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Emotional freedom techniques on nurses’ stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial

Citation: Berna Dincer, Demet Inangil, Emotional freedom techniques on nurses’ stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial, EXPLORE, 2020, ISSN 1550-8307, https://doi.org/10.1016/j.explore.2020.11.012
(http://www.sciencedirect.com/science/article/pii/S1550830720303839)

Full Paper is available for free access at the above first link.

Abstract

Background and Objective
Infectious disease outbreaks pose psychological challenges to the general population, and especially to healthcare workers. Nurses who work with COVID-19 patients are particularly vulnerable to emotions such as fear and anxiety, due to fatigue, discomfort, and helplessness related to their high intensity work. This study aims to investigate the efficacy of a brief online form the Emotional Freedom Techniques (EFT) in the prevention of stress, anxiety, and burnout in nurses involved in the treatment of COVID patients.

Methods
The study is a randomized controlled trial. It complies with the guidelines prescribed by the Consolidated Standards of Reporting Trials (CONSORT) checklist. It was conducted in a COVID-19 department at a university hospital in Turkey. We recruited nurses who care for patients infected with COVID-19 and randomly allocated them into an intervention group (n = 35) and a no-treatment control group (n = 37). The intervention group received one guided online group EFT session.

Results
Reductions in stress (p < .001), anxiety (p < .001), and burnout (p < .001) reached high levels of statistical significance for the intervention group. The control group showed no statistically significant changes on these measures (p > .05).

Conclusions
A single online group EFT session reduced stress, anxiety, and burnout levels in nurses treating COVID-19.

Craig’s Notes:

This recently published research was a wonderful discovery. As I write this in December of 2020 in the U.S. we are amidst the highest peak of positive tests and deaths resulting from the COVID 10 pandemic. It is having an incredibly stressful effect on public physical and emotional health and mortality, politics, finances/business, families, educational/school systems and of course frontline healthcare systems and healthcare workers.

With the understanding that with surging numbers of COVID-19 infected sick individuals in hospitals, nurses were being significantly exposed not only to the virus but to the associated stress, anxiety and potential burnout related to the pandemic which has now been around and growing for the past 12 months. Documenting easy to administer approaches to decrease these emotional and psychological consequences for healthcare workers who are typically overwhelmed and overworked as a result of the pandemic is of extreme importance for being able to provide consistent high quality health care.

According to the authors’ discussion: “The current COVID-19 outbreak has led to major changes in the healthcare system worldwide. Increased workload, long working hours, discomfort caused by personal protection equipment, fear of contamination, and most importantly obscurity, may lead to burnout.11,32 Nurses play a key role in fighting the COVID-19 infection. Their physical and psychological safety is of paramount importance. According to an analysis of 14 studies conducted on healthcare professionals who care for COVID-19 patients, serious levels of anxiety and depression symptoms were detected in up to 14.5% of the participants.”

This study, conducted in a COVID-19 department at a university hospital in Turkey. Study participants included nurses who care for patients infected with COVID-19 and were randomly allocated into a single 20 minute online EFT session intervention group of 35 and a no-treatment control group (n = 37). The purpose of the study was see if EFT could have a positive effect on nurses’ stress, anxiety, and burnout levels who were working in a COVID-19 unit.

The results of this randomized control trial were quite remarkable and in line with many previous related EFT studies for stress and anxiety and burnout in other populations. The results by the authors indicate:  Reductions in stress (p < .001), anxiety (p < .001), and burnout (p < .001) reached high levels of statistical significance for the intervention group. The control group showed no statistically significant changes on these measures (p > .05).

What is quite remarkable is that this was performed:

  1. Online with no risk of COVID-19 interpersonal transmission
  2. The results were achieved with a SINGLE 20 minute EFT session
  3. The results were HIGHLY significant compared to the control group

Also noteworthy is the statistician was blinded and the authors declared no conflicts of interest.

Of course this is a pilot study with only 72 nurses and no longer term follow-up performed to measure the sustenance of the results achieved. That being said, online group EFT delivery offers a simple to administer, cost-efficient and very effective method for supporting health care workers that are on the frontline of the COVID-19 pandemic and its availability should in my opinion be ramped up as soon as is feasible.

Craig Weiner, DC