Bagheri 2019.

Study characteristics
Methods	Study design: randomised controlled trial Study grouping: parallel group
Participants	Baseline characteristics Cognitive‐behavioural therapy + relaxation Age in years (mean ± SD): NR Sex (N (% female)): NR Sample size: 30 Years of experience (mean ± SD): NR Control (no intervention) Age in years (mean ± SD): NR Sex (N (% female)): NR Sample size: 30 Years of experience (mean ± SD): NR Overall Age in years (mean ± SD): 33.21 ± 7.04 Sex (N (% female)): 52 (88%) Sample size: 60 Years of experience (mean ± SD): NR Included criteria: nurses of both sexes, undergraduate and postgraduate education, all age groups, more than one year experience of clinical work, and working in different wards. Excluded criteria: having a chronic physical and psychological illness, taking drugs that affected the mental system, and loss of a first‐degree relative (father, mother, spouse or child) less than six months beforehand. It was also announced that one of the admission requirements was the principle of confinement to educational materials and issues raised by the group members in each session. Pretreatment: age and the variable burnout and its subscales before intervention were not significantly different in the two groups. Compliance rate: NR Response rate: NR Type of healthcare worker: various healthcare professionals including nurses 44 (75%), head nurses 10 (17%) and supervisors 5 (9%)
Interventions	Intervention characteristics Cognitive‐behavioural therapy + relaxation Type of the intervention: Intervention type 1 ‐ to focus one’s attention on the experience of stress Description of the intervention: at the beginning of each session, the objectives of the meeting were discussed, followed by a summing up of the previous meeting. A few minutes were then allocated to examining the homework from the previous meeting. The total therapeutic goals of the sessions were as follows: Session One: provides participants with the information that physiological, cognitive and behavioural processes interact with each other, that emotions have cognitive, physiological and behavioural components, and that all or most emotional responses have cognitive components; Session Two: empowers participants to receive the preliminary thoughts between the event and the emotional response and to write them in three columns, (I) the activating event, (II) beliefs or thoughts, and (III) emotional outcomes; Session Three: participants recognise the most important aspects of the cognitive theories of depression, anxiety and anger, become familiar with the characteristics of happy thoughts and how they can be reached, identify important cognitive distortions and discover their ability to recognise them in their thoughts. Finally, they must recognise their potential resistance to cognitive therapy, and learn strategies to deal with this resistance; Session Four: participants become acquainted with the point that their thoughts, just like emotional outcomes, have behavioural consequences, and that also their behavioural consequences may be ineffective; Session Five: focus' on the nature of schemas (central beliefs, thoughts, inefficient attitudes), and the relationship between schemas and happy thoughts, as well as on downward arrows for identifying schemas; Session Six: participants accept the principle that beliefs are volatile. Dominant cultural beliefs change throughout human history, and individuals also change their beliefs over time; Session Seven: focus' on the understanding that beliefs can be evaluated based on a number of criteria, that beliefs can have different degrees of efficiency, and that individuals use a set of beliefs to organise their behaviours that are, to some extent, consistent and compatible with other beliefs held by others. Consistency with other beliefs and the beliefs of other people has an implicit implication on the correctness of that belief. Session Eight: participants can apply a logical analysis to their beliefs. Logical analysis is the strongest technique for challenging people’s beliefs. An important aspect of logical analysis is that it has multiple ways of challenging beliefs in itself. Therefore, in this way, through the challenge to their beliefs participants tend to conclude that their beliefs are true or false. Session Nine: participants can “oppose” their negative beliefs, and in Session Ten they can create a practical application for themselves that will encourage them to continue practising techniques and approaches they have learnt throughout the program, and provide a program for continuity and sustainability of alteration. In order to achieve the proposed therapeutic goals, cognitive behavioural methods are taught to them. The number of sessions: 10 Duration of each session on average: 1.5 to 2 hours Duration of the entire intervention: 2.5 months Duration of the entire intervention short vs long: Short Intervention deliverer: Clinical psychiatrist with a Master degree. Intervention form: Group, face‐to‐face Control (no intervention) Type of the intervention: NA Description of the intervention: Meanwhile, no psychological intervention was performed on the control group. The number of sessions: NA Duration of each session on average: NA Duration of the entire intervention: NA Duration of the entire intervention short vs long: NA Intervention deliverer: NA Intervention form: NA
Outcomes	Maslach Burnout Inventory ‐ Emotional Exhaustion Outcome type: ContinuousOutcome Maslach Burnout Inventory ‐ Depersonalisation Outcome type: ContinuousOutcome Maslach Burnout Inventory ‐ Personal accomplishment (lack of) Outcome type: ContinuousOutcome
Identification	Sponsorship source: NR Country: Iran Setting: Hospital Comments: NR Authors name: Bagheri T Institution: Burn Research Centre, Iran University of Medical Sciences, Tehran, Email: mahnoushmomeni@gmail.com, momeni.m@iums.ac.ir Address: Burn Research Centre, Motahari Hospital, Rashid Yasami St, Vali‐e‐asr Ave, Tehran, Iran Time period: 2014
Notes	MBI‐EE included in analysis 1.1
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "They were assigned by the block randomization method to two groups of 30 subjects." Unclear how randomization took place.
Allocation concealment (selection bias)	Unclear risk	Quote: "Participants in the study included all nurses, head nurses and supervisors who met the inclusion criteria. They were assigned by the block randomization method to two groups of 30 subjects." Unable to judge whether participants or researchers could foresee the outcome of block randomization.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Participants not blinded.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Participants were not blinded whereas outcomes are self‐reported.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Not described.
Selective reporting (reporting bias)	High risk	Quote: "their annual evaluation. Outcome measures: A demographic questionnaire was used to collect personal, social and occupational data including age, sex, marital status, educational level, work experience, overtime worked per month, work area, work shift, number of children and economic status. Burnout in all participants in the study was determined by the Maslach Burnout Questionnaire. Maslach Burnout Questionnaire (MBQ). The Maslach Burnout Questionnaire has 22 items which measure burnout in the three dimensions of emotional exhaustion (9 questions), personality depersonalization (5 questions), and individual performance (8 questions). In order to determine the total burnout score, questions 1, 2, 3, 5, 6, 9, 10, 12, 13, 14, 15, 19, 21 and 22 are considered (+) and questions 4, 7, 8, 11, 16, 17, 18 and 20 (‐), and then aggregated. Results for burnout frequency will be 35 to 84 (high), ‐15 to 34 (average), ‐16 to ‐66 (low) and for burnout severity 40 to 98 (high), ‐18 to 39 (average) and ‐19 to ‐77 (low). The validity of the questionnaire was verified by Maslach and Jackson and its reliability was calculated through Cronbach’s alpha, which was reported between ‐0.60 and 0.08. In Sedghi’s research, the reliability was determined to be 0.78. 20 The Cronbach’s alpha was reported as 0.8 in the present study. Data collection. In the second stage, the nurses in the intervention group received group cognitive therapy. In the third stage, immediately after and one month after training completion, the burnout level of all participants in the study was determined and evaluated by the Maslach burnout inventory. Data analysis. Data were extracted" In the trial register it is mentioned that the primary outcome is the Job Stress Questionnaire and the General Health questionnaire a secondary outcome while those have not been reported. https://en.irct.ir/trial/8633
Other bias	Unclear risk	The response rate nor the compliance rate have been reported.