Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Apr 7;2015(4):CD002892.
doi: 10.1002/14651858.CD002892.pub5.

Preventing occupational stress in healthcare workers

Jani H Ruotsalainen  1 , Jos H Verbeek, Albert Mariné, Consol Serra
Affiliations
Review

Preventing occupational stress in healthcare workers

Jani H Ruotsalainen et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Healthcare workers can suffer from occupational stress as a result of lack of skills, organisational factors, and low social support at work. This may lead to distress, burnout and psychosomatic problems, and deterioration in quality of life and service provision.

Objectives: To evaluate the effectiveness of work- and person-directed interventions compared to no intervention or alternative interventions in preventing stress at work in healthcare workers.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, NIOSHTIC-2 and Web of Science up to November 2013.

Selection criteria: Randomised controlled trials (RCTs) of interventions aimed at preventing psychological stress in healthcare workers. For organisational interventions, interrupted time-series and controlled before-and-after (CBA) studies were also eligible.

Data collection and analysis: Two review authors independently extracted data and assessed trial quality. We used Standardised Mean Differences (SMDs) where authors of trials used different scales to measure stress or burnout. We combined studies that were similar in meta-analyses. We used the GRADE system to rate the quality of the evidence.

Main results: In this update, we added 39 studies, making a total of 58 studies (54 RCTs and four CBA studies), with 7188 participants. We categorised interventions as cognitive-behavioural training (CBT) (n = 14), mental and physical relaxation (n = 21), combined CBT and relaxation (n = 6) and organisational interventions (n = 20). Follow-up was less than one month in 24 studies, one to six in 22 studies and more than six months in 12 studies. We categorised outcomes as stress, anxiety or general health.There was low-quality evidence that CBT with or without relaxation was no more effective in reducing stress symptoms than no intervention at one month follow-up in six studies (SMD -0.27 (95% Confidence Interval (CI) -0.66 to 0.13; 332 participants). But at one to six months follow-up in seven studies (SMD -0.38, 95% CI -0.59 to -0.16; 549 participants, 13% relative risk reduction), and at more than six months follow-up in two studies (SMD -1.04, 95% CI -1.37 to -0.70; 157 participants) CBT with or without relaxation reduced stress more than no intervention.CBT interventions did not lead to a considerably greater effect than an alternative intervention, in three studies.Physical relaxation (e.g. massage) was more effective in reducing stress than no intervention at one month follow-up in four studies (SMD -0.48, 95% CI -0.89 to -0.08; 97 participants) and at one to six months follow-up in six studies (SMD -0.47; 95% CI -0.70 to -0.24; 316 participants). Two studies did not find a considerable difference in stress between massage and taking extra breaks.Mental relaxation (e.g. meditation) led to similar stress symptom levels as no intervention at one to six months follow-up in six studies (SMD -0.50, 95% CI -1.15 to 0.15; 205 participants) but to less stress in one study at more than six months follow-up. One study showed that mental relaxation reduced stress more effectively than attending a course on theory analysis and another that it was more effective than just relaxing in a chair.Organisational interventions consisted of changes in working conditions, organising support, changing care, increasing communication skills and changing work schedules. Changing work schedules (from continuous to having weekend breaks and from a four-week to a two-week schedule) reduced stress with SMD -0.55 (95% CI -0.84 to -0.25; 2 trials, 180 participants). Other organisational interventions were not more effective than no intervention or an alternative intervention.We graded the quality of the evidence for all but one comparison as low. For CBT this was due to the possibility of publication bias, and for the other comparisons to a lack of precision and risk of bias. Only for relaxation versus no intervention was the evidence of moderate quality.

Authors' conclusions: There is low-quality evidence that CBT and mental and physical relaxation reduce stress more than no intervention but not more than alternative interventions. There is also low-quality evidence that changing work schedules may lead to a reduction of stress. Other organisational interventions have no effect on stress levels. More randomised controlled trials are needed with at least 120 participants that compare the intervention to a placebo-like intervention. Organisational interventions need better focus on reduction of specific stressors.

PubMed Disclaimer

Conflict of interest statement

Jani Ruotsalainen: None known.

Jos Verbeek: None known.

Consol Serra: None known.

