Effectiveness of cognitive interventions in mitigating mental fatigue among healthcare professionals in hospital settings: A systematic review
Mental fatigue poses a significant challenge to healthcare professionals in hospital settings, impairing cognitive performance, emotional well-being, and job satisfaction. This systematic review evaluates the effectiveness of cognitive interventions, including mindfulness programs, online psychological interventions, and telehealth cognitive-behavioral therapy (CBT), in mitigating mental fatigue among healthcare workers. A comprehensive literature search across PubMed, b-on, Web of Science, and Scopus identified six studies published between 2016 and 2023. These studies reported that cognitive interventions significantly reduced burnout and stress levels, with up to a 30% decrease in emotional exhaustion and improved coping mechanisms. In addition, participants demonstrated enhanced emotional well-being, reflected in increased mindfulness and life satisfaction scores of as much as 25%. Mindfulness-based programs and telehealth CBT were particularly effective in fostering resilience and improving overall cognitive function. However, the review also highlighted the need for future research to explore the long-term effects of these interventions, their cost-effectiveness, and innovative methods to improve accessibility and scalability, such as digital platforms. Integrating cognitive interventions into routine healthcare practice can enhance staff well-being, improve patient outcomes, and contribute to a more supportive work environment.
- Balogh, E.P., Miller, B.T., Ball, J.R., Committee on Diagnostic Error in Health Care, Board on Health Care Services, Institute of Medicine & The National Academies of Sciences, Engineering, and Medicin. (2015). Overview of diagnostic error in health care. In: Improving Diagnosis in Health Care. United States: National Academies Press (US). Available from: https://www.ncbi.nlm.nih.gov/books/NBK338594 [Last accessed on 2024 Apr 19].
- Bhardwaj, P., Pathania, M., Bahurupi, Y., Kanchibhotla, D., Harsora, P., & Rathaur, V.K. (2023). Efficacy of mHealth aided 12-week meditation and breath intervention on change in burnout and professional quality of life among health care providers of a tertiary care hospital in North India: A randomized waitlist-controlled trial. Frontiers in Public Health, 11:1258330. https://doi.org/10.3389/fpubh.2023.1258330
- Cochrane Library of Cochrane Methods. (2008). Risk of Bias Tools- ROBINS-I Tool. Available from: https://www.riskofbias.info/ welcome/home [Last accessed on 2024 Apr 19].
- Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, 18(1):41. https://doi.org/10.1186/s12960-020-00469-9
- Dames, S., Young, W., Krigolson, O., Zhang, K., Stoller, L., & Bartle, R. (2022). Changes in cognitive control following a novel resilience-focused nursing educational program: An exploratory study. Quality Advancement in Nursing Education - Avancées En Formation Infirmière, 8(2):6. https://doi.org/10.17483/2368-6669.1330
- Duarte, J. (2017). Professional quality of life in nurses: Contribution for the validation of the Portuguese version of the Professional Quality of Life Scale-5 (ProQOL-5). Analise Psicologica, 35:529-542. https://doi.org/10.14417/ap.1260
- Duarte, J., & Pinto-Gouveia, J. (2016). Effectiveness of a mindfulness-based intervention on oncology nurses’ burnout and compassion fatigue symptoms: A non-randomized study. International Journal of Nursing Studies, 64:98-107. https://doi.org/10.1016/j.ijnurstu.2016.10.002
- Fukumori, T., Goto, T., & Sato, H. (2018). Development, reliability, and validity of a Japanese version of the professional quality of life scale for nurses. The Japanese Journal of Psychology, 89(2):150-159. https://doi.org/10.4992/jjpsy.89.17202
- Galiana, L., Arena, F., Oliver, A., Sansó, N., & Benito, E. (2017). Compassion satisfaction, compassion fatigue, and burnout in Spain and Brazil: ProQOL validation and cross-cultural diagnosis. Journal of Pain and Symptom Management, 53(3):598-604. https://doi.org/10.1016/j.jpainsymman.2016.09.014
- Gonçalves, S., Marques, P., & Matos, R.S. (2024). Exploring aromatherapy as a complementary approach in palliative care: A systematic review. Journal of Palliative Medicine, 27(9):1247-1266. https://doi.org/10.1089/jpm.2024.0019
- Higgins, J.P., & Green, S. (2008). Cochrane Handbook for Systematic Reviews of Interventions. London: Cochrane Collaboration.
