Development of an Artificial Intelligence–Based Tailored Mobile Intervention for Nurse Burnout: Single-Arm Trial (Preprint)
Authors: Cho Aram , Cha Chiyoung , Baek Gumhee 
Published: November 2023

BACKGROUND

Nurse burnout leads to an increase in turnover, which is a serious problem in the health care system. Although there is ample evidence of nurse burnout, interventions developed in previous studies were general and did not consider specific burnout dimensions and individual characteristics.

OBJECTIVE

The objectives of this study were to develop and optimize the first tailored mobile intervention for nurse burnout, which recommends programs based on artificial intelligence (AI) algorithms, and to test its usability, effectiveness, and satisfaction.

METHODS

In this study, an AI-based mobile intervention, Nurse Healing Space, was developed to provide tailored programs for nurse burnout. The 4-week program included mindfulness meditation, laughter therapy, storytelling, reflective writing, and acceptance and commitment therapy. The AI algorithm recommended one of these programs to participants by calculating similarity through a pretest consisting of participants’ demographics, research variables, and burnout dimension scores measured with the Copenhagen Burnout Inventory. After completing a 4-week program, burnout, job stress, stress response using the Stress Response Inventory Modified Form, the usability of the app, coping strategy by the coping strategy indicator, and program satisfaction (1: very dissatisfied; 5: very satisfied) were measured. The AI recognized the recommended program as effective if the user’s burnout score reduced after the 2-week program and updated the algorithm accordingly. After a pilot test (n=10), AI optimization was performed (n=300). A paired 2-tailed <i>t</i> test, ANOVA, and the Spearman correlation were used to test the effect of the intervention and algorithm optimization.

RESULTS

Nurse Healing Space was implemented as a mobile app equipped with a system that recommended 1 program out of 4 based on similarity between users through AI. The AI algorithm worked well in matching the program recommended to participants who were most similar using valid data. Users were satisfied with the convenience and visual quality but were dissatisfied with the absence of notifications and inability to customize the program. The overall usability score of the app was 3.4 out of 5 points. Nurses’ burnout scores decreased significantly after the completion of the first 2-week program (<i>t</i>=7.012; <i>P</i>&lt;.001) and reduced further after the second 2-week program (<i>t</i>=2.811; <i>P</i>=.01). After completing the Nurse Healing Space program, job stress (<i>t</i>=6.765; <i>P</i>&lt;.001) and stress responses (<i>t</i>=5.864; <i>P</i>&lt;.001) decreased significantly. During the second 2-week program, the burnout level reduced in the order of participation (<i>r</i>=–0.138; <i>P</i>=.04). User satisfaction increased for both the first (<i>F</i>=3.493; <i>P</i>=.03) and second programs (<i>F</i>=3.911; <i>P</i>=.02).

CONCLUSIONS

This program effectively reduced burnout, job stress, and stress responses. Nurse managers were able to prevent nurses from resigning and maintain the quality of medical services using this AI-based program to provide tailored interventions for nurse burnout. Thus, this app could improve qualitative health care, increase employee satisfaction, reduce costs, and ultimately improve the efficiency of the health care system.