Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses

Case study: Developing a strategy combining human and empirical interventions to support the resilience of healthcare workers exposed to a pandemic in an academic hospital

The COVID-19 pandemic has put healthcare workers under important psychological pressure. Concerns have been raised regarding the mental health and psychological status of healthcare workers and have underlined the need for institutions to develop long-term interventions to support their resilience. The current case study presents the way a large university hospital in Brussels, Belgium, has evolved to deal with this health crisis and support its workers. Initiatives were multiple and complementary, as it was decided to combine different forms of clinical interventions that were developed by psychologists, psychiatrists, and human resources, to an empirical approach including a large survey that permitted to reach a much larger audience (the results of the study have been published previously). We describe the initially proposed measures of psychological support, including the creation of a telephone hotline, the presence of psychologists among teams of dedicated COVID-19 units, discussion groups, and individualized follow-ups, and their consequences on healthcare workers. Second, we address how these initial measures of support were modified to tailor in the best way possible the needs of healthcare workers, using a research action project that used a survey to measure and address the psychological distress of healthcare workers. We explain how, through different objectives (screening of distress, adaptation of initial measures based on reported needs, active reinforcement of individual and collective resilience, reminder of availability of help, and normalization of distress), a research action project can be a form of support and is an effective way for an institution to show its pre-occupation for the mental health of its teams. The current case study highlights how an institution can provide support and the importance of the use of a combined strategy to limit the consequences of a major health crisis on the mental health of its healthcare workers. Improving the resilience of healthcare workers both in the short and long term is of the essence to maintain optimal care of patients.

Burnout: A Mindful Framework for the Radiologist

Burnout, the outcome of prolonged stress or frustration, manifests as both mental and physical fatigue affecting over half of healthcare workers. This article will discuss the etiologies, problems, and potential solutions to burnout related issues that are impacting radiologists. Factors placing radiologists at risk for burnout as well the impact of burnout upon the radiologist, the department, staff, and patients they serve will also be discussed. An emphasis will also be placed upon recognition, solutions, and a collective response to burnout. Readers should be able to perform a self-assessment of their own risk for burnout and understand what can be done to dissolve and prevent burnout amongst their colleagues. In doing so, our hope is that radiologists will develop greater insight, awareness, and ultimately empathy for the unique challenges that others in the radiology community may face.

Factors Affecting Occupational Burnout Among Nurses Including Job Satisfaction, Life Satisfaction, and Life Orientation: A Cross-Sectional Study

Purpose

Everyday nursing practice under demanding conditions, high mental and physical strain may result in occupational burnout. There is still a need for studies on the comprehensive identification of burnout among nursing staff. This study aimed to evaluate factors affecting occupational burnout among nurses, including job satisfaction, life satisfaction, and dispositional optimism.

Methods

The study involved 625 survey participants with a mean age of 49.47 years and was conducted between January and December 2018. The inclusion criteria were job experience >1 year, current nurse work activity, and written informed consent to participate in the study. The study used standardized research tools such as Maslach Burnout Inventory (MBI), Life Orientation Test-Revised version (LOT-R), Satisfaction with Life Scale (SWLS), and Satisfaction with Job Scale (SWJS). Also, sociodemographic data were collected using a self-developed questionnaire. The STROBE guidelines were followed.

Results

Emotional exhaustion (EE) was significantly greater in respondents with medium life satisfaction (SWLS). Also, EE was significantly greater in pessimists and those with a neutral orientation than in optimists (LOT-R). Housing conditions and family-related problems were significant factors differentiating depersonalization (DEP). Reduced personal accomplishment (PA) was more significant in respondents with a bachelor’s degree than in those with a master’s degree. Also, decreased PA was significantly greater in respondents with low life satisfaction than those with medium life satisfaction. Life satisfaction and life orientation were significant factors differentiating job dissatisfaction among the health-related and psychological variables.

Conclusion

Burnout was found to be related to individual, interpersonal and organizational feelings. There was an interrelationship between personality traits, where a higher level of occupational burnout was found among nurses with a pessimist attitude. Health programs should be implemented to identify and eliminate burnout through mental health support, improved communication skills, optimized teamwork, and evidence-based interventions.

Attitudes and Perceptions of Multidisciplinary Cancer Care Clinicians Toward Telehealth and Secure Messages

Importance

Telehealth use including secure messages has rapidly expanded since the COVID-19 pandemic, including for multidisciplinary aspects of cancer care. Recent reports described rapid uptake and various benefits for patients and clinicians, suggesting that telehealth may be in standard use after the pandemic.

