Effectiveness of mindfulness-based interventions on psychosocial well-being and occupational-related outcomes among nurses in the intensive care unit: A systematic review and meta-analysis.

Abstract

Mindfulness-based interventions may contribute to the mental health status and well-being of nurses. Current results are inconsistent, and there are no systematic review and meta-analyses for intensive care unit (ICU) nurses. The aim of this study was to assess the effectiveness of mindfulness-based interventions on psychosocial well-being and occupational-related outcomes among nurses in the ICU. We conducted a comprehensive literature search across 12 electronic databases, including PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, CNKI, Wanfang, VIP, SinoMed, ClinicalTrials.gov, and preprint repositories (bioRxiv and medRxiv). Additionally, we screened the reference lists of included studies to identify other potentially relevant research. The search covered records from the inception of each database up to July 2024. Two researchers independently screened studies and extracted data. ReviewManager (version 5.3 was used to conduct the meta-analysis. A total of 29 studies were included in the meta-analysis to evaluate the effects of mindfulness-based interventions across different timeframes: immediate-term effects (within 10 days post intervention), short-term effects (10 days-3 months), medium-term effects (3-6 months), and long-term effects (beyond 6 months). The results showed that mindfulness-based interventions significantly alleviated anxiety (mean difference [MD]: -10.80, 95% confidence interval [CI]: [-16.76, -4.83], I2 = 78%, P < 0.001) and depression (MD: -12.02, 95% CI: [-12.43, -11.61], I2 = 0%, P < 0.001) in the medium term for ICU nurses. Significant immediate-term effects were observed on well-being (standardised mean difference [SMD]: 0.58, 95% CI: [0.40, 0.76], I2 = 0%, P < 0.001), resilience (MD: 14.41, 95% CI: [9.71, 19.11], I2 = 91%, P < 0.001), and death anxiety (MD: -2.35, 95% CI: [-4.39, -0.31], I2 = 30%, P = 0.02). Mindfulness-based interventions also showed significant short-term effects on well-being (SMD: 0.54, 95% CI: [0.10, 0.99], I2 = 43%, P = 0.02), sleep quality (MD: -1.19, 95% CI: [-2.32, -0.05], I2 = 50%, P = 0.04), and stress (SMD: -0.75, 95% CI: [-1.34, -0.17], I2 = 79%, P = 0.01). Significant effects were observed across immediate-term, short-term, and medium-term timeframes for stress reduction (medium-term effects: MD: -9.69, 95% CI: [-10.18, -9.21], I2 = 0%, P < 0.001) and mindfulness improvement (medium-term effects: MD: 9.28, 95% CI: [7.20, 11.37], I2 = 0%, P < 0.001). Additionally, mindfulness-based interventions significantly reduced burnout in the immediate term (SMD: -1.28, 95% CI: [-2.31, -0.25], I2 = 92%, P = 0.01). Mindfulness-based interventions have a positive effect in improving psychosocial well-being and occupational-related outcomes for ICU nurses. Nursing managers may consider integrating mindfulness-based interventions into ICU nurses' practice to enhance their well-being. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42024572633 (available at https://www.crd.york.ac.uk/PROSPERO/view/CRD42024572633.).