Author(s)

Meredith Mealer¹, Debra Boeldt², Kathryn Cochran¹, Rachel Hodapp³, Jeri Forster⁴, David Conrad⁵, Barbara O. Rothbaum⁶, Sona Dimidjian², Marc Moss^3*

¹Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA.
²Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.
³Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
⁴Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA.
⁵Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
⁶Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, USA.

Objective: Critical care nurses work in a challenging intensive care (ICU) environment that results in work-related psychological distress. Our objective was to pilot an in-person or virtual mindfulness-based cognitive therapy (MBCT) program enhanced resilience and a similarly designed attention control group. Methods: We randomized ICU nurses with symptoms of burnout syndrome and decreased resilience to an MBCT program or a similarly formatted book club control. Our primary outcome was change in resilience as measured by the Connor-Davidson Resilience Scale (CD-RISC). Results: One-hundred one nurses completed study-related procedures. Overall, 70% had baseline symptoms of anxiety and 26% had symptoms of depression. For the in-person cohorts, there was no statistical difference between intervention and control groups regarding the total number of sessions attended (3.85 days ± 1.4 versus 3.75 days ± 0.15; p = 0.64). Using the Client/Patient Satisfaction Questionnaire-8 (CSQ-8), satisfaction scores were higher in the intervention group for weeks two through four of the program: p = 0.03, 0.0003, 0.007 respectively. There was no difference in the change in CD-RISC scores between the two groups (mean difference: treatment = 5.0, control = 7.0; p = 0.30). The online intervention cohort had greater improvements in the change of their median emotional exhaustion burnout scores when compared to the in-person intervention cohorts (-5 [-8 to -1.5] vs. 2 [-5 to 8], p = 0.049). Conclusions: We developed a feasible and acceptable in-person and online MBCT-ICU intervention that did not increase resilience scores in ICU nurses when compared to an attention control group. These results could help guide the proper design of larger trials to determine the efficacy of other resilience interventions.

Burnout Syndrome, Mindfulness, Cognitive Behavioral Therapy, Critical Care, Nursing

Mealer, M. , Boeldt, D. , Cochran, K. , Hodapp, R. , Forster, J. , Conrad, D. , Rothbaum, B. , Dimidjian, S. and Moss, M. (2021) A Mindfulness-Based Cognitive Therapy (MBCT) Intervention to Improve Resilience and Mitigate Symptoms of Burnout Syndrome in Critical Care Nurses: Results of a Randomized Trial. Open Journal of Nursing, 11, 653-667. doi: 10.4236/ojn.2021.118055.