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Cited by 217Occupational Health and BurnoutMindfulness and Compassion InterventionsStress and Burnout Research

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

Open access
Suleiman‐Martos, Nora, Gomez‐Urquiza, Jose L., Aguayo‐Estremera, Raimundo, Cañadas‐De La Fuente, Guillermo A., De La Fuente‐Solana, Emilia I., Albendín‐García, Luis·2020·Journal of Advanced Nursing
DOI 10.1111/jan.14318
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Abstract

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.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis found that mindfulness-based interventions were generally associated with reduced burnout among nurses, especially emotional exhaustion, but the quantitative evidence was limited to two studies. The authors conclude that mindfulness training may help reduce nurse burnout, while calling for more randomized controlled trials.

Key findings

  • The review included 17 articles (8 randomized controlled trials and 9 quasi-experimental studies), with a total sample of 632 nurses; most participants were women, ranging from 87% to 100% across studies.
  • In all included studies, emotional exhaustion decreased after mindfulness intervention, with reported reductions of 14.32–31%; depersonalization decreased by 7–17.60% in some studies, while several others found no significant changes; total burnout scores decreased by 12–30% in three studies.
  • The meta-analysis included only 2 studies, with N = 46 nurses in intervention groups and N = 44 in control groups. For emotional exhaustion, the mean difference was 1.32 (95% CI: −9.41 to 6.78), with lower values in the intervention group; for depersonalization, the mean difference was 1.91 (95% CI: −4.50 to 0.68) in favour of intervention; for personal accomplishment, the mean difference was 2.12 (95% CI: −9.91 to 14.14) in favour of intervention.
  • Heterogeneity was I² = 71% for emotional exhaustion, 26% for depersonalization, and 95% for personal accomplishment.

Methods

  • Systematic review and meta-analysis following PRISMA recommendations; databases searched were CINAHL, LILACS, Medline, ProQuest, PsycINFO, Scielo, and Scopus, using the search equation “Nurs* AND burnout AND mindfulness” in June 2019.
  • Inclusion criteria were clinical trial or quasi-experimental study, analysis of mindfulness-based intervention impact on burnout, sample of nurses, publication in English, Spanish, French, or Portuguese, and no year restriction.
  • Quality was appraised with Oxford Centre for Evidence-Based Medicine levels and Cochrane Collaboration Risk of Bias tool; when sufficient data were available, random-effects meta-analyses were performed for each burnout dimension using Review Manager 5.3, with heterogeneity assessed by I².

Limitations

  • The authors state that very few randomized controlled trials were available, so only limited data could be meta-analysed and results should be interpreted with caution.
  • The authors note heterogeneity of mindfulness approaches, including reduced session times or combined treatment approaches, which may have affected inter-study findings; they also cite limited intervention duration and follow-up, and a sample mainly composed of female nurses.
  • Evident from the text: the meta-analysis included only 2 studies with small samples, confidence intervals were wide and crossed zero for all three burnout dimensions, and heterogeneity was high for emotional exhaustion and personal accomplishment.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1111/jan.14318

Cites

101 of 101 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 91 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    In all cases, decreased levels of emotional exhaustion (EE) were reported following the mindfulness intervention.

    “In all cases, decreased levels of EE were reported following the mindfulness intervention.”
    Quote in the paperSubstantial claim
  • Findingcitation

    The sample populations initially presented medium-high levels of EE, ranging from 42-69%.

    “The sample populations initially presented medium-high levels of EE, ranging from 42-69% (Mealer et al., 2014;Montanari et al., 2018).”
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  • Findingcitation

    The intervention achieved reductions in EE of 14.32-31% (to medium-low levels).

    “The intervention achieved reductions in EE of 14.32-31% (to mediumlow levels) (Mackenzie et al., 2006;Mealer et al., 2014;Montanari et al., 2018;Norouzinia et al., 2017;Poulin, Mackenzie, Soloway, & Karayolas, 2008).”
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  • Findingcitation

    Several authors observed medium-high initial levels of depersonalization (D), which after the intervention had decreased by 7-17.60%.

