Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review.
Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review.
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DOI：
10.1186/s13643-017-0526-3
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发表时间：
2017-07-17
影响因子：
3.7
通讯作者：
Ireland MJ
中科院分区：
文献类型：
--
作者：
Clough BA;March S;Chan RJ;Casey LM;Phillips R;Ireland MJ
职业压力和职业倦怠在医生中非常普遍，可能对患者，医生和组织结果产生不利影响。本研究的目的是审查和评估心理干预的证据，旨在减少职业压力和职业倦怠的医生。对报告针对医生职业压力或职业倦怠的心理社会干预措施的原始研究文章进行了系统综述，这些文章以英语发表，并在至少两个时间点收集了数据。在5个电子数据库中进行检索，并通过Google Scholar手动检索。提取的数据涉及研究特征和结果、质量和严谨性以及交付和参与模式。研究采用推荐强度分类法（SORT）和关键评估技能计划（CASP）进行评估。23篇文章进行了审查，其中报告的干预措施，利用认知行为，放松和支持性的讨论策略。只有12项研究允许估计干预前后的影响。认知行为干预显示出最强有力的证据，特别是在减轻压力方面。确定了一些证据来支持基于放松的方法的有效性，但没有发现基于讨论的干预措施（如Balint组）的有效性的证据。根据SORT，被审查的研究缺乏质量，没有研究的质量评级为1，整体证据被评为B级。由于研究样本质量不高，未合并效应量。这项审查发现，尽管增加了科学的关注，研究的质量检查的好处，心理社会/行为干预的职业压力和职业倦怠的医生仍然很低。尽管如此，集中在认知和行为原则的干预措施似乎显示出减少医生压力和倦怠的希望。当前综述的局限性包括缺乏偏倚风险评估或合并分析。提高这一领域的研究质量的建议，以及目前的证据体的影响进行了讨论。PROSPERO CRD 42016032595本文的在线版本（doi：10.1186/s13643 - 017 - 0526 - 3）包含补充材料，可供授权用户使用。
Occupational stress and burnout are highly prevalent among medical doctors and can have adverse effects on patient, doctor, and organisational outcomes. The purpose of the current study was to review and evaluate evidence on psychosocial interventions aimed at reducing occupational stress and burnout among medical doctors. A systematic review was conducted for original research articles reporting on psychosocial interventions targeting occupational stress or burnout among medical doctors, published in the English language, and with data collected at a minimum of two time points. Searches were conducted across five electronic databases, as well as by manual search of Google Scholar. Data was extracted relating to study characteristics and outcomes, quality and rigour, as well as modes of delivery and engagement. Studies were appraised using the Strength of Recommendation Taxonomy (SORT) and Critical Appraisal Skills Programme (CASP). Twenty-three articles were reviewed, which reported on interventions utilising cognitive-behavioural, relaxation, and supportive discussion strategies. Only 12 studies allowed estimation of pre- to post-intervention effects. Cognitive behavioural interventions demonstrated the strongest evidence, particularly for reducing stress. Some evidence was identified to support the efficacy of relaxation-based approaches, but no such evidence was found for the efficacy of discussion-based interventions, such as Balint groups. There was a lack of quality among reviewed studies, with no studies receiving a quality rating of 1, and the overall body of evidence being rated as level B, according to the SORT. Effect sizes were not pooled due to a lack of quality among the study sample. This review found that despite increased scientific attention, the quality of research examining the benefits of psychosocial/behavioural interventions for occupational stress and burnout in medical doctors remains low. Despite this, interventions focused on cognitive and behavioural principles appear to show promise in reducing doctor stress and burnout. Limitations of the current review include a lack of risk of bias assessment or pooling of analyses. Recommendations for improving the quality of research in this area, as well as implications of the current body of evidence are discussed. PROSPERO CRD42016032595 The online version of this article (doi:10.1186/s13643-017-0526-3) contains supplementary material, which is available to authorized users.
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DOI：
10.1016/j.jamcollsurg.2010.09.025
发表时间：
2011-02-01
影响因子：
5.2
作者：
Arora, Sonal;Aggarwal, Rajesh;Sevdalis, Nick
通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
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作者：
Gopal, R;Glasheen, JJ;Prochazka, AV
通讯作者：
Prochazka, AV