Cited by 170Mindfulness and Compassion InterventionsHealthcare professionals’ stress and burnoutStress and Burnout Research

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Mindfulness training for healthcare professionals and trainees: A meta-analysis of randomized controlled trials

Spinelli, Christina, Wisener, Melanie, Khoury, Bassam·2019·Journal of Psychosomatic Research

DOI 10.1016/j.jpsychores.2019.03.003

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Abstract

Objective Healthcare professionals (HCPs) experience a wide range of physical and psychological symptoms that can affect quality of patient care. Previous meta-analyses exploring mindfulness-based interventions (MBIs) for HCPs have been limited by their narrow scope regarding intervention type, target population, and/or measures, and reliance on uncontrolled studies; therefore, a more comprehensive and methodologically rigorous examination is warranted. This meta-analysis quantified the effectiveness of MBIs on distress, well-being, physical health, and performance in HCPs and HCPs-in-training.Method RCTs examining the effect of meditation and MBIs on HCPs and HCPs-in-training were identified and reviewed. Two independent reviewers extracted data and assessed risk of bias.Results Thirty-eight studies were included in the analyses (n = 2505; 75.88% female). Intervention had a significant moderate effect on anxiety (Hedge's g = 0.47), depression (Hedge's g = 0.41), psychological distress (Hedge's g = 0.46), and stress (Hedge's g = 0.52). Small to moderate effects were also found for burnout (Hedge's g = 0.26) and well-being at post-intervention (Hedge's g = 0.32). Effects were not significant for physical health and performance. Larger intervention effects on overall outcomes were found with HCPs (Hedge's g = 0.52), with Mindfulness-based Stress Reduction intervention (Hedge's g = 0.47), and inactive controls (Hedge's g = 0.36).Conclusions Results suggest mindfulness-based interventions are effective in reducing distress and improving well-being in HCPs and HCP-ITs. Subgroup analyses suggest the importance of exploring potential participants' needs prior to selecting the type of mindfulness intervention. Future studies should assess changes in mindfulness and include active controls.

