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Cited by 81Healthcare professionals’ stress and burnoutStress and Burnout ResearchOccupational Health and Burnout

Burnout in the emergency department: Randomized controlled trial of an attention-based training program

Dunne, Pádraic J., Lynch, Julie, Prihodova, Lucia, O'Leary, Caoimhe, Ghoreyshi, Atiyeh, Basdeo, Sharee A., Cox, Donal J., Breen, Rachel +5 more·2019·Journal of Integrative Medicine
DOI 10.1016/j.joim.2019.03.009
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Abstract

Background Burnout (encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty. Objective The aim of this study was to apply an attention-based training (ABT) program to reduce burnout among emergency multidisciplinary team (MDT) members from a large urban hospital. Design, setting, participants and interventions Emergency MDT members were randomized to either a no-treatment control or an intervention group. Intervention group participants engaged in a four session (4 h/session) ABT program over 7 weeks with a practice target of 20 min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device. Main outcome measures The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters. Results The ABT program resulted in a significant reduction (P < 0.05; T1 [one week before intervention] vs T3 [follow-up at two months after intervention]) in burnout, specifically, emotional exhaustion, with an effect size (probability of superiority) of 59%. Similar reductions were observed for stress (P < 0.05) and anxiety (P < 0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression. Conclusion This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group. Trial registration ClinicalTrials.gov identifier NCT02887300.

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Crossref · 10.1016/j.joim.2019.03.009

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  • In the meditation intervention subgroup, depersonalization (DP) was not significantly reduced: Cohen's d SMD -0.10 (95% CI -0.28 to 0.07, p = 0.25, I2 = 0%).

    “In the subgroup of meditation intervention studies [50–58], the Cohen’s d SMD was found to be non-statistically significant in EE (-0.30, 95% CI -0.61 to 0.02, p = 0.25, I2 = 63.1%) and DP (-0.10, 95% CI -0.28 to 0.07, p = 0.25, I2 = 0%), but statistically significant in PA (0.22, 95% CI 0.03 to 0.40, p = 0.02, I2 = 0%).”

    From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [51]

  • In the meditation intervention subgroup, personal accomplishment (PA) was significantly improved: Cohen's d SMD 0.22 (95% CI 0.03 to 0.40, p = 0.02, I2 = 0%).

    “In the subgroup of meditation intervention studies [50–58], the Cohen’s d SMD was found to be non-statistically significant in EE (-0.30, 95% CI -0.61 to 0.02, p = 0.25, I2 = 63.1%) and DP (-0.10, 95% CI -0.28 to 0.07, p = 0.25, I2 = 0%), but statistically significant in PA (0.22, 95% CI 0.03 to 0.40, p = 0.02, I2 = 0%).”

    From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [51]

  • In the meditation intervention subgroup, emotional exhaustion (EE) was not significantly reduced: Cohen's d SMD -0.30 (95% CI -0.61 to 0.02, p = 0.25, I2 = 63.1%).

    “In the subgroup of meditation intervention studies [50–58], the Cohen’s d SMD was found to be non-statistically significant in EE (-0.30, 95% CI -0.61 to 0.02, p = 0.25, I2 = 63.1%) and DP (-0.10, 95% CI -0.28 to 0.07, p = 0.25, I2 = 0%), but statistically significant in PA (0.22, 95% CI 0.03 to 0.40, p = 0.02, I2 = 0%).”

    From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [51]

  • Eight studies (72.7%) were categorized as high risk of bias in the second or third domain due to naive per protocol analysis from complete cases at the end of the studies.

    “Also, 8 studies [45, 51, 52, 57, 63, 64, 74], comprising 72.7% of the total, were categorized as high risk of bias in the second or third domain due to naive per protocol analysis from complete cases at the end of the studies.”

    From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [51]

  • Outcome measurements were conducted using various versions of the validated Maslach Burnout Inventory (MBI): 26 studies used the 22-item MBI, 5 used the 9-item MBI, 1 used the 20-item Dutch version, and 1 used the 16-item MBI.

    “Outcome measurements were conducted using various versions of the validated MBI. Specifically, 26 studies (78.7%) used the 22-item MBI [44, 45, 47–49, 51, 52, 54, 56, 58, 60–65, 67, 68, 70–76], 5 studies (15.2%) employed the 9-item MBI [50, 53, 55, 59, 69], 1 study (3.0%) used the 20-item Dutch version of the MBI [57], and 1 study (3.0%) utilized the 16-item MBI [66].”

    From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [51]

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Authors
Dunne, P. J., Lynch, J., Prihodova, L., O'Leary, C., Ghoreyshi, A., Basdeo, S. A., Cox, D. J., Breen, R., Sheikhi, A., Carroll, Á., Walsh, C., McMahon, G., & White, B.
Affiliations
  • Trinity College Dublin (IE)
  • Royal College of Physicians of Ireland (IE)
  • Fitbit (United States) (US)
  • University of Limerick (IE)
  • Health Service Executive (IE)
  • St. James's Hospital (IE)
Corresponding author
Dunne, Pádraic J.
ORCID
Venue
Journal of Integrative Medicine
Publisher
Elsevier BV
Published
2019-05
Volume
17
Issue
3
Pages
173-180
ISSN
  • 1672-1977 (ISSN-L)
  • 2095-4964
DOI
10.1016/j.joim.2019.03.009
OpenAlex
W2929546857
Cited by
81
References
34
Citations by year
2026: 4 · 2025: 6 · 2024: 15 · 2023: 7 · 2022: 28 · 2021: 11 · 2020: 7 · 2019: 3
FWCI
16.78
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Chinese Integrative Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
Health Research Board (CRFSJH-2017-1)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
burnout, emergency department staff, emotional exhaustion, depersonalization, personal accomplishment, stress, anxiety, heart rate variability, inflammatory cytokines, sleep, mindfulness-based interventions, health workforce retention
MeSH terms
Adult, Attention, Burnout, Professional, Emergency Service, Hospital, Emotions, Female, Humans, Hydrocortisone, Male, Middle Aged, Physicians, Saliva, Teaching, Young Adult

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