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Ann. psychophysiol. 
ISSN 2412-3188 (Online)|2410-1354 (Print) 

APP| Published By AEIRC| https://doi.org/10.29052/2412-3188.v10.i2.2023.84-90 

Original Article 

Mindfulness Intervention Mitigates 
Trauma-Induced Cognitive Decline  
Among Healthcare Professionals 
Shereen1, Syeda Farah Batool2, Ayesha Maryam1 & Syed Akmal Sultan3 

1Department of Medical Technology, Malir University of Science & Technology, Karachi-
Pakistan. 
2Department of Psychology, Malir University of Science & Technology, Karachi-Pakistan. 
3Department of Orthopaedic Surgery & Physiotherapy, Shaheed Mohtarma Benazir Bhutto 
Institute of Trauma, Karachi-Pakistan. 
. 

Abstract 
Background: Healthcare professionals are vulnerable to trauma-induced cognitive 
decline due to their exposure to traumatic events in the workplace. Mindfulness-
based interventions have shown promise in mitigating stress and improving 
cognitive function. This study aimed to investigate the impact of a mindfulness 
intervention on trauma-induced cognitive decline among healthcare professionals. 
Methodology: A comparative cohort study was conducted with 54 participants 
randomly assigned to intervention (n=25) and control (n=24) groups. The 
intervention group received an eight-week mindfulness program, while the 
control group received no intervention. Cognitive function, burnout, and 
perceived stress were assessed using pre- and post-intervention standardized 
measures. 
Results: The intervention group demonstrated significant improvements in 
cognitive function, evidenced by increased Montreal Cognitive Assessment 
(MOCA) scores (p < 0.01). Additionally, significant reductions were observed in 
emotional exhaustion and depersonalization scores, along with decreased 
perceived stress levels (p < 0.01). The control group showed marginal 
improvements in cognitive function but experienced a significant increase in 
depersonalization (p < 0.05). Both groups exhibited reduced perceived stress post-
intervention. 
Conclusion: The findings suggest that mindfulness practices effectively prevent 
cognitive impairment in trauma patients and enhance their cognitive and 
emotional well-being. 

Keywords 
Mindfulness Intervention, Trauma-Induced Cognitive Decline, Healthcare 

Professionals, Cognitive Function, Burnout, Perceived Stress 

Citation: Shereen, Batool SF. Mindfulness 
Intervention Mitigates Trauma-Induced 
Cognitive Decline Among Healthcare 
Professionals. APP. 2023;10(2): 84-90 

Corresponding Author Email: 
ayesha@maliruniversity.edu.pk 

DOI: 10.29052/2412-3188.v10.i2.2023.84-90 

Received 16/10/2023 

Accepted 26/11/2023 

Published 01/12/2023 

Copyright © The Author(s). 2023. This is an 
open-access article distributed under the 
terms of the Creative Commons Attribution 
4.0 International License, which permits 
unrestricted use, distribution, and 
reproduction in any medium, provided the 
original author and source are credited.  

Funding: The author(s) received no 
specific funding for this work. 

Conflicts of Interests: The authors have 
declared that no competing interests exist. 

https://doi.org/10.29052/2412-3188.v10.i2.2023.
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85 

ISSN 2412-3188 (Online)| 2410-1354 (Print) 

APP| Published By AEIRC| Volume 10 Issue 2 

Introduction 
Healthcare professionals face significant 
challenges in their daily work, often exposed 
to traumatic events that can profoundly 
impact their cognitive function and mental 
well-being1. Instances such as patient deaths, 
medical errors, and encounters with violence 
can lead to trauma-induced cognitive decline 
among healthcare professionals, manifesting 
as memory impairment, diminished 
concentration, and reduced attention span. 
These consequences not only affect job 
performance but also jeopardize overall 
well-being2. 

In response to these challenges, 
mindfulness-based interventions have 
emerged as a promising avenue for 
mitigating stress and enhancing cognitive 
function across diverse populations3. It 
cultivates a nonjudgmental and accepting 
stance toward the present moment4. 
Through this practice, individuals can 
bolster attention, reduce emotional 
reactivity, and foster cognitive flexibility5. 