Objective

To examine attitudes and perceptions of multidisciplinary cancer care clinicians toward telehealth and secure messages.

Design, Setting, and Participants

Cross-sectional specialty-specific survey (ie, some questions appear only for relevant specialties) among multidisciplinary cancer care clinicians, collected from April 29, 2020, to June 5, 2020. Participants were all 285 clinicians in the fields of medical oncology, radiation oncology, surgical oncology, survivorship, and oncology navigation from all 21 community cancer centers of Kaiser Permanente Northern California.

Main Outcomes and Measures

Clinician satisfaction, perceived benefits and challenges of telehealth, perceived quality of telehealth and secure messaging, preferred visit and communication types for different clinical activities, and preferences regarding postpandemic telehealth use.

Results

A total of 202 clinicians (71%) responded (104 of 128 medical oncologists, 34 of 37 radiation oncologists, 16 of 62 breast surgeons, 18 of 28 navigators, and 30 of 30 survivorship experts; 57% (116 of 202) were women; 73% [147 of 202] between ages 36-55 years). Seventy-six percent (n = 154) were satisfied with telehealth without statistically significant variations based on clinician characteristics. In-person visits were thought to promote a strong patient-clinician connection by 99% (n = 137) of respondents compared with 77% (n = 106) for video visits, 43% (n = 59) for telephone, and 14% (n = 19) for secure messages. The most commonly cited benefits of telehealth to clinicians included reduced commute (79%; n = 160), working from home (74%; n = 149), and staying on time (65%; n = 132); the most commonly cited negative factors included internet connection (84%; n = 170) or equipment problems (72%; n = 146), or physical examination needed (64%; n = 131). Most respondents (59%; n = 120) thought that video is adequate to manage the greater part of patient care in general; and most deemed various telehealth modalities suitable for any of the queried types of patient-clinician activities. For some specific activities, less than half of respondents thought that only an in-person visit is acceptable (eg, 49%; n = 66 for end-of-life discussion, 35%; n = 58 for new diagnosis). Most clinicians (82%; n = 166) preferred to maintain or increase use of telehealth after the pandemic.

Conclusions and Relevance

In this survey of multidisciplinary cancer care clinicians in the COVID-19 era, telehealth was well received and often preferred by most cancer care clinicians, who deemed it appropriate to manage most aspects of cancer care. As telehealth use becomes routine in some cancer care settings, video and telephone visits and use of asynchronous secure messaging with patients in cancer care has clear potential to extend beyond the pandemic period.

The item network and domain network of burnout in Chinese nurses

Background

As a common social phenomenon, nurses’ occupational burnout has a high incidence rate, which seriously affects their mental health and nursing level. The current assessment mostly uses the total score model and explores the influence of external factors on burnout, while the correlation between burnout items or dimensions is less explored. Ignoring the correlation between the items or dimensions may result in a limited understanding of nurse occupational burnout. This paper explores the item and dimension network structure of the Maslach Burnout Inventory-General Survey (MBI-GS) in Chinese nurses, so as to gain a deeper understanding of this psychological construct and identify potential targets for clinical intervention.

Methods

A total of 493 Chinese nurses were recruited by cluster sampling. All participants were invited to complete the survey on symptoms of burnout. Network analysis was used to investigate the item network of MBI-GS. In addition, community detection was used to explore the communities of MBI-GS, and then network analysis was used to investigate the dimension network of MBI-GS based on the results of community detection. Regularized partial correlation and non-regularized partial correlation were used to describe the association between different nodes of the item network and dimension network, respectively. Expected influence and predictability were used to describe the relative importance and the controllability of nodes in both the item and dimension networks.

Results

In the item network, most of the strongly correlated edges were in the same dimension of emotional exhaustion (E), cynicism (C) and reduced professional efficacy (R), respectively. E5 (Item 5 of emotional exhaustion, the same below) “I feel burned out from my work”, C1 “I have become more callous toward work since I took this job”, and R3 “In my opinion, I am good at my job” had the highest expected influence (z-scores = 0.99, 0.81 and 0.94, respectively), indicating theirs highest importance in the network. E1 “I feel emotionally drained from my work” and E5 had the highest predictability (E1 = 0.74, E5 = 0.74). It shows that these two nodes can be interpreted by their internal neighbors to the greatest extent and have the highest controllability in the network. The spinglass algorithm and walktrap algorithm obtained exactly the same three communities, which are consistent with the original dimensions of MBI-GS. In the dimension network, the emotional exhaustion dimension was closely related to the cynicism dimension (weight = 0.65).

