Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 12, 2024
Date Accepted: Oct 4, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Digital Mindfulness Training for Burnout Reduction in Physicians: A Clinician-Driven Approach
ABSTRACT
Background:
Physician burnout is widespread in healthcare systems, with harmful consequences on physicians, patients, and healthcare organizations. Mindfulness training (MT) has proven effective in reducing burnout, but often its time-consuming requirements pose challenges for physicians who are already struggling with their busy schedules.
Objective:
The aims of this research are to design a short and pragmatic digital MT program with input from clinicians specifically to address burnout, and to test its efficacy in physicians.
Methods:
Two separate non-randomized pilot studies were carried out. In the first study, 27 physicians received the digital MT in a podcast format, while in the second study, 29 physicians and nurse practitioners accessed to the same training through a free app-based platform. The main outcome measure was cynicism, one dimension of burnout. The secondary outcome measures were emotional exhaustion (the second dimension of burnout), anxiety, depression, intolerance of uncertainty, empathy (personal distress, perspective taking and empathic concern subscales), self-compassion and mindfulness (nonreactivity and non-judgment subscales). In the second study, worry, sleep disturbances and difficulties in emotion regulation were also measured. Changes in outcomes were assessed using self-report questionnaires administered before and after the treatment and one month later as follow-up.
Results:
Both studies showed that MT decreased cynicism (33% reduction, Ps≤.044, rs ≥0.41 at posttreatment; 33% reduction, Ps≤.044, rs≥0.45 at follow-up), while improvements in emotional exhaustion were observed solely in the first study (25% reduction, P=.016, r=0.50 at posttreatment; 25% reduction, P=.008, r=0.62 at follow-up). There were also significant reductions of anxiety (Ps≤.014, rs ≥0.49 at posttreatment; Ps≤.01, rs≥0.54 at follow-up), intolerance of uncertainty (Ps≤.03, rs ≥0.57 at posttreatment; Ps<.001, rs≥0.66 at follow-up), and personal distress (P=.026, rs=0.43 at posttreatment; Ps=.026, rs=0.46 at follow-up), while increases of self-compassion (Ps≤.015, rs ≥0.50 at posttreatment; Ps≤.006, rs≥0.59 at follow-up) and mindfulness (nonreactivity: Ps≤.001, rs ≥0.69 at posttreatment; Ps≤.004, rs≥0.58 at follow-up; non-judgment: Ps≤.009, rs ≥0.50 at posttreatment; Ps≤.028, rs≥0.60 at follow-up). Additionally, the second study reported significant decreases in worry (P=.036, r=0.40 at posttreatment; P=.006, r=0.58 at follow-up), sleep disturbances (P=.036, r=0.42 at posttreatment; P=.013, r=0.53 at follow-up), and difficulties in emotion regulation (P=.005, r=0.54 at posttreatment; P<.001, r=0.70 at follow-up). However, no changes were observed over time for depression or perspective-taking and empathic concern. Finally, both studies revealed significant positive correlations between burnout and anxiety (cynicism: rs ≥0.38; Ps ≤.035; emotional exhaustion: rs≥0.58; Ps≤.001).
Conclusions:
To our knowledge, this research is the first where clinicians were involved in designing an intervention targeting burnout. These findings suggest that this digital MT serve as a viable and effective tool for alleviating burnout and anxiety among physicians. Clinical Trial: ClinicalTrials.gov NCT06145425; https://clinicaltrials.gov/study/NCT06145425
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