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

The DOI matches its Crossref record; 101 of the 101 references it cites were found in a registry or an index; none of the 91 sources its claims cite is checked for support yet.

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.

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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.

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Integrity signals

Registry

Crossref · 10.1111/jan.14318

Cites

101 of 101 references verified0 citation errors · 0 not checkable

Statistics

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Claims the paper makes

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

None of the sources cited for this claim have been checked yet.
In the paper
“The sample populations initially presented medium-high levels of EE, ranging from 42-69% (Mealer et al., 2014;Montanari et al., 2018).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.2 | The effectiveness of mindfulness training in reducing burnout
What the sources say
- Not checked yetcites Mealer et al., 2014
- Not checked yetcites Montanari et al., 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.2 | The effectiveness of mindfulness training in reducing burnout
What the sources say
- Not checked yetcites Mackenzie et al., 2006
- Not checked yetcites Mealer et al., 2014
- Not checked yetcites Montanari et al., 2018
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.2 | The effectiveness of mindfulness training in reducing burnout
What the sources say
- Not checked yetcites Gauthier et al., 2015
- Not checked yetcites Mealer et al., 2014
- Not checked yetcites Norouzinia et al., 2017
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.2 | The effectiveness of mindfulness training in reducing burnout
What the sources say
- Not checked yetcites Duarte & Pinto-Gouveia, 2016
- Not checked yetcites Hevezi, 2016
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“in a study that followed up outcomes over a longer period over time, the adherence fell to 12.8% (Duarte & Pinto-Gouveia, 2016).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.3 | Duration and monitoring of mindfulness interventions
What the sources say
- Not checked yetcites Duarte & Pinto-Gouveia, 2016
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Mealer et al. (2014) andPoulin et al. (2008), the mindfulness intervention produced mean rises in PA ranging from 4.22% to 8%”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Mealer et al. (2014)
- Not checked yetcites Poulin et al. (2008)
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Cohen-Katz et al. (2005) found that 3 months after an MBSR programme, the changes obtained only persisted in one of the burnout dimensions (EE)”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Cohen-Katz et al. (2005)
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“In the studies conducted by Craigie et al. (2016), Delaney (2018) and Dos Santos et al. (2016), the total burnout score decreased by 12-30% after nurses followed mindfulness-based programmes”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Craigie et al. (2016)
- Not checked yetcites Delaney (2018)
- Not checked yetcites Dos Santos et al. (2016)
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
In the paper
“a similarly negative relationship for D immediately after the intervention”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Gauthier et al. (2015)
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Bazarko et al. (2013) measured a stable average score, for all dimensions of burnout, after 2 and 4 months”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Bazarko et al. (2013)
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Ceravolo and Raines (2018) recorded an increase in the burnout score during the three subsequent months”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Ceravolo and Raines (2018)
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“and a positive one for PA”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Gauthier et al. (2015)
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“Gauthier et al. (2015)observed a negative relationship between the EE dimension of burnout and MBSR, immediately following the intervention and at the 1-month follow-up”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Gauthier et al. (2015)
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Mindfulness programmes have achieved tangible effects in reducing burnout in healthcare personnel (Eby et al., 2019;Eriksson, Germundsjö, Åström, & Rönnlund, 2018;Hamilton-West, Pellatt-Higgins, & Pillai, 2018;Lu et al., 2019)”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 1.1 | Background
What the sources say
- Not checked yetcites Eby et al., 2019
- Not checked yetcites Eriksson et al., 2018
- Not checked yetcites Hamilton-West et al., 2018
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Burnout syndrome is a common occupational hazard for nursing staff.”
- Also stated in: § 1 | INTRODUC TI ON · plain
  “who often present high levels of burnout (Akman, Ozturk, Bektas, Ayar, & Armstrong, 2016;Gómez-Urquiza et al., 2017;Molina-Praena et al., 2018;Monsalve-Reyes et al., 2018;Pradas-Hernández et al., 2018).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > Abstract
What the sources say
- Not checked yetcites Akman et al., 2016
- Not checked yetcites Gómez-Urquiza et al., 2017
- Not checked yetcites Molina-Praena et al., 2018
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Even though there are other meta-analysis about interventions for occupational stress and well-being in healthcare professionals (Lomas, Medina, Ivtzan, Rupprecht, & Eiroa-Orosa, 2019;Ruotsalainen et al., 2015;Slemp, Jach, Chia, Loton, & Kern, 2019) none is focused on nurses burnout.”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 1.1 | Background
What the sources say
- Not checked yetcites Lomas et al., 2019
- Not checked yetcites Ruotsalainen et al., 2015
- Not checked yetcites Slemp et al., 2019
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Luberto et al., 2017
- Not checked yetcites Guillaumie et al., 2017
- Not checked yetcites Huang et al., 2019
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“In this respect, too, a negative correlation has been reported between work satisfaction and mindfulness training in paediatric intensive care units.”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Gauthier et al., 2015
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“In hospital services where nurses may be especially vulnerable to burnout, such as intensive care units and oncology, mindfulness intervention is considered an effective instrument (Duarte & Pinto-Gouveia, 2016;Podgurski, Greco, Croom, Arnold, & Claxton, 2019).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Duarte & Pinto-Gouveia, 2016
- Not checked yetcites Podgurski et al., 2019
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes

