Navigating Burnout: The Mediating Role of Mindfulness and the Mediterranean Lifestyle in Fostering Job Satisfaction and Well-being

1. Introduction

Burnout has become a prevalent issue in modern workplaces, affecting individuals across various professions and industries [1]. Defined as a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress, burnout not only detrimentally impacts individual well-being but also carries significant consequences for organizational productivity and effectiveness [2,3]. Amidst growing concerns about burnout, there is an increasing recognition of the importance of exploring factors that may mitigate its onset and alleviate its effects.

Mindfulness, characterized by present-moment awareness and nonjudgmental acceptance of one's experiences, has garnered attention as a potential resilience-building strategy against burnout [4]. Studies have suggested that mindfulness practices can enhance psychological well-being, reduce stress, and promote adaptive coping mechanisms [5,6]. Furthermore, the Mediterranean lifestyle, encompassing dietary patterns rich in fruits, vegetables, whole grains, and olive oil, along with regular physical activity, sleep quality, nature relatedness, and social engagement, has been associated with numerous health benefits, including reduced risk of cardiovascular diseases and improved mental health outcomes [7,8].

While existing research has independently examined the relationships between burnout, mindfulness, job satisfaction, and lifestyle factors such as the Mediterranean diet, there remains a gap in understanding how these variables interact within the context of workplace well-being. Controversies exist regarding the efficacy of mindfulness interventions in workplace settings, with some studies reporting significant improvements in stress management and job satisfaction, while others suggest more modest effects [9,10]. Similarly, although observational studies have highlighted the health-promoting effects of the Mediterranean lifestyle, questions remain regarding its applicability to diverse populations and its specific mechanisms of action [11,12].

Considering these considerations, this cross-sectional study aims to investigate the mediating role of mindfulness and the Mediterranean lifestyle in fostering job satisfaction and well-being among employees. By examining the interplay between burnout, mindfulness, lifestyle choices, and workplace outcomes, this research seeks to contribute to a deeper understanding of the mechanisms underlying employee well-being. It is anticipated that the findings of this study will shed light on potential interventions and strategies to mitigate burnout and enhance job satisfaction in organizational settings. Ultimately, by promoting employee well-being, organizations can cultivate a healthier and more productive workforce, thereby fostering a positive organizational culture and achieving long-term success.

This study aims to address the gap in existing literature by elucidating the mediating pathways through which mindfulness and the Mediterranean lifestyle influence job satisfaction and well-being in the workplace. By integrating perspectives from psychology, nutrition, and organizational behavior, this research seeks to offer valuable insights into the complex dynamics of burnout and workplace well-being.

2. Materials and Methods

2.1. Design and Procedure

The study's design and procedure involved the implementation of a cross-sectional research design, utilizing an online survey conducted in both Greek and English languages through the Sogolytics online survey tool [13]. The initial two survey questions acted as criteria for inclusion and exclusion, ensuring participants' acknowledgment of the study's terms and conditions and confirming their age fell within the specified range of 18 to 65 years. Distribution of the survey occurred through direct messaging on various social media platforms, supplemented with follow-up reminders to enhance participant engagement and facilitate addressing any inquiries or concerns regarding the study. This combined approach leverages the benefits of both web-based and e-mailed questionnaires [14-16].

Before initiating the data collection process, the research's objectives and hypotheses were clearly delineated, providing a comprehensive framework for subsequent analysis and interpretation of the research findings. The final sample meeting the inclusion-exclusion criteria consisted of 407 adults.