Within the healthcare domain, an increasing 
body of research has explored the potential 
of mindfulness-based interventions in 
alleviating trauma-induced cognitive 
decline among professionals. Notable 
studies, such as the randomized controlled 
trial led by Duarte et al., have demonstrated 
the efficacy of mindfulness-based stress 
reduction programs in improving cognitive 
function and mitigating burnout symptoms 
among healthcare workers6. Similarly, 
investigations by Shute et al. have 
underscored the benefits of mindfulness 
interventions in ameliorating cognitive 
function and alleviating symptoms of post-
traumatic stress disorder (PTSD) in 
healthcare professionals exposed to 
workplace trauma7. 

Despite these promising findings, further 
exploration is warranted to delineate the 
long-term effects of mindfulness practices on 
cognitive function in healthcare 
professionals. Moreover, tailored 
interventions that effectively support the 
mental health and well-being of this critical 
workforce need to be developed. Thus, this 
study seeks to contribute to this growing 
body of knowledge by examining the impact 
of mindfulness on trauma-induced cognitive 
decline among healthcare professionals and 
elucidating pathways for enhancing their 
resilience and cognitive functioning. 

Methodology 
Study Design 
This comparative cohort study aimed to 
investigate the efficacy of a mindfulness-
based intervention in mitigating trauma-
induced cognitive decline among healthcare 
professionals. 

Setting 
Participants were recruited from various 
healthcare settings, including hospitals, 
clinics, and other healthcare facilities, 
ensuring a diverse and representative 
sample of healthcare professionals who had 
experienced traumatic events in the 
workplace. 

Participants 
Healthcare professionals who had 
encountered traumatic events in their 
workplace environments and were at risk of 
developing trauma-induced cognitive 
decline were included in the study. 
Participants were selected based on 
predefined eligibility criteria, including 
professional experience in healthcare 
settings and exposure to traumatic incidents. 
Recruitment methods involved outreach 
through institutional channels, professional 
networks, and targeted advertisements. 



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Group Allocation 
A total of 50 participants were randomly 
allocated to either the intervention or control 
group. The intervention group received a 
mindfulness-based program delivered by a 
trained instructor over eight weeks, 
consisting of mindfulness practices such as 
meditation, body scan, and mindful 
breathing. The control group received no 
intervention during the study period. 

Variables: 
The primary variable of interest was 
cognitive function, which was assessed 
using the Montreal Cognitive Assessment 
(MoCA), a standardized cognitive test 
widely used to evaluate various cognitive 
domains, including memory, attention, 
language, and visuospatial abilities. The 
maximum score is 30 points, and a score of 
26 or above is generally considered normal. 
Scores below 26 may indicate mild cognitive 
impairment or other cognitive deficits. 

Secondary variables encompassed 
psychological measures, including 
symptoms of burnout, stress, and 
depression. Perceived stress was measured 
using the Perceived Stress Scale (PSS), a 10-
item scale designed to assess the degree of 
uncontrollable and unpredictable situations 
experienced in the past month. The PSS 
items are rated on a 5-point scale ranging 
from 0 (never) to 4 (very often), with higher 
scores indicating greater levels of perceived 
stress. 

The Maslach Burnout Inventory (MBI), a 22-
item questionnaire, was employed to 
evaluate burnout levels across three scales: 
emotional exhaustion (EE), 
depersonalization (DP), and professional 
achievement (PA). Each subscale consists of 
a series of statements to which respondents 
rate their agreement on a Likert scale (e.g., 
from 0 to 6). Higher scores on the subscales 
of Emotional Exhaustion and 

Depersonalization and lower scores on 
Personal Accomplishment indicate higher 
levels of burnout. 

Data Sources/Measurement  
Data collection involved multiple sources 
and instruments. Cognitive function was 
evaluated using standardized tests 
administered at baseline, post-intervention, 
and during follow-up assessments. Self-
report measures of burnout, stress, and 
depression were obtained through validated 
scales (MBI and PSS). Demographic and 
employment-related information was also 
collected to characterize the study 
population comprehensively. 