    “Several authors observed medium-high initial levels of D, which after the intervention had decreased by 7-17.60% (Gauthier et al., 2015;Mealer et al., 2014;Norouzinia et al., 2017).”
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  • Findingcitation

    Two studies focused on oncology departments found that the intervention reduced burnout to a moderate level.

    “Two focused on oncology departments, where high levels of burnout have been reported (Duarte & Pinto-Gouveia, 2016;Hevezi, 2016) and found that the intervention reduced burnout to a moderate level.”
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  • Classified as probably not a substantial claim. 25
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    Findingown data

    The final sample for analysis was composed of 17 articles.

    “the final sample obtained for analysis was composed of 17 articles”
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    Findingown data

    Of the 17 included articles, eight were randomized controlled trials and nine were quasi-experimental studies.

    “Of the 17 articles included in the final sample, eight referred to randomized controlled trial and nine described quasi-experimental studies.”
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    Findingown data

    After reading titles and abstracts, 631 articles were excluded because they did not meet the inclusion criteria or were duplicates.

    “After reading the title and abstract of each one, 631 were excluded because they did not meet the inclusion criteria or because they were duplicates.”
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    Findingown data

    In total, 673 articles were found in the different databases.

    “In total, 673 articles were found in the different databases.”
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    Findingown data

    In nine papers, a mindfulness-based intervention was compared with a control group; in eight studies, effects of a mindfulness programme were analysed over time, with follow-up ranging from 1 to 13 months.

    “In nine of the papers, a mindfulness-based intervention was compared with the results for a control group and eight studies analysed the effects of a mindfulness programme over time, with follow-up ranging from 1 month (Craigie et al., 2016;Gauthier, Meyer, Grefe, & Gold, 2015) to 13 months (Watanabe et al., 2019).”
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    Findingown data

    Four studies analysed the influence of MBSR on specific hospital units.

    “Among the studies included in our review, four analysed the influence of MBSR on specific hospital units.”
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    Findingcitation

    For nurses working in intensive care units, mindfulness training reduced levels of burnout, enhanced satisfaction and fostered positive cognitive retraining.

    “The same pattern of results was observed for nurses working in intensive care units (Gauthier et al., 2015;Mealer et al., 2014), where the mindfulness training reduced levels of burnout, enhanced satisfaction and fostered positive cognitive retraining (Duarte & Pinto-Gouveia, 2016).”
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    Findingcitation

    Other authors observed medium-low levels of D, with no significant changes following the intervention.

    “However, other authors observed medium-low levels for this parameter, with no significant changes following the intervention (Cohen-Katz et al., 2005;Mackenzie et al., 2006;Montanari et al., 2018;Poulin et al., 2008;Watanabe et al., 2019).”
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    • cites Mackenzie et al., 2006

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    Findingcitation

    Mealer et al. (2014) reported low levels of personal accomplishment (PA) (77%) pre-intervention; other authors observed moderate levels for this parameter.

    “Mealer et al. (2014) reported low levels of PA (77%) pre-intervention; however, other authors observed moderate levels for this parameter (Mackenzie et al., 2006;Norouzinia et al., 2017;Poulin et al., 2008).”
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    Findingown data

    Six papers analysed outcomes under the traditional MBSR approach, with a total duration of 8 weeks.

    “Six papers (Bazarko et al., 2013;Ceravolo & Raines, 2018;Cohen-Katz et al., 2005;Delaney, 2018;Norouzinia et al., 2017;Poulin et al., 2008) analysed outcomes achieved under the traditional MBSR approach, with a total duration of 8 weeks.”
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    Findingcitation

    Several authors showed that a brief intervention can be effective, reducing burnout and maintaining the positive outcome.

    “Several authors (Craigie et al., 2016;Dos Santos et al., 2016;Slatyer et al., 2018) showed that a brief intervention can be effective, reducing burnout and maintaining the positive outcome”
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    Findingnone given

    Before the intervention, the nurses in each of the study populations considered showed high levels of burnout.

    “Before the intervention, the nurses in each of the study populations considered showed high levels of burnout.”
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    Findingown data

    For EE, the difference in means was 1.32 (95% CI: -9.41-6.78), with lower mean values in the intervention group.

    “For EE, the difference in the means was 1.32 (95% CI: -9.41-6.78),with lower mean values in the intervention group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Two studies provided the data necessary to perform a statistical analysis of possible bias.

