Non-Pharmacological Interventions for ICU Nurses’ Burnout Syndrome: A Meta-Analysis

• Chetan Ramesh Sangati,*  
• Bhairgouda Patil,  
• Sanjay Alagundi,  
• Veerupayya Pujar

Abstract

Background: Burnout syndrome is a critical issue among Intensive Care Unit (ICU) nurses due to high workloads, emotional distress, and constant exposure to life-threatening situations. Characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, burnout negatively impacts both the well-being of nurses and the quality of patient care. While pharmacological interventions may offer some relief, non-pharmacological strategies are increasingly recognized as essential for preventing and managing burnout without the risk of medication-related side effects. Aims&Objective: This meta-analysis aims to evaluate the effectiveness of various non-pharmacological interventions, such as art therapy, guided meditation, mindfulness-based stress reduction, cognitive-behavioral therapy (CBT), and peer support programs, in reducing the symptoms of burnout syndrome among ICU nurses. Materials&Methods: A systematic literature search was conducted across multiple databases (PubMed, CINAHL, PsycINFO, and Cochrane Library) for randomized controlled trials (RCTs) and quasi-experimental studies evaluating non-pharmacological interventions for burnout in ICU nurses. Studies published between 2010 and 2024 were included. The primary outcome measure was the reduction in burnout symptoms as assessed by validated scales such as the Maslach Burnout Inventory (MBI). Data extraction and quality assessment were performed independently by two reviewers, and statistical analyses were conducted using a random-effects model to calculate pooled effect sizes. Results: A total of 18 studies involving 2,346 ICU nurses were included in the meta-analysis. The pooled effect size indicated that non-pharmacological interventions significantly reduced emotional exhaustion (Hedges’ g = 0.67, 95% CI [0.45, 0.89], p < 0.01) and depersonalization (Hedges’ g = 0.59, 95% CI [0.38, 0.81], p < 0.01) while improving personal accomplishment (Hedges’ g = 0.53, 95% CI [0.30, 0.76], p < 0.01). Among the interventions, mindfulness-based stress reduction and CBT showed the highest efficacy, followed by art therapy and guided meditation. Peer support programs also demonstrated moderate effectiveness but were less studied. Conclusion: The findings suggest that non-pharmacological interventions, particularly mindfulness and cognitive-behavioral therapies, are effective in reducing burnout symptoms among ICU nurses. These interventions offer a sustainable, low-risk alternative to pharmacological approaches, contributing to better mental health outcomes and improved nurse retention in high-stress environments. Future research should focus on larger, multi-center trials and explore the long-term impacts of these interventions.

Keywords

ICU nurses, burnout syndrome, non-pharmacological interventions, mindfulness, cognitive-behavioral therapy, meta-analysis