Bias  
To minimize bias, standardized instruments 
were used for outcome assessment, and 
random allocation of participants to 
intervention groups was employed. 

Study Size 
Sample size calculation determined that 50 
participants would provide adequate 
statistical power to detect meaningful 
differences in cognitive function between 
intervention groups, considering a 
significance level of 0.05, a power of 80%, 
and a moderate effect size (Cohen's d = 0.5). 

Quantitative Variables 
Quantitative variables included age and 
outcome measures (e.g., cognitive test 
scores, burnout subscale scores, perceived 
stress levels). 

Statistical Methods 
Descriptive statistics summarized 
participant characteristics, while inferential 
statistics, such as paired sample t-tests and 
analysis of variance (ANOVA), were used to 
compare outcomes within and between 
groups. A significance level of p < 0.05 was 
applied. Statistical analyses were conducted 
using SPSS version 22.0. 



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Ethical Considerations 
The study adhered to ethical principles, 
including obtaining informed consent from 
participants, ensuring confidentiality, and 
obtaining ethical approval from institutional 
review boards. 

Result 
Participants 

The study included a total of 54 enrolled 

subjects, with 25 individuals allocated to the 

intervention group and 24 to the control 

group. Among the participants, a 

predominant proportion were females, 

representing 87.04% of the total cohort.  

The majority of participants had attained 

secondary education (55.56%), with 

significant representation from the Islamic 

faith (55.56%), followed by Hindu (18.52%) 

and Christian (16.67%) religions. All 

participants were nurses (90.74%), and the 

majority resided in rural areas (53.70%), with 

a considerable proportion from lower socio-

economic backgrounds (46.30%). 

Descriptive Data 

Table 1 provides a comprehensive overview 

of the demographic characteristics of the 

enrolled subjects, encompassing gender 

distribution, educational attainment, 

religious affiliation, occupation, residence, 

and socio-economic status. 

Outcome Data 

Table 2 presents the pre and post-

intervention comparison of cognitive 

function, burnout inventory, and perceived 

stress scale scores in both study groups.  

The outcomes are measured using the 

Montreal Cognitive Assessment (MOCA) for 

cognitive function, the Maslach Burnout 

Inventory (MBI) for burnout assessment 

(specifically emotional exhaustion, 

depersonalization, and personal 

accomplishment), and the Perceived Stress 

Scale (PSS) for stress evaluation. 

Main Results 

The intervention group exhibited significant 

improvements across all measured 

outcomes. Specifically, participants in the 

intervention group demonstrated a notable 

increase in MOCA scores, indicating 

enhanced cognitive function (p<0.01).  

Additionally, significant reductions were 

observed in MBI scores for emotional 

exhaustion and depersonalization, as well as 

a significant decrease in PSS scores (p<0.01).  

In contrast, the control group displayed 

marginal improvements in cognitive 

function but exhibited no significant changes 

in emotional exhaustion and personal 

accomplishment. However, a significant 

increase in depersonalization scores was 

noted (p<0.05).  

Similar to the intervention group, the control 

group also experienced a significant 

reduction in perceived stress (p<0.01). 



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Table 1: Demographic data of the enrolled subjects. 

Variables 
Total 

(N=54) 
Intervention 

Group (N=25) 
Control 

Group (N=24) 

Gender 
Male 02(3.70) 01(4.00) 01(4.17) 

Female 47(87.04) 24(96.00) 23(95.83) 

Education 

None - - - 

Primary 09(16.67) 05(20.00) 04(16.67) 

Secondary 30(55.56) 15(60.00) 15(62.50) 

Higher Secondary 10(18.52) 05(20.00) 05(20.83) 

Religion 

Islam 30(55.56) 15(60.00) 15(62.50) 

Hindu 10(18.52) 10(40.00) 10(41.67) 

Christian 09(16.67) 04(16.00) 05(20.83) 

Occupation 
Nurse 49(90.74) 24(96.00) 24(100) 

Midwives - - - 

Residence 
Rural 29(53.70) 15(60.00) 14(58.33) 

Urban 20(37.04) 10(40.00) 10(41.67) 

Socio-economic Status 

Lower 25(46.30) 13(52.00) 12(50.00) 

Middle 17(31.48) 09(36.00) 08(33.33) 

Upper 07(12.96) 04(16.00) 03(12.50) 

Table 2: Pre and Post-Intervention Comparison of Cognitive Function and 

Psychological Measures. 

