Mobile Mindfulness for Psychological Distress and Burnout among Frontline COVID-19 Nurses: A Pilot Randomized Trial
Elias H. Pratt, Levent Hall, Christina Jennings, Maren K Olsen, Adina Jan, Alice Parish, Laura S Porter, Christopher E Cox
Annals of the American Thoracic Society June 8, 2023 DOI: 10.1513/annalsats.202301-025oc (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot randomized trial Peer reviewed |
|---|---|
| Sample size | 102 |
| Population | Nurses working in COVID-19 units at a single hospital |
| Intervention | Mobile mindfulness |
| Duration | 1 month |
| Measures | Patient Health Questionnaire-9, General Anxiety Disorder-7, Perceived Stress Scale-4, Maslach Burnout Inventory |
| Topics | Meditation |
| Citations | 25 |
| Registration | NCT04816708 |
| Key findings | Mobile mindfulness met feasibility targets for randomization (90%) and retention (86%) but had modest use, with only 28% of intervention participants completing at least one session weekly. Intervention participants showed a greater reduction in depression symptoms (PHQ-9 difference in differences -2.21), but depersonalization burnout scores decreased more in controls (difference in differences 1.60), and no other distress or burnout differences were found. |
Abstract
Abstract Rationale The coronavirus disease (COVID-19) pandemic exacerbated psychological distress and burnout in frontline healthcare workers. Interventions addressing psychological distress and burnout among these workers are lacking.
Objectives: To determine the feasibility and explore the impact of mobile mindfulness to treat psychological distress and burnout among nurses in frontline COVID-19 units.
Methods: We conducted a pilot randomized trial of 102 nurses working in COVID-19 units at a single hospital between May 2021 and January 2022. Participants were randomized to mobile mindfulness (intervention) or waiting list (control). The primary outcome was feasibility, assessed by comparing rates of randomization, retention, and intervention completion to predefined targets. Secondary outcomes were changes in psychological distress (Patient Health Questionnaire-9, General Anxiety Disorder-7, Perceived Stress Scale-4) and burnout symptoms (Maslach Burnout Inventory) after 1 month.
Results: We randomized 102 of 113 consented individuals (90%, target 80%), and 88 completed follow-up (86%, target 80%). Among 69 intervention participants, 19 completed ⩾1 mindfulness session per week (28%, target 60%), and 13 completed ⩾75% of mindfulness sessions (19%, target 50%). Intervention participants had greater decreases in Patient Health Questionnaire-9 scores than control subjects (difference in differences, −2.21; 95% confidence interval, −3.99, −0.42; P = 0.016), but the Maslach Burnout Inventory depersonalization scores decreased more in the control arm than in the intervention arm (difference in differences, 1.60; 95% confidence interval, 0.18, 3.02; P = 0.027). There were no other changes in emotional distress or burnout symptoms.
Conclusions: This trial of mobile mindfulness in frontline nurses met feasibility targets for randomization and retention, but participants had modest intervention use. Intervention participants had a reduction in depression symptoms, but not in burnout. Clinical trial registered with www.clinicaltrials.gov (NCT04816708).
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 5
- The efficacy of mindfulness apps on symptoms of depression and anxiety: An updated meta-analysis of randomized controlled trials. Clinical Psychology Review February 1, 2024
- Mobile Mindfulness Intervention for Psychological Distress Among Intensive Care Unit Survivors: A Randomized Clinical Trial. JAMA Internal Medicine July 1, 2024
- Effectiveness of mindfulness-based interventions on burnout, resilience and sleep quality among nurses: a systematic review and meta-analysis of randomized controlled trials. BMC Nursing July 1, 2025
- Mobile App-Based Mindfulness Intervention for Addressing Psychological Distress Among Survivors of Hospitalization for COVID-19 Infection. CHEST critical care June 1, 2024
- Effects of Self-Guided Digital Mindfulness Interventions on the Mental Health of Health Care Workers: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR mHealth and uHealth August 21, 2026
Cites 6
- Mindfulness Interventions Annual Review of Psychology September 30, 2016
- Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians JAMA September 22, 2009
- How long does a mindfulness‐based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress Journal of Clinical Psychology March 23, 2009
- The effect of mindfulness training on burnout syndrome in nursing: a systematic review and meta-analysis. Journal of Advanced Nursing February 5, 2020
- Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical Psychology Review February 1, 2018
and 1 more in the library