design was conducted in Brazilian PC services, and the sample included 407 PC workers. The measures evaluated EA, self-criticism, mindfulness, depression, and anxiety.

RESULTS

The one-factor model of the AAQ-II replicated the original version structure. The AAQ-II presented good internal consistency among Brazilian PC providers. A multiple regression model demonstrated higher relationships with self-criticism than mindfulness skills. The criterion validity of the AAQ-II on anxiety and depression was stronger in the context of more severe symptoms.

CONCLUSIONS

The AAQ-II is an appropriate questionnaire to measure the lack of psychological flexibility among Brazilian PC workers in the sense of EA.

Be(com)ing other-oriented: Mindfulness-trained leaders’ experiences of their enhanced social awareness

The potential significance of mindfulness for social relations at work has been recognized in the recent management literature, yet a thorough investigation has been lacking into how mindfulness may help leaders tap into their other-orientation. In this study, we examine whether and how mindfulness training contributes to the development of leaders’ social awareness by studying the experiences of 62 leaders who participated in an 8-week-long mindfulness training program. Our study contributes to the literature on management learning and mindfulness in leadership in three ways. First, it identifies how the leaders who participated in mindfulness training see themselves developing toward becoming more socially aware in situations involving followers across the three interlinked domains of human functioning—the cognitive, affective, and behavioral—clarifying mindfulness as an interpersonal phenomenon. Second, it highlights mindfulness as a value-based developmental practice instead of merely a personal stress reduction and attention-enhancement technique. Third, it proposes mindfulness training as a viable approach to enhance leaders’ social awareness through a combination of a formal program and continuous self-development, departing from the views of mindfulness as a “quick fix.” It also provides a conceptual framework that illustrates the pathway with the potential to build social leadership capacity.

The Use of Music to Manage Burnout in Nurses: A Systematic Review

OBJECTIVE

There is a high prevalence of burnout in nurses. This systematic review investigates the use of music to manage burnout in nurses.

DATA SOURCE

MEDLINE (Ovid), MEDLINE InProcess/ePubs, Embase, APA PsycINFO, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched.

STUDY INCLUSION AND EXCLUSION CRITERIA

Full-text articles were selected if the study assessed the use of music to manage burnout in nurses. Burnout was defined according to the International Classification of Diseases 11th Revision.

DATA EXTRACTION

Data were extracted using an Excel sheet. The second and third authors independently extracted study characteristics, frequency and type of music engagement, measures of burnout, and burnout outcomes (occupational stress, coping with stress, and related symptoms such as anxiety).

DATA SYNTHESIS

Study and outcome data were summarized.

RESULTS

The literature search resulted in 2210 articles and 16 articles were included (n = 1205 nurses). All seven cross-sectional studies reported upon nurses' self-facilitated use of music including music listening, playing instruments, and music entertainment for coping or preventing stress, supporting wellbeing, or enhancing work engagement. Externally-facilitated music engagement, including music listening, chanting, percussive improvisation, and song writing, was reported in the four randomized controlled trials and five cohort studies with reductions in burnout outcomes.

CONCLUSIONS

Self-facilitated and externally-facilitated music engagement can help to reduce burnout in nurses.

Effects of Mobile App-Based Mindfulness Practice on Healthcare Workers: a Randomized Active Controlled Trial

Objectives

Amidst the COVID-19 pandemic, healthcare workers (HCWs) may be at greater risk of suffering from psychological distress compared to the general population. This study aimed to investigate the effects of mindfulness practice as delivered using Headspace on psychological and cognitive outcomes among HCWs in Singapore.

Methods

A total of 80 HCWs were recruited and randomly assigned to engage in either 3 weeks (10 min/day) of mindfulness practice using Headspace or an active control condition (Lumosity; involving playing cognitive games). Participants were administered several self-report measures and two working memory (digit span) tasks at pre- and post-intervention, and one-month follow-up.

