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Available online at ajdhs.com 

Asian Journal of Dental and Health Sciences 
Open Access to Dental and Medical Research 

Copyright  © 2024 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided 

the original author and source are credited 
 

 

 

Addressing Stress Among Healthcare Workers Using Mindfulness-Based 
Interventions 

Pallav Dave * 

Regulatory Compliance Analyst, Louisville, KY,40223, USA 

Article Info: 
_____________________________________________ 
Article History: 

Received   11 April 2024     
Reviewed  29 May 2024 
Accepted   19 June 2024 
Published 15 July 2024 

_____________________________________________ 
Cite this article as:  

Dave P, Addressing Stress Among Healthcare 
Workers Using Mindfulness-Based Interventions, 
Asian Journal of Dental and Health Sciences. 2024; 
4(2):56-60 

DOI: http://dx.doi.org/10.22270/ajdhs.v4i2.89    

_____________________________________________ 

*Address for Correspondence:   

Pallav Dave, Regulatory Compliance Analyst, 
Louisville, KY,40223, USA 

Abstract 
_________________________________________________________________________________________________________________ 

Stress is rampant among healthcare workers in different patient care settings. Healthcare workers 
are one of the groups that report high workplace stress levels with some studies reporting these 
levels to be as high as 70 to 90%. Stress was particularly rampant among healthcare workers during 
the COVID-19 pandemic because most workers were overwhelmed and could not provide the best 
care for their patients. Stress among healthcare workers is likely to continue because the work 
conditions that contribute to this high level of stress are becoming more rampant. For instance, 
demanding work, long and unpredictable work hours, and high administrative burdens continue to 
be rampant. Other factors such as an increase in the number of people affected by multiple chronic 
conditions and the aging workers are also putting a lot of strain on healthcare and among healthcare 
workers. Considering the staff shortages, taking care of people with numerous needs can increase 
stress levels which explains why healthcare workers report high levels of stress. Considering the 
negative effects of stress on healthcare workers' health and well-being, it is important to have 
effective interventions in place to deal with this stress such as mindfulness training. Research has 
shown that mindfulness-based interventions have a lot of potential when it comes to addressing 
work-related stress. It also helps to deal with depression and anxiety. To increase effectiveness, 
mindfulness training can also be incorporated as part of wellness programs in the workplace. 

keywords: mindfulness training, mindfulness-based interventions, stress, burnout, healthcare 
workers  

 

Introduction  

Stress is rampant in healthcare with statistics 
indicating that healthcare workers in different patient care 
settings are significantly affected. According to a study by 
Prasad et al. high levels of stress were reported by healthcare 
workers during the COVID-19 pandemic.1 In a 2022 survey 
involving 11,964 nurses, 70% reported experiencing high levels 
of stress at the height of the COVID-19 pandemic.2 Similarly, 
high levels of stress were reported by physicians during the 
same time period.3 Although high levels of stress were reported 
among healthcare professionals during the COVID-19 
pandemic, stress is not new to healthcare. High levels of stress 
were reported among healthcare workers prior to the COVID-
19 pandemic with some studies reporting stress levels of up to 
90%.4,5 Research indicates that stress among healthcare 
workers is likely to continue increasing as working conditions 
that contribute to this stress become more rampant.6 

Different factors explain why high levels of stress are 
reported among healthcare workers. Healthcare workers 
report higher levels of stress because they are constantly 
exposed to stressful and emotional situations that involve a lot 
of emotional labor. Emotional labor in this case means the 
ability to manage emotions while working with patients and 
ensuring that one’s emotions do not affect the performance of 
their duties.7 Emotional labor has been shown to have an effect 
on the physical and mental health of healthcare professionals.8 
Healthcare workers who perform emotional labor for extended 
periods of time are more likely to report emotional exhaustion 
and an increased likelihood of burnout. Exposure to human 

suffering and working under pressure are also factors that 
contribute to higher levels of stress among healthcare workers. 
Emotional workers are also more prone to pressure because of 
the increased risk of exposure. This was particularly witnessed 
during the COVID-19 pandemic where fear of exposure to 
disease was one of the factors that led to high stress levels that 
were reported at the time.1 Healthcare workers also report 
high-stress levels because of demanding work, long and 
unpredictable work hours, financial strain, and high 
administrative burdens.  