Variables 

Intervention Group (N=25) Control Group (N=24) 

p-value2Pre Post 
p-value1

Pre Post 
p-value1

Mean ± SD Mean ± SD 

MOCA 24.8±2.1 26.0±2.0 <0.01 24.5± 2.3 24.8±2.2 <0.01 0.034 

MBI 

EE 29.8±4.1 28.0±3.2 <0.01 30.2±4.5 30.2±3.5 0.012 0.012 

D 15.2±2.0 14.5±1.8 <0.01 15.5±2.2 15.8±2.0 0.027 <0.01 

PA 33.2±3.2 34.0±3.5 0.015 32.8±3.5 32.5±3.0 0.018 0.018 

PSS 28.5±3.5 25.0±2.8 <0.01 28.1±5.35 28.0±3.2 <0.01 <0.01 
MOCA-Montreal Cognitive Assessment; MBI-Maslach Burnout Inventory; PSS-Perceived Stress Scale; EE-
Emotional Exhaustion; D-Depersonalization; PA-Personal Accomplishment 
1Intergroup comparison before and after intervention 
2Between group comparison after intervention

Discussion 
The findings of this study highlight the 
positive effects of a mindfulness-based stress 
reduction intervention on various outcomes 
related to cognitive function, burnout, and 
perceived stress among healthcare 
professionals.  

Firstly, the intervention group demonstrated 
significant improvements in cognitive 
function, as evidenced by the notable 
increase in Montreal Cognitive Assessment 
scores. This suggests that engaging in 
mindfulness practices may enhance 
cognitive abilities, such as memory, 
attention, and executive function, among 
healthcare professionals who have 



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ISSN 2412-3188 (Online)| 2410-1354 (Print) 

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experienced traumatic events in the 
workplace8,9. 

Furthermore, participants in the intervention 
group experienced significant reductions in 
emotional exhaustion and 
depersonalization, as measured by the MBI. 
These findings are in line with the existing 
literature10, 11 indicating that the mindfulness 
intervention effectively mitigates symptoms 
of burnout, which are commonly observed 
among healthcare professionals due to the 
demanding nature of their work and 
exposure to traumatic events. 

Additionally, the significant decrease in 
perceived stress, as indicated by the PSS 
scores, suggests that the mindfulness 
intervention may help healthcare 
professionals manage stress more effectively 
and improve their overall psychological 
well-being, which is also reported in other 
studies12-14. This finding is particularly 
noteworthy given the high levels of stress 
commonly experienced by healthcare 
professionals, which can adversely affect job 
performance and quality of life.  

In contrast, the control group exhibited only 
marginal improvements in cognitive 
function and no significant changes in 
emotional exhaustion and personal 
accomplishment. However, a concerning 
increase in depersonalization scores was 
noted in the control group, which may 
indicate a worsening of interpersonal 
relationships and emotional detachment 
among healthcare professionals. 

Overall, these results underscore the 
potential benefits of mindfulness-based 
interventions in reducing trauma-induced 
cognitive decline and promoting well-being 
among healthcare professionals. By 
enhancing cognitive function, reducing 
burnout symptoms, and alleviating 
perceived stress, MBSR interventions have 

the potential to improve the overall 
resilience and mental health of healthcare 
professionals in high-stress work 
environments. 

Conclusion 
The findings suggest that mindfulness 
interventions improve trauma-induced 
cognitive decline and well-being among 
healthcare professionals.  

Acknowledgment 
The authors are grateful to the Koohi Goth 
Hospital and the healthcare workers who 
took part in the study.  

References 
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Shaikh Muhammad Tariq. Emotional stress
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