Results

There were no significant between-condition changes on any outcome variables from pre- to post-intervention. From pre-intervention to 1-month follow-up, there were significantly greater improvements among Headspace participants on fear of COVID-19 (p = .005), compassion satisfaction (p = .007), trait mindfulness (p = .002), self-compassion (p = .005), sleep quality (p = .002), and the forward digit span task (p < .001). Several outcomes were mediated by increases in trait mindfulness or self-compassion.

Conclusions

Use of Headspace may lead to downstream benefits in reducing distress and improving psychological health outcomes among HCWs. The findings have implications for improving psychological support resources for HCWs amidst a pandemic.

Trial Registration

ClinicalTrials.gov (Identifier: NCT04936893).

Investigating the impact of modified mindfulness-based stress reduction (MBSR) program on occupational burnout and other mental health status among nonmedical staff in a hospital: a randomized controlled trial

OBJECTIVE

Burnout is a prolonged psychological response to a longstanding interpersonal stressor at work. It can progress to other mental illnesses, such as anxiety and depression. In today's society, burnout has become widespread, and it is currently a serious challenge in health systems. This study intended to investigate the impact of mindfulness training on burnout and depression, anxiety, and stress of nonmedical staff in a hospital in Shiraz-Iran.

METHOD

Fifty nonmedical staff in a Shiraz-Iran hospital were enrolled in this two groups' randomized controlled trial. The intervention group was trained by a modified mindfulness-based stress reduction (MBSR) program, and the control group received no intervention. The outcome was assessed by the Copenhagen burnout inventory (CBI) and DASS-21 questionnaire on three occasions including before T0, immediately after T1, and 3 months after the intervention T2.

RESULTS

Comparing the score changes between intervention and control groups showed that the reduction of work‑distaste‑related burnout, client‑related burnout, anxiety, and stress scores in the intervention group was significantly more than in the control group in the time interval from T0 to T1. The scores in the intervention group in three subscales of CBI, including work‑characteristic‑related burnout, work‑distaste‑related burnout, and client‑related burnout, decreased significantly immediately after the training (T1) compared to before (T0). Also, the scores did not change significantly after 3 months following training.

CONCLUSIONS

Mindfulness training can be used as an effective way to improve occupational burnout, anxiety, and stress in occupations other than health professionals. Its effect is stable for at least a few months. It is recommended that future studies focus on investigating the feasible way to integrate this training into the working environment. Forthcoming studies should also determine whether the impact of this intervention will last longer and find possible ways to extend its influence.

Prevalence, levels and related factors of burnout in nurse managers: A multi-centre cross-sectional study

AIMS

The aims of this study are to analyse the prevalence and levels of burnout syndrome in nurse managers and to evaluate the relationship between burnout and related sociodemographic, occupational and psychological factors.

BACKGROUND

Burnout syndrome, defined as an emotional response to chronic stress, is a major problem among nurse managers.

METHODS

The study was conducted using a cross-sectional survey design and data collected by the Maslach Burnout Inventory, the revised NEO Five Factor Inventory and the Educational-Clinical Questionnaire for Anxiety and Depression. The sample population consisted of 86 nurse managers from different hospitals from the Public Health Service of Andalusia, Spain.

RESULTS

A total of 22.4% of the participants presented high levels of emotional exhaustion, 21% experienced depersonalisation and 57.6% had little sense of personal accomplishment. Working long shifts was related to burnout. Emotional exhaustion and depersonalization were predicted by depression, while personal accomplishment was predicted by conscientiousness, agreeableness and openness.

CONCLUSIONS

A total of 34.1% of the participants presented high levels of burnout, manifested by feelings of low personal accomplishment. Psychological and occupational factors play an important role in the development of this syndrome.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers should seek to detect burnout among staff and colleagues matching the risk profile for this condition and promote interventions to prevent it.