2.2. Scales

2.2.1. Mindfulness Attention Awareness Scale (MAAS-15)

The Mindful Attention Awareness Scale (MAAS-15) is a well-regarded and extensively used instrument for measuring mindfulness [17]. Developed by Kirk Warren Brown and Richard M. Ryan, this self-report tool focuses on an individual's attentive awareness of present-moment experiences [18]. Comprising 15 items, the MAAS captures key aspects of mindfulness, particularly attention and awareness in daily life. Unlike traditional mindfulness scales, it assesses the natural capacity for sustained attention across various activities rather than concentrating solely on meditation or specific mindfulness practices. This broad approach makes the MAAS a versatile and comprehensive assessment suitable for diverse contexts and populations. Its strong psychometric properties, including high internal consistency, test-retest reliability, and construct validity, underscore its reliability as a measure of mindfulness. The scale's clear and straightforward language ensures it is accessible to respondents regardless of their prior knowledge of mindfulness concepts. Its widespread application across different cultural and demographic groups highlights its cross-cultural relevance, which is essential for assessing subjective experiences [19]. Additionally, the MAAS-15 has been validated in Greek [20]. In our study, the MAAS-15 demonstrated a reliable internal consistency index (Cronbach’s α) of 0.896.

2.2.2. Mediterranean Diet Adherence Scale (14-MEDAS)

The 14-MEDAS scale, developed by Schroeder et al. [21] within the framework of the PREDIMED study, is a 14-item tool designed to evaluate adherence to the Mediterranean diet. An example question from the 14-MEDAS is, "Do you use olive oil as your main culinary fat?" Each question is scored from 0 to 1, resulting in a total 14-MEDAS score ranging from 0 to 14 points. Scores of 0 to 5 indicate low adherence, 6 to 9 signify moderate adherence, and 10 to 14 represent high adherence [21]. The scale has been validated in various countries and languages, including Greek. The Greek version of the 14-MEDAS demonstrated substantial concordance (81.2 ± 10.7%) with the Food Frequency Questionnaire (FFQ) in a study by García-Conesa et al. [22], confirming its validity and reliability as a research instrument for assessing adherence to the Mediterranean diet within the Greek population.

2.2.3. Burnout Assessment Tool (BAT-12)

The BAT-12 was utilized to measure burnout levels among participants in this study. The BAT-12, a concise version of the original BAT [23], encompasses 12 items that evaluate core dimensions of burnout, including exhaustion, mental distance, cognitive impairment, and emotional impairment. Each item is rated on a 5-point Likert scale, ranging from 1 ("never") to 5 ("always"), allowing for a detailed assessment of burnout symptoms. The BAT-12 has demonstrated robust psychometric properties, including high internal consistency and construct validity, making it a reliable instrument for assessing burnout across various occupational groups [24]. This tool’s concise nature ensures ease of administration while maintaining comprehensive coverage of the burnout construct, which is essential for accurate and efficient data collection in large-scale studies. This scale has been validated in Greek [25], and in our study had an excellent internal consistency index (Cronbach’s α) of 0.904.

2.2.4. Single Item Job Satisfaction Scale

Job satisfaction was assessed individually using a single-item tool, where participants rated their satisfaction with their current job. This item was scored on a four-point Likert scale, with the options being satisfied, fairly satisfied, fairly dissatisfied, and dissatisfied, and was reverse scored so that higher scores indicated greater satisfaction. Adapted from the Brief Job Stress Questionnaire, developed with funding from a Japanese Ministry of Labor research grant, this item has been widely used in previous studies to measure workplace job satisfaction. In the validation study by Nakata et al. (2013), this scale demonstrated significant test-retest reliability over one year, with a correlation coefficient of r=0.468 for job satisfaction (p<0.001), making this single item scale an acceptable tool for measuring job satisfaction [26].

2.2.5. Single Item Sleep Quality Scale (SQS)

The SQS is a validated, single-item sleep quality scale intended to offer a straightforward and practical assessment of sleep quality. Participants respond to a single question about their sleep quality over the past 7 days, using a 0-10 visual analogue scale. Although the single-item format of the SQS enables individuals to rate their own sleep quality, the inclusion of a discretized visual analogue scale enhances the measurement’s sensitivity [27]. This scale is recognized as a valid tool for evaluating sleep quality in healthy adults [28].