Conclusions

The network model is a useful tool to study burnout in Chinese nurses. This study explores the item and domain network structure of nurse burnout from the network perspective. By calculating the relevant indicators, we found that E5, C1, and R3 were the most central nodes in the item network and cynicism was the central node in the domain network, suggesting that interventions aimed at E5, C1, R3 and cynicism might decrease the overall burnout level of Chinese nurses to the greatest extent. This study provides potential targets and a new way of thinking for the intervention of nurse burnout, which can be explored and verified in clinical practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00670-8.

New graduate nurse wellbeing, work wellbeing and mental health: A quantitative systematic review

BACKGROUND

The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who experience both psychological wellbeing and illbeing in their first year of practice.

OBJECTIVE

To determine published prevalence, predictors, barriers and enablers of new graduate registered nurse wellbeing, work wellbeing and mental health.

DESIGN

Systematic review of quantitative research.

DATA SOURCES

Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Quantitative and mixed-methods studies were considered for inclusion if published in English from 2009 to 2019 reporting primary data analysis including new graduate nurses' wellbeing, work wellbeing and mental health.

REVIEW METHODS

Quantitative studies were systematically identified then screened and appraised against pre-determined inclusion criteria. Analysis was conducted by grouping according to analytical methods and results reported as a narrative synthesis.

RESULTS

Thirty-four studies were included. The quality of the evidence was variable with just a quarter of the studies being assessed as meeting the quality criteria on all nine measures. For the new graduate nurses prevalence of wellbeing, levels of resilience, optimism, and hope were found to be high. For work wellbeing, most reported higher job satisfaction by 12-months. For work illbeing, levels of burnout were moderately high, predominantly in terms of emotional exhaustion, and stress was initially high, particularly in terms of workload, but decreased over time. For the predictors, job satisfaction was positively predicted by structural empowerment and career satisfaction, and negatively predicted by co-worker incivility, supervisor incivility and emotional exhaustion. For work illbeing, stress was a positive predictor for intent to leave. Stress reductions were associated with momentary levels of high task mastery, social acceptance and role clarity.

CONCLUSIONS

For new graduate nurses, levels of emotional exhaustion, workload and stress were moderately high to high initially, decreasing over time as the graduate nurses' job satisfaction increased. Most studies focused on the nurses' intent to resign or stay and both psychological capital and work engagement positively predicted intent to stay whereas work stress positively predicted intent to resign. Resilience and group cohesion moderated the negative effects of some variables, thus may be potential enablers of work wellbeing. The standards of research reporting or design were generally sub-optimal according to quality indicators. Systematic review registration number: (CRD42020148812).

The prevalence and stressors of job burnout among medical staff in Liaoning, China: a cross-section study

BACKGROUND

Sustained attention to the prevalence and associated factors of burnout in China is important for the health care service quality and related reform. In this study, we investigated the prevalence of job burnout among medical staff in Liaoning province, China; performed a survey of subjective perception ranking for the main stressors among respondents; estimated the effect of stresses from work tasks and the relationship with patients on job burnout in order to provide improved strategy and suggestion for hospital administrators.

METHODS

The respondents were from 8 hospitals in 3 cities in Liaoning province, China. Data were collected and analyzed including the following sections: (1) demographic characteristics; (2) work situations; (3) ranking of six stressors; (4) job burnout scale; (5) effort-reward imbalance scale; (6) work violence scale; (7) fear of malpractice scale. A total of 1056 individuals became the study objects. A statistical analysis and hierarchical linear regression analysis were performed to explore the prevalence of burnout and the effects of stressors.

RESULTS

The prevalence of job burnout was 20.5, and 72.9% of all respondents reported a least one symptom of burnout. The respondents who were male, 30-39 years old, had a master's degree or high and working hours > 60 h per week, came from obstetrics and gynecology or pediatrics profession prone to job burnout. The relationship with patients and work tasks are the top two ranking stressors in the subjective perception survey. Regression analysis showed that the relationship with patients explained 19.2, 16.8 and 2.0% of variance in burnout subscales EE, DP and PA, respectively and work tasks explained 23.5, 16.0 and 5.24% of variance in burnout subscales EE, DP and PA, respectively.