Explanatory Models of Burnout Diagnosis Based on Personality Factors and Depression in Managing Nurses

Nurse managers are affected by burnout due to the high degree of interaction between managers with their registered nurses. Explanatory models based on psychological, and personality related variables purvey an estimation to level changes in the three dimensions of the burnout syndrome. A categorical-response logistic ordinal regression model, supported on a quantitative, crosscutting, multicentre, descriptive study with 86 nursing managers in the Andalusian Health Service in Granada, Spain is performed for each dimension. The three models included different variables related to personality, as well as depression as the only explanatory variable included in all the models. The risk factor neuroticism was significant at population level and related to emotional exhaustion, whilst responsibility was significant in the model estimated to personal accomplishment dimension. Finally, depression was significant for the three dimensions of Burnout. This analysis provides useful information to help the diagnosis and evolution of this syndrome in this collective.

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.

The Relationship Between Mindfulness and Conflict Resolution Styles Among Nurse Managers: A Cross-Sectional Study

Introduction

Mindfulness might help nurse managers in dealing with conflicts. However, the relationship between mindfulness and conflict resolution styles were still not clearly understood.

Objective

To identify the relationship between mindfulness and conflict resolution and to predict the conflict resolution styles of nurse managers through mindfulness.

Methods

A descriptive correlational cross-sectional design was employed. A convenience sample of 197 nurse managers was recruited from five public and two university hospitals. Data about nurse managers' mindfulness and conflict management styles were collected through self-reported scales. The data was collected between January and March 2020.

Results

Mindfulness was significantly associated with integrating (r = 0.31, p < .001) and obliging (r = 0.14, p = .045) conflict resolution styles. Mindfulness was able to uniquely predict using the integrating conflict resolution style (χ² = 4.65, p = .031).

Conclusions

Mindfulness is uniquely related to integrating conflict resolution among nurse managers. The findings encourage stakeholders in health care organizations to develop training programs to improve managers' conflict resolution skills and to invest in managers' mindfulness.

Mediating Effects of Emotion Regulation between Socio-Cognitive Mindfulness and Achievement Emotions in Nursing Students

BACKGROUND

Mindfulness is known as an effective emotion regulation strategy and is beneficial for improving emotions. While meditative mindfulness has been widely studied, socio-cognitive mindfulness has received little attention in nursing literature, despite its potential benefits to the field. This study investigated relationships between nursing students' socio-cognitive mindfulness, emotion regulation (reappraisal and suppression), and achievement emotions, and explored the mediating effects of emotion regulation.

METHODS

A total of 459 nursing students from three universities in Korea completed the questionnaire measuring the study variables. Structural equation modeling and path analysis were conducted to test the hypotheses.

RESULTS

Socio-cognitive mindfulness was found to positively influence reappraisal while negatively influencing suppression. Additionally, socio-cognitive mindfulness positively predicted positive achievement emotions but negatively predicted negative emotions. Reappraisal positively influenced positive emotions, whereas suppression positively influenced negative emotions. Furthermore, reappraisal mediated the link between mindfulness and positive emotions, and suppression mediated the link between mindfulness and negative emotions.

CONCLUSIONS

Socio-cognitive mindfulness may be effective in regulating emotions among nursing students by enhancing reappraisal and reducing suppression. Mediating effects highlight the relevance of students' emotion regulation in nursing education, suggesting the need to develop emotion regulation education programs.

The effect of progressive muscle relaxation exercises on compassion satisfaction, burnout, and compassion fatigue of nurse managers

PURPOSE

To investigate the effect of progressive muscle relaxation exercises on compassion satisfaction, burnout, and compassion fatigue of nurse managers.

DESIGN AND METHODS

A pretest, posttest, one-group quasi-experimental study was carried out with 30 nurse managers and they were received "Jacobson: Progressive Muscle Relaxation Exercises" in a group once in a week for 8 weeks.

FINDINGS

After the second month, the mean compassion fatigue (p < 0.01) and the mean burnout scores (p = 0.01) were decreased.

PRACTICE IMPLICATIONS

It is recommended to expand progressive muscle relaxation exercises and to conduct studies in different groups to increase the professional quality of life.