2.2.6. The EuroQol 5-Dimension 5-Level Questionnaire (EQ-5D-5L)

The EQ-5D-5L is a tool for assessing health-related quality of life (HRQoL), offering a comprehensive and multidimensional evaluation. Developed by the EuroQol Group, this standardized measure evaluates health status across five domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The EQ-5D-5L is noted for its simplicity and ease of administration; respondents rate their health state on each dimension using a five-level scale, providing a more nuanced and refined assessment compared to its predecessor, the EQ-5D-3L. This improved granularity allows for a more precise quantification of health states, enhancing sensitivity to subtle changes in health conditions and treatment outcomes [29]. Additionally, the EQ-5D-5L has been validated in Greek [30]. Its versatility and brevity make it suitable for various applications, including clinical trials, population health surveys, and economic evaluations in healthcare. This standardized measure facilitates cross-comparisons across different health conditions and interventions, enabling healthcare professionals, researchers, and policymakers to make informed decisions based on a robust assessment of HRQoL [31]. Despite its widespread use and applicability, the EQ-5D-5L has limitations, such as its generic nature, which may not capture condition-specific nuances. Nonetheless, its ability to succinctly capture multidimensional aspects of HRQoL, its simplicity in administration, and its adaptability across diverse populations solidify its position as an indispensable tool for assessing health outcomes and guiding healthcare interventions [32]. The EQ-5D-5L score (EQ Index) is calculated by converting responses on the five dimensions of health (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) into a single index using country-specific value sets, typically ranging from -0.594 to 1, where 1 represents full health and values less than 0 indicate health states worse than death [33].

2.3. Demographics, Anthropometrics, and Lifestyle

To minimize survey dropout rates [34], questions related to demographic and anthropometric data were placed at the end of the survey. Demographic inquiries included education, employment status, marital status, and gender. Participants were asked to provide their height and weight for the calculation of their Body Mass Index (BMI). Although self-reported height and weight may not provide the most accurate data regarding respondents' body composition, it remains a valid method for calculating BMI in adult populations across diverse socio-demographic groups [35]. Based on established guidelines [36], individuals' BMIs were classified into subcategories, including underweight, normal weight, overweight, and obesity. The lifestyle of the participants was assessed through yes-or-no questions concerning their physical activity, proximity to nature, and social interactions. The thresholds for each activity were established based on existing literature [37-39]. High levels of physical activity, frequent social interactions, and proximity to nature are regarded as integral components of the Mediterranean lifestyle. [40-42].

2.4. Statistical Analysis

A comprehensive examination of the data was undertaken to detect any potential exclusions. Instances where participants abruptly terminated the questionnaire (Missing Completely at Random) led to the exclusion of the corresponding data from the analysis [43]. In cases of inadvertent omissions (Missing at Random), missing data points were substituted with the mean value derived from all respondents' responses.

The data were exported in a format compatible with importing and processing in SPSS v28. Data analysis and visualization were conducted using the statistical analysis software SPSS v28 along with SRplot free online platform. Before subjecting the data to statistical tests, a regularity check was performed to ensure their distribution met predefined criteria. It is recommended in the literature to conduct the regularity test before proceeding with statistical analyses. To ensure the most precise and reliable evaluation of regularity, a combination of visual inspection and the Shapiro-Wilk test was employed [44]. Statistical analysis involved Pearson’s correlation, independent samples t-test, and one-way ANOVA for continuous variables determined to follow a normal distribution using the Kolmogorov-Smirnov test. Multinomial logistic regression analysis was conducted to assess the impact of mindfulness on HRQoL in individuals with IBD, adjusting for potential confounders. The predetermined level of statistical significance was set at p<0.05.

3. Results

3.1. Participant Demographics

Initially, the survey included 497 individuals. Following the exclusion of 75 respondents who failed to meet the survey's inclusion criteria and 15 whose responses were either incomplete (answering less than 50% of total questions) or sporadic (items answered in less than 3 minutes), the final cohort comprised 407 adults. Among these, 68.3% identified as women, 31% as men, and 0.7% as non-binary. Notably, a significant discrepancy (p<0.05) in MAAS-15 and 14-MEDAS means, was observed across educational status, with highly educated individuals exhibiting higher scores. The majority of participants (61.6%) fell within the 18-to-29 age bracket.