CONCLUSION

The Chinese medical staff had high prevalence of job burnout. Some factors of demographic and work situations were associated with job burnout. The medical staff considered the relationship with patients and work tasks are the two major stressors. These two stressors are also the major indicators associated with job burnout. The hospital administrators should be aware of the risk of burnout. Efforts should be made to ameliorate the status of job burnout.

Burnout and Its Relationship with Demographic and Job-Related Variables among Dentists in Lithuania: A Cross-Sectional Study

Although burnout has been described as a serious hazard for personal and professional lives and has been surveyed among dentists in many countries, no study has been published regarding burnout among dentists in Lithuania. This study aimed to evaluate the burnout level among Lithuanian dentists and its association with demographic variables, job satisfaction, and other job-related variables. The data were collected among dentists online or during professional conferences while using an anonymous questionnaire (n = 380). The Maslach Burnout Inventory (MBI) was used to evaluate the burnout level. A Poisson regression was applied for the analysis of relationships between variables. We observed that 42.3% of the respondents had a high emotional exhaustion (EE) (95% confidence interval (CI): 37.4-42.3%), while 18.7% (95% CI: 15.0-22.9%) and 28,2% (95% CI: 23.4-32.6%) had high depersonalization (DP) and low personal accomplishment (PA), respectively. Nonetheless, 15.3% (95% CI: 11.8-18.9%) of the study population experienced a high level of overall burnout. An original job satisfaction index was elaborated. It was significantly associated with sum scores of all burnout dimensions: with the EE sum score (Ratio of Sum Score Means (RSSM) 1.54; 95% CI: 1.46-1.62), DP sum score (RSSM 1.59; 95% CI: 1.45-1.74), and PA sum score (RSSM 0.88; 95% CI: 0.84-0.92). It was concluded that Lithuanian dentists can be characterised by high burnout intensity and high prevalence of burnout, being especially evident in emotional exhaustion. The dentist with low job satisfaction appeared to be the most vulnerable to all burnout dimensions.

Incorporating Virtual Reality to Improve Otolaryngology Resident Wellness: One Institution's Experience

OBJECTIVE

Burnout is defined as work-related emotional exhaustion, depersonalization, and decreased sense of accomplishment. Virtual reality (VR) has emerged as an effective treatment modality for various conditions related to anxiety, however, few studies have assessed its role for stress management in residents. We hypothesize that VR-based mindfulness meditation can reduce resident burnout in real-world settings.

STUDY DESIGN

Prospective randomized crossover trial.

METHODS

Resident participants completed the validated Maslach Burnout Inventory (MBI). One group used a VR-based meditation app; the second group received no intervention. After a 2-month rotation, all subjects completed an MBI and crossed over to the other arm. Wilcoxon rank-sum tests were used to compare MBI scores before and after intervention, and to compare results by gender and postgraduate year. Mann-Whitney U tests were used to assess qualitative differences between participants.

RESULTS

Eighteen residents completed the study. Five participants were female and 13 were male. Weekly use of VR-guided meditation and paced breathing was associated with a significant decrease in emotional exhaustion (P = .009), and on subgroup analysis, male gender specifically was associated with a decrease in emotional exhaustion (P = .027). In the post-intervention survey, 42.9% subjects reported that VR encouraged them to employ paced breathing techniques, 71.4% reported that they would use the technology if regularly available, and 21.4% reported they would use paced breathing in the future.

CONCLUSION

VR-based therapy may serve as a successful tool in stress management and reduce the rate of burnout among otolaryngology residents.

LEVEL OF EVIDENCE

NA Laryngoscope, 131:1972-1976, 2021.

Apheresis physician well-being during the COVID-19 pandemic: Results of a survey

Background

The COVID‐19 pandemic has placed additional stressors on physician lives. In this study, we report findings from a survey conducted among attending physician (AP) members of the American Society for Apheresis (ASFA) to elucidate the status of their well‐being during the COVID‐19 pandemic as well as resources provided or actions taken by their institutions and themselves personally to maintain or improve their well‐being.

Study Design and Methods

A 17‐question, voluntary, IRB‐approved survey regarding well‐being was distributed to the ASFA AP members between August 26, 2020 and September 16, 2020. The descriptive analyses were reported as number and frequency of respondents for each question. Non‐parametric chi‐square tests, ANOVA, and paired t‐tests were performed to determine differences in categorical variables, changes in well‐being scores, and compare time points, respectively.

