Work-related stress is a major cause of employee dissatisfaction, absenteeism, turnover, and ill-health. Hospital healthcare workers face a number of significant work-related stresses including the physical, cognitive, and emotional demands of caring for seriously ill people. Hospitals can benefit from interventions designed to reduce occupational stress, retain personnel, and prevent burnout.
Errazuriz et al. [Journal of Psychiatric Research] tested the efficacy of a mindfulness intervention on hospital healthcare worker distress when compared to a stress management course or waitlist control.
The researchers randomly assigned 105 Chilean non-physician hospital healthcare workers (average age = 40 years; 98% female) to Mindfulness Based Stress Reduction (MBSR), a stress management course, or a waitlist control. Twenty-three percent of participants met the pretest cut-off criteria for being psychologically distressed.
MBSR and stress management groups met in 2-hour weekly group sessions for 8 weeks. The MBSR intervention followed the usual MBSR protocol minus the all-day retreat. The stress management course was a pre-existing hospital program comprised of lectures, interpersonal support and experiential activities on topics such as visualizing strengths, relaxation, self-care, resilience, and seeking social support.
Participants were assessed at baseline, after intervention, and at 4-month follow-up on self-report measures of general and occupational psychological distress, job satisfaction, perceived stress, and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ). Cortisol in saliva, a stress hormone, was collected three times over the course of a single day at baseline and post- intervention.
Participant attrition was high, with 73% completing at least one measure at post-intervention, and 50% completing at least one measure at follow-up.
Immediate post-intervention results showed the MBSR group had significantly less distress and reported higher job satisfaction than the stress management and waitlist groups. The MBSR group also scored significantly higher on FFMQ “describing” and “acting with awareness” facets than stress management group.
For the physiological marker, the MBSR group had a significantly smaller increase in cortisol during the first 45 minutes after morning awakening relative to the comparison groups.
There were no significant differences between stress management and waitlist controls on any measure. At 4-month follow-up, the MBSR group showed significantly less social role dysfunction and significantly higher FFMQ “observing” compared to the stress management group.
The study shows MBSR is more effective than a hospital-delivered stress management course in reducing short-term distress and increasing short-term work satisfaction in Chilean hospital healthcare workers. Most of these effects did not persist on 4-month follow-up, suggesting the need for continued practice to maintain gains. The study is limited by its small sample size and high rate of attrition.
Errazuriz, A., Schmidt, K., Undurraga, E. A., Medeiros, S., Baudrand, R., Cussen, D., Henriquez, M., Celhay, P., & Figueroa, R. A. (2020). Effects of mindfulness-based stress reduction on psychological distress in health workers: A three-arm parallel randomized controlled trial. Journal of Psychiatric Research.