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Comparison of two brief mindfulness interventions for anxiety, stress and burnout in mental health professionals: a randomised crossover trial
Ruiz‐Íñiguez, R., Montero, A. C., Burgos-Julián, F. A., Roche, J. R. F., & Germán, M. Á. S. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1160714 · Cited by 26
“Studies and reviews conducted on the impact of MBIs on healthcare professionals have similar results, reporting improvements in stress and anxiety, but the impact on burnout remains unclear due to conflicting conclusions (Rudaz et al., 2017; Suyi et al., 2017; Janssen et al., 2018; Spinelli et al., 2019; Green and Kin…”
BackgroundResult
Mindfulness and Happiness
Khoury, B. (2023) · Mindfulness · doi:10.1007/s12671-023-02226-0 · Cited by 9
“This is particularly important as many mindfulness-based intervention studies, especially those involving nonclinical populations, have consistently shown moderate positive effects on quality-of-life measures (Khoury et al., 2015; Querstret et al., 2020; Spinelli et al., 2019).”
BackgroundResultSelf-citation
Effects of online mindfulness-based stress reduction training on depression and anxiety symptoms among psychiatric healthcare workers in a randomized controlled trial: the mediating role of emotional suppression
Wu, Y., Ban, Y., Pan, G., Yao, M., Liu, L., Chen, T., & Wu, H. L. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06967-1 · Cited by 9
“The sample size was calculated using effect sizes from previous related publications [28], with G*Power statistical software version 3.1 [29, 30].”
Influential
Exploring the Potential Impact of a Virtual Body Scan Meditation Exercise Conducted With Pet Dogs on Recipients and Facilitators
Kogan, L. R., & Bussolari, C. J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.698075 · Cited by 10
Burnout in Portuguese physiotherapists, prevalence and influencing factors
Seixas, A., Marqués, T., Moreira-Silva, I., Azevedo, J., Ventura, N., & Rodrigues, S. (2020) · International Journal of Occupational and Environmental Safety · doi:10.24840/2184-0954_004.001_0003 · Cited by 10
Effectiveness of a Mindfulness and Self-Compassion Standard Training Program versus an Abbreviated Training Program on Stress in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain
Verdes-Montenegro-Atalaya, J. C., de Torres, L. Á. P., Liétor-Villajos, N., Bartolomé-Moreno, C., Moreno-Martos, H., Rodríguez, L. A. G., Grande-Grande, T., Pardo-Hernández, R., del Barco, B. L., Santamaría‐Peláez, M., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph181910230 · Cited by 11
Enhancing Rigor in Quantitative Meta-Analyses for Mindfulness Research: A Comprehensive Guide
Sperling, E. L., Khoury, B., Sutton, A., Price‐Blackshear, M. A., & Bettencourt, B. A. (2025) · Mindfulness · doi:10.1007/s12671-025-02517-8 · Cited by 8
“…of MBIs for particular populations (e.g., youth, Borquist-Conlon et al., 2019; incarcerated populations, Per et al., 2020; health-care workers, Spinelli et al., 2019); settings where MBIs took place (e.g., schools, Carsley et al., 2018; prisons, Per et al., 2020); and outcomes of the MBIs…”
Self-citation
JCS/JCC/JACR/JATS 2024 Guideline on Cardiovascular Practice With Consideration for Diversity, Equity, and Inclusion
Tsukada, Y. T., Aoki‐Kamiya, C., Mizuno, A., Nakayama, A., Ide, T., Aoyama, R., Honye, J., Hoshina, K., Ikegame, T., Inoue, K., et al. (2025) · Circulation Journal · doi:10.1253/circj.cj-23-0890 · Cited by 10
The Link between Mindfulness and Self-Compassion: A Meta-Analysis
Schutte, N. S., & Malouff, J. M. (2025) · International Journal of Applied Positive Psychology · doi:10.1007/s41042-025-00228-y · Cited by 15
“For example, studies have found that mindfulness training leads to decreased negative emotions (Spinelli et al., 2019) and that self-compassion training leads to increased well-being (Kotera & Gordon, 2021).”
The mediating role of basic psychological needs satisfaction in the relationship between trait mindfulness and psychological distress in clinical trainees
Renault, R., Laurin, J. C., Khoury, B., & Spinelli, C. (2022) · Counselling Psychology Quarterly · doi:10.1080/09515070.2022.2121684 · Cited by 8