Stress has a profound effect on healthcare workers 
affecting both their physical and mental health. The toll that 
comes with workplace stress has been reported to lead to 
burnout when it extends for long periods.1 Physically, stress 
increases the risk of migraines, irritable bowel syndrome, and 
rashes.9 Workplace stress also increases the likelihood of 
emotional exhaustion, lower professional efficacy, 
depersonalization, reduced timely-decision making, 
inadequacy, lower work efficiency, and reduced quality of 
care.10 Mentally, workplace stress has been attributed to higher 
levels of anxiety and depression.10 All these are likely to affect 
the ability of healthcare workers to deliver care. For instance, 
healthcare workers' stress has been attributed to increased risk 
of medical errors, decreased patient satisfaction, increased risk 
of hospital-acquired infections, and increased length of hospital 
stay.11 Overall, workplace stress affects care provision. It 
increases the risk of safety incidents and lowers overall quality 
of care.  

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Pallav Dave                                                                                                                                  Asian Journal of Dental and Health Sciences. 2024; 4(2):56-60 

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The profound effects of workplace stress on 
healthcare workers necessitate the need for interventions that 
can rectify the situation and improve their overall health and 
well-being. Several interventions have been suggested to 
address workplace stress over the years. For instance, rest and 
relaxation is highly encouraged as a measure of addressing 
workplace stress. Other interventions that are encouraged to 
deal with stress are breathing exercises, meditation, healthy 
eating, adopting healthy sleeping habits, and physical exercise. 
Although these measures have been shown to alleviate the 
effect of stress, they may not be able to adequately address long-
term stress. This necessitates evidence-based approaches such 
as mindfulness training to deal with workplace stress. The 
effectiveness of mindfulness training in reducing workplace 
stress among healthcare workers has been established through 
research.12 Mindfulness training can be tailored to different 
healthcare settings which makes it suitable to address stress in 
different groups of healthcare workers. 

This review seeks to establish whether mindfulness 
training is an effective measure of addressing stress among 
healthcare workers. It explores different types of mindfulness 
training and their effectiveness when it comes to dealing with 
workplace stress.  

Types of Mindfulness-Based Interventions 

Mindfulness is a concept that originates from the 
Buddhist tradition and which is cultivated through a number of 
different meditation practices.13 Mindfulness refers to a form of 
attention training that seeks to direct an individual’s attention 
to focus on everyday, present-moment experiences.14 This is 
done with an attitude of curiosity, acceptance, and non-
judgmental. Mindfulness is done with different aims with one of 
the objectives being to train people to respond to situations in 
a manner that is reflective instead of responding to them 
automatically.13 As noted in the definition, mindfulness seeks to 
direct an individual’s attention to focus on present-moment 
experiences. With this definition in mind, mindfulness can be 
defined as a psychological state that aims to promote an 
individual’s awareness.15 It puts one in a state of being aware 
which significantly improves their well-being. Mindfulness is 
also associated with psychological well-being because elements 
of mindfulness such as awareness and non-judgmental 
acceptance of one’s present-moment experiences are regarded 
as effective against factors that cause psychological distress 
such as fear, anxiety worry among others.16 Mindfulness can be 
acquired through training and different forms of Mindfulness-
Based Interventions (MBI). These interventions aim to enhance 
a person’s proximal skills such as non-judgmental attention 
control which play a crucial role in reducing symptoms that may 
affect one’s psychological well-being.17 In addition to improving 
one’s psychological well-being, mindfulness training enables an 
individual to be able to recognize their thoughts, emotions, and 
physical sensations better. The ability to recognize one’s 
thoughts and emotions better is what enables an individual to 
respond to stressful situations in a better manner. Mindfulness 
also increases resilience towards stressful situations. This is 
why mindfulness training is recommended as an effective 
strategy for dealing with stress among healthcare workers.  

