Parola Vitor, Coelho Adriana, Cardoso Daniela, Sandgren Anna, Apóstolo João
1Institute of Biomedical Sciences Abel Salazar: University of Porto, Porto, Portugal 2Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal 3Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden 4Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden 5Portugal Centre for Evidence-Based Practice: a Joanna Briggs Institute Centre of Excellence, Coimbra, Portugal.
JBI Database System Rev Implement Rep. 2017 Jul;15(7):1905-1933. doi: 10.11124/JBISRIR-2016-003309.
More than ever, the current increasing need for palliative care leads to health professionals providing this type of care which further leads to multiple challenges, and stressful and demanding situations. The multiple challenges of working in palliative care put health professionals working in this context at the risk of burnout.
To examine the evidence on the prevalence of burnout among health professionals working in palliative care.
The current review included studies that encompass qualified health professionals working in palliative care, caring for patients 18 years of age or older.
The current review considered studies reporting on the point prevalence of burnout, measured by a burnout scale, such as, but not limited to, the Maslach Burnout Inventory, Burnout Measure and Copenhagen Burnout Inventory.
The current review considered studies conducted in the context of specialist palliative care, more specifically, palliative care units, specialized palliative home care or hospices.
The current review considered observational study designs, including prospective and retrospective cohort, case-control and cross-sectional studies.
An initial search of MEDLINE (via PubMed) and CINAHL was undertaken, followed by a second search for published and unpublished studies since 1975 in major healthcare-related electronic databases. Studies written in English, Spanish and Portuguese were included.
Two independent reviewers assessed the methodological quality of studies using the standardized critical appraisal instrument from the Joanna Briggs Institute. No studies were excluded from the review based on the methodological appraisal.
Data were extracted using a data extraction table, taking into account the review questions.
Significant differences were found between condition measures, thus we were unable to perform a meta-analysis.
Eight cross-sectional studies met the inclusion criteria, with a total of 1406 health professionals. The sample was limited to nurses, physicians and social workers. None of the included articles presented data about other health professionals. Seven of the included studies assessed the prevalence of burnout using the same instrument - the Maslach Burnout Inventory. Data revealed a prevalence of burnout of 17.3% among health professionals. Personal Accomplishment was the sub-scale from the Maslach Burnout Inventory that had the highest prevalence (19.5%). Nurses had higher levels of Emotional Exhaustion (19.5%) and Depersonalization (8.2%), and physicians had lower levels of Personal Accomplishment (41.2%). The prevalence of burnout was, however, higher in social workers (27%). The palliative care context with the highest prevalence of burnout was home care (19.6%).
The current systematic review contributes to a body of empirical knowledge that can facilitate the professional development of palliative care teams by highlighting the prevalence of burnout in health professionals, which staff category is the most affected (social workers), and which palliative care context has the highest prevalence (home care).
当前对姑息治疗的需求日益增长，这使得卫生专业人员提供此类护理，进而带来了多重挑战以及压力巨大且要求苛刻的情况。姑息治疗工作中的多重挑战使在此环境中工作的卫生专业人员面临职业倦怠的风险。
研究姑息治疗领域卫生专业人员职业倦怠患病率的相关证据。
纳入标准 参与者类型：本次综述纳入的研究涵盖了在姑息治疗领域工作、照顾18岁及以上患者的合格卫生专业人员。
本次综述考虑了通过职业倦怠量表（如但不限于马氏职业倦怠量表、职业倦怠测量工具和哥本哈根职业倦怠量表）测量职业倦怠时点患病率的研究。
本次综述考虑了在专科姑息治疗背景下开展的研究，更具体地说，是姑息治疗病房、专科姑息家庭护理或临终关怀机构。
本次综述考虑了观察性研究设计，包括前瞻性和回顾性队列研究、病例对照研究和横断面研究。
首先对MEDLINE（通过PubMed）和CINAHL进行了检索，随后对1975年以来主要医疗相关电子数据库中已发表和未发表的研究进行了二次检索。纳入了用英语、西班牙语和葡萄牙语撰写的研究。
两名独立评审员使用乔安娜·布里格斯研究所标准化的批判性评价工具评估研究的方法学质量。基于方法学评价，本次综述未排除任何研究。
使用数据提取表提取数据，同时考虑综述问题。
在条件测量方面发现了显著差异，因此我们无法进行荟萃分析。
八项横断面研究符合纳入标准，共有1406名卫生专业人员。样本仅限于护士、医生和社会工作者。纳入的文章均未提供其他卫生专业人员的数据。七项纳入研究使用同一工具——马氏职业倦怠量表评估职业倦怠患病率。数据显示，卫生专业人员中职业倦怠患病率为17.3%。个人成就感是马氏职业倦怠量表中患病率最高的子量表（19.5%）。护士的情感耗竭水平（19.5%）和去个性化水平（8.2%）较高，而医生的个人成就感水平较低（41.2%）。然而，社会工作者的职业倦怠患病率更高（27%）。职业倦怠患病率最高的姑息治疗背景是家庭护理（19.6%）。
本次系统综述为实证知识体系做出了贡献，通过强调卫生专业人员职业倦怠的患病率、受影响最严重的人员类别（社会工作者）以及职业倦怠患病率最高的姑息治疗背景（家庭护理），有助于促进姑息治疗团队的专业发展。