Results

Based on the responses of 70 attending level physicians representing the United States (U.S., 53, 75.7%) and outside the U.S. (17, 24.3%), the following were observed: (1) COVID‐19 negatively affects the well‐being of a sub‐population of APs, (2) neither institutional nor individual measures to improve well‐being completely resolved the problem of decreased AP well‐being during the pandemic, and (3) personal actions may be superior to institutional resources.

Conclusion

There is a widespread decline in AP well‐being during the COVID‐19 pandemic that was not adequately improved by institutional or personal resources/actions taken. Institutions and physicians must work together to implement strategies including resources and actions that could further improve AP physician well‐being during a public health crisis.

Neuropathic Low Back Pain and Burnout among Hungarian Workers

Burnout is an increasingly prevalent syndrome mainly involving those working in human services. Although it is categorized as an occupational phenomenon and not as a medical condition, it seems to be strongly associated with several diseases such as pain syndromes. However, no studies examined the association between neuropathic low back pain and burnout. This questionnaire-based study was carried out between April 2019 and March 2020 in three main sites among teachers, social workers and healthcare workers. Demographic criteria included age, gender, marital status, number of children, type of work, years spent with work, work schedule, legal relation, secondary employment. Included diseases were diabetes, hypertension, ischemic heart disease, generalized pain (pain involving more than one area of the body) and depression. Low back pain was assessed by the painDETECT questionnaire, burnout was measured with the Maslach Burnout Inventory (MBI) and depression was measured by the Beck Depression Inventory. Dysfunctional attitudes were also recorded. Overall, 1500 questionnaires were successfully delivered and 1141 responses received (response rate of 76%). Three hundred social workers, 399 teachers, 339 paramedics, 35 doctors and 68 medical attendants have completed our survey. In a multivariate analysis including of all factors (demographic criteria, burnout, depression, dysfunctional attitudes, comorbidity etc.) neuropathic low back pain was associated with age > 62 (OR = 3.981, p = 0.01), number of children ≥ 2 (OR = 2.638, p = 0.003), job type (being a social worker) (OR = 6.654, p < 0.001), burnout (OR = 2.577, p < 0.001), current depression (OR = 2.397, p < 0.001), and suffering from generalized pain (OR= 4.076, p < 0.001). This is the first study showing the association of burnout and neuropathic low back pain, which is the most common cause of disability. Based on our results neuropathic low back pain and burnout have similar risk factors and consequences which raises the possibility of similar pathophysiology.

The association between nurses' burnout and objective care quality indicators: a cross-sectional survey in long-term care wards

Background

Worldwide, rather few studies have examined the association between burnout and care quality using objectively measured quality indicators, with most of the studies have relied on perceived quality outcomes. This study aimed to examine the association between staff nurses’ burnout and selected objective quality metrics in long-term care wards in Japan.

Methods

This is a secondary analysis of a cross-sectional survey. Nurse managers and staff nurses working at randomly selected hospitals with long-term care wards—the equivalent of skilled nursing homes in Western countries— completed self-administered, anonymous questionnaires. The questionnaires collected data regarding care quality indicators, staff nurses’ burnout, and other confounders (e.g., ward size, participants’ years of experience, and patients’ conditions). All statistical analyses were conducted at the ward level. A multivariate regression analysis was used to examine associations between burnout and outcome indicators.

Results

Data from 196 wards in 196 hospitals (196 nurse managers and 2473 staff nurses) across Japan were analyzed. Multivariate regression analysis showed that higher emotional exhaustion was associated with higher rates of pneumonia and pressure ulcers (p-value = .036 and .032, respectively), and that reduced personal accomplishment was associated with higher rates of tube feeding (p-value = .018). A larger ward size was also associated with low rates of pneumonia (regression coefficient = −.001, p-value = .019).

Conclusions

Staff nurses’ burnout is a significant determinant of care quality in long-term care wards, implying that organizations that implement burnout reducing strategies may see greater benefits in patient outcomes. A large ward size was significantly associated with better care outcomes—specifically, low rates of pneumonia. Future research needs to determine feasible quality improvement measures in small-scale long-term care facilities, and to provide more comprehensive insights on ward-level variables that influence care quality in long-term care settings.