Different types of mindfulness-based interventions 
exist. Some of the most popular are mindfulness-based stress 
reduction (MBSR), mindfulness-based cognitive therapy 
(MBCT), mindfulness-based art therapy (MBAT), mindfulness-
based pain management (MBPM), acceptance and commitment 
therapy (ACT), and dialectical behavior therapy. Mindfulness-
based stress reduction (MBSR) is attributed to Jon Kabat-Zinn. 
He developed the therapy in 1979. MBSR is a structured group 
program whose main focus is to ensure an individual acquires 
mindfulness progressively.18 The program takes approximately 
8 to 10 weeks and can comprise 10 to 40 participants. The 

groups that are involved in the program can be homogenous or 
heterogenous when it comes to the disorders or problems of 
participants. The average session of MBSR takes approximately 
2.5 hours for every single session.18 These sessions are done 
weekly. Additionally, the program involves additional single all-
day sessions per course that are done on a weekend. Exercises 
and topics relating to mindfulness are covered in each session. 
The instructor guides the group in these exercises during each 
session. Some of these exercises are yoga, meditation, breathing 
techniques, group dialogue, and gratitude journaling.19 
Mindfulness during stressful situations and social interactions 
are also done during these sessions. MBSR also involves 
homework assignments which are done on a daily basis. These 
assignments take an average of 45 minutes and are in the form 
of mindful yoga, meditation practice, and applying mindfulness 
in different situations in life.  

Research has documented that MBSR is an effective 
form of mindfulness training when it comes to reducing stress, 
dealing with depression, and addressing anxiety. MBSR is 
effective when it comes to dealing with stress because it 
reduces emotional reactivity and enhances an individual’s 
cognitive appraisal.19 In addition to addressing stress and other 
psychological disorders, MBSR can be used to alleviate 
symptoms of chronic pain in patients dealing with different 
conditions.19,20 Therefore, MBSR can be used to increase the 
ability of individuals to cope with distress and disability more 
so for people going through devastating conditions such as 
chronic pain and psychological disorders.  

Another form of mindfulness training that is 
widespread in healthcare is mindfulness-based cognitive 
therapy (MBCT). MBCT integrates principles of cognitive 
therapy into the mindfulness-based stress reduction (MBSR) 
program to address recurring episodes of depression.21 MBCT 
was designed to prevent relapse in people with recurrent 
depression and was found to reduce the risk of relapse 
significantly. MBCT reduces depression relapse by making 
people more aware of their thoughts, feelings, and bodily 
sensations and relating to them differently.22 It teaches 
important skills that allow individuals to dissociate from 
habitual cognitive routines more so thoughts that trigger 
depression which reduces the risk of relapse and recurrence. 
Different techniques are employed when using MBCT. They 
include mindfulness meditation, yoga, mindfulness stretching, 
and mindfulness practices. Similar to MBSR, techniques such as 
mindfulness meditation seek to teach individuals how to 
consciously pay attention to their thoughts and feelings without 
being judgmental.  

Just like MBSR, MBCT is also an 8-week program with 
weekly sessions lasting 2 hours each. MBCT also encompasses 
different forms of meditation practices which can be classified 
as both formal and informal. Some of these practices are sitting 
and walking meditations, guided body scans, breathing 
exercises, mindful movement, and focused awareness of daily 
routine activities.23 Each session aims to bring attention to 
breathing or bodily sensations. As such, the meditations are 
guided with similar intent. Although the sessions are done in 
groups, emphasis is also placed on developing an independent 
practice and expanding mindfulness to mental events including 
thoughts and emotions. Similar to MBSR, MBCT also 
encompasses homework assignments which are 45-minute 
sessions done on a daily basis with a focus on mindfulness 
activities.23 These are done using guided meditation recordings. 
Although MBCT is similar to MBSR, there are some sessions that 
differ. For instance, MBCT encompasses cognitive therapy and 
psychoeducation about depression.23 With regard to cognitive 
therapy, MBCT teaches people that attempting to resist or avoid 
unwanted thoughts and feelings does not make these feelings 
go away. Instead, it intensifies them which increases the risk of 



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depression. However, unlike cognitive behavioral therapy, 
MBCT does not place a lot of emphasis on changing or altering 
thought content. Instead, emphasis is placed on individual 
awareness of the relationship they have with their thoughts and 
feelings.24 As a result, the aim is to enhance a person’s 
metacognitive awareness. In addition to cognitive therapy and 
psychoeducation, MBCT also provides individuals with the 
necessary support that can lead to better well-being. The 
support can entail listening to music, taking walks, or even 
taking a bath.  