Albert Marine: None known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Funnel plot of comparison: 1 Cognitive‐behavioural intervention vs no Intervention (SMD), outcome: 1.1 Any Stress‐related Outcome (follow‐up up to 1 month).
4
4
Funnel plot of comparison: 1 Cognitive‐behavioural intervention vs no Intervention (SMD), outcome: 1.2 Any Stress‐related Outcome (follow‐up 1 ‐ 6 months).
5
5
Funnel plot of comparison: 3 Relaxation vs. no intervention (SMD), outcome: 3.2 Any stress outcome (follow‐up 1 ‐ 6 months).
1.1
1.1. Analysis
Comparison 1 Cognitive‐behavioural intervention vs no Intervention (SMD), Outcome 1 Any Stress‐related Outcome (follow‐up up to 1 month).
1.2
1.2. Analysis
Comparison 1 Cognitive‐behavioural intervention vs no Intervention (SMD), Outcome 2 Any Stress‐related Outcome (follow‐up 1 ‐ 6 months).
1.3
1.3. Analysis
Comparison 1 Cognitive‐behavioural intervention vs no Intervention (SMD), Outcome 3 Any Stress‐related Outcome (follow‐up more than 6 months).
1.4
1.4. Analysis
Comparison 1 Cognitive‐behavioural intervention vs no Intervention (SMD), Outcome 4 State‐Trait Anxiety Inventory (follow‐up up to 1 month).
1.5
1.5. Analysis
Comparison 1 Cognitive‐behavioural intervention vs no Intervention (SMD), Outcome 5 State‐Trait Anxiety Inventory (follow‐up 1 ‐ 6 months).
1.6
1.6. Analysis
Comparison 1 Cognitive‐behavioural intervention vs no Intervention (SMD), Outcome 6 General Health Questionnaire (follow‐up up to 1 month).
2.1
2.1. Analysis
Comparison 2 Cognitive‐behavioural intervention vs. non‐stress management intervention (SMD), Outcome 1 Any stress scale (follow‐up 1 ‐ 6 months).
2.2
2.2. Analysis
Comparison 2 Cognitive‐behavioural intervention vs. non‐stress management intervention (SMD), Outcome 2 Any stress scale (follow‐up more than 6 months).
2.3
2.3. Analysis
Comparison 2 Cognitive‐behavioural intervention vs. non‐stress management intervention (SMD), Outcome 3 Anxiety (follow‐up 1 ‐ 6 months).
3.1
3.1. Analysis
Comparison 3 Relaxation vs. no intervention (SMD), Outcome 1 Any stress outcome (follow‐up up to 1 month).
3.2
3.2. Analysis
Comparison 3 Relaxation vs. no intervention (SMD), Outcome 2 Any stress outcome (follow‐up 1 ‐ 6 months).
3.3
3.3. Analysis
Comparison 3 Relaxation vs. no intervention (SMD), Outcome 3 Any stress outcome (follow‐up more than 6 months).
3.4
3.4. Analysis
Comparison 3 Relaxation vs. no intervention (SMD), Outcome 4 State Anxiety (follow‐up 1 ‐ 6 months).
3.5
3.5. Analysis
Comparison 3 Relaxation vs. no intervention (SMD), Outcome 5 Trait Anxiety (follow‐up 1 ‐ 6 months).
3.6
3.6. Analysis
Comparison 3 Relaxation vs. no intervention (SMD), Outcome 6 General Health (follow‐up 1 ‐ 6 months).
4.1
4.1. Analysis
Comparison 4 Relaxation vs. other intervention (SMD), Outcome 1 Any stress outcome.
4.2
4.2. Analysis
Comparison 4 Relaxation vs. other intervention (SMD), Outcome 2 Any anxiety outcome.
4.3
4.3. Analysis
Comparison 4 Relaxation vs. other intervention (SMD), Outcome 3 General Health Questionnaire.
5.1
5.1. Analysis
Comparison 5 Organisational intervention vs. no intervention (SMD), Outcome 1 Any stress‐related outcome (follow‐up up to 1 month).
5.2
5.2. Analysis
Comparison 5 Organisational intervention vs. no intervention (SMD), Outcome 2 Any stress‐related outcome RCTs (follow‐up 1 ‐ 6 months).
5.3
5.3. Analysis
Comparison 5 Organisational intervention vs. no intervention (SMD), Outcome 3 Any stress‐related outcome (follow‐up more than 6 months).
5.4
5.4. Analysis
Comparison 5 Organisational intervention vs. no intervention (SMD), Outcome 4 The Short Form Health Survey (SF‐36) (follow‐up more than 6 months).
6.1
6.1. Analysis
Comparison 6 Organisational intervention vs. other intervention (SMD), Outcome 1 Any stress‐related outcome (follow‐up up to 1 month).
6.2
6.2. Analysis
Comparison 6 Organisational intervention vs. other intervention (SMD), Outcome 2 Any stress‐related outcome (follow‐up 1 ‐ 6 months).
6.3
6.3. Analysis
Comparison 6 Organisational intervention vs. other intervention (SMD), Outcome 3 Any stress‐related outcome (follow‐up more than 6 months).
6.4
6.4. Analysis
Comparison 6 Organisational intervention vs. other intervention (SMD), Outcome 4 General Health Questionnaire (total score).
7.1
7.1. Analysis
Comparison 7 Cognitive‐behavioural intervention vs. no intervention (MD), Outcome 1 Maslach Burnout Inventory (follow‐up up to 1 month).
7.2
7.2. Analysis
Comparison 7 Cognitive‐behavioural intervention vs. no intervention (MD), Outcome 2 Maslach Burnout Inventory (follow‐up 1 to 6 months).
8.1
8.1. Analysis
Comparison 8 Cognitive‐behavioural intervention and relaxation vs. no intervention (MD), Outcome 1 Maslach Burnout Inventory (follow‐up up to 1 month).
9.1
9.1. Analysis
Comparison 9 Cognitive‐behavioural intervention vs. other intervention (MD), Outcome 1 Maslach Burnout Inventory (follow‐up more than 6 months).
10.1
10.1. Analysis
Comparison 10 Relaxation vs. no intervention (MD), Outcome 1 Maslach Burnout Inventory (follow‐up 1 ‐ 6 months).
11.1
11.1. Analysis
Comparison 11 Organisational intervention vs. no intervention (MD), Outcome 1 Maslach Burnout Inventory (follow‐up less than 1 month).
11.2
11.2. Analysis
Comparison 11 Organisational intervention vs. no intervention (MD), Outcome 2 Maslach Burnout Inventory (follow‐up 1 ‐ 6 months).
11.3
11.3. Analysis
Comparison 11 Organisational intervention vs. no intervention (MD), Outcome 3 Maslach Burnout Inventory or Oldenburg Burnout Inventory (follow‐up more than 6 months).
12.1
12.1. Analysis
Comparison 12 Organisational intervention vs. other intervention (MD), Outcome 1 Maslach Burnout Inventory (follow‐up 1 ‐ 6 months).
13.1
13.1. Analysis
Comparison 13 Cognitive‐behavioural intervention vs. no Intervention (SUBGROUPS) (SMD), Outcome 1 Any Stress‐related Outcome (follow‐up up to 1 month).
13.2
13.2. Analysis
Comparison 13 Cognitive‐behavioural intervention vs. no Intervention (SUBGROUPS) (SMD), Outcome 2 Any Stress‐related Outcome (follow‐up 1 ‐ 6 months).
14.1
14.1. Analysis
Comparison 14 Relaxation vs. no intervention (SUBGROUPS) (SMD), Outcome 1 Any stress outcome (follow‐up to 1 month).
14.2
14.2. Analysis
Comparison 14 Relaxation vs. no intervention (SUBGROUPS) (SMD), Outcome 2 Any stress outcome (follow‐up 1 ‐ 6 months).
See this image and copyright information in PMC

