The acceptability of mindfulness-based interventions to reduce burnout in nurses: A cross-cultural comparative study
Creators: name: Mahmoud Ahmed Ismail, Khaldoun
Publisher: name: University of Wollongong
Year: 2025
Subjects: classificationCode: 4205
subject: Nursing
subject: FOS: Health sciences

description: <b>Background:</b> Burnout, characterised by emotional exhaustion, depersonalisation, and reduced personal accomplishment, poses a significant challenge for nurses in their professional lives, potentially impacting their well-being, patient safety, and the overall caregiving process. Extensive evidence supports the efficacy of interventions aimed at reducing the risk of burnout, with numerous systematic reviews highlighting the success of mindfulness-based approaches. However, there has been no investigation regarding nurses' perceptions of the acceptability of these interventions, warranting further investigation.<b>Aim:</b> The primary aim of this higher-degree research program was to explore nurses’ perceptions of the acceptability of mindfulness-based interventions to reduce the risk of burnout.<b>Methods:</b> Using an embedded mixed-methods approach, quantitative and qualitative data were collected concurrently with emphasis placed on the quantitative data. Nurses from Australia and Jordan were invited to complete a questionnaire exploring the acceptability of mindfulness-based interventions to reduce the risk of burnout. The questionnaire included a 39-item scale which was theoretically informed by Sekhon’s Theoretical Framework of Acceptability. The questionnaire included professional and demographic data and three open-ended questions. Nurses were also invited to participate in semi-structured interviews.Quantitative survey data were analysed using descriptive and inferential statistics. Construct validity and reliability of the instrument were established using exploratory factor analysis. Qualitative data were analysed using manifest content analysis for the open-ended survey questions and a deductive-inductive content analysis for the semi-structured interviews.<b>Findings:</b> Of the 194 survey respondents, 56.7% (n=110) were Australian nurses, and just over half (52.6%) were female. The mean age of survey respondents was 36.6 years (range 19 to 69 years), more than half had a bachelor’s degree (59.3%), and most were working as clinicians (90.2%). The majority of participants (86.6%) reported they had experienced burnout and approximately half (55.7%) indicated that they had practiced some form of mindfulness.The 20-item ACCREDIT Scale had a four-factor structure, acceptability to the individual, the profession and the organisation, and barriers to implementation. The internal consistency was high, the overall Cronbach’s alpha for the final scale was 0.93, with subscales ranging from 0.72 to 0.91. Overall, 83% of respondents agreed that mindfulness-based interventions were acceptable to reduce the risk of burnout however, differences between Australian and Jordanian nurses were noted, with Jordanian nurses reporting lower overall scores on the ACCREDIT Scale (89.6 vs. 99.5, p&lt;0.001), and lower scores for three of the sub-scales (Individual, Profession, Organisation—all p&lt;0.05). Differences were also noted between nurses and managers, with nurses reporting higher scores for the subscale Profession (20.09 vs. 17.89, p=0.045), and lower scores for the subscale Barriers (15.19 vs. 18.11, p&lt;0.01). In multiple linear regression, a history of practicing mindfulness (ß= 7.056, p= 0.012), and residing in Jordan (ß= -7.983, p= 0.015) were the strongest predictors of the acceptability of mindfulness-based interventions.Analysis of the open-ended questions revealed adequate staffing/ ratios (35%), and management/ workplace support (32%) were the most common suggestions for preventing burnout. Respondents considered mindfulness-based interventions were more likely to be maintained long-term with allocation of regular work time (36.5%).Findings from the semi-structured interviews (n=12) revealed that although nurses were open to and interested in mindfulness-based interventions, barriers such as time constraints, heavy workloads and staff shortages, along with financial and physical space limitations, meant they were likely to struggle to incorporate mindfulness-based interventions into their workday. Interview participants in a clinical role suggested that including mindfulness-based interventions in their workday may impact on workflow and compromise patient care. Cultural differences were evident, with Jordanian nurses describing prayer as a mindfulness practice, emphasizing its role in alleviating stress among the Muslim nursing community. Of the two nurse managers interviewed, while they agreed that mindfulness-based interventions to reduce nurse burnout were acceptable from their perspective, both expressed concerns about the financial implications of implementing these interventions in their clinical setting.<b>Conclusion: </b>This study has identified that while nurses reported mindfulness-based interventions to reduce the risk of burnout were on the whole acceptable, barriers such as workload, resource and financial constraints, and cultural differences need to be addressed for successful implementation. The study also highlights differences in acceptance and perceptions between Australian and Jordanian nurses, as well as between clinical nurses and nurse managers, suggesting the need for a comprehensive understanding of both the practical and cultural challenges associated with implementing such interventions in the clinical setting.