3.2. HRQoL Correlations

Using Pearson’s correlation analysis, statistically significant relationships (p < 0.05) were identified between several lifestyle factors and health-related quality of life (HRQoL). Specifically, mindfulness, physical activity, sleep quality, and sociality demonstrated positive correlations with HRQoL, while burnout showed a significant negative correlation. The strongest positive correlation was observed with mindfulness (Figure 1).

3.3. Burnout Correlations

To investigate the potential associations between BAT-12, MAAS-15, 14-MEDAS, and the EQIndex of the participants, Pearson’s correlation coefficients were calculated. The statistical analysis revealed a significant negative correlation of BAT-12 with MAAS-15, 14-MEDAS, and the EQIndex. Additionally, a positive correlation of the EQIndex with MAAS-15, and 14-MEDAS was observed (Table 1).

3.4. Burnout and the Mediterranean Lifestyle

Apart from the negative correlation with Mindfulness, HRQoL and the Mediterranean diet, the analysis revealed significant negative correlations between burnout and various components of the Mediterranean lifestyle, including sleep quality, proximity to nature, physical activity, and sociality (Figure 2). Specifically, higher levels of sleep quality were associated with lower levels of burnout (r = -0.45, p < 0.01), indicating that participants who reported better sleep quality experienced fewer symptoms of burnout. Similarly, proximity to nature was inversely correlated with burnout (r = -0.38, p < 0.01). This suggests that individuals who had more frequent access to natural environments reported lower burnout levels. Physical activity also showed a significant negative correlation with burnout (r = -0.42, p < 0.01). Participants engaging in regular physical activity reported less burnout, underscoring the protective role of exercise against stress and exhaustion. Lastly, sociality was found to be negatively correlated with burnout (r = -0.40, p < 0.01). Higher levels of social interaction and support were associated with reduced burnout symptoms, highlighting the importance of social connections in mitigating burnout (Figure 2).

3.5. Burnout, Mindfulness, and the Mediterranean Diet

A one-way analysis of variance (ANOVA) was performed to assess the impact of burnout levels (low, medium, and high) on mindfulness (MAAS-15 scores) and adherence to the Mediterranean diet (MEDAS-14 scores). For mindfulness (MAAS-15), the results indicated a statistically significant effect of burnout levels on mindfulness scores, p < 0.05. This suggests that burnout levels had a significant impact on participants' mindfulness scores. Similarly, for adherence to the Mediterranean diet (MEDAS-14), a one-way ANOVA also revealed a statistically significant effect of burnout levels, p < 0.05. This indicates that burnout levels significantly influenced adherence to the Mediterranean diet (Figure 3).

A multinomial logistic regression analysis was performed to examine the association between burnout levels (low, medium, and high) and mindfulness as the outcome variable. Odds ratios (OR) and p-values are presented for each burnout level, with the high burnout group used as the reference category. For the low burnout score, there was a statistically significant association with mindfulness, with an odds ratio of 1.216 (95% CI: 1.153–1.283), p = 0.001. This indicates that participants with low burnout were significantly more likely to report higher mindfulness levels compared to those with high burnout. Similarly, the medium burnout score was also significantly associated with mindfulness, with an odds ratio of 1.098 (95% CI: 1.059–1.138), p = 0.002. This suggests that individuals with medium burnout were more likely to exhibit higher mindfulness than those in the high burnout group. As the reference category, the high burnout score showed an odds ratio of 1.000 (95% CI: 1.000–1.000), p = 1.000, indicating no difference in mindfulness within this group (Figure 4).

3.6. Burnout, and Job Satisfaction

After conducting multinomial logistic regression analysis, this figure illustrates the hazard ratios (HR) for burnout associated with varying levels of job satisfaction, with "Satisfied" as the reference category. The analysis reveals that individuals who are “Fairly unsatisfied” (HR = 1.189, p = 0.001) and “Unsatisfied” (HR = 1.237, p = 0.001) face significantly elevated risks of burnout compared to those in the satisfied group. Meanwhile, the “Fairly satisfied” group shows a non-significant increase in burnout risk (HR = 1.042, p = 0.054). These results underscore the protective role of job satisfaction in mitigating burnout, with lower satisfaction levels correlating with a heightened burnout risk (Figure 4).