    “Two of the studies of mindfulness-based interventions (Mackenzie et al., 2006;Norouzinia et al., 2017) provided the data necessary to perform a statistical analysis of possible bias (see Figure 2).”
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    Findingcitation

    Some authors observed no significant changes or even an increase in postintervention burnout score.

    “Regarding the duration of the benefits obtained, some authors observed no significant changes or even reported an increase in the postintervention burnout score.”
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    Findingcitation

    Other studies of MBSR used shorter versions, lasting 6 weeks.

    “The other studies of MBSR used shorter versions, lasting 6 weeks (Dos Santos et al.,”
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    Findingown data

    Heterogeneity I2 results were 71% for EE, 26% for D and 95% for PA.

    “Regarding heterogeneity, the I 2 results were 71% for EE, 26% for D and 95% for PA.”
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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The total sample of nurses was N=46 for the intervention group and N=44 for the control group.

    “The total sample of nurses was N = 46 for the intervention group and N = 44 for the control group.”
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    Findingcitation

    Some studies of workers in intensive care and oncology departments have observed no changes in burnout levels, or improvements only in EE but not in D or PA.

    “However, some studies of workers in these departments have observed no changes in burnout levels, or improvements only in EE but not in D or PA, possibly due to the high initial levels of burnout experienced (Moody et al., 2013).”
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    Findingcitation

    The studies in question reported high dropout rates, a pattern repeated in other studies of healthcare workers.

    “However, the studies in question (Duarte & Pinto-Gouveia, 2016;Wong, Teng, Chee, Doshi, & Lim, 2018) reported high dropout rates, a pattern that has been repeated in other studies of healthcare workers (De Vibe et al., 2018;Shapiro, Astin, Bishop, & Cordova, 2005).”
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    Findingnone given

    The duration of the intervention and the time allowed for follow-up were limited.

    “Another question is that of the limited duration of the intervention and of the time allowed for follow-up”
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    Findingcitation

    Montanari et al. (2018) reported that moderate levels of personal accomplishment in their sample remained unchanged after mindfulness training, corroborating Norouzinia et al. (2017) and Watanabe et al. (2019).

    “Montanari et al. (2018) reported that the moderate levels of PA in their sample remained unchanged after mindfulness training, thus corroborating the earlier findings of Norouzinia et al. (2017) and Watanabe et al. (2019)”
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    Findingnone given

    The remaining studies addressed in the review are quasi-experimental in nature and lack randomization.

    “The remaining studies addressed in our review are quasi-experimental in nature, lacking randomization”
    Quote in the paperSubstantial claim

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    Findingnone given

    Follow-up studies of nurses' adherence to the programme recorded rates of 60-100% in the short term.

    “Follow-up studies of nurses' adherence to the programme recorded rates of 60-100% in the short term”
    Quote in the paperNot a substantial claim

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    Premisecitation

    Mindfulness training has positive effects in studies with nurses, although the types of intervention vary and different effect sizes have been reported.

    “Their positive effect has also been demonstrated in studies with nurses, although the types of intervention vary and different effect sizes have been reported (Dos Santos et al., 2016;Slatyer, Craigie, Heritage, Davis, & Rees, 2018).”
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    Study design and conductnone given

    No study was excluded; all articles reached a quality level according to quality assessment tools.

    “No study was excluded, all articles reached a quality level according to quality assessment tools.”
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    Study design and conductown data

    The degree of agreement on coding was tested by Cohen's kappa and the intraclass correlation coefficient.

    “The degree of their agreement on this coding was tested by Cohen's kappa and the intraclass correlation coefficient.”
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    Study design and conductcitation

    The studies were classified by level of evidence in accordance with the recommendations of the Oxford Center for Evidence-based Medicine (OCEBM).

    “The studies were classified by level of evidence in accordance with the recommendations of the Oxford Center for Evidence-based Medicine (OCEBM) (Howick et al., 2011).”
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    Study design and conductnone given

    Data were recorded using a data coding manual, by two researchers working independently.

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    Study design and conductnone given

    Heterogeneity of the sample was assessed by the I2 index.