Update of

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Ali 2011 {published data only}
    1. Ali NA, Hammersley J, Hoffmann SP, O'Brien JM Jr, Phillips GS, Rashkin M, et al. Continuity of care in intensive care units: a cluster‐randomized trial of intensivist staffing. American Journal of Respiratory and Critical Care Medicine 2011;184(7):803‐8. - PubMed
Bittman 2003 {published data only}
    1. Bittman B, Bruhn KT, Stevens C, Westengard J, Umbach PO. Recreational music‐making: a cost‐effective group interdisciplinary strategy for reducing burnout and improving mood states in long‐term care workers. Advances in Mind‐Body Medicine 2003;19(3‐4):4‐15. - PubMed
Bourbonnais 2011 {published data only}
    1. Bourbonnais R, Brisson C, Vinet A, Vézina M, Abdous B, Gaudet M. Effectiveness of a participative intervention on psychosocial work factors to prevent mental health problems in a hospital setting. Occupational and Environmental Medicine 2006;63(5):335‐42. - PMC - PubMed
    1. Bourbonnais R, Brisson C, Vinet A, Vézina M, Lower A. Development and implementation of a participative intervention to improve the psychosocial work environment and mental health in an acute care hospital. Occupational and Environmental Medicine 2006;63(5):326‐34. - PMC - PubMed
    1. Bourbonnais R, Brisson C, Vézina M. Long‐term effects of an intervention on psychosocial work factors among healthcare professionals in a hospital setting. Occupational and Environmental Medicine 2011;68(7):479‐86. - PubMed
Brennan 2006 {published data only}
    1. Brennan MK, DeBate RD. The effect of chair massage on stress perception of hospital bedside. Journal of Bodywork and Movement Therapies 2006;10(4):335‐42.
Carson 1999 {published data only}
    1. Carson J, Cavagin J, Bunclark J, Maal S, Gournay K, Kuipers E, et al. Effective communication in mental health nurses: did social support save the psychiatric nurse?. NT Research 1999;4:31‐42.
Cohen‐Katz 2005 {unpublished data only}
    1. Cohen‐Katz J, Wiley SD, Capuano T, Baker DM, Kimmel S, Shapiro S. The effects of mindfulness‐based stress reduction on nurse stress and burnout, Part II: A quantitative and qualitative study. Holistic Nursing Practice 2005;19(1):26‐35. - PubMed
Delvaux 2004 {published data only}
    1. Delvaux N, Razavi D, Marchal S, Bredart A, Farvacques C, Slachmuylder JL. Effects of a 105 hours psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study. British Journal of Cancer 2004;90(1):106‐14. - PMC - PubMed
Ewers 2002 {published data only}
    1. Ewers P, Bradshaw T, McGovern J, Ewers B. Does training in psychosocial interventions reduce burnout rates in forensic nurses?. Journal of Advanced Nursing 2002;37(5):470‐6. - PubMed
Finnema 2005 {published data only}
    1. Finnema E, Droes RM, Ettema T, Ooms M, Ader H, Ribbe M, et al. The effect of integrated emotion‐oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial. International Journal of Geriatric Psychiatry 2005;20(4):330‐43. - PubMed
Gardner CBT 2005 {published data only}
    1. Gardner B, Rose J, Mason O, Tyler P, Cushway D. Cognitive therapy and behavioural coping in the management of work‐related stress: An intervention study. Work and Stress 2005;19(2):137‐52.
Gardner Coping 2005 {published data only}
    1. Gardner B, Rose J, Mason O, Tyler P, Cushway D. Cognitive therapy and behavioural coping in the management of work‐related stress: An intervention study. Work and Stress 2005;19(2):137‐52.
Gärtner 2013 {published data only}
    1. Gärtner FR, Nieuwenhuijsen K, Ketelaar SM, Dijk FJH, Sluiter JK. The Mental Vitality @ Work Study: effectiveness of a mental module for workers E‐health surveillance for nurses and allied health care professionals on their help‐seeking behavior. Journal of Occupational and Environmental Medicine 2013;55(10):1219‐29. - PubMed
    1. Ketelaar SM, Gärtner FR, Bolier L, Smeets O, Nieuwenhuijsen K, Sluiter JK. Mental Vitality @ Work‐‐a workers' health surveillance mental module for nurses and allied health care professionals: process evaluation of a randomized controlled trial. Journal of Occupational and Environmental Medicine 2013;55(5):563‐71. - PubMed
Ghazavi 2010 {published data only}
    1. Ghazavi Z, Lohrasbi F, Mehrabi T. Effect of communication skill training using group psycho‐education method on the stress level of psychiatry ward nurses. Iranian Journal of Nursing and Midwifery Research 2010;15(Suppl 1):395‐400. - PMC - PubMed
Griffith 2008 {published data only}
    1. Griffith JM, Hasley JP, Liu H, Severn DG, Conner LH, Adler LE. Qigong stress reduction in hospital staff. Journal of Alternative and Complementary Medicine 2008;14(8):939‐45. - PMC - PubMed
Günüsen 2010 {published data only}
    1. Gunusen N, Ustun B. An RCT of coping and support groups to reduce burnout among nurses. International Nursing Review 2010;57(4):485‐92. - PubMed
Hansen 2006 {published data only}
    1. Hansen TM, Hansen B, Ringdal GI. Does aromatherapy massage reduce job‐related stress? Results from a randomised, controlled trial. International Journal of Aromatherapy 2006;16:89‐94.
Heaney 1995 {published data only}
    1. Heaney CA, Price RH, Rafferty J. Increasing coping resources at work: a field experiment to increase social support, improve work team functioning, and enhance employee mental health. Journal of Organizational Behavior 1995;16:335‐52.
Jensen 2006 {published data only}
    1. Jensen LD, Gonge H, Jors E, Ryom P, Foldspang A, Christensen MA, et al. Prevention of low back pain in female eldercare workers: randomized controlled work site trial. Spine 2006;31(16):1761‐9. [PUBMED: 16845347] - PubMed
Jones 2000a {published data only}
    1. Jones MC, Johnston DW. Evaluating the impact of a worksite stress management programme for distressed students: a randomised controlled trial. Psychology and Health 2000;15:689‐706.
Ketelaar 2013 {published data only}
    1. Ketelaar SM, Gärtner FR, Bolier L, Smeets O, Nieuwenhuijsen K, Sluiter JK. Mental Vitality @ Work‐‐a workers' health surveillance mental module for nurses and allied health care professionals: process evaluation of a randomized controlled tTrial. Journal of Occupational and Environmental Medicine 2013;55(5):563‐71. - PubMed
    1. Ketelaar SM, Nieuwenhuijsen K, Gärtner FR, Bolier L, Smeets O, Sluiter JK. Effect of an E‐mental health approach to workers' health surveillance versus control group on work functioning of hospital employees: a cluster‐RCT. PLoS ONE 2013; Vol. 8, issue 9. - PMC - PubMed
Klatt 2012 {published data only}
    1. Klatt M, Steinberg B, Marks D, Duchemin A. Changes in physiological and psychological markers of stress in hospital personnel after a low‐dose mindfulness‐based worksite intervention. BMC Complementary and Alternative Medicine 2012;12(Suppl 1):O16.
Kurebayashi 2012 {published data only}
    1. Kurebayashi LF, Gnatta JR, Borges TP, Belisse G, Coca S, Minami A, et al. The applicability of auriculo‐therapy with needles or seeds to reduce stress in nursing professionals. Revista da Escola de Enfermagem da USP 2012; Vol. 46, issue 1:89‐95. - PubMed
Kwok 2012 {published data only}
    1. Kwok WO. The effects of an intervention program (medi) on reducing occupational stress in emergency department nurses. Dissertation Abstracts International: Section B: The Sciences and Engineering 2012; Vol. 72, issue 7‐B:3963.
Lai 2011 {published data only}
    1. Lai HL, Li YM. The effect of music on biochemical markers and self‐perceived stress among first‐line nurses: a randomized controlled crossover trial. Journal of Advanced Nursing 2011;67(11):2414‐24. - PubMed
Le Blanc 2007 {published data only}
    1. Blanc PM, Hox JJ, Schaufeli WB, Taris TW, Peeters MC. Take care! The evaluation of a team‐based burnout intervention program for oncology care providers. Journal of Appled Psychology 2007;92(1):213‐27. - PubMed
Lee 1994 {published data only}
    1. Lee S, Crockett MS. Effect of assertiveness training on levels of stress and assertiveness experienced by nurses in Taiwan, Republic of China. Issues in Mental Health Nursing 1994;15(4):419‐32. - PubMed
Leiter 2011 {published data only}
    1. Leiter MP, Laschinger HK, Day A, Oore DG. The impact of civility interventions on employee social behavior, distress, and attitudes. The Journal of Applied Psychology 2011;96(6):1258‐74. - PubMed
Lemaire 2011 {published data only}
    1. Lemaire JB, Wallace JE, Lewin AM, Grood J, Schaefer JP. The effect of a biofeedback‐based stress management tool on physician stress: a randomized controlled clinical trial. Open Medicine 2011;5(4):e154‐65. - PMC - PubMed
