Effects of mobile mindfulness on emergency department work stress: A randomised controlled trial

Abstract

Objective: High-occupational stress among ED staff has a detrimental impact on both staff wellness and patient care. The objective of the study is to determine whether 4 weeks of smartphone app-guided mindfulness practice reduces stress levels of ED staff. Methods: This two-arm randomised controlled trial was conducted in two Australian EDs in 2019-2020. Eligible participants were randomly assigned (1:1) to either an App group or a Wait to Treat group to practice daily 10 min app-guided mindfulness for 4 weeks. Online surveys were collected for both groups at three time periods: before (T1), immediately after (T2) and 3 months after cessation (T3). Then the Wait to Treat group received the same intervention, followed by surveys immediately after the intervention (T4) and 3 months later (T5). Primary outcome was measured using the Perceived Stress Scale. Secondary outcomes were measured using the Maslach Burnout Inventory (three subscales: emotional exhaustion, depersonalisation and personal accomplishment), Mindfulness Attention Awareness Scale and Warwick-Edinburgh Mental Well-being Scale. Both intention-to-treat and per-protocol analysis were performed. Repeated measurement data were analysed by the linear mixed model. Results: Of 148 enrolled participants 98 completed all the surveys, but only half (48%) reported continuous use of the app. Based on the results of the intention-to-treat analysis, there was a statistically significant improvement of perceived stress levels (F = 15.70, P < 0.001), all three components of burnout (emotional exhaustion [F = 14.22, P < 0.001], depersonalisation [F = 3.62, P = 0.030], personal accomplishment [F = 7.51, P < 0.001]), mindfulness (F = 8.83, P < 0.001) and wellbeing levels (F = 10.71, P < 0.001) from pre-intervention to 3 months later with small effect sizes. Conclusion: Results of the present study demonstrate that brief mindfulness training via innovative digital technology had a small positive effect in improving emergency staff stress, burnout, mindfulness and wellbeing.

Effects of a Mindfulness Intervention Comprising an App, Web-Based Workshops, and a Workbook on Perceived Stress Among Nurses and Nursing Trainees: Protocol for a Randomized Controlled Trial

“…The results from the few available RCTs on digitally supported mindfulness interventions among nurses working in acute inpatient care settings are heterogeneous, do not include long-term follow-up (maximum 4 months), and have rarely been conducted in Europe (except for the study by Fiol-DeRoque et al [ 16 ]) [ 20 - 23 ]. Two studies showed significant reductions in anxiety and stress, as well as an increase in work satisfaction, following participation in digitally supported mindfulness interventions after 3 months [ 20 - 22 ]. However, 3 studies found no significant between-group differences in their outcomes [ 16 , 22 , 23 ].…”

“…Two studies showed significant reductions in anxiety and stress, as well as an increase in work satisfaction, following participation in digitally supported mindfulness interventions after 3 months [ 20 - 22 ]. However, 3 studies found no significant between-group differences in their outcomes [ 16 , 22 , 23 ]. They had an observation time of 1 month and 1 to 4 months [ 22 ].…”

“…However, 3 studies found no significant between-group differences in their outcomes [ 16 , 22 , 23 ]. They had an observation time of 1 month and 1 to 4 months [ 22 ].…”

“…To decrease dropouts and increase meditation practice, variables related to adherence and acceptability should be investigated [ 22 ]. This study distinguishes between adherence and acceptability.…”

Advantages and disadvantages of mobile applications for workplace health promotion: A scoping review

“…Examples of these apps are the Calm app [ 43 , 57 ] and Headspace. Effectiveness in terms of, e.g., stress perception, perceived mindfulness and perceived well-being could be demonstrated [ 27 , 34 , 39 , 40 ]. Deady et al (2020) found that the HeadGear app decreased depressive symptoms, anxiety symptoms and sick days, though it increased self-rated work productivity and demonstrated high acceptability and utility.…”