Describe the clinical issue or problem you are addressing.

Describe the clinical issue or problem you are addressing.

A Sample Answer For the Assignment: Describe the clinical issue or problem you are addressing.

Title:  Describe the clinical issue or problem you are addressing.

 Benchmark – Part B: Literature Review

Nursing is a high-stress profession that often takes a toll on nurses. The nature of the profession and the working conditions pose a risk of work-related stress and burnout among nurses. The common sources of stress for nurses include the emotional cost of caring, workload, lack of reward and shift rotation, need for knowledge, and complex interpersonal relationships (Tran et al., 2019). Mindfulness meditation has been proposed to increase nurses’ empathy, overall attention, and presence with patients and families. This paper seeks to synthesize the research on the use of Mindfulness meditation into a literature review in relation to the PICOT statement: In nurses (P), does training on Mindfulness meditation (I), compared to no intervention (C), reduce stress levels (O) within six months (T)?

Methods

The literature search aimed to identify peer-reviewed articles relevant to the PICOT statement. For the literature review, I used the GCU Library to search for peer-reviewed research articles. I used keywords from the PICOT statement, including ‘Nurses,’ ‘Mindfulness meditation, ‘Occupational Stress,’ and ‘Stress reduction.’ The keywords ensured the relevance of the articles. I searched for English language articles published from January 2017 to April 2021 to limit the search to articles published within the last five years.

To distinguish potentially relevant articles for focused searching, I reviewed each citation and. I also reviewed the abstract in the articles that had an abstract. However, I encountered Discrepancies in inclusion, which I resolved by re-review. I evaluated each of the published peer-reviewed articles for completeness in reporting the factors identified in Part A of the assignment.

Literature Synthesis: Part A

This section will analyze the main components of the peer-reviewed articles, such as subjects, research methods, and key findings. I will also explain the rationale for how the articles support the PICOT statement.

Articles’ Analysis

Janssen et al. (2018) conducted an exploratory study to acquire a deeper understanding of the impact of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) on employees’ mental health. The researchers conducted a systematic review using PubMed, PsycINFO, and CINAHL, of studies examining the impact of MBSR and MBCT on several facets of employees’ mental health. The study found that MBSR contributed to reduced emotional, stress, psychological distress, anxiety, depression, and occupational stress (Janssen et al., 2018). Improvements were identified in mindfulness, personal accomplishment, self-compassion, quality of sleep, and relaxation. The article supports my PICOT as it proves that Mindfulness interventions effectively reduce work-related stress and improve psychological functioning among employees.

Kriakous et al. (2020) aimed to update the current evidence base and increase understanding of the effectiveness of MBSR on improving the psychological functioning of healthcare professionals (HCPs). The researchers conducted a systematic review of quantitative studies, including randomized controlled trials, pre-post designs, controlled clinical trials, and studies with up to a 12-month follow-up. The study found that MBSR effectively reduces HCPs’ experiences of depression, anxiety, and stress and elevates HCP levels of mindfulness and self-compassion (Kriakous et al., 2020). Nevertheless, MBSR did not seem effective in reducing burnout or improving resilience. The study supports the PICOT since it establishes that Mindfulness meditation can be an effective intervention in improving the psychological functioning of HCPs, including nurses.

Lin et al. (2019) examined the impact of a modified MBSR program on stress, affect, and resilience levels among nurses in general hospitals in mainland China. The study employed a randomized controlled trial by randomly assigning 110 nurses to an intervention versus the control group. The intervention group demonstrated reduced stress and negative affect and increased positive affect and resilience after the intervention (Lin et al., 2019). The article supports the PICOT since it informs us that a Meditation program is an effective intervention for nurses to reduce stress and improve resilience.

Penque (2019) examined the impact of MBSR on job-relevant factors, such as mindfulness, empathy, self-compassion, serenity, job satisfaction, incidental overtime, and job burnout. The study employed a quasi-experimental, longitudinal, pretest and posttest, correlational study. Participants included 61 RNs working at a 619-bed tertiary care hospital in the upper mid-western US. The study findings revealed a reduced burnout and improved specific psychological factors, including self-compassion, mindfulness, and serenity among nurses enrolled in the MBSR (Penque, 2019). The article supports the PICOT since it demonstrates that Mindfulness is an effective approach to improve various psychosocial aspects of health and nurses’ wellbeing, which can help reduce turnover rates.

Van der Riet et al. (2018) sought to critically appraise the literature related to the efficacy of mindfulness meditation programs for nurses and nursing students. The researchers conducted a comprehensive literature search using Medline, CINAHAL, PsycINFO, EMCORE, EMBASE, ERIC, and SCOPUS. The study found that mindfulness meditation positively impacts nurses’ and nursing students’ anxiety, stress, depression, burnout, sense of wellbeing, and empathy (Van der Riet et al., 2018). The article supports my PICOT since it reveals that mindfulness meditation effectively prevents and manages occupational stress and burnout, which often afflicts nurses and student nurses.