Li 2011 {published data only}
    1. Li HC, Wang LS, Lin YH, Lee I. The effect of a peer‐mentoring strategy on student nurse stress reduction in clinical practice. International Nursing Review 2011;58(2):203‐10. - PubMed
Lökk 2000 {published data only}
    1. Lökk J, Arnetz B. Impact of management change and an intervention program on health care personnel. Psychotherapy and Psychosomatics 2000;69(2):79‐85. - PubMed
    1. Lökk J, Arnetz B. Psychophysiological concomitants of organizational change in health care personnel: effects of a controlled intervention study. Psychotherapy and Psychosomatics 1997;66(2):74‐7. - PubMed
Lucas 2012 {published data only}
    1. Lucas B, Trick W, Evans A, Weinstein R, Varkey A, Smith J, et al. Emotional exhaustion, life stress, and perceived control among medicine ward attending physicians: A randomized trial of 2‐versus 4‐week ward rotations. Journal of Hospital Medicine 2011;6(4):S43‐4.
    1. Lucas BP, Trick WE, Evans AT, Mba B, Smith J, Das K, et al. Effects of 2‐ vs 4‐week attending physician inpatient rotations on unplanned patient revisits, evaluations by trainees, and attending physician burnout: a randomized trial. JAMA 2012;308(21):2199‐207. - PubMed
Mackenzie 2006 {published data only}
    1. Mackenzie CS, Poulin PA, Seidman‐Carlson R. A brief mindfulness‐based stress reduction intervention for nurses and nurse aides. Applied Nursing Research 2006;19(2):105‐9. - PubMed
Martins 2011 {published data only}
    1. Martins AE, Davenport MC, Valle MD, Lalla S, Dominguez P, Ormando L, et al. Impact of a brief intervention on the burnout levels of pediatric residents. Jornal de Pediatria 2011;87(6):493‐8. - PubMed
McElligott 2003 {published data only}
    1. McElligott D, Holz MB, Carollo L, Somerville S, Baggett M, Kuzniewski S, et al. A pilot feasibility study of the effects of touch therapy on nurses. Journal of the New York State Nurses Association 2003;34(1):16‐24. - PubMed
Melchior 1996 {published data only}
    1. Melchior ME, Philipsen H, Abu‐Saad HH, Halfens RJ, Berg AA, Gassman P. The effectiveness of primary nursing on burnout among psychiatric nurses in long‐stay settings. Journal of Advanced Nursing 1996;24(4):694‐702. - PubMed
Moody 2013 {published data only}
    1. Moody K, Kramer D, Santizo RO, Magro L, Wyshogrod D, Ambrosio J, et al. Helping the helpers: mindfulness training for burnout in pediatric oncology‐‐a pilot program. Journal of Pediatric Oncology Nursing 2013;30(5):275‐84. - PubMed
Moyle 2013 {published data only}
    1. Moyle W, Cooke M, O'Dwyer ST, Murfield J, Johnston A, Sung B. The effect of foot massage on long‐term care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial. BMC Nursing 2013;12:5. - PMC - PubMed
Norvell 1987 {published data only}
    1. Norvell N, Belles D, Brody S, Freund A. Worksite stress management for medical care personnel: results from a pilot program. Journal for Specialists in Group Work 1987;57:118‐26.
Oman 2006 {published data only}
    1. Oman D, Hedberg J, Thoresen CE. Passage meditation reduces perceived stress in health professionals: A randomized, controlled trial. Journal of Consulting and Clinical Psychology 2006;74(4):714‐9. - PubMed
Palumbo 2012 {published data only}
    1. Palumbo MV, Wu G, Shaner‐McRae H, Rambur B, McIntosh B. Tai Chi for older nurses: A workplace wellness pilot study. Applied Nursing Research 2012;25(1):54‐9. - PMC - PubMed
Peterson 2008 {published data only}
    1. Peterson U, Bergstrom G, Samuelsson M, Asberg M, Nygren A. Reflecting peer‐support groups in the prevention of stress and burnout: randomized controlled trial. Journal of Advanced Nursing 2008;63(5):506‐16. - PubMed
Proctor 1998 {published data only}
    1. Proctor R, Stratton‐Powell H, Tarrier N, Burns A. The impact of training and support on stress among care staff in nursing and residential homes for the elderly. Journal of Mental Health 1998;7(1):59‐71.
Razavi 1993 {published data only (unpublished sought but not used)}
    1. Razavi D, Delvaux N, Marchal S, Bredart A, Farvacques C, Paesmans M. The effects of a 24‐h psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study. European Journal of Cancer 1993;29A(13):1858‐63. - PubMed
Redhead 2011 {published data only}
    1. Redhead K, Bradshaw T, Braynion P, Doyle M. An evaluation of the outcomes of psychosocial intervention training for qualified and unqualified nursing staff working in a low‐secure mental health unit. Journal of Psychiatric and Mental Health Nursing 2011;18(1):59‐66. - PubMed
Reynolds 1993 {published data only}
    1. Reynolds S, Taylor E, Shapiro D. Session impact and outcome in stress management‐training. Journal of Community & Applied Social Psychology 1993;3(4):325‐37.
Romig 2012 {published data only}
    1. Romig MC, Latif A, Gill RS, Pronovost PJ, Sapirstein A. Perceived benefit of a telemedicine consultative service in a highly staffed intensive care unit. Journal of Critical Care 2012;27(4):426.e9‐16. - PubMed
Rowe 2006 {published data only}
    1. Rowe MM. Four‐year longitudinal study of behavioral changes in coping with stress. American Journal of Health Behavior 2006;30(6):602‐12. - PubMed
    1. Rowe MM. Teaching health‐care providers coping: results of a two‐year study. Journal of Behavioral Medicine 1999;22(5):511‐27. - PubMed
Saganha 2012 {published data only}
    1. Saganha JP, Doenitz C, Greten T, Efferth T, Greten HJ. Qigong therapy for physiotherapists suffering from burnout: A preliminary study. Journal of Chinese Integrative Medicine 2012;10(11):1233‐9. - PubMed
Salles 2013 {published data only}
    1. Salles A, Nandagopal K, Walton G. Belonging: A simple, brief intervention decreases burnout. Journal of the American College of Surgeons 2013;217(3):S116.
Schrijnemaekers 2003 {published data only}
    1. Schrijnemaekers VJ, Rossum E, Candel MJ, Frederiks CM, Derix MM, Sielhorst H, et al. Effects of emotion‐oriented care on work‐related outcomes of professional caregivers in homes for elderly persons. Journals of Gerontology Series B‐Psychological Sciences & Social Sciences 2003;58(1):S50‐7. - PubMed
Shapiro 2005 {published data only}
    1. Shapiro SL, Astin JA, Bishop SR, Cordova M. Mindfulness‐based stress reduction for health care professionals: results from a randomized trial. International Journal of Stress Management 2005;12(2):164‐76.
Sood 2011 {published data only}
    1. Sood A, Prasad K, Schroeder D, Varkey P. Stress management and resilience training among department of medicine faculty: A pilot randomized clinical trial. Journal of General Internal Medicine 2011;26(8):858‐61. - PMC - PubMed
Stanton 1988 {published data only}
    1. Stanton HE. Relaxation, deepening, and ego‐enhancement: a stress reduction "package". Australian Psychologist 1988;23:315‐22.
Tsai 1993 {published data only}
    1. Tsai SL, Crockett MS. Effects of relaxation training, combining imagery, and meditation on the stress level of Chinese nurses working in modern hospitals in Taiwan. Issues in Mental Health Nursing 1993;14(1):51‐66. - PubMed
Uchiyama 2013 {published data only}
    1. Uchiyama A, Odagiri Y, Ohya Y, Takamiya T, Inoue S, Shimomitsu T. Effect on mental health of a participatory intervention to improve psychosocial work environment: a cluster randomized controlled trial among nurses. Journal of Occupational Health 2013;55(3):173‐83. - PubMed
Von Baeyer 1983 {published data only}
    1. Baeyer C, Krause L. Effectiveness of stress management training for nurses working in a burn treatment unit. International Journal of Psychiatry in Medicine 1983;13(2):113‐26. - PubMed
West 1984 {published data only}
    1. West DJ Jr, Horan JJ, Games PA. Component analysis of occupational stress inoculation applied to registered nurses in an acute care hospital setting. Journal of Counseling Psychology 1984;31(2):209‐18.
Yamagishi 2008 {published data only}
    1. Yamagishi M, Kobayashi T, Nakamura Y. Effects of web‐based career identity training for stress management among Japanese nurses: a randomized control trial. Journal of Occupational Health 2008;50(2):191‐3. - PubMed
Yazdani 2010 {published data only}
    1. Yazdani M, Rezaei S, Pahlavanzadeh S. The effectiveness of stress management training program on depression, anxiety and stress of the nursing students. Iranian Journal of Nursing and Midwifery Research 2010;15(4):208‐15. - PMC - PubMed
Yung 2004 {published data only}
    1. Yung PM, Fung MY, Chan TM, Lau BW. Relaxation training methods for nurse managers in Hong Kong: a controlled study. International Journal of Mental Health Nursing 2004;13(4):255‐61. - PubMed