- Karim, E., Pavel, H.R., Nikanfar, S., Hebri, A., Roy, A., Nambiappan, H.R., et al. (2024). Examining the landscape of cognitive fatigue detection: A comprehensive survey. Technologies, 12(3):3. https://doi.org/10.3390/technologies12030038
- Koinis, A., Giannou, V., Drantaki, V., Angelaina, S., Stratou, E., & Saridi, M. (2015). The impact of healthcare workers job environment on their mental-emotional health. Coping strategies: The case of a local general hospital. Health Psychology Research, 3(1):1984. https://doi.org/10.4081/hpr.2015.1984
- Koulivand, P.H., Khaleghi Ghadiri, M., & Gorji, A. (2013). Lavender and the nervous system. Evidence-Based Complementary and Alternative Medicine, 2013:681304. https://doi.org/10.1155/2013/681304
- Leary, S., Weingart, K., Topp, R., & Bormann, J. (2018). The effect of Mantram repetition on burnout and stress among VA staff. Workplace Health and Safety, 66(3):120-128. https://doi.org/10.1177/2165079917697215
- LeGal, P., Rheaume, A., & Mullen, J. (2019). The long-term effects of psychological demands on chronic fatigue. Journal of Nursing Management, 27(8):1673-1681. https://doi.org/10.1111/jonm.12857
- Lock, A.M., Bonetti, D.L., & Campbell, A.D.K. (2018). The psychological and physiological health effects of fatigue. Occupational Medicine (Lond), 268(8):502-511. https://doi.org/10.1093/occmed/kqy109
- Marcora, S.M., Staiano, W., & Manning, V. (2009). Mental fatigue impairs physical performance in humans. Journal of Applied Physiology (1985), 106(3):857-864. https://doi.org/10.1152/japplphysiol.91324.2008
- Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial Medicine, 15(1):16. https://doi.org/10.1186/s13030-021-00219-w
- Ong, N.Y., Teo, F.J.J., Ee, J.Z.Y., Yau, C.E., Thumboo, J., Tan, H.K., et al. (2024). Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: A systematic review and meta-analysis. General Psychiatry, 37(3):e101115. https://doi.org/10.1136/gpsych-2023-101115
- Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. Rayyan-a web and mobile app for systematic reviews. Systematic Reviews, 2016;5:210. https://doi.org/10.1186/s13643-016-0384-4
- Page, M.J., McKenzie, J.E., Bossuyt, P.M, Boutron, I., Hoffmann, T.C., Mulrow, C.D., et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 2021;372:n71. https://doi.org/10.1136/bmj.n71
- Roever, L. (2018). PICO: Model for clinical questions. Evidence- Based Medicine and Practice, 3:115. https://doi.org/10.4172/2471-9919.1000115
- Samson, T., Iecovich, E., & Shvartzman, P. (2016). Psychometric characteristics of the Hebrew version of the professional quality-of-life scale. Journal of Pain and Symptom Management, 52(4):575-581.e1. https://doi.org/10.1016/j.jpainsymman.2016.03.019
- Sattayakhom, A., Wichit, S., & Koomhin, P. (2023). The effects of essential oils on the nervous system: A scoping review. Molecules, 28(9):3771. https://doi.org/10.3390/molecules28093771
- Schäfer, S.K., von Boros, L., Schaubruch, L.M., Kunzler, A.M., Lindner, S., Koehler, F., et al. (2024). Digital interventions to promote psychological resilience: A systematic review and meta-analysis. NPJ Digital Medicine, 7(1):30. https://doi.org/10.1038/s41746-024-01017-8
- Shen, J., Yu, H., Zhang, Y., & Jiang, A. (2015). Professional quality of life: A cross-sectional survey among Chinese clinical nurses. Nursing and Health Sciences, 17(4):507-515. https://doi.org/10.1111/nhs.12228
- Søvold, L.E., Naslund, J.A., Kousoulis, A.A., Saxena, S., Qoronfleh, M.W., Grobler, C., et al. (2021). Prioritizing the mental health and well-being of healthcare workers: An urgent global public health priority. Frontiers in Public Health, 9:679397. https://doi.org/10.3389/fpubh.2021.679397
- Varney, E., & Buckle, J. (2012). Effect of inhaled essential oils on mental exhaustion and moderate burnout: A small pilot study. Journal of Alternative and Complementary Medicine, 19(1):69-71. https://doi.org/10.1089/acm.2012.0089
- Wang, J., Song, B., Shao, Y., & Zhu, J. (2021). Effect of online psychological intervention on burnout in medical residents from different majors: An exploratory study. Frontiers in Psychology, 12:632134. https://doi.org/10.3389/fpsyg.2021.632134
- Weiner, L., Berna, F., Nourry, N., Severac, F., Vidailhet, P., & Mengin, A.C. (2020). Efficacy of an online cognitive behavioral therapy program developed for healthcare workers during the COVID-19 pandemic: The REduction of STress (REST) study protocol for a randomized controlled trial. Trials, 21(1):870. https://doi.org/10.1186/s13063-020-04772-7
- Whitfield, T., Barnhofer, T., Acabchuk, R., Cohen, A., Lee, M., Schlosser, M., et al. (2022). The effect of mindfulness-based programs on cognitive function in adults: A systematic review and meta-analysis. Neuropsychology Review, 32(3):677-702. https://doi.org/10.1007/s11065-021-09519-y
- Wilz, G., Reder, M., Meichsner, F., & Soellner, R. (2018). The Tele. TAnDem intervention: Telephone-based CBT for family caregivers of people with dementia. The Gerontologist, 58(2\):e118-e129. https://doi.org/10.1093/geront/gnx183