Literature Synthesis: Part B

This section will discuss the limitations, controversies, similarities, and differences of the selected peer-reviewed studies.

Limitations and Controversies

The quality of the studies used in Janssen et al. (2018) study was limited.  The study used two high methodological quality studies, while 15 were medium and six were of low quality. Kriakous et al. (2020) systematic literature review used weak to moderate quality articles and used small sample sizes and self-selected samples. Limitations in the Lin et al. (2019) study include using convenience sampling to select hospitals. The limitation affects the representativeness of the sample to some extent. Besides, the sample size used was relatively small and thus required a larger randomized control trial to validate the results.

The study by Penque (2019) did not have a randomized controlled sample or comparison group, which may overestimate the true benefit of the intervention. Besides, the study sample was limited to one geographic area, and the results cannot be generalized to the whole population. The study used a self-administered survey, which is open to response bias. Van der Riet et al. (2018) study included studies that used relatively small sample sizes, limiting the generalizability and representativeness of the results. No controversies were identified in any of the selected studies.

Similarities/ Differences

Similarities identified in the articles include the purpose of the study. All the included studies sought to examine the impact of MBSR on factors such as stress, anxiety, depression, resilience, and psychological functioning. The studies’ findings are also similar since they reveal that MBSR reduces stress, anxiety, and depression levels, improves resilience and psychological wellbeing, and increasing levels of mindfulness and self-compassion. Studies that conducted a systematic review used similar databases such as PsycINFO, PubMed, and CINAHL, and Medline. Furthermore, the two articles that conducted experimental studies both used nurses as their subjects. The intervention was also similar since the subjects were enrolled in an MBSR program.

Differences in the articles include the methodologies used. Three of the studies conducted a systematic literature review; one article employed a quasi-experimental correlational study, while another used a randomized controlled trial. Besides, studies that employed a systematic review used differing numbers of articles. Janssen et al. used 24, Kriakous et al. used 30, and Van der Riet et al. included 16 studies in the review.

Areas of Further Study

Based on the literature review, we know that MBSR effectively reduces psychological distress, depression, anxiety, emotional exhaustion, and occupational stress among employees in the short term. We also know that MBSR increases levels of mindfulness, empathy, resilience, and self-compassion. However, we do not know the long-term impact of MBSR on the psychological wellbeing of nurses. We also do not know the effect of MBSR on other constructs such as burnout, sleep disturbances, and job satisfaction. Further studies are needed to establish the long-term impact of MBSR on nurses’ psychological outcomes, job satisfaction, and turnover rates. Additionally, further studies should focus on the minimum number and length of MBSR sessions and daily practice required to maintain its efficacy. They should also focus on the type and order of the therapeutic components and mindfulness interventions that should be included in the MBSR programs.

Conclusion

Nurses encounter unusual stressors in the patient care environment, which contribute to mental health problems, such as depression, anxiety, fatigue, and insomnia. Mindfulness meditation has been found effective in helping nurses develop skills to manage work-related stress and improve their health. The selected studies suggest that MBSR can be implemented in organizations to improve the psychological functioning of employees, decrease stress and negative affect and improve positive affect and resilience. MBSR thus has the potential to increase work satisfaction, decrease incidental overtime and job burnout. The selected studies support my PICOT statement on training nurses on Mindfulness meditation to reduce stress levels. The MBSR approach can thus be applied in my PICOT to prevent mental disorders and improve mental wellbeing among nurses.

References

Janssen, M., Heerkens, Y., Kuijer, W., van der Heijden, B., & Engels, J. (2018). Effects of Mindfulness-Based Stress Reduction on employees’ mental health: A systematic review. PloS one, 13(1), e0191332. https://doi.org/10.1371/journal.pone.0191332

Kriakous, S. A., Elliott, K. A., Lamers, C., & Owen, R. (2020). The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review. Mindfulness, 1–28. Advance online publication. https://doi.org/10.1007/s12671-020-01500-9

Lin, L., He, G., Yan, J., Gu, C., & Xie, J. (2019). The effects of a modified mindfulness-based stress reduction program for nurses: A randomized controlled trial. Workplace health & safety, 67(3), 111-122.

Penque, S. (2019). Mindfulness to promote nurses’ wellbeing. Nursing Management, 50(5), 38. https://doi.org/10.1097/01.NUMA.0000557621.42684.c4

Tran, T. T. T., Nguyen, N. B., Luong, M. A., Bui, T. H. A., Phan, T. D., Ngo, T. H., … & Nguyen, T. Q. (2019). Stress, anxiety, and depression in clinical nurses in Vietnam: a cross-sectional survey and cluster analysis. International journal of mental health systems, 13(1), 1-11. https://doi.org/10.1186/s13033-018-0257-4

Van der Riet, P., Levett-Jones, T., & Aquino-Russell, C. (2018). The effectiveness of mindfulness meditation for nurses and nursing students: An integrated literature review. Nurse education today, 65, 201-211. https://doi.org/10.1016/j.nedt.2018.03.018