Nursing Students' Meditative and Sociocognitive Mindfulness, Achievement Emotions, and Academic Outcomes: Mediating Effects of Emotions

BACKGROUND

This study integrates the underexamined sociocognitive mindfulness and achievement emotions in nursing.

PURPOSE

This study examined the relationships between meditative and sociocognitive mindfulness and between mindfulness, achievement emotions, and academic outcomes. It also investigated the mediating effects of achievement emotions.

METHODS

In total, 459 Korean nursing students completed a questionnaire measuring mindfulness, achievement emotions, and academic outcomes. Three-step regression analysis and Sobel test were performed to explore the mediating effects of achievement emotions.

RESULTS

Meditative and sociocognitive mindfulness correlated with each other; they correlated positively with positive achievement emotions and academic outcomes and negatively with negative emotions. Students' positive emotions correlated positively with academic outcomes, whereas negative emotions correlated negatively. The mediating effects of emotions on the relationships between mindfulness and academic outcomes were found.

CONCLUSIONS

Both mindfulness perspectives are related to enhancing students' positive emotions and reducing negative emotions, ultimately influencing their academic outcomes. The mediation results emphasize the benefits of positive emotions and disadvantages of negative emotions between mindfulness and outcomes.

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.

The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review

Objectives

Burnout and occupational stress are frequently experienced by healthcare professionals (HCPs). Mindfulness-based stress reduction (MBSR) has been found to improve the psychological health outcomes of HCPs. To date, systematic reviews and meta-analyses have primarily focused upon empirical investigations into the reduction of stress amongst HCPs using MBSR and are limited to empirical studies published before December 2019. This systematic review aimed to update the current evidence base and broaden our understanding of the effectiveness of MBSR on improving the psychological functioning of HCPs.

Methods

Three electronic databases (Medline, Psych Info and Web of Science) were searched without time frame restrictions. Quantitative studies included randomised controlled trials, clinical controlled trials, pre-post designs and studies with up to a 12-month follow-up period. All studies included in the review employed a MBSR programme, standardised measures of psychological functioning and qualified HCPs as participants.

Results

Using PRISMA guidelines thirty studies were included in the review. The reviewed literature suggested that MBSR was effective in reducing HCPs experiences of anxiety, depression and stress. MBSR was also found to be effective in increasing HCP levels of mindfulness and self-compassion. However, MBSR did not appear as effective in reducing burnout or improving resilience amongst HCPs. Abbreviated MBSR programmes were found to be as effective as the traditional 8-week MBSR programmes.

Conclusions

MBSR is an effective intervention which can help improve the psychological functioning of HCPs. Recommendations include improving the overall quality of the studies by employing more robust controlled designs with randomisation, increased sample sizes with heterogeneous samples, and making active comparisons between interventions used.

Burnout in Nursing Managers: A Systematic Review and Meta-Analysis of Related Factors, Levels and Prevalence

Burnout syndrome is a major problem in occupational health, which also affects nursing managers. The main aim was to analyze the level, prevalence and risk factors of burnout among nursing managers. A systematic review with meta-analysis was conducted. The databases used were Medline (Pubmed), PsycINFO, CINAHL, LILACS, Scielo and Scopus. The search equation was “burnout AND nurs* AND (health manager OR case managers)”. Nursing managers present high levels of emotional exhaustion and a high degree of depersonalization. Some studies show that variables like age, gender, marital status, having children or mobbing and other occupational factors are related with burnout. The prevalence estimation of emotional exhaustion with the meta-analysis was high; 29% (95% CI = 9–56) with a sample of n = 780 nursing managers. The meta-analytical estimation of the correlation between burnout and age was r = −0.07 (95% CI = −0.23–0.08). Work overload, the need to mediate personnel conflicts, lack of time and support from superior staff, contribute to the development of burnout among nursing managers.

Holistic Nursing in Practice: Mindfulness-Based Yoga as an Intervention to Manage Stress and Burnout

PURPOSE

Effects of a mindfulness-based (MB) yoga practice on stress, burnout, and indicators of well-being among nurses and health care professionals (HCPs).