4. Discussion

In this study, we investigated the interplay between mindfulness, the Mediterranean lifestyle, burnout, job satisfaction, and health-related quality of life among employees in Greece. Our findings shed light on the intricate relationships among these variables, offering valuable insights into how fostering mindfulness and adopting elements of the Mediterranean lifestyle can mitigate burnout and enhance overall well-being in the workplace.

The negative associations observed between mindfulness, the Mediterranean lifestyle, and burnout align with previous research highlighting the beneficial effects of mindfulness practices and healthy lifestyle choices on psychological well-being. Our findings corroborate studies demonstrating that mindfulness interventions can reduce burnout symptoms by promoting stress reduction and enhancing emotional regulation [45]. Similarly, adherence to the Mediterranean lifestyle, characterized by a diet rich in fruits, vegetables, and omega-3 fatty acids, combined with regular physical activity and social engagement, has been linked to lower levels of stress and improved mental health outcomes [46].

Furthermore, our identification of burnout as a predicting factor of job satisfaction echoes the findings of numerous studies indicating that burnout negatively impacts job satisfaction and organizational commitment [47]. The inverse relationship between mindfulness and burnout underscores the importance of incorporating mindfulness-based interventions in workplace wellness programs to foster employee satisfaction and retention.

Our hypothesis that mindfulness and the Mediterranean lifestyle would be negatively associated with burnout was supported by the data. The mediating role of mindfulness in mitigating burnout suggests that cultivating present-moment awareness and non-judgmental acceptance can buffer individuals against the detrimental effects of chronic workplace stressors. Similarly, adherence to the Mediterranean lifestyle, encompassing dietary habits, physical activity, social connectedness, and adequate sleep, appears to act as a protective factor against burnout, possibly by bolstering resilience and promoting overall health and well-being.

The predictive relationship between mindfulness and burnout reinforces the notion that individuals with higher levels of mindfulness are better equipped to manage stressors and maintain psychological equilibrium in demanding work environments. Moreover, our finding that burnout predicts job satisfaction underscores the far-reaching implications of burnout on organizational outcomes, highlighting the imperative for employers to prioritize employee well-being initiatives.

Our study presents some limitations. The cross-sectional design precludes causal inferences, and the reliance on self-report measures may introduce response bias. Additionally, sampling bias inherent in online survey recruitment and limited generalizability of findings to broader populations are notable concerns. However, despite these limitations, our study boasts several strengths. We integrated multiple constructs, including mindfulness, the Mediterranean lifestyle, burnout, job satisfaction, and health-related quality of life, providing a comprehensive understanding of their interrelationships in the workplace. Moreover, through mediation analyses, we elucidated the mediating role of mindfulness in the relationship between the Mediterranean lifestyle and burnout, offering valuable insights into potential pathways for intervention.

The implications of our findings extend beyond the workplace to broader public health and policy domains. By elucidating the role of mindfulness and lifestyle factors in mitigating burnout and enhancing job satisfaction, our study underscores the importance of holistic approaches to employee well-being that address not only job-related stressors but also lifestyle behaviors.

Future research endeavors may delve deeper into the mechanisms underlying the relationship between mindfulness, the Mediterranean lifestyle, and burnout, employing longitudinal designs to examine causal pathways and potential moderators. Additionally, exploring the effectiveness of workplace interventions targeting mindfulness training and lifestyle modifications in reducing burnout and improving job satisfaction could provide valuable insights for organizational stakeholders.

In conclusion, our study contributes to the burgeoning literature on workplace well-being by highlighting the salutary effects of mindfulness and the Mediterranean lifestyle in mitigating burnout and promoting job satisfaction among employees. By fostering a culture of mindfulness and supporting healthy lifestyle choices, organizations can cultivate resilient, engaged workforce conducive to sustainable productivity and flourishing.