Pospos Sarah, Young Ilanit Tal, Downs Nancy, Iglewicz Alana, Depp Colin, Chen James Y, Newton Isabel, Lee Kelly, Light Gregory A, Zisook Sidney
University of California San Diego, La Jolla, CA, USA.
Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA.
Acad Psychiatry. 2018 Feb;42(1):109-120. doi: 10.1007/s40596-017-0868-0. Epub 2017 Dec 18.
Being a healthcare professional can be a uniquely rewarding calling. However, the demands of training and practice can lead to chronic distress and serious psychological, interpersonal, and personal health burdens. Although higher burnout, depression, and suicide rates have been reported in healthcare professionals, only a minority receive treatment. Concerns regarding confidentiality, stigma, potential career implications, and cost and time constraints are cited as key barriers. Web-based and mobile applications have been shown to mitigate stress, burnout, depression, and suicidal ideation among several populations and may circumvent these barriers. Here, we reviewed published data on such resources and selected a small sample that readily can be used by healthcare providers.
We searched PubMed for articles evaluating stress, burnout, depression, and suicide prevention or intervention for healthcare students or providers and identified five categories of programs with significant effectiveness: Cognitive Behavioral Therapy (online), meditation, mindfulness, breathing, and relaxation techniques. Using these categories, we searched for Web-based (through Google and beacon.anu.edu.au -a wellness resource website) and mobile applications (Apple and mobile. va.gov/appstore ) for stress, burnout, depression, and suicide prevention and identified 36 resources to further evaluate based on relevance, applicability to healthcare providers (confidentiality, convenience, and cost), and the strength of findings supporting their effectiveness.
We selected seven resources under five general categories designed to foster wellness and reduce burnout, depression, and suicide risk among healthcare workers: breathing (Breath2Relax), meditation (Headspace, guided meditation audios), Web-based Cognitive Behavioral Therapy (MoodGYM, Stress Gym), and suicide prevention apps (Stay Alive, Virtual Hope Box).
This list serves as a starting point to enhance coping with stressors as a healthcare student or professional in order to help mitigate burnout, depression, and suicidality. The next steps include adapting digital health strategies to specifically fit the needs of healthcare providers, with the ultimate goal of facilitating in-person care when warranted.
成为一名医疗保健专业人员可能是一项极具意义的职业。然而,培训和实践的要求可能导致长期的困扰以及严重的心理、人际和个人健康负担。尽管据报道医疗保健专业人员的倦怠、抑郁和自杀率较高,但只有少数人接受治疗。对保密性、耻辱感、潜在的职业影响以及成本和时间限制的担忧被认为是主要障碍。基于网络和移动应用程序已被证明可以减轻几类人群的压力、倦怠、抑郁和自杀念头,并且可能规避这些障碍。在此,我们回顾了关于此类资源的已发表数据,并挑选了一小部分可供医疗保健提供者轻松使用的样本。
我们在PubMed上搜索评估针对医学生或医疗保健提供者的压力、倦怠、抑郁和自杀预防或干预的文章,并确定了五类具有显著效果的项目:认知行为疗法(在线)、冥想、正念、呼吸和放松技巧。利用这些类别,我们在网络上(通过谷歌和beacon.anu.edu.au——一个健康资源网站)以及移动应用程序(苹果应用商店和mobile.va.gov/appstore)中搜索用于压力、倦怠、抑郁和自杀预防的资源,并根据相关性、对医疗保健提供者的适用性(保密性、便利性和成本)以及支持其有效性的研究结果的力度,确定了36种资源进行进一步评估。
我们在五个一般类别下挑选了七种资源,旨在促进医护人员的健康并降低其倦怠、抑郁和自杀风险:呼吸类(Breath2Relax)、冥想类(Headspace、引导冥想音频)、基于