Effect of Mindfulness-Based Intervention on Psychological Outcomes in Surgeons: Systematic Review and Meta-Analysis.

Summary

Mindfulness-based interventions (MBIs) significantly enhance psychological well-being among surgeons, with 179 surgical residents participating in a comprehensive analysis. MBIs led to a notable reduction in stress levels by 3.24 points on the Perceived Stress Scale and improved mindfulness by nearly 4 points. Additionally, burnout decreased by nearly 2 points, alongside reductions in depersonalization and emotional exhaustion. However, MBIs did not significantly impact depression or anxiety. These findings highlight the potential of MBIs to foster healthier work environments for surgeons.

Abstract

To evaluate the effect of mindfulness-based interventions (MBIs) on psychological outcomes in surgeons. A PRISMA-compliant systematic review and meta-analysis (random effects modeling) was performed searching for comparative studies. Primary outcomes were stress (Perceived Stress Scale, PSS-10) and mindfulness (Cognitive and Affective Mindfulness Scale-Revised, CAMS-R). Secondary outcomes were burnout and anxiety (abbreviated Maslach Burnout Inventory [aMBI], Patient Health Questionnaire-2 [PHQ-2], and State-Trait Anxiety Inventory [STAI]). Surgical residents numbering 179 (MBIs 98 vs. control 81) from five studies (4 RCTs and 1 cohort study) were included. At baseline, both cohorts were comparable in terms of stress (PSS-10, p = 0.420), mindfulness (CAMS-R, p = 0.620), burnout (aMBI, p = 0.980), depersonalization (p = 740), emotional exhaustion (p = 480), depression (PHQ-2, p = 0.280), and anxiety (STAI, p = 0.060). MBIs reduced stress (PSS-10; MD: -3.24, 95% CI -6.10 to -0.39, and p = 0.030), improved mindfulness (CAMS-R; MD: 3.97, 95% CI 2.57-5.37, and p < 0.00001), and reduced burnout (aMBI; MD: -1.98, 95% CI -3.57 to -0.38, and p = 0.020), depersonalization (MD: -2.80, 95% CI -5.22 to -0.38, and p = 0.020), and emotional exhaustion (MD: -3.20, 95% CI -5.48 to -0.92, and p = 0.0006). MBIs did not influence depression (PHQ-2; MD: -0.46, 95% CI -1.32 to -0.40, and p = 0.290) or anxiety (STAI; MD: -0.16, 95% CI -2.62 to -2.30, and p = 0.900). MBIs may improve psychological outcomes as shown by better mindfulness (high certainly), less stress (moderate certainty), and burnout (moderate certainty). Whether MBIs translate into better long-term surgical performance and patient outcomes should be the focus of future research. PROSPERO registration number: CRD42024595967.

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