Effect of Balint Group on Burnout and Self-efficacy of Nurse Leaders in China: A Randomised Controlled Trial

Background: Burnout is common among nurses and is related to negative outcomes of medical care. This study aimed to explore the effectiveness of Balint group activities in burnout reduction among nurse leaders in a Chinese hospital.

Methods: This was a randomised controlled trial with a pre- and post-test. A total of 80 nurse leaders were randomly assigned to either a Balint group (n=40) or a non-Balint group (n=40). Participants in the Balint group completed Balint training for a period of three months. Participants in both groups completed the Maslach Burnout Inventory-Human Services Survey (MBI) and the General Self-Efficacy Scale (GSES) at the beginning and end of the study（three months later ）. Balint group members also completed the Group Climate Questionnaire-Short Format the end of the study（three months later ）.

Study Overview

• Status: Completed
• Conditions: Burnout; Self Efficacy
• Intervention / Treatment: Other: Balint group activities

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 100044
      • Shan Qu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: ADULT; OLDER_ADULT; CHILD
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. nurse leaders in clinical departments
2. voluntary participation

Exclusion Criteria:

a. previous participation in Balint groups

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: SINGLE_GROUP
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Balint group; Participants in the Balint group completed Balint training for a period of three months.	Other: Balint group activities; A Balint group is a working form that focuses on the professional doctor-patient relationship. Participants in the Balint group completed Balint training for a period of at least three months, which included two lectures and 10 small group discussion sessions held once a month for one hour at a time (on Thursdays from 12 to 1 PM). Balint group is a closed group including one to two group leaders and six to twelve participants, with sessions lasting 60 to 90 minutes.
NO_INTERVENTION: non-Balint group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale emotional exhaustion (MBI-EE)	Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The EE subscale evaluates the feeling of excessive emotional stress and exhaustion due to work, which is characterized by mental, emotional, and physical exhaustion	The first time for participants in both groups was assessed the MBI-EE questionnaire at baseline.
Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale emotional exhaustion (MBI-EE)	Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The EE subscale evaluates the feeling of excessive emotional stress and exhaustion due to work, which is characterized by mental, emotional, and physical exhaustion	The second time for participants in both groups was assessed the MBI-EE questionnaire through Balint group activities completion, 3 months later
Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale depersonalization (MBI-DP)	Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The DP subscale measures unsympathetic and impersonal response to patients, and is regarded as a form of alienation.	The first time for participants in both groups was assessed the MBI-DP questionnaire at baseline.
Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale depersonalization (MBI-DP)	Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The DP subscale measures unsympathetic and impersonal response to patients, and is regarded as a form of alienation.	The second time for participants in both groups was assessed the MBI-DP questionnaire through Balint group activities completion, 3 months later
Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale personal accomplishment (MBI- PA)	Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The PA subscale assesses work-related ability and sense of accomplishment .	The first time for participants in both groups was assessed the MBI-PA questionnaire at baseline.
Maslach Burnout Inventory-Human Services Survey (MBI-HSS) subscale personal accomplishment (MBI- PA)	Maslach Burnout Inventory-Human Services Survey (MBI-HSS) includes 22 items across three domains: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). The scoring range for each item is 0 (never felt) to 6 (felt every day). The PA subscale assesses work-related ability and sense of accomplishment .	The second time for participants in both groups was assessed the MBI-PA questionnaire through Balint group activities completion, 3 months later

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The General Self-Efficacy Scale (GSES)	The General Self-Efficacy Scale (GSES) is a 10-item scale used to measure individuals' overall self-confidence in dealing with different environmental challenges or unprecedented situations. Participants are asked to rate 10 questions by choosing one of four response options: 1 (completely incorrect), 2 (almost incorrect), 3 (relatively correct), or 4 (completely correct). A higher score indicates a higher level of general self-efficacy.	The first time for participants in both groups was assessed the GSES questionnaire at baseline.
The General Self-Efficacy Scale (GSES)	The General Self-Efficacy Scale (GSES) is a 10-item scale used to measure individuals' overall self-confidence in dealing with different environmental challenges or unprecedented situations. Participants are asked to rate 10 questions by choosing one of four response options: 1 (completely incorrect), 2 (almost incorrect), 3 (relatively correct), or 4 (completely correct). A higher score indicates a higher level of general self-efficacy.	The second time for participants in both groups was assessed the GSES questionnaire through Balint group activities completion, 3 months later

Collaborators and Investigators

• Sponsor: Peking University People's Hospital
• Investigators: Principal Investigator: Shan Qu, Qu, Peking University People's Hospital

Study record dates

Study Major Dates

• Study Start (ACTUAL): July 1, 2020
• Primary Completion (ACTUAL): January 1, 2022
• Study Completion (ACTUAL): January 1, 2022

Study Registration Dates

• First Submitted: January 17, 2023
• First Submitted That Met QC Criteria: January 27, 2023
• First Posted (ACTUAL): February 8, 2023

Study Record Updates

• Last Update Posted (ACTUAL): February 8, 2023
• Last Update Submitted That Met QC Criteria: January 27, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Burnout, Psychological
• Other Study ID Numbers: balint2022

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No