Factorial Validity and Variance of the Maslach Burnout Inventory between Demographic and Workload Groups among Dentists of Lithuania

There is a lack of evidence about burnout syndrome among Lithuanian dentists; as a reliable instrument to examine the syndrome in this professional group has not yet been tested. The study aimed to investigate the performance of the items and the subscales of the Maslach burnout inventory (MBI) by validating its factorial structure and analyzing its variance between demographic and workload groups of dental professionals in Lithuania. The survey was conducted among practicing dentists online or during the scientific conferences for dentists using an anonymous questionnaire. To evaluate the level of burnout the MBI was chosen. Reports of a total of 380 respondents were examined. Three-factor structure of the MBI with cross-loading of two items suggested a good fit to data (χ²/df = 1.67; CFI = 0.93; TLI = 0.93; IFI = 0.93; and RMSEA = 0.059) and was invariant across demographic and workload groups of dentists. Multigroup factorial analysis revealed that females as compared to males had higher average emotional exhaustion; and the respondents up to 30 years as compared to respondents over 30 years of age had higher averages of the emotional exhaustion and depersonalization components. Highly specialized dentists (oral surgeons, prosthodontists, orthodontists, endodontists and poedodontists) were particularly less prone to burnout syndrome than dentists of general practice. It was concluded that the MBI offers factorial validity and demonstrates its invariant structure and variance of burnout dimensions across demographic and workload groups. These findings are informative for burnout prevention and intervention programs among dentists in Lithuania. Such information may contribute to lessen professional burnout among dentists in Lithuania.

Relative Impact of Mindfulness, Self-Compassion, and Psychological Flexibility on Alcohol Use and Burnout Among Law Enforcement Officers

Objectives: In the present study, we investigated the relative impact of improvements in mindfulness, self-compassion, and psychological flexibility in predicting decreased burnout and alcohol use in a sample of law enforcement officers (LEOs) participating in a mindfulness-based intervention (MBI). Design: This study is a secondary analysis of pre/post data collected as part of a larger randomized controlled trial of mindfulness-based resilience training (MBRT). Subjects: This secondary analysis comprises pre/post data from 28 LEOs recruited from a metropolitan area and its outlying regions in the Pacific Northwest. Intervention: MBRT is a MBI tailored specifically to the culture and needs of LEOs and other first responders. Outcome measures: All included data were obtained through self-report measures. Mindfulness was assessed by the Five Facet Mindfulness Questionnaire-Short Form, self-compassion was assessed by the Self-Compassion Scale-Short Form, psychological flexibility was assessed by the Acceptance and Action Questionnaire-II, alcohol use was measured by the PROMIS® (v1.0) Alcohol Use-Short Form, and burnout was assessed by the Oldenburg Burnout Inventory. Results: In the first regression, only increases in mindfulness significantly predicted decreased postintervention problematic alcohol use. In the second regression, only increases in self-compassion significantly predicted decreased postintervention burnout. Conclusions: This study builds upon a growing body of literature on the relative impact of mindfulness, self-compassion, and psychological flexibility in predicting outcomes among high-stress cohorts. Results suggest that different components of MBIs may be emphasized to achieve unique benefits. The Clinical Trial Registration number for the parent study is NCT02521454.

The Immediate Effects of Lavender Aromatherapy Massage versus Massage in Work Stress, Burnout, and HRV Parameters: A Randomized Controlled Trial

Background

Occupational stress is a common issue faced by workers in every discipline. Complementary and alternative medicine (CAM) therapies, such as aromatherapy massage or massage, have antistress effects in the literature. The purpose of this randomized clinical trial with triple blinds is to evaluate the immediate effects of lavender aromatherapy massage for improving work stress, burnout, and HRV parameters of female employees in a university.

Methods

A total of 53 subjects in experimental group whereas 57 subjects in control group completed interventions and measurement and led to power of 0.98. Inferential statistics, as independent t-test, paired t-test, and Chi-Square test, were performed to verify the expected relationships.

Results

The present study found that subjects in experimental group reported a lower role stress and less inclined to type A personality trait after aromatherapy massage with lavender. For control group, only less inclined to type A personality trait was reported after receiving massage. For burnout, a significant lower personal burnout and work-related burnout were reported after aromatherapy massage whereas only increased client-related burnout was reported in control group. For HRV, both the experimental and control groups reported higher SDNN and RMSSD in time domain after intervention. Contradictory HRT and PSI in time domain were significantly lower after intervention. In frequency domain of HRV, both groups reported significantly higher value in VLF and HF. In addition, the experimental group reported significantly higher value in TP and LF after intervention.

Conclusions

Both the lavender aromatherapy massage and massage did show immediate effect on different dimensions of work stress, burnout, and HRV. These two interventions can be applied as routine leisure activities by personal preference to reduce stresses occurring in work environment.