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Background <p>The COVID-19 pandemic significantly impacted the mental health of frontline healthcare workers (HCWs), but solid evidence on psychological interventions for HCWs remains limited.</p> Objective <p>Whether an adjusted therapist-assisted Mindfulness-based Stress Reduction group intervention (adjusted MBSR) is superior to a minimal self-guided mindfulness-based intervention (self-guided MBI) in improving mental health of HCWs during the COVID-19 pandemic.</p> Design <p>Randomized controlled trial.</p> Participants <p>201 frontline HCWs (47 physicians, 120 nurses, 34 supporting staff); enrollment between June 2020 and September 2021.</p> Interventions <p>A 4-week adjusted MBSR with eight biweekly 1.5-h sessions; or a 4-week self-guided MBI with 24 mindfulness/compassion exercises.</p> Measures <p>Primary outcome was the Patient Health Questionnaire – Somatic, Anxiety and Depressive Symptom Scales (PHQ-SADS) at 6-month follow-up. Secondary outcomes included posttraumatic symptoms, insomnia, alcohol use, repetitive negative thinking, mental well-being, posttraumatic growth, mindfulness, and self-compassion at post-intervention and 3- and 6-month follow-up.</p> Key Results <p>At 6-month follow-up, the adjusted MBSR was not superior to the self-guided MBI (mean difference (SE) PHQ-SADS, 0.23 (1.03), <i>P</i>=0.82). Both interventions showed similar within-group improvement in PHQ-SADS (Cohen’s <i>d</i> between baseline and 6-month follow-up: adjusted MBSR −0.78 (95% CI −1.07; −0.48), self-guided MBI −0.72 (95% CI −1.01; −0.43)). Secondary outcomes showed that symptom trajectories differed between groups for PHQ-SADS (intervention*time <i>F</i>(3, 420)=3.99, <i>P</i>=0.008), with greater reduction at post-intervention for adjusted MBSR, and posttraumatic growth (intervention*time <i>F</i>(3, 350)=5.32, <i>P</i>=0.001), with exclusive increase post-intervention in adjusted MBSR. Both interventions showed comparable significant within-group improvements on posttraumatic symptoms, insomnia, repetitive negative thinking, mental well-being, mindfulness, and self-compassion.</p> Conclusions <p>The adjusted MSBR was not superior to the self-guided MBI; both were accompanied by significant reductions of depressive, anxiety, and somatic symptoms after 4 weeks of treatment which was sustained at 6-month follow-up. Further research is needed to investigate the possible role of MBIs to support HCWs involved in future healthcare crises.</p> Trial Registration <p>ClinicalTrials.gov NCT04720404; onderzoekmetmensen.nl/en NL73793.091.20</p>

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Mindfulness-Based Interventions for Mental Health Outcomes in Frontline Healthcare Workers During the COVID-19 Pandemic: A Randomized Controlled Trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月19日

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  • Marieke Arts-de Jong,
  • Dirk E. M. Geurts,
  • Philip Spinhoven,
  • Henricus G. Ruhé,
  • Anne E. M. Speckens

摘要

Background

The COVID-19 pandemic significantly impacted the mental health of frontline healthcare workers (HCWs), but solid evidence on psychological interventions for HCWs remains limited.

Objective

Whether an adjusted therapist-assisted Mindfulness-based Stress Reduction group intervention (adjusted MBSR) is superior to a minimal self-guided mindfulness-based intervention (self-guided MBI) in improving mental health of HCWs during the COVID-19 pandemic.

Design

Randomized controlled trial.

Participants

201 frontline HCWs (47 physicians, 120 nurses, 34 supporting staff); enrollment between June 2020 and September 2021.

Interventions

A 4-week adjusted MBSR with eight biweekly 1.5-h sessions; or a 4-week self-guided MBI with 24 mindfulness/compassion exercises.

Measures

Primary outcome was the Patient Health Questionnaire – Somatic, Anxiety and Depressive Symptom Scales (PHQ-SADS) at 6-month follow-up. Secondary outcomes included posttraumatic symptoms, insomnia, alcohol use, repetitive negative thinking, mental well-being, posttraumatic growth, mindfulness, and self-compassion at post-intervention and 3- and 6-month follow-up.

Key Results

At 6-month follow-up, the adjusted MBSR was not superior to the self-guided MBI (mean difference (SE) PHQ-SADS, 0.23 (1.03), P=0.82). Both interventions showed similar within-group improvement in PHQ-SADS (Cohen’s d between baseline and 6-month follow-up: adjusted MBSR −0.78 (95% CI −1.07; −0.48), self-guided MBI −0.72 (95% CI −1.01; −0.43)). Secondary outcomes showed that symptom trajectories differed between groups for PHQ-SADS (intervention*time F(3, 420)=3.99, P=0.008), with greater reduction at post-intervention for adjusted MBSR, and posttraumatic growth (intervention*time F(3, 350)=5.32, P=0.001), with exclusive increase post-intervention in adjusted MBSR. Both interventions showed comparable significant within-group improvements on posttraumatic symptoms, insomnia, repetitive negative thinking, mental well-being, mindfulness, and self-compassion.

Conclusions

The adjusted MSBR was not superior to the self-guided MBI; both were accompanied by significant reductions of depressive, anxiety, and somatic symptoms after 4 weeks of treatment which was sustained at 6-month follow-up. Further research is needed to investigate the possible role of MBIs to support HCWs involved in future healthcare crises.

Trial Registration

ClinicalTrials.gov NCT04720404; onderzoekmetmensen.nl/en NL73793.091.20