“…practice, there is enough empirical data supporting the benefits of mindfulness training in reducing psychological distress among mental health professionals and trainees to promote its inclusion in the curriculum of clinical trainees (for a meta-analysis, see Spinelli, Wisener, & Khoury, 2019).”
Self-citation
Development and Implementation of a Brief Healthcare Professional Support Program Based in Gratitude, Mindfulness, Self-compassion, and Empathy
Victorson, D. E., Sauer, C., Horowitz, B., & Wolf-Beadle, J. (2021) · JONA The Journal of Nursing Administration · doi:10.1097/nna.0000000000001000 · Cited by 8
“Meta-analytic findings among healthcare providers suggest that increased emotion regulation, empathy, and compassion that result frommindfulness training are related to increased job satisfaction(18) and lower stress and burnout in physicians.(19,20) Not only are these practices helpful for healthcare professionals, b…”
Background
Shared meditation involving cancer patients, health professionals and third persons is relevant and improves well-being: IMPLIC pilot study
Prevost, V., Lefèvre‐Arbogast, S., Leconte, A., Delorme, C., Benoit, S., Tran, T., & Clarisse, B. (2022) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-022-03599-w · Cited by 8
“Regarding the impact of mindfulness on the suffering of health professionals, recent meta-analyses have shown that mindfulness reduces work distress [14, 15] and improves caregiver well-being [15].”
Background
Work Ability and Well-Being Management and Its Barriers and Facilitators in Multinational Organizations: A Scoping Review
Shiri, R., & Bergbom, B. (2023) · Healthcare · doi:10.3390/healthcare11070978 · Cited by 8
The Profound Implications of the Meaning of Health for Health Care and Health Equity
Fiscella, K. A., & Epstein, R. M. (2023) · Milbank Quarterly · doi:10.1111/1468-0009.12660 · Cited by 9
Online Mindfulness-Based Interventions for Healthcare Professionals: A Scoping Review
Baek, G., Cha, C., Lee, M., & Cho, A. (2024) · Workplace Health & Safety · doi:10.1177/21650799241254554 · Cited by 9
Impact of burnout on turnover, medical errors, medical leave and a cross-sectional study of contributing factors among Chilean physicians
Villalón, F., Mundt, A. P., Hirmas, A., Rivera, R. M., & Guiloff, R. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-099773 · Cited by 7
Bir Üniversite Hastanesinde Çalışan Hemşirelerin Bilinçli Farkındalık Düzeylerinin Belirlenmesi
Aşık, E., & Albayrak, S. (2020) · Sağlık Bilimlerinde Değer · doi:10.33631/duzcesbed.718133 · Cited by 7
Meditation involving people with cancer, medical staff and witnesses: a pilot study exploring improvement in wellness and connectedness
Prevost, V., Clarisse, B., Leconte, A., Delorme, C., Benoit, S., & Tran, T. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-048164 · Cited by 7
Mindful Opportunity to Reflect on Experience: Interdisciplinary Mind–Body Medicine Skills Training for Health-care Professionals
Barnhill, J. L., Gerkin, J. S., Moura, V. L., & Weil, A. (2020) · Global Advances in Health and Medicine · doi:10.1177/2164956120907876 · Cited by 7
“A growing body of literature demonstrates that mindfulness-based interventions, including mind–body medicine skills, support the well-being of health-care professionals.(10) Mindfulness practices such as meditation are known to balance the autonomic nervous system and promote neurophysiologic changes in the hypothalam…”
Background
Scalable and sustainable approaches to address the well‐being of healthcare personnel
Giordano, N. A., Swan, B. A., Johnson, T. M., Cimiotti, J. P., Muirhead, L., Wallace, M., & Mascaro, J. S. (2022) · Journal of Advanced Nursing · doi:10.1111/jan.15505 · Cited by 6
Mindfulness-Based Interventions for Mental Health Outcomes in Frontline Healthcare Workers During the COVID-19 Pandemic: A Randomized Controlled Trial
Jong, M. A.-D., Geurts, D. E. M., Spinhoven, P., Ruhé, H. G., & Speckens, A. E. M. (2025) · Journal of General Internal Medicine · doi:10.1007/s11606-025-09529-z · Cited by 7
Shared Meditation Involving Cancer Patients, Health Professionals and Third Persons: Perceptions of Participants Through a Focus Group Study
Prevost, V., Tran, T., Clarisse, B., Leconte, A., Duchange, N., Moutel, G., & Gouriot, M. (2023) · Integrative Cancer Therapies · doi:10.1177/15347354231186995 · Cited by 5
