Abstract: Background: The level of occupational stress of nurses working in intensive and critical
care units is high. Although many studies have assessed the effectiveness of
stress management interventions among intensive and critical care nurses, the methodological
quality of these studies remains unclear.
Purpose: The purpose of this review was to summarize and appraise the methodological
quality of primary studies on interventions for management of occupational
stress among intensive and critical care nurses.
Methods: This review was reported according to the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature
search was conducted to identify primary studies that assessed the effectiveness
of interventions in managing occupational stress among intensive and critical care
nurses using multiple databases from January 2009 to June 2019.
Results: Twelve studies published between 2011 and 2019 were eligible for inclusion.
These included studies were classified as being of good or fair quality. The consensus
across the included studies was that, compared with control condition, cognitivebehavioural
skills training and mindfulness-based intervention were more effective in
reducing occupational stress among intensive and critical care unit nurses.
Conclusion: Further research should focus on methodologically strong studies by
blinding the outcome assessors, using Randomized Controlled Trial (RCT) design with
an active control group, using standardized assessment tools, and reporting enough
details about the stress management intervention-related adverse events.
Relevance to clinical practice: This review demonstrates the need for high methodological
quality studies to rigorously evaluate the effectiveness of stress management
interventions before it can be recommended for use in clinical practice to reduce
stress in intensive and critical care unit nurses. In addition, attention should be given
to developing research protocols that place more emphasis on interventions aimed at
the organization level to address the growing problem of occupational stress among
intensive and critical care nurses.