Effect of Balint Group on Burnout and Self-efficacy of Nurse Leaders in China: A Randomised Controlled Trial

Study Overview
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Brief Summary
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Background: Burnout is common among nurses and is related to negative outcomes of medical care. This study aimed to explore the effectiveness of Balint group activities in burnout reduction among nurse leaders in a Chinese hospital. Methods: This was a randomised controlled trial with a pre- and post-test. A total of 80 nurse leaders were randomly assigned to either a Balint group (n=40) or a non-Balint group (n=40). Participants in the Balint group completed Balint training for a period of three months. Participants in both groups completed the Maslach Burnout Inventory-Human Services Survey (MBI) and the General Self-Efficacy Scale (GSES) at the beginning and end of the study（three months later ）. Balint group members also completed the Group Climate Questionnaire-Short Format the end of the study（three months later ）.

Official Title
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Effect of Balint Group on Burnout and Self-efficacy of Nurse Leaders in China: A Randomised Controlled Trial

Conditions
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Burnout, Self Efficacy

Intervention / Treatment
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* Other: Balint group activities


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: nurse leaders in clinical departments voluntary participation Exclusion Criteria: a. previous participation in Balint groups
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Balint group<br>Participants in the Balint group completed Balint training for a period of three months. | Other: Balint group activities<br>* A Balint group is a working form that focuses on the professional doctor-patient relationship. Participants in the Balint group completed Balint training for a period of at least three months, which included two lectures and 10 small group discussion sessions held once a month for one hour at a time (on Thursdays from 12 to 1 PM). Balint group is a closed group including one to two group leaders and six to twelve participants, with sessions lasting 60 to 90 minutes.<br>|
| No Intervention: non-Balint group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale emotional exhaustion (MBI-EE) | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The EE subscale evaluates the feeling of excessive emotional stress and exhaustion due to work, which is characterized by mental, emotional, and physical exhaustion | The first time for participants in both groups was assessed the MBI-EE questionnaire at baseline. | 
| Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale emotional exhaustion (MBI-EE) | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The EE subscale evaluates the feeling of excessive emotional stress and exhaustion due to work, which is characterized by mental, emotional, and physical exhaustion | The second time for participants in both groups was assessed the MBI-EE questionnaire through Balint group activities completion, 3 months later | 
| Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale depersonalization (MBI-DP) | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The DP subscale measures unsympathetic and impersonal response to patients, and is regarded as a form of alienation. | The first time for participants in both groups was assessed the MBI-DP questionnaire at baseline. | 
| Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale depersonalization (MBI-DP) | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The DP subscale measures unsympathetic and impersonal response to patients, and is regarded as a form of alienation. | The second time for participants in both groups was assessed the MBI-DP questionnaire through Balint group activities completion, 3 months later | 
| Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale personal accomplishment (MBI- PA) | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The PA subscale assesses work-related ability and sense of accomplishment . | The first time for participants in both groups was assessed the MBI-PA questionnaire at baseline. | 
| Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale personal accomplishment (MBI- PA) | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The PA subscale assesses work-related ability and sense of accomplishment . | The second time for participants in both groups was assessed the MBI-PA questionnaire through Balint group activities completion, 3 months later | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The General Self-Efficacy Scale (GSES) | The General Self-Efficacy Scale (GSES) is a 10-item scale used to measure individuals' overall self-confidence in dealing with different environmental challenges or unprecedented situations. Participants are asked to rate 10 questions by choosing one of four response options: 1 (completely incorrect), 2 (almost incorrect), 3 (relatively correct), or 4 (completely correct). A higher score indicates a higher level of general self-efficacy. | The first time for participants in both groups was assessed the GSES questionnaire at baseline. | 
| The General Self-Efficacy Scale (GSES) | The General Self-Efficacy Scale (GSES) is a 10-item scale used to measure individuals' overall self-confidence in dealing with different environmental challenges or unprecedented situations. Participants are asked to rate 10 questions by choosing one of four response options: 1 (completely incorrect), 2 (almost incorrect), 3 (relatively correct), or 4 (completely correct). A higher score indicates a higher level of general self-efficacy. | The second time for participants in both groups was assessed the GSES questionnaire through Balint group activities completion, 3 months later |