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Journal of Integrative Medicine: Volume , 2019   Issue 3,  Pages: 173-180

DOI: 10.1016/j.joim.2019.03.009
Research Article
Burnout in the emergency department: randomized controlled trial of an attention-based training program
1. Pádraic J Dunne (Trinity Translational Medicine Institute, Trinity College, Dublin D08 W9RT, Ireland E-mail: padraicdunne@rcsi.com)
2. Julie Lynch (Research Department, Royal College of Physicians of Ireland, Dublin D02 E434, Ireland )
3. Lucia Prihodova (Research Department, Royal College of Physicians of Ireland, Dublin D02 E434, Ireland )
4. Caoimhe O’Leary (Research Department, Royal College of Physicians of Ireland, Dublin D02 E434, Ireland )
5. Atiyeh Ghoreyshi (Department of Innovation, Fitbit Inc. San Francisco, California 94105, USA )
6. Sharee A Basdeo (Health Research Institute, Main Building, University of Limerick, Limerick V94 X5K6, Ireland )
7. Donal J Cox (Health Research Institute, Main Building, University of Limerick, Limerick V94 X5K6, Ireland )
8. Rachel Breen (Research Department, Royal College of Physicians of Ireland, Dublin D02 E434, Ireland )
9. Ali Sheikhi (Health Research Institute, Main Building, University of Limerick, Limerick V94 X5K6, Ireland )
10. áine Carroll (Health Service Executive, Dr Steevens’ Hospital, Steevens’ Lane, Dublin D08 W2A8, Ireland )
11. Cathal Walsh (Health Service Executive, Dr Steevens’ Hospital, Steevens’ Lane, Dublin D08 W2A8, Ireland )
12. Geraldine McMahon (Department of Emergency Medicine, St. James’s Hospital, Dublin D08 W9RT, Ireland )
13. Barry White (National Centre for Hereditary Coagulation Disorders, St. James’s Hospital, Dublin D08 W9RT, Ireland )

ABSTRACT 

Background: Burnout (encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.
Objective: The aim of this study was to apply an attention-based training (ABT) program to reduce burnout among emergency multidisciplinary team (MDT) members from a large urban hospital. 
Design, setting, participants and interventions: Emergency MDT members were randomized to either a no-treatment control or an intervention group. Intervention group participants engaged in a four session (4 h/session) ABT program over 7 weeks with a practice target of 20 min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device. 
Main outcome measures: The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters.
Results: The ABT program resulted in a significant reduction (P < 0.05; T1 [one week before intervention] vs T3 [follow-up at one week after intervention]) in burnout, specifically, emotional exhaustion, with an effect size (probability of superiority) of 59%. Similar reductions were observed for stress (P < 0.05) and anxiety (P < 0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression. 
Conclusion: This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group.
Trial registration: ClinicalTrials.gov identifier NCT02887300.
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Please cite this article as:
Pádraic J Dunne, Julie Lynch, Lucia Prihodova, Caoimhe O’Leary, Atiyeh Ghoreyshi, Sharee A Basdeo, Donal J Cox, Rachel Breen, Ali Sheikhi, áine Carroll, Cathal Walsh, Geraldine McMahon, Barry White. Burnout in the emergency department: randomized controlled trial of an attention-based training program. J Integr Med. 2019; (3): 173-180.
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