Effect of an 8-Week Mindfulness Meditation Training Program on Psychological Distress in Caregivers and on Behavioral and Psychological Symptoms in People with Alzheimer’s Disease: A Randomized Controlled Trial
Pérez, A. S., Quesada-Rico, M. P., Mendialdua-Canales, D., Hurtado‐Pomares, M., Navarrete‐Muñoz, E. M., Valera‐Gran, D., Peral‐Gómez, P., Gil, G. B., Millán, P. G., González-Caballero, G., et al. (2024) · Mindfulness · doi:10.1007/s12671-024-02374-x · Cited by 7
“Furthermore, several meta-analyses (Burton et al., 2017; Spinelli et al., 2019; van der Riet et al., 2018) agree that the strongest finding of the impact of MBI relates to stress reduction (moderate effect), while for depression the impact is moderate to low.”
Apophatic Inquiry: Living the Questions Themselves
Visse, M. A., Hansen, F. T., & Leget, C. J. W. (2020) · International Journal of Qualitative Methods · doi:10.1177/1609406920958975 · Cited by 5
“The Inner Space must not be confused with being “mindful” or learning to work with “mindfulness” in professional work (Spinelli et al., 2019).”
Background
Modern changes in the model of professional and pedagogical training of medicines in the context of European integration processes
Tsekhmister, Y. V., Inessa, V., Гуменюк, В. В., Єфремова, О. В., & Serhii, D. (2022) · International Journal of Health Sciences · doi:10.53730/ijhs.v6n2.9440 · Cited by 5
“Spinelli et al. (2019), propose mindfulness training for healthcare providers and trainees in a metaanalysis of randomized controlled trials.”
Background
The impact of mindfulness training for nurses in lowering stress and enhancing well-being
Shah, U. N., Gupta, S., & Koshy, B. (2023) · Salud Ciencia y Tecnología · doi:10.56294/saludcyt2023446 · Cited by 5
The impact of a mindfulness-based stress reduction training program on depression, anxiety, and stress in Moroccan nurses
Ksiksou, J., Maskour, L., & Alaoui, S. (2023) · Kontakt · doi:10.32725/kont.2023.028 · Cited by 5
Novel Web-Based Drop-In Mindfulness Sessions (Pause-4-Providers) to Enhance Well-Being Among Health Care Workers During the COVID-19 Pandemic: Descriptive and Qualitative Study
Elliott, M., Khallouf, C., Hirsch, J., Meschino, D. D. C., Zamir, O., & Ravitz, P. (2023) · JMIR Formative Research · doi:10.2196/43875 · Cited by 6
Holistic Healing Through Mindfulness: An Experimental Study Addressing Psychological Challenges Among Nurses Caring for Patients With COVID-19
Alhawatmeh, H. N., Abusaif, L., Alharrasi, M., ABUALRUB, R. F., & Hamaideh, S. H. (2025) · Journal of Holistic Nursing · doi:10.1177/08980101251323021 · Cited by 6
“By equipping nurses with practical tools, mindfulness interventions help them navigate challenging healthcare environments more effectively (Spinelli et al., 2019).”
Mind–body effects of mindfulness-based training in athletes: a preliminary randomized controlled trial
Campo, C., Cellucci, F., Treggiari, G., Spedicato, G. A., Lasaponara, S., & Conversi, D. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1755043 · Cited by 5
“Existing literature indicates that mindfulness-based training can generate positive psychological effects, including improved wellbeing, better emotional and behavioral regulation, and reduced stress (Keng et al., 2011; Spinelli et al., 2019; Accoto et al., 2021).”
Effects of a Workplace Well-Being Program on Professional Quality of Life Among Health Care Personnel
Giordano, N. A., Duva, I., Swan, B. A., Johnson, T. M., Cimiotti, J. P., Lamis, D. A., Hillman, J., Gowgiel, J. C., Giordano, K., Rider, N. L., et al. (2025) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/j.jcjq.2025.04.008 · Cited by 4
Mindfulness training for community-based psychotherapists: a feasibility study
Sucich, J. T., Lehrer, J., Breitbart, V., & Julliard, K. N. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-01205-x · Cited by 4
“Introduction Mindfulness training has been shown to benefit the mental health and well-being of both behavioral health patients [1, 2, 3, 4, 5], and health professionals, including social workers [6, 7, 8, 9] and other psychotherapists [10, 11].”
Background
Interactions between Personality and Types of Mindfulness Practice in Reducing Burnout in Mental Health Professionals