Probably not a substantial claim. 25
It may state two separate claims as one. 26

None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.1 | Characteristics of the studies included
What the sources say
- Not checked yetcites Craigie et al., 2016
- Not checked yetcites Gauthier et al., 2015
- Not checked yetcites Watanabe et al., 2019
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.2 | The effectiveness of mindfulness training in reducing burnout
What the sources say
- Not checked yetcites Gauthier et al., 2015
- Not checked yetcites Mealer et al., 2014
- Not checked yetcites Duarte & Pinto-Gouveia, 2016
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.2 | The effectiveness of mindfulness training in reducing burnout
What the sources say
- Not checked yetcites Cohen-Katz et al., 2005
- Not checked yetcites Mackenzie et al., 2006
- Not checked yetcites Montanari et al., 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.2 | The effectiveness of mindfulness training in reducing burnout
What the sources say
- Not checked yetcites Mealer et al., 2014
- Not checked yetcites Mackenzie et al., 2006
- Not checked yetcites Norouzinia et al., 2017
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.3 | Duration and monitoring of mindfulness interventions
What the sources say
- Not checked yetcites Bazarko et al., 2013
- Not checked yetcites Ceravolo & Raines, 2018
- Not checked yetcites Cohen-Katz et al., 2005
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.3 | Duration and monitoring of mindfulness interventions
What the sources say
- Not checked yetcites Craigie et al., 2016
- Not checked yetcites Dos Santos et al., 2016
- Not checked yetcites Slatyer et al., 2018
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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 effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.4 | Meta-analysis of the effect size of the mindfulness intervention in reducing the impact of burnout
What the sources say
- Not checked yetcites Mackenzie et al., 2006
- Not checked yetcites Norouzinia et al., 2017
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The other studies of MBSR used shorter versions, lasting 6 weeks (Dos Santos et al.,”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 3.3 | Duration and monitoring of mindfulness interventions
What the sources say
- Not checked yetcites Dos Santos et al., 2016
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Moody et al., 2013
Strength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Duarte & Pinto-Gouveia, 2016
- Not checked yetcites Wong et al., 2018
- Not checked yetcites De Vibe et al., 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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)”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Montanari et al. (2018)
- Not checked yetcites Norouzinia et al. (2017)
- Not checked yetcites Watanabe et al. (2019)
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 1.1 | Background
What the sources say
- Not checked yetcites Dos Santos et al., 2016
- Not checked yetcites Slatyer et al., 2018
Load-bearingStrength:boosted· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 2.5 | Quality appraisal
What the sources say
- Not checked yetcites Howick et al., 2011
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The risk of bias was analysed by pairs of independent reviewers using the Cochrane Collaboration Risk of Bias tool (Higgins & Green, 2011).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 2.5 | Quality appraisal
What the sources say
- Not checked yetcites Higgins & Green, 2011
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Braun et al., 2019
- Not checked yetcites Fortney et al., 2013
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Duchemin et al., 2015
- Not checked yetcites Steinberg et al., 2017
- Not checked yetcites Sallon et al., 2017
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: Regular training maintains low levels of burnout.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Guillaumie et al., 2017
- Not checked yetcites Huang et al., 2019
- Not checked yetcites Young et al., 2018
Strength:boosted· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Meyer et al., 2018
- Not checked yetcites O'Mahony et al., 2016
- Not checked yetcites Veiga et al., 2019
Strength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Askey-Jones, 2018
- Not checked yetcites Fortney et al., 2013
- Not checked yetcites Lebares et al., 2018
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“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).”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Sallon et al., 2017
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Andrés-Rodríguez et al., 2019
- Not checked yetcites Zhang et al., 2019
- Not checked yetcites Hedman-Lagerlöf et al., 2018
Strength:boosted· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“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;”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 4 | D ISCUSS I ON
What the sources say
- Not checked yetcites Hemanth & Fisher, 2015
- Not checked yetcites Hunter, 2019
- Not checked yetcites Irving et al., 2014
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“following the recommendations of the PRISMA statement (Moher, Liberati, Tetzlaff, & Altman, 2009)”
§ The effect of mindfulness training on burnout syndrome in nursing: A systematic review and meta-analysis > 5 | CON CLUS ION
What the sources say
- Not checked yetcites Moher, Liberati, Tetzlaff, & Altman, 2009
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.