The ability of MBCT to enhance a person’s 
metacognitive awareness can explain why it is an effective 
technique for dealing with depression, anxiety, stress, and other 
psychological problems.25,26 The fact that MBCT makes a person 
more aware of their thoughts and feelings means that they are 
able to identify early warning signs of depression and other 
psychological problems before the symptoms worsen. Besides, 
research has established that MBCT is effective in dealing with 
recurring depression with patients who have used the method 
showing significant improvement.26  

In addition to MBSR and MBCT, there are other 
interventions of mindfulness training such as mindfulness-
based pain management, mindfulness-based art therapy, 
acceptance and commitment therapy, and dialectical behavior 
therapy all of which have been shown to have varying forms of 
success when it comes to dealing with different issues. For 
instance, mindfulness-based pain management is an 
intervention that is used to help people manage chronic pain.27 
The intervention has also been shown to improve depression 
symptoms and overall quality of life.27 Mindfulness-based art 
therapy is a mindfulness intervention that integrates 
mindfulness practices and art.28 It allows an individual to 
engage in creative art as a way of self-exploration. This is done 
in a mindful manner in that the art is performed in a curious, 
kind, non-judgmental manner, and when an individual is aware 
of the present moment.28 Research shows that mindfulness-
based art therapy can be used to reduce emotional distress, 
anxiety, pain, and depression. Acceptance and commitment 
therapy (ACT) is an additional form of mindfulness intervention 
that encourages people to address negative thoughts, feelings, 
and sensations while providing guidance to commit to value-
based actions.29 Dialectical behavior therapy encourages 
people to develop healthy ways of coping with stress and other 
negative emotions. Combining different forms of mindfulness 
interventions can have a positive impact on stress and negative 
emotions among healthcare workers. Different mindfulness 
interventions can help healthcare workers address stress, 
depression, negative emotions, and other psychological issues 
that result from their work.  

Mindfulness as a Measure to Address Stress 
among Healthcare Workers 

Healthcare workers continue to face profound 
workplace stress despite the numerous measures that have 
been put in place to address it. Organizational measures such as 
reducing workload, and improving workplace relationships 
have not been entirely effective in dealing with stress among 
healthcare workers because of the nature of work.30 For 
instance, during COVID-19, healthcare workers experienced 
significant loss which impacted their ability to provide care and 
increased stress levels. The feeling of not being able to 
adequately provide care because of limited resources and an 
overwhelming number of patients contributed to higher stress 
levels during this period. Besides, the fear of getting infected 
and seeing their colleagues lose their lives because of the virus 
also led to higher stress levels. Newer problems also continue 
to emerge in healthcare and there are inadequate measures to 
address them. These factors explain why workplace stress is 

prevalent among healthcare workers and why more measures 
are needed to address it. Addressing workplace stress is 
important because it has been shown to influence patient 
health and safety.31 Workplace stress also increases the cost of 
care and affects the health and well-being of healthcare 
workers. Therefore, using measures that are shown to work in 
addressing stress is vital for overall good outcomes and well-
being. 

Research has shown that mindfulness training has a 
lot of potential when it comes to addressing stress and other 
psychological problems such as depression and anxiety among 
healthcare workers.32,33 Combining different mindfulness-
based interventions reduces overall stress, depression, and 
anxiety in both clinical and non-clinical populations. According 
to a meta-analysis done by Ruiz-Fernandez et al. mindfulness 
therapies were shown to be beneficial to healthcare 
professionals in helping them to manage and reduce stress.13 

Mindfulness was also found effective in increasing self-
compassion among healthcare personnel. Mindfulness 
programs were also found to be effective in helping workers to 
respond effectively to stressors in the workplace.34 The study 
which included different workers in healthcare such as 
dieticians, physicians, social workers, nurses, clinical trainees, 
and health researchers utilized MBST to provide mindfulness 
training. Some of the skills that were offered are mindfulness, 
relaxation response, positive affect-generating meditation, and 
guided imagery or hypnosis.34 The training resulted in 
significant changes in stress levels, empathy, mindfulness, and 
resilience despite the fact that it was offered online. A similar 
study done by Shapiro et al. on medical and premedical 
students had similar findings.35 The study showed that 
mindfulness was an effective intervention in reducing 
psychological distress including depression and anxiety. 
Mindfulness training also increased overall empathy levels and 
overall well-being.  