Ruiz‐Íñiguez, R., Montero, A. C., Burgos-Julián, F. A., Roche, J. R. F., & Germán, M. Á. S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18136721 · Cited by 5
The effects of mindfulness on health profession students’ simulation training outcomes: An integrative review
Takhdat, K., Lamtali, S., & Adib, A. R. E. (2021) · Nurse Education Today · doi:10.1016/j.nedt.2021.105082 · Cited by 5
Effect of passage meditation program on nurses' level of hope and resilience who caring for patients with COVID 19
Elnehrawy, S., & Zewiel, M. A. A. (2021) · Tanta Scientific Nursing Journal · doi:10.21608/tsnj.2021.198905 · Cited by 4
“Tables (5): reveal correlation between the Total nurses hope Score and Demographic Data for studied sample.”
BackgroundInfluential
Mindfulness as a Protective Factor Against Increased Tobacco and Alcohol Use in Hospital Workers Following the First COVID-19-Related Lockdown: a Study in Southern France
Barré, T., Ramier, C., Mounir, I., David, R., Menvielle, L., Marcellin, F., Carrieri, P., Protopopescu, C., & Chérikh, F. (2022) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-021-00739-0 · Cited by 4
“Our results highlight the need for greater training in mindfulness for all hospital workers—whether healthcare professionals or not (Ruiz-Fernández et al., 2020; Spinelli et al., 2019)—both to increase their dispositional mindfulness and to limit the detrimental impact of stress (in turn limiting this impact on hospit…”
Result
Rapid and sustainable self-questionnaire for large-scale psychological screening in pandemic conditions for healthcare workers
Romero, C. S., Otero, M. C., Lozano, M., Delgado, C. F., Benito, A., Catalá, J. C., Iftimi, A. A., Andrés, J. A. D., & Luedi, M. M. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2022.969734 · Cited by 5
Mindfulness in Pediatrics: Practices to Improve Clinician and Patient Mental Health and Enhance Well-Being
Kohut, S. A., & Saltzman, A. (2021) · Pediatric Annals · doi:10.3928/19382359-20210117-01 · Cited by 5
Evidence to Support Mindful Healthcare Professionals
Kraemer, K. M., Wang, A., O’Bryan, E. M., & Luberto, C. M. (2022) · Springer eBooks · doi:10.1007/978-3-030-91062-4_2 · Cited by 3
An Intervention to Increase Situational Awareness and the Culture of Mutual Care (Foco) and Its Effects During COVID-19 Pandemic: A Randomized Controlled Trial and Qualitative Analysis
Kozasa, E. H., Lacerda, S. S., Polissici, M. A., Coelho, R. D. S., Farias, G. D. S., Chaves, P., & Leão, E. R. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.570786 · Cited by 5
Development of the process of determining essential hazardous psychosocial factors of employee stress risk
Bazaluk, O., Tsopa, V. A., Чеберячко, С. І., Deryugin, O. V., Nesterova, O. Y., Sokurenko, S., & Lozynskyi, V. G. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1414695 · Cited by 2
Selbst(für)sorge und Achtsamkeit praktizieren und fördern
Heidenreich, T., & Michalak, J. (2020) · Springer Reference Pflege, Therapie, Gesundheit · doi:10.1007/978-3-662-58685-3_10-1 · Cited by 3

Authors: Spinelli, C., Wisener, M., & Khoury, B.
Affiliations: McGill University (CA)
Corresponding author: Spinelli, Christina
ORCID: Spinelli, Christina
Wisener, Melanie
Khoury, Bassam
Venue: Journal of Psychosomatic Research
Publisher: Elsevier BV
Published: 2019-05
Volume: 120
Pages: 29-38
ISSN: 0022-3999 (ISSN-L)
DOI: 10.1016/j.jpsychores.2019.03.003
OpenAlex: W2922353268
Cited by: 170
References: 91
Citations by year: 2026: 17 · 2025: 19 · 2024: 14 · 2023: 28 · 2022: 31 · 2021: 35 · 2020: 25 · 2019: 1
FWCI: 3.63
Type: journal article
Language: en
Update notices: erratum (2019-08-01)
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Psychosomatic Research (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
Keywords: mindfulness-based interventions, healthcare workers, medical trainees, anxiety, depression, psychological distress, burnout, well-being, stress, mindfulness-based stress reduction, meditation, occupational health
MeSH terms: Health Personnel, Humans, Stress, Psychological, Randomized Controlled Trials as Topic, Mindfulness

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Mindfulness training for healthcare professionals and trainees: A meta-analysis of randomized controlled trials

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