References to studies excluded from this review

Andersen 2010 {published data only}
    1. Andersen I, Borritz M, Christensen KB, Diderichsen F. Changing job‐related burnout after intervention‐‐a quasi‐experimental study in six human service organizations. Journal of Occupational and Environmental Medicine 2010;52(3):318‐23. - PubMed
Baldelli 2004 {published data only}
    1. Baldelli MV, Fabbo A, Costopulos C, Carbone G, Gatti R, Zucchl P. Is it possible to reduce job burnout of the health care staff working with demented patients?. Archives of Gerontology and Geriatrics. Supplement 2004;Suppl(9):51‐6. - PubMed
Bay 2010 {published data only}
    1. Bay PS, Ivy SS, Terry CL. The effect of spiritual retreat on nurses' spirituality: a randomized controlled study. Holistic Nursing Practice 2010;24(3):125‐33. - PubMed
Beddoe 2004 {published data only}
    1. Beddoe AE, Murphy SO. Does mindfulness decrease stress and foster empathy among nursing students?. The Journal of Nursing Education 2004;43(7):305‐12. - PubMed
Bormann 2006 {published data only}
    1. Bormann JE, Oman D, Kemppainen JK, Becker S, Gershwin M, Kelly A. Mantram repetition for stress management in veterans and employees: a critical incident study. Journal of Advanced Nursing 2006;53(5):502‐12. - PubMed
Bost 2006 {published data only}
    1. Bost N. The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses. Australian Journal of Advanced Nursing 2006;23(4):28‐33. - PubMed
Bourbonnais 2006a {published data only}
    1. Bourbonnais R, Brisson C, Vinet A, Vézina M, Abdous B, Gaudet M. Effectiveness of a participative intervention on psychosocial work factors to prevent mental health problems in a hospital setting. Occupational and Environmental Medicine 2006;63(5):335‐42. - PMC - PubMed
Bourbonnais 2006b {published data only}
    1. Bourbonnais R, Brisson C, Vinet A, Vézina M, Lower A. Development and implementation of a participative intervention to improve the psychosocial work environment and mental health in an acute care hospital. Occupational and Environmental Medicine 2006;63(5):326‐34. - PMC - PubMed
Brinkborg 2011 {published data only}
    1. Brinkborg H, Michanek J, Hesser H, Berglund G. Acceptance and commitment therapy for the treatment of stress among social workers: A randomized controlled trial. Behaviour Research and Therapy 2011;49(6‐7):389‐98. - PubMed
Bruneau 2004 {published data only}
    1. Bruneau BM, Ellison GT. Palliative care stress in a UK community hospital: evaluation of a stress‐reduction programme. International Journal of Palliative Nursing 2004;10(6):296‐304. - PubMed
Cámara Conde 2009 {published data only}
    1. Cámara Conde N, Carretero Román J, Sánchez Alfonso J, Reina Alonso CN. Effectiveness of a nurse cognitive behavioral intervention to reduce stress in health professionals in emergency extra hospital devices of SUMMA 112 [Spanish]. Nure Investigación 2010; Vol. 7, issue 45:1‐29.
Cohen 2005 {published data only}
    1. Cohen M, Gagin R. Can skill‐development training alleviate burnout in hospital social workers?. Social Work in Health Care 2005;40(4):83‐97. - PubMed
Cooke 2007 {published data only}
    1. Cooke M, Holzhauser K, Jones M, Davis C, Finucane J. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter. Journal of Clinical Nursing 2007;16(9):1695‐703. - PubMed
Cuneo 2011 {published data only}
    1. Cuneo CL, Curtis Cooper M‐R, Drew CS, Naoum‐Heffernan C, Sherman T, Walz K, et al. The effect of Reiki on work‐related stress of the registered nurse. Journal of Holistic Nursing 2011;29(1):33‐43. - PubMed
Cutshall 2011 {published data only}
    1. Cutshall SM, Wentworth LJ, Wahner‐Roedler DL, Vincent A, Schmidt JE, Loehrer LL, et al. Evaluation of a biofeedback‐assisted meditation program as a stress management tool for hospital nurses: a pilot study. Explore‐the Journal of Science and Healing 2011;7(2):110‐2. - PubMed
Davis 2005 {published data only}
    1. Davis C, Cooke M, Holzhauser K, Jones M, Finucane J. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses. Australasian Emergency Nursing Journal. 2005;8(1‐2):43‐50. - PubMed
Diaz‐Rodriguez 2011a {published data only}
    1. Diaz‐Rodriguez L, Arroyo‐Morales M, Cantarero‐Villanueva I, Fernandez‐Lao C, Polley M, Fernandez‐de‐las‐Penas C. The application of reiki in nurses diagnosed with burnout syndrome has beneficial effects on concentration of salivary IgA and blood pressure. Revista Latino‐Americana de Enfermagem 2011;19(5):1132‐8. - PubMed
Diaz‐Rodriguez 2011b {published data only}
    1. Diaz‐Rodriguez L, Arroyo‐Morales M, Fernandez‐de‐las‐Penas C, Garcia‐Lafuente F, Garcia‐Royo C, Tomas‐Rojas I. Immediate effects of reiki on heart rate variability, cortisol levels, and body temperature in health care professionals with burnout. Biological Research for Nursing 2011;13(4):376‐82. - PubMed
Drain 1991 {published data only}
    1. Drain CB, Dirks KR, Jenkins OC, Campbell JK, Finstuen K, Johnson GR. Comparison of two instructional methods on the levels of physiologic and psychologic stress as measured by blood cortisol and the State‐Trait Anxiety Inventory. Nurse Anesthesia 1991;2(4):172‐83. - PubMed
Dunn 2007 {published data only}
    1. Dunn PM, Arnetz BB, Christensen JF, Homer L. Meeting the imperative to improve physician well‐being: assessment of an innovative program. Journal of General Internal Medicine 2007;22(11):1544‐52. - PMC - PubMed
Edmonds 2012 {published data only}
    1. Edmonds C, Lockwood GM, Bezjak A, Nyhof‐Young J. Alleviating emotional exhaustion in oncology nurses: an evaluation of Wellspring's "Care for the Professional Caregiver Program". Journal of Cancer Education 2012;27(1):27‐36. - PubMed
Elo 2000 {published data only}
    1. Elo A‐L, Lehtomäki K, Nuutinen I, Hulkkonen A. Työterveyshenkilöstön stressin ja työuupumuksen ehkäisy : evaluoitu interventio. Työ Ja Ihminen 2000;14(2):395‐407.
Freedy 1994 {published data only}
    1. Freedy JR, Hobfoll SE. Stress inoculation for reduction of burnout: a conservation of resources approach. Anxiety, Stress, and Coping 1994;6:311‐25.
Galantino 2005 {published data only}
    1. Galantino ML, Baime M, Maguire M, Szapary PO, Farrar JT. Short Communication: Association of psychological and physiological measures of stress in health‐care professionals during an 8‐week mindfulness meditation program: mindfulness in practice. Stress and Health 2005;21(4):255‐61.
Gorter 2001 {published data only}
    1. Gorter RC, Eijkman MAJ, Hoogstraten J. A career counseling program for dentists: Effects on burnout. Patient Education and Counseling 2001;43(1):23‐30. - PubMed
Holt 2006 {published data only}
    1. Holt J, Mar C. Reducing occupational psychological distress: a randomized controlled trial of a mailed intervention. Health Education Research. 2006;21(4):501‐7. - PubMed
Isaksson Rø 2008 {published data only}
    1. Isaksson Rø KE, Gude T, Tyssen R, Aasland OG. Counselling for burnout in Norwegian doctors: One year cohort study. BMJ 2008;337(7679):a2004. - PMC - PubMed
Isaksson Rø 2010 {published data only}
    1. Isaksson Rø KE, Gude T, Tyssen R, Aasland OG. A self‐referral preventive intervention for burnout among Norwegian nurses: One‐year follow‐up study. Patient Education and Counseling 2010;78(2):191‐7. - PubMed
Italia 2008 {published data only}
    1. Italia S, Favara‐Scacco C, Cataldo A, Russo G. Evaluation and art therapy treatment of the burnout syndrome in oncology units. Psycho‐Oncology 2008;17(7):676‐80. - PubMed
Johansson 1991 {published data only}
    1. Johansson N. Effectiveness of a stress management program in reducing anxiety and depression in nursing students. Journal of American College Health 1991;40(3):125‐9. - PubMed
Ju 2006 {published data only}
    1. Ju ZM, Shi K, Wan Q. Effect of organizational intervention on job burnout of the Plateau nurses in Tibet. [Chinese]. Chinese Journal of Clinical Psychology 2006;14(6):654.
Kendall 2005 {published data only}
    1. Kendall J, Waddington C, Kendall C. The daily moment: a stress reduction program for cancer center staff. Journal of Oncology Management 2005;14(3):68‐71. - PubMed
Keyes 1988 {published data only}
    1. Keyes JB, Dean SF. Stress inoculation training for direct contact staff working with mentally retarded persons. Behavioral Residential Treatment 1988;3:315‐23.
Koivu 2012 {published data only}
    1. Koivu A, Saarinen PI, Hyrkas K. Does clinical supervision promote medical‐surgical nurses' well‐being at work? A quasi‐experimental 4‐year follow‐up study. Journal of Nursing Management 2012;20(3):401‐13. - PubMed
Kushnir 1994 {published data only}
    1. Kushnir T, Malkinson R, Ribak J. Teaching stress management skills to occupational and environmental health physicians and practitioners. A graduate‐level practicum. Journal of Occupational Medicine 1994;36(12):1335‐40. - PubMed
Kushnir 1998 {published data only}
    1. Kushnir T, Malkinson R, Ribak J. Rational thinking and stress management in health workers: a psychoeducational program. International Journal of Stress Management 1998;5(3):169‐78.
Lai 2012 {published data only}
    1. Lai HL, Liao KW, Huang C Y, Chen PW, Peng TC. Effects of music on immunity and physiological responses in healthcare workers: a randomized controlled trial. Stress Health 2013;29(2):91‐8. - PubMed
Lewis 1990 {published data only}
    1. Lewis DJ, McLin PA. Stress management: a program designed to facilitate coping. Journal of Continuing Education in Nursing 1990;21(5):212‐5. - PubMed
McCue 1991 {published data only}
    1. McCue JD, Sachs CL. A stress management workshop improves resident's coping skills. Archives of Internal Medicine 1991;151(11):2273‐7. - PubMed
Michie 1992 {published data only}