    “Heterogeneity of the sample was assessed by the I 2 index.”
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    Study design and conductcitation

    Risk of bias was analysed by pairs of independent reviewers using the Cochrane Collaboration Risk of Bias tool.

    “The risk of bias was analysed by pairs of independent reviewers using the Cochrane Collaboration Risk of Bias tool (Higgins & Green, 2011).”
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    Study design and conductown data

    The process of study selection was carried out by two investigators working independently and a third was consulted if any disagreement arose.

    “The process was carried out by two investigators working independently and a third was consulted if any disagreement arose.”
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    Interpretationcitation

    In every case, the mindfulness programme produced a reduction in burnout among these nurses, to a degree comparable with that reported in similar studies focused on physicians and other healthcare personnel.

    “In every case, the mindfulness programme produced a reduction in burnout among these nurses, to a degree comparable with that reported in similar studies focused on physicians and other healthcare personnel (Braun et al., 2019;Fortney, Luchterband, Zakletskaia, Zgierska, & Rakel, 2013).”
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    Interpretationcitation

    EE scores were reduced by the intervention and PA scores increased, but no significant changes were observed in D.

    “Regarding the individual dimensions of burnout, EE scores were reduced by the intervention (Duchemin, Steinberg, Marks, Vanover, & Klatt, 2015;Steinberg, Klatt, & Duchemin, 2017) and those for PA increased.However, no significant changes were observed in D (Sallon, Katz-Eisner, Yaffe, & Bdolah-Abram, 2017;Verweij, van Ravesteijn, van Hooff, Lagro-Janssen, & Speckens, 2018).”
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    Interpretationreasoning

    This outcome may be due to low adherence by the nurses taking part in the studies.

    “This outcome may be due to low adherence by the nurses taking part in the studies, since regular training is known to maintain low levels of burnout.”
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    • Rests on an assumption: Regular training maintains low levels of burnout.

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    Premisecitation

    Mindfulness training produces increases in brain activity associated with positive moods and the regulation of emotions.

    “Mindfulness training for nurses also enhances positive cognitive retraining (Luberto et al., 2017), an outcome that has been corroborated by studies of brain images, which have shown that mindfulness training produces increases in brain activity, associated with positive moods and the regulation of emotions (Guillaumie, Boiral, & Champagne, 2017;Huang et al., 2019;Young et al., 2018).”
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    Premisecitation

    Some researchers have observed improvements in reactions to posttraumatic situations and positive effects on stress biomarkers such as reduction in salivary cortisol levels.

    “Some researchers have even observed improvements in reactions to posttraumatic situations (Meyer et al., 2018;O'Mahony, Gerhart, Grosse, Abrams, & Levy, 2016) and even positive effects on stress biomarkers such as reduction in cortisol salivary cortisol levels (Veiga et al., 2019).”
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    Premisecitation

    Other authors have observed persistent improvements, lasting up to 12 months postintervention, with a reduction of 8.2% in burnout scores.

    “Nevertheless, in line with some of our review findings, other authors have observed persistent improvements, lasting up to 12 months postintervention, with a reduction of 8.2% in burnout scores (Askey-Jones, 2018; Fortney et al., 2013;Lebares et al., 2018;Martín-Asuero & García-Banda, 2010;Steinberg et al., 2017).”
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    Premisecitation

    The regulation of burnout levels has been associated with adherence to mindfulness training and with perseverance.

    “The regulation of burnout levels has been associated with adherence to mindfulness training and with perseverance, which are considered to be complementary forces (Sallon et al., 2017).”
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    Premisecitation

    Studies have highlighted long-term beneficial effects of these resources in individuals suffering from fibromyalgia, cancer, mental disorders, stress and insomnia.

    “Thus, studies have highlighted the long-term beneficial effects that these resources have produced in individuals suffering from pathologies such as fibromyalgia (Andrés-Rodríguez et al., 2019), cancer (Zhang, Zhao, & Zheng, 2019), mental disorders (Hedman-Lagerlöf, Hedman-Lagerlöf, & Öst, 2018; Rupp, Jürgens, Doebler andor, & Buhlmann, 2019), stress (Gawrysiak et al., 2018) and insomnia (Wang et”
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    Interpretationreasoning

    These results may have a positive impact for well-being and quality of life in nurses and also for the quality care.