Mindfulness training helps to reduce stress through a 
number of mechanisms. Mindfulness influences two stress 
pathways in the brain which leads to changes in brain 
structures and activity in regions that deal with attention and 
emotion regulation.36,37 These changes influence how a person 
copes with stressful situations or regulate their emotions. 
Mindfulness-based interventions such as MBCT and MBSR also 
help to reduce stress by changing how people react to negative 
thoughts and emotions.38 People who engage in mindfulness 
training tend to focus on the present and are less likely to put 
much thought into negative thoughts and emotions. Reducing 
focus on negative thoughts enables individuals to find positive 
ways to cope. In healthcare, there are different situations that 
increase negative thoughts and emotions. Stressful workplace 
conditions can increase negative thoughts and emotions among 
healthcare workers elevating stress levels. Using mindfulness 
training to address these negative emotions can lead to positive 
outcomes. Besides, mindfulness training emphasises the need 
to focus on the awareness of the present moment. As such, it can 
increase attention and concentration on the present moment 
reducing worry about past situations or future situations. Doing 
so is likely to increase focus which can lead to better decision-
making.  

Mindfulness training can also be used to improve the 
health and well-being of healthcare workers. Healthcare 
workers often encounter situations that are likely to impact 
their health and well-being.39 (Sue, 2019). Mindfulness helps to 
foster empathy and self-compassion. Empathy and self-
compassion are important when dealing with events that are 
likely to trigger stress.  

The importance of mindfulness-based interventions 
in addressing stress is established in research. However, it is 
important to take note of the existing limitations and how these 



Pallav Dave                                                                                                                                  Asian Journal of Dental and Health Sciences. 2024; 4(2):56-60 

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limitations could impact their overall efficiency. First, 
mindfulness does not take into account that people react 
differently to different interventions and techniques and what 
may be effective for one person may not be effective for 
another.40 Because people may react differently to these 
techniques, their effectiveness may be different. Secondly, the 
use of mindfulness interventions by people with a limited 
understanding of mental health may have negative effects. 
Limited understanding of mental health may limit positive 
outcomes associated with mindfulness-based interventions. 
Mindfulness can also increase stress response, negative 
emotions, and dissociation in some individuals leading to an 
opposite effect than what was expected.41 Besides, the cost-
effectiveness of mindfulness-based interventions in large 
organizational settings is yet to be established. Although the 
interventions are generally considered to be effective because 
they are administered in groups, the cost can be higher if 
administered to individuals.33 Therefore, there is a need to 
consider the potential limitations of mindfulness interventions 
and put measures in place that can minimize negative effects.  

Conclusion 

Stress is rampant among healthcare workers in 
different patient care settings. Even before the COVID-19 
pandemic, stress was still prevalent with high levels reported 
among healthcare workers. During Covid-19, the number of 
healthcare workers affected by stress almost tripled raising 
concern about the effective measures that could be used to 
address the problem. Stress among healthcare workers is likely 
to continue because the work conditions that contribute to this 
high level of stress are becoming more rampant. For instance, 
demanding work, long and unpredictable work hours, and high 
administrative burdens continue to be rampant. Besides, the 
aging population and the number of people affected by chronic 
conditions are continuing to rise. Such factors put a lot of 
demands on healthcare workers which explains the high level 
of stress in this population. Considering the negative effects of 
stress on healthcare workers' health and well-being, it is 
important to have effective interventions in place to deal with 
this stress. Mindfulness training has been shown to have 
potential when it comes to addressing stress among healthcare 
workers. In addition to reducing stress, it has been shown to 
improve empathy, self-compassion, and reduce depression and 
anxiety. Different mindfulness-based interventions can be used 
but MBSR and MBCT are the most commonly used when dealing 
with stress. Mindfulness training can also be incorporated as 
part of wellness programs in the workplace to increase 
accessibility to more healthcare professionals.  

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Pallav Dave                                                                                                                                  Asian Journal of Dental and Health Sciences. 2024; 4(2):56-60 

[60]                                                                                                                                                                                                                                              AJDHS.COM 

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