    1. Michie S. Evaluation of a staff stress management service. Health Manpower Management 1992;18(1):15‐7. - PubMed
Michie 1994 {published data only}
    1. Michie S, Sandhu S. Stress management for clinical medical students. Medical Education 1994;28(6):528‐33. - PubMed
Moeini 2011 {published data only}
    1. Moeini B, Hazavehei SMM, Hosseini Z, Aghamolaei T, Moghimbeigi A. The impact of cognitive‐behavioral stress management training program on job stress in Hospital nurses: Applying PRECEDE model. Journal of Research in Health Sciences 2011;11(2):114‐20. - PubMed
Murphy 1983 {published data only}
    1. Murphy LR. A comparison of relaxation methods for reducing stress in nursing personnel. Human Factors 1983;25(4):431‐40. - PubMed
Newsome 2010 {published data only}
    1. Newsome S. Effects of a mindfulness course on helping professionals in training: Examining levels of perceived stress, mindfulness, and self‐compassion. Dissertation Abstracts International Section A: Humanities and Social Sciences 2010;71(1‐A):97.
Newton 2006 {published data only}
    1. Newton JT, Allen CD, Coates J, Turner A, Prior J. How to reduce the stress of general dental practice: The need for research into the effectiveness of multifaceted interventions. British Dental Journal 2006;200(8):437‐40. - PubMed
Nhiwatiwa 2003 {published data only}
    1. Nhiwatiwa FG. The effects of single session education in reducing symptoms of distress following patient assault in nurses working in medium secure settings. Journal of Psychiatric & Mental Health Nursing 2003;10(5):561‐8. - PubMed
Nooryan 2011 {published data only}
    1. Nooryan K, Gasparyan K, Sharif F, Zoladl M. The effect of teaching emotional intelligence (EI) items on job related stress in physicians and nurses working in ICU wards in hospitals, Yerevan, Armenia. International Journal of Collaborative Research on Internal Medicine and Public Health 2011;3(10):704‐13.
Nooryan 2012 {published data only}
    1. Nooryan K, Gasparyan K, Sharif F, Zoladl M. Controlling anxiety in physicians and nurses working in intensive care units using emotional intelligence items as an anxiety management tool in Iran. International Journal of General Medicine 2012;5:5‐10. - PMC - PubMed
Orly 2011 {published data only}
    1. Orly S, Rivka B, Rivka E, Dorit SE. Are cognitive‐behavioral interventions effective in reducing occupational stress among nurses?. Applied Nursing Research 2012;25(3):152‐7. - PubMed
Ortega Ruiz 2008 {published data only}
    1. Ortega Ruiz C, Lopez Rios F, Gomez Martin S. Psychological intervention for professional burnout in the Palliative Care Unit at Gregorio Maranon University Hospital. Medicina Paliativa 2008;15(2):93‐7.
Panda 2010 {published data only}
    1. Panda M, Cunningham CJL. Addressing and preventing stress, fatigue and burnout in health care providers. Journal of General Internal Medicine 2010;25:S437‐8.
Pemberton 2008 {published data only}
    1. Pemberton E, Turpin PG. The effect of essential oils on work‐related stress in intensive care unit nurses. Holistic Nursing Practice 2008;22(2):97‐102. - PubMed
Petterson 1998 {published data only}
    1. Petterson IL, Arnetz BB. Psychosocial stressors and well‐being in health care workers. The impact of an intervention program. Social Science and Medicine 1998;47(11):1763‐72. - PubMed
Petterson 2006 {published data only}
    1. Petterson IL, Donnersvard HA, Lagerstrom M, Toomingas A. Evaluation of an intervention programme based on empowerment for eldercare nursing staff. Work and Stress 2006;20(4):353‐69.
Pipe 2009 {published data only}
    1. Pipe TB, Bortz JJ, Dueck A, Pendergast D, Buchda V, Summers J. Nurse leader mindfulness meditation program for stress management: a randomized controlled trial. Journal of Nursing Administration 2009;39(3):130‐7. - PubMed
Poulin 2008 {published data only}
    1. Poulin PA, Mackenzie CS, Soloway G, Karayolas E. Mindfulness training as an evidenced‐based approach to reducing stress and promoting well‐being among human services professionals. International Journal of Health Promotion and Education 2008;46(2):72‐80.
Prasad 2011 {published data only}
    1. Prasad K, Wahner‐Roedler DL, Cha SS, Sood A. Effect of a single‐session meditation training to reduce stress and improve quality of life among health care professionals: a "dose‐ranging" feasibility study. Alternative Therapies in Health and Medicine 2011;17(3):46‐9. - PubMed
Ridge 2011 {published data only}
    1. Ridge M, Wells J, Denny M, Cunningham J, Chalder T. Developing a web‐based stress management intervention for occupational support workers. Journal of Mental Health 2011;20(2):185‐97. - PubMed
Russler 1991 {published data only}
    1. Russler MF. Multidimensional stress management in nursing education. Journal of Nursing Education 1991;30(8):341‐6. - PubMed
Saadat 2012 {published data only}
    1. Saadat H, Snow DL, Ottenheimer S, Dai F, Kain ZN. Wellness program for anesthesiology residents: a randomized, controlled trial. Acta Anaesthesiologica Scandinavica 2012;56(9):1130‐8. - PubMed
Salyers 2011 {published data only}
    1. Salyers MP, Hudson C, Morse G, Rollins AL, Monroe‐DeVita M, Wilson C, et al. BREATHE: a pilot study of a one‐day retreat to reduce burnout among mental health professionals. Psychiatric Services 2011;62(2):214‐7. - PMC - PubMed
Sarid 2010 {published data only}
    1. Sarid O, Berger R, Segal‐Engelchin D. The impact of cognitive behavioral interventions on SOC, perceived stress and mood states of nurses. Procedia‐Social and Behavioral Sciences 2010;2(2):928‐32.
Schaufeli 1995 {published data only}
    1. Schaufeli WB. The evaluation of a burnout workshop for community nurses. Journal of Health and Human Services Administration 1995;18(1):11‐30. - PubMed
Shanafelt 2014 {published data only}
    1. Shanafelt TD, Kaups KL, Nelson H, Satele DV, Sloan JA, Oreskovich MR, et al. An interactive individualized intervention to promote behavioral change to increase personal well‐being in US surgeons. Annals of Surgery 2014;259(1):82‐8. - PMC - PubMed
Sharif 2004 {published data only}
    1. Sharif F, Armitage P. The effect of psychological and educational counselling in reducing anxiety in nursing students. Journal of Psychiatric and Mental Health Nursing 2004;11(4):386‐92. - PubMed
Sharif 2013 {published data only}
    1. Sharif F, Rezaie S, Keshavarzi S, Mansoori P, Ghadakpoor S. Teaching emotional intelligence to intensive care unit nurses and their general health: a randomized clinical trial. International Journal of Occupational and Environmental Medicine 2013;4(3):141‐8. - PubMed
Tang 2010 {published data only}
    1. Tang R, Tegeler C, Larrimore D, Cowgill S, Kemper KJ. Improving the well‐being of nursing leaders through healing touch training. Journal of Alternative and Complementary Medicine 2010;16(8):837‐41. - PubMed
Taylor 2001 {published data only}
    1. Taylor B, Lo R. The effects of Healing Touch on the coping ability, self esteem and general health of undergraduate nursing students. Complementary Therapies in Nursing & Midwifery 2001;7(1):34‐42. - PubMed
Te Brake 2001 {published data only}
    1. Brake HT, Gorter R, Hoogstraten J, Eijkman M. Burnout intervention among Dutch dentists: long‐term effects. European Journal of Oral Sciences 2001;109(6):380‐7. - PubMed
Van Dierendonck 1998 {published data only}
    1. Dierendonck D, Schaufeli W, Buunk BP. The evaluation of an individual burnout intervention program: the role of inequity and social support. Journal of Applied Psychology 1998;83(3):392‐407.
Villani 2011 {published data only}
    1. Villani D, Grassi A, Cognetta C, Toniolo D, Cipresso P, Riva G. Self‐help stress management training through mobile phones: An experience with oncology nurses. Psychological Services 2013;10(3):215‐22. - PubMed
Villani 2012 {published data only}
    1. Villani D, Grassi A, Cognetta C, Cipresso P, Toniolo D, Riva G. The effects of a mobile stress management protocol on nurses working with cancer patients: a preliminary controlled study. Studies in Health Technology and Informatics 2012;173:524‐8. - PubMed
Wassel 1993 {published data only}
    1. Wassel ML. A stress management incentive program for nursing staff during Operation Desert Storm. American Association of Occupational Health Nurses Journal 1993;41(8):393‐5. - PubMed
Wetzel 2011 {published data only}
    1. Wetzel CM, George A, Hanna GB, Athanasiou T, Black SA, Kneebone RL, et al. Stress management training for surgeons‐a randomized, controlled, intervention study. Annals of Surgery 2011;253(3):488‐94. - PubMed
Winefield 1998 {published data only}
    1. Winefield H, Farmer E, Denson L. Work stress management for women general practitioners: An evaluation. Psychology, Health and Medicine 1998;3(2):163‐70.
Yamagishi 2007 {published data only}
    1. Yamagishi M, Kobayashi T, Kobayashi T, Nagami M, Shimazu A, Kageyama T. Effect of web‐based assertion training for stress management of Japanese nurses. Journal of Nursing Management 2007;15(6):603‐7. - PubMed
Yong 2011 {published data only}
    1. Yong J, Kim J, Park J, Seo I, Swinton J. Effects of a spirituality training program on the spiritual and psychosocial well‐being of hospital middle manager nurses in Korea. Journal of Continuing Education in Nursing 2011;42(6):280‐8. - PubMed
Young 2001 {published data only}
    1. Young LE, Bruce A, Turner L, Linden W. Evaluation of mindfulness‐based stress reduction intervention. Canadian Nurse 2001;97(6):23‐6. - PubMed
Zimber 2001 {published data only}
    1. Zimber A, Rudolf A, Teufel S. A training program to reduce distress among geriatric caregivers [Arbeitsbelastungen in der Altenpflege reduzieren: Ein Trainingsprogramm für Mitarbeiter und Leitugskräfte]. Zeitschrift fur Gerontologie und Geriatrie 2001;34(5):401‐7. - PubMed