44 of 44

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.”

4 of 4

Claims other papers make about this one

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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

Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
The measurement of experienced burnout
Maslach, C., & Jackson, S. E. (1981) · Journal of Organizational Behavior · doi:10.1002/job.4030020205 · Cited by 14,496 · cited 1×
“Burnout syndrome arises from chronic exposure to stress-provoking factors and is characterized by three dimensions: emotional exhaustion (EE); depersonalization (D); and low personal accomplishment (PA) (Maslach & Jackson, 1981).”
Background
Job burnout
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.397 · Cited by 12,852
Mindfulness-based interventions in context: Past, present, and future
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bpg016 · Cited by 8,615
Mindfulness-based interventions in context: Past, present, and future.
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy/bpg016 · Cited by 8,612
Untitled work
(2008) · Medical Entomology and Zoology · Cited by 7,477
Healthcare staff wellbeing, burnout, and patient safety: a systematic review
Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016) · PLOS ONE · doi:10.1371/journal.pone.0159015 · Cited by 1,683
Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies
Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. M. D. (2017) · PLOS ONE · doi:10.1371/journal.pone.0185781 · Cited by 1,508 · cited 1×
“…available at https://publo ns.com/publo n/10.1111/jan.14318. impact on physical and mental health (Bagheri Hosseinabadi et al., 2019; McVicar, 2016; Salvagioni et al., 2017), decreases productivity and quality of care (Cañadas-De la Fuente et al., 2018; Daigle, Talbot, & French, 2018; Dall'Ora,…”
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Research works printed but not linked: 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.

Sorted by citations

Mindfulness-based interventions: an overall review
Zhang, D., Lee, E. K. P., Mak, E. C. W., Ho, C. Y., & Wong, S. Y. S. (2021) · British Medical Bulletin · doi:10.1093/bmb/ldab005 · Cited by 668
“reducing depression and burnout and improving emotional resilience.(76,77) However,”
Background
Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials
Galante, J., Friedrich, C., Dawson, A. F., Modrego-Alarcón, M., Gebbing, P., Delgado-Suárez, I., Gupta, R., Dean, L., Dalgleish, T., White, I. R., et al. (2021) · PLOS Medicine · doi:10.1371/journal.pmed.1003481 · Cited by 319
Prevalence, risk factors and burnout levels in intensive care unit nurses: a systematic review and meta-analysis
Ramírez-Elvira, S., Romero-Béjar, J. L., Suleiman-Martos, N., Gómez-Urquiza, J. L., Monsalve-Reyes, C., Cañadas-De la Fuente, G. A., & Albendín-García, L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182111432 · Cited by 267
“Thus, it is essential to provide interventions to improve mental health and promote coping strategies [52,53].”
BackgroundSelf-citation
The Relationship between Mindfulness and Emotional Intelligence as a Protective Factor for Healthcare Professionals: Systematic Review
Picón, N. J., Romero‐Martín, M., Ponce‐Blandón, J. A., Ramírez‐Baena, L., Palomo-Lara, J. C., & Gómez-Salgado, J. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18105491 · Cited by 216
“There is evidence of the impact and effectiveness of mindfulness for healthcare professionals, resulting in the reduction of stress and the promotion of self-compassion and self-care [32–35], the reduction of emotional exhaustion and the incidence of burnout [36,37], the improvement of wellbeing and mental health, and…”
BackgroundResult
Burnout among healthcare providers during COVID-19: Challenges and evidence-based interventions
Sultana, A., Sharma, R., Hossain, M. M., Bhattacharya, S., & Purohit, N. (2020) · Indian Journal of Medical Ethics · doi:10.20529/ijme.2020.73 · Cited by 156

See all 217

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: Suleiman‐Martos, Nora
Gomez‐Urquiza, Jose L.
Aguayo‐Estremera, Raimundo
Albendín‐García, Luis
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: bronze
doi.org
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 › Medicine › Public Health, Environmental and Occupational Health › 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

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

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