Summary of findings 2. An intervention in which one's attention is away from the experience of stress compared to no intervention/wait list/placebo/no stress‐reduction intervention for stress reduction in healthcare workers.
| An intervention in which one's attention is away from the experience of stress compared to no intervention/wait list/placebo/no stress‐reduction intervention for stress reduction in healthcare workers | ||||
| Patient or population: healthcare workers Setting: various healthcare settings Intervention: an intervention in which one's attention is away from the experience of stress Comparison: no intervention/wait list/placebo/no stress‐reduction intervention | ||||
| Outcomes | Anticipated absolute effects* (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | What happens |
| Risk with an intervention in which one's attention is away from the experience of stress | ||||
| Stress symptoms (follow‐up up to and including 3 months after end of intervention) | SMD 0.55 lower (0.70 lower to 0.40 lower) | 2366 (35 RCTs) | ⊕⊕⊝⊝ Low 1 | On the short term, an intervention in which one's attention is away from the experience of stress may result in a reduction in stress symptoms. The standardized mean difference translates back to 6.8 fewer (8.6 fewer to 4.9 fewer) points on the MBI‐emotional exhaustion scale2. |
| Stress symptoms (follow‐up > 3 to 12 months after end of intervention) | SMD 0.41 lower (0.79 lower to 0.03 lower) | 427 (6 RCTs) | ⊕⊕⊝⊝ Low 1 | On the medium term, an intervention in which one's attention is away from the experience of stress may result in a reduction in stress symptoms. The standardized mean difference translates back to 5.0 fewer (9.7 fewer to 0.4 fewer) points on the MBI‐emotional exhaustion scale2. |
| Stress symptoms (follow‐up >12 months after end of intervention) | ‐ | (0 RCTs) | ‐ | No studies reported the long‐term effect on stress symptoms of focusing one's attention away from the experience of stress. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; SMD: standardized mean difference | ||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||
1 The certainty of the evidence was downgraded by two levels for very serious risk of bias (bias arising from the randomisation process and lack of blinding; i.e. performance bias) in combination with some inconsistency and suspicion of publication bias.
3 The MBI‐emotional exhaustion scale has a total score of 54 and we used the mean score (23.6) and standard deviation (12.2) of the control healthcare workers population in Fiol DeRoque 2021 as reference for interpreting the effect sizes. A score below 18 points is regarded as a low score on emotional exhaustion and a score above 36 as a high score on emotional exhaustion (Maslach 1996).