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

Abstract

Objectives: To evaluate the effect of mindfulness-based interventions (MBIs) on psychological outcomes in surgeons.

Methods: 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]).

Results: 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).

Conclusions: 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.

Trial registration: PROSPERO registration number: CRD42024595967.

Keywords: burnout; mindfulness; stress; surgeons.