DESIGN

A randomized controlled trial, 80 HCPs assigned to either MB yoga intervention or control group.

METHOD

The MB yoga intervention group (n = 41) attended weekly yoga classes and practiced yoga independently. The control group (n = 39) did not receive the yoga intervention. Study participants completed pre- and postintervention questionnaires, instruments included (a) Perceived Stress Scale; (b) Maslach Burnout Inventory; (c) Vitality subscale of the Medical Outcomes Study Short Form-36; (d) Global Sleep Quality item, (e) Mindfulness Awareness Survey, and (f) subscale of the Brief Serenity Scale. Diurnal salivary cortisol and blood pressure were assessed pre and postintervention.

RESULTS

Significant improvements (p < .01) noted in MB yoga compared with control for self-reported factors, including stress (Perceived Stress Scale), burnout (Maslach Burnout Inventory), vitality (Medical Outcomes Study Short Form-36), sleep (GSQ), serenity/inner haven (IH), and mindfulness (Mindfulness Awareness Survey). Diurnal cortisol slopes and blood pressure were not significantly improved.

CONCLUSION

The MB yoga intervention had a statistically significant effect on the health and well-being of nurses and HCPs, most specifically for measures of stress; perceived stress, burnout, vitality, sleep quality, serenity, and mindfulness.

The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis

AIM

To analyse the effect of mindfulness training on levels of burnout among nurses.

BACKGROUND

Burnout syndrome is a common occupational hazard for nursing staff. Mindfulness training has been proposed as a valid intervention for burnout.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

The CINAHL, LILACS, Medline, ProQuest, PsycINFO, Scielo and Scopus databases were consulted, using the search equation 'Nurs * AND burnout AND mindfulness'. There was no restriction on the year of publication.

REVIEW METHODS

Papers were selected for analysis in accordance with the PRISMA guidelines. The meta-analysis was carried out using Review Manager 5.3 software.

RESULTS

The sample was of 17 articles including 632 nurses. Mindfulness training reduces levels of burnout, producing lower scores for emotional exhaustion and depersonalization and higher for personal accomplishment. The differences in the means were 1.32 (95% CI: -9.41-6.78), 1.91 (95% CI: -4.50-0.68) and 2.12 (95% CI: -9.91-14.14), respectively, between the intervention and control groups.

CONCLUSION

Mindfulness training reduces the emotional burden and hence levels of burnout, among nurses. However, further randomized clinical trials are required.

Effectiveness of Lifestyle Health Promotion Interventions for Nurses: A Systematic Review

BACKGROUND

Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention most likely to have positive outcomes are unknown.

OBJECTIVE

To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses.

METHODS

A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9-3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed.

RESULTS

Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group (n = 51, 37.5%). The majority of interventions focused on education, physical activity, mindfulness, or relaxation. Thirty-seven (27%) studies had a multimodal intervention approach. On average, studies had relatively small samples (median = 61; mode = 30) and were conducted predominantly in North America (USA/Canada, n = 53). The findings were mixed overall, with some studies reporting benefits and others finding no effects. Dietary habits was the most successfully improved outcome (8/9), followed by indices of body composition (20/24), physical activity (PA) (11/14), and stress (49/66), with >70% of relevant studies in each of these categories reporting improvements. The lowest success rate was for work-related outcomes (16/32). Separate analysis of RCTs indicated that interventions that focus solely on education might be less likely to result in positive outcomes than interventions targeting behavioural change.

CONCLUSIONS

Interventions targeting diet, body composition, PA, or stress are most likely to have positive outcomes for nurses' health and/or wellbeing. The methodologically strongest evidence (RCTs) is available for body composition and stress. Interventions relying solely on educational approaches are least likely to be effective. Organisational outcomes appear to be more challenging to change with lifestyle intervention, likely requiring more complex solutions including changes to the work environment. There is a need for more high-quality evidence since many studies had moderate or high risk of bias and low reporting quality.