References to studies awaiting assessment

Khaghanizadeh 2008 {published data only}
    1. Khaghanizadeh M, Vafadar Z, Salari M, Ebadi A. Effects of suggestions' system on decreasing job burn out among the staff. Journal of Psychology 2008;12(46):213‐26.
Ruehl 2013 {published data only}
    1. Ruehl BD. The psychological and physical heatlh effects of written emotional expression in pediatric hematology/oncology, intensive care, and neonatal intensive care nursing staff. Alliant International University 2013:Psy.D.: 319 p.

References to ongoing studies

Gomez‐Gascon 2013 {published data only}
    1. Gomez‐Gascon T, Martin‐Fernandez J, Galvez‐Herrer M, Tapias‐Merino E, Beamud‐Lagos M, Mingote‐Adan JC. Effectiveness of an intervention for prevention and treatment of burnout in primary health care professionals. BMC Family Practice 2013;14(1):173. - PMC - PubMed
Niks 2013 {published data only}
    1. Niks IMW, Jonge J, Gevers JMP, Houtman ILD. Design of the DISCovery project: tailored work‐oriented interventions to improve employee health, well‐being, and performance‐related outcomes in hospital care. BMC Health Services Research 2013; Vol. 13. - PMC - PubMed
Spoor 2010 {published data only}
    1. Spoor E, Jonge J, Hamers JP. Design of the DIRECT‐project: interventions to increase job resources and recovery opportunities to improve job‐related health, well‐being, and performance outcomes in nursing homes. BMC Public Health 2010;10:293. - PMC - PubMed