    “These results may have a positive impact for well-being and quality of life in nurses and also for the quality care.”
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    Interpretationcitation

    Although mindfulness interventions have shown effectiveness in reducing burnout syndrome among nurses, there is still a limitation in knowing for which aspect is more effective.

    “Although mindfulness interventions have shown effectiveness in reducing burnout syndrome among nurses, there is still a limitation in knowing for which aspect is more effective like, for example, improving patient care, develop of enhanced awareness, sense of pleasure of the moment, changes in the personality of the conductor or increased curiosity and hope for the new (Hemanth & Fisher, 2015;”
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    Interpretationreasoning

    Mindfulness, through body-mind training, allows workers to address and overcome situations of severe emotional impact.

    “Mindfulness, through body-mind training, allows workers to address and overcome situations of severe emotional impact.”
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    Study design and conductcitation

    The review followed the recommendations of the PRISMA statement.

    “following the recommendations of the PRISMA statement (Moher, Liberati, Tetzlaff, & Altman, 2009)”
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  • The paper relies on this without support.

    Regular training maintains low levels of burnout.

    “since regular training is known to maintain low levels of burnout.”

  • The paper relies on this without support.

    The outcome measures of burnout used in the included studies are comparable enough to pool in meta-analysis.

    “When sufficient statistical data were available, three meta-analyses were performed of random effects, one for each dimension of burnout syndrome.”

  • The paper relies on this without support.

    The mindfulness interventions in the included studies are comparable enough to combine in meta-analysis.

    “Two of the studies of mindfulness-based interventions (Mackenzie et al., 2006;Norouzinia et al., 2017) provided the data necessary to perform a statistical analysis of possible bias (see Figure 2).”

  • The paper relies on this without support.

    The two studies included in the meta-analysis are representative of the effect of mindfulness on burnout in nurses.

    “The total sample of nurses was N = 46 for the intervention group and N = 44 for the control group.”
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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Claim that EE decreased in every case conflicts with Mealer table

    Minor

    The Mealer intervention group's EE value rises from 9 before intervention to 13.0 after intervention, contrary to the statement that EE decreased in all cases.

  • Delaney is counted as an MBSR study despite its MBSCR classification

    Minor

    The text includes Delaney among six studies using the traditional MBSR approach, but Table 1 classifies its programme as MBSCR.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Howick J. Chalmers I. Glasziou P. Greenhalg T. Heneghan C. Liberati A. Thornton H.(2011).The Oxford 2011 Levels of Evidence[updated June 2019]. Available fromhttps://www.cebm.net/2016/05/ocebm‐levels‐of‐evidence.

Cited by

Sorted by citations

Related

Authors
Suleiman‐Martos, N., Gomez‐Urquiza, J. L., Aguayo‐Estremera, R., Cañadas‐De La Fuente, G. A., De La Fuente‐Solana, E. I., & Albendín‐García, L.
Affiliations
  • Universidad de Granada (ES)
  • Nursing Department University of Granada Granada Spain
  • Universidad de Málaga (ES)
  • Brain, Mind and Behavior Research Center (CIMCYC) University of Granada Granada Spain
ORCID
Venue
Journal of Advanced Nursing
Publisher
Wiley
Published
2020-03-04
Volume
76
Issue
5
Pages
1124-1140
ISSN
  • 0309-2402 (ISSN-L)
  • 1365-2648
DOI
10.1111/jan.14318
OpenAlex
W3004541954
Cited by
217
References
101
Citations by year
2026: 25 · 2025: 33 · 2024: 40 · 2023: 46 · 2022: 29 · 2021: 33 · 2020: 11
FWCI
7.32
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Advanced Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by-nc-nd)
Funders
Junta de Andalucía (P11HUM-7771)
Topics
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
Keywords
mindfulness training, burnout, nurses, emotional exhaustion, depersonalization, personal accomplishment, occupational stress, nurse well-being
MeSH terms
Burnout, Psychological, Adult, Behavior Therapy, Burnout, Professional, Female, Humans, Male, Middle Aged, Nursing Staff, Mindfulness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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