Additional references

Awa 2010
    1. Awa WL, Plaumann M, Walter U. Burnout prevention: a review of intervention programs. Patient Education and Counseling 2010;78(2):184‐90. - PubMed
Beck 1961
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry 1961;4:561‐71. - PubMed
Benoliel 1990
    1. Benoliel JQ, McCorkle R, Georgiadou F, Denton T, Spitzer A. Measurement of stress in clinical nursing. Cancer Nursing 1990;13(4):221‐28. - PubMed
Bhui 2012
    1. Bhui KS, Dinos S, Stansfeld SA, White PD. A synthesis of the evidence for managing stress at work: a review of the reviews reporting on anxiety, depression, and absenteeism. Journal of Environmental and Public Health 2012 Feb 14 [epub ahead of print];2012:515874. - PMC - PubMed
Campbell 2001
    1. Campbell MK, Mollison J, Grimshaw JM. Cluster trials in implementation research: estimation of intra‐cluster correlation and sample size. Statistics in Medicine 2001;20(3):391‐9. - PubMed
Chiesa 2009
    1. Chiesa A, Serretti A. Mindfulness‐based stress reduction for stress management in healthy people: a review and meta‐analysis. Journal of Alternative and Complementary Medicine 2009;15(5):593‐600. - PubMed
Cohen 1983
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior 1983;24(4):385‐96. - PubMed
Cooper 1988
    1. Cooper CL, Sloane SJ, Williams S. The Occupational Stress Indicator. Windsor, Berkshire: NFER‐Nelson, 1988.
Cooper 2001
    1. Cooper CL, Dewe P, O'Driscoll MP. Organizational Stress. London: SAGE, 2001.
Deckard 1994
    1. Deckard G, Meterko M, Field D. Physician burnout: an examination of personal, professional, and organizational relationships. Medical Care 1994;32(7):745‐54. - PubMed
DeFrank 1987
    1. DeFrank RS, Cooper CL. Worksite stress management interventions: their effectiveness and conceptualisation. Journal of Managerial Psychology 1987;2(1):4‐10.
Derogatis 1976
    1. Derogatis L, Rickels K, Rock A. The SCL‐90 and MMPI: A step in the validation of a new self‐report scale. British Journal of Psychiatry 1976;128:280‐9. - PubMed
Derogatis 1983
    1. Derogatis LR, Melisaratos N. The Brief Symptom Inventory: an introductory report. Psychological Medicine 1983;13(3):595‐605. - PubMed
EPOC 2013
    1. Cochrane Effective Practice and Organisation of Care Group. Interrupted time series (ITS) analyses. epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/21%20Interrupted... (accessed 9 July 2014):1‐5.
Eurofound 2012
    1. Eurofound. Fifth European Working Conditions Survey. www.eurofound.europa.eu/publications/htmlfiles/ef1182.htm. Luxembourg, (accessed 7 July 2014):na.
Firth‐Cozens 1999
    1. Firth‐Cozens J, Payne R. Stress in Health Professionals. Chichester: Wiley, 1999.
Galbraith 2011
    1. Galbraith N, Brown K. Assessing intervention effectiveness for reducing stress in student nurses: quantitative systematic review. Journal of Advanced Nursing 2011;67(4):709‐21. - PubMed
Gilbody 2006
    1. Gilbody S, Cahill J, Barkham M, Richards D, Bee P, Glanville J. Can we improve the morale of staff working in psychiatric units? A systematic review. Journal of Mental Health 2006;15(1):7‐17.
Goldberg 1991
    1. Goldberg D, Williams P. A User's Guide to the General Health Questionnaire. London: NFER–Nelson, 1991.
Gray‐Toft 1981
    1. Gray‐Toft P, Anderson JG. The Nursing Stress Scale: Development of an instrument. Journal of Psychopathology and Behavioral Assessment 1981;3(1):11‐23.
Günthner 2010
    1. Günthner A, Batra A. Prevention of burnout by stress management (in German). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2012;55(2):183‐9. - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org. The Cochrane Collaboration.
HSE 2013
    1. Health and Safety Executive. Stress and Psychological Disorders in Great Britain 2013. www.hse.gov.uk/statistics/causdis/stress/stress.pdf (accessed 7 July 2014):na.
Jacobson 1996
    1. Jacobson BH, Aldana SG, Goetzel RZ, Vardell KD, Adams TB, Piedras RJ. The relationship between perceived stress and self‐reported illness‐related absenteeism. American Journal of Health Promotion 1996;11(1):54‐61. - PubMed
Jones 2000b
    1. Jones MC, Johnston DW. Reducing distress in first level and student nurses: a review of the applied stress management literature. Journal of Advanced Nursing 2000;32(1):66‐74. - PubMed
Karasek 1992
    1. Karasek R. Stress prevention through work reorganization: a summary of 19 international case studies. Conditions of Work Digest 1992;11:23‐42.
Karasek 1998
    1. Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. Journal of Occupational Health Psychology 1998;3(4):322‐55. - PubMed
Lamontagne 2007
    1. Lamontagne AD, Keegel T, Louie AM, Ostry A, Landsbergis PA. A systematic review of the job‐stress intervention evaluation literature, 1990‐2005. International Journal of Occupational and Environmental Health 2007;13(3):268‐80. [PUBMED: 17915541] - PubMed
Malgorzata 2010
    1. Małgorzata W, Merecz D, Drabek M. Stress prevention programs‐‐strategies, techniques, effectiveness. Part II. Organizational activities to prevent stress at work. Medycyna Pracy 2010;61(2):191‐204. - PubMed
Maslach 1982
    1. Maslach C. Burnout: the Cost of Caring. New York, NY: Prentice‐Hall, 1982.
Maslach 1996
    1. Maslach C, Jackson SE, Leiter SP. Maslach Burnout Inventory Manual. 3rd Edition. Palo Alto, CA: Consulting Psychologists Press, 1996.
McNeely 2005
    1. McNeely E. The consequences of job stress for nurses' health: time for a check‐up. Nursing Outlook 2005;53(6):291‐9. - PubMed
Michie 2003
    1. Michie S, Williams S. Reducing work related psychological ill health and sickness absence: a systematic literature review. Occupational and Environmental Medicine 2003;60(1):3‐9. - PMC - PubMed
Mimura 2003
    1. Mimura C, Griffiths P. The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review. Occupational and Environmental Medicine 2003;60(1):10‐5. - PMC - PubMed
Murphy 1995
    1. Murphy S. Stress management in work settings: a critical review of the health effects. American Journal of Health Promotion 1995;11(2):112‐35. - PubMed
Paris 2010
    1. Paris M Jr, Hoge MA. Burnout in the mental health workforce: A review. Journal of Behavioral Health Services & Research 2010;37(4):519‐28. - PubMed
Payne 1987
    1. Payne RL, Firth‐Cozens J. Stress in Health Professionals. Chichester: Wiley, 1987.
Petrie 2006
    1. Petrie A, Sabin C. Medical Statistics at a Glance. Malden (MA), USA: Blackwell Publishing Ltd, 2006.
Pulido‐Martos 2012
    1. Pulido‐Martos M, Augusto‐Landa J, Lopez‐Zafra E. Sources of stress in nursing students: A systematic review of quantitative studies. International Nursing Review 2012;59(1):15‐25.
Raiger 2005
    1. Raiger J. Applying a cultural lens to the concept of burnout. Journal of Transcultural Nursing 2005;16(1):71‐6. - PubMed
Ramirez 1996
    1. Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM. Mental health of hospital consultants: the effects of stress and satisfaction at work. Lancet 1996;347(9003):724‐8. - PubMed
Richardson 2008
    1. Richardson KM, Rothstein HR. Effects of occupational stress management intervention programs: a meta‐analysis. Journal of Occupational Health Psychology 2008;13(1):69‐93. - PubMed
Rohland 2004
    1. Rohland BM, Kruse GR, Rohrer JE. Validation of a single‐item measure of burnout against the Maslach Burnout Inventory among physicians. Stress and Health 2004;20:75‐79.
Rowe 1999
    1. Rowe MM. Teaching health‐care providers coping: results of a two‐year study. Journal of Behavioral Medicine 1999;22(5):511‐27. - PubMed
Schaufeli 2003
    1. Schaufeli WB, Buunk BP. Burnout: An overview of 25 years of research and theorizing. In: Schabracq MJ, Winnubst JAM, Cooper CL editor(s). The Handbook of Work and Health Psychology. 2nd Edition. Chichester: Wiley, 2003:383‐424.
Siegrist 2004
    1. Siegrist J, Starke D, Chandola T, Godin I, Marmot M, Niedhammer I, et al. The measurement of effort‐reward imbalance at work: European comparisons. Social Science and Medicine 2004;58(8):1483‐99. - PubMed
Spielberger 1970
    1. Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State‐Trait Anxiety Inventory (Self‐Evaluation Questionnaire). Palo Alto, CA: Mind Garden, 1970.
Van der Hek 1997
    1. Hek H, Plomp HN. Occupational stress management programmes: a practical overview of published effect studies. Occupational Medicine [London] 1997;47(3):133‐41. - PubMed
Van der Klink 2001
    1. Klink JJ, Blonk RW, Schene AH, Dijk FJ. The benefits of interventions for work‐related stress. American Journal of Public Health 2001;91(2):270‐6. - PMC - PubMed
van Wyk 2010
    1. Wyk BE, Pillay‐Van Wyk V. Preventive staff‐support interventions for health workers. Cochrane Database of Systematic Reviews 2010, Issue 3. [DOI: 10.1002/14651858.CD003541] - DOI - PubMed
Weinberg 2000
    1. Weinberg A, Creed F. Stress and psychiatric disorder in healthcare professionals and hospital staff. Lancet 2000;355(9203):533‐7. - PubMed
Williamson 1994
    1. Williamson AM. Managing stress in the workplace .2. the scientific basis (knowledge‐base) for the guide. International Journal of Industrial Ergonomics 1994;14(1‐2):171‐96.

References to other published versions of this review

Marine 2006
    1. Marine A, Ruotsalainen Jani H, Serra C, Verbeek Jos H. Preventing occupational stress in healthcare workers. Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd, 2006, issue 4. [DOI: 10.1002/14651858.CD002892.pub2] - DOI - PMC - PubMed
Serra 2000
    1. Serra C. Occupational health programmes for psychological stress in health care professionals. Cochrane Database of Systematic Reviews 2001, Issue 1,. [DOI: 10.1002/14651858.CD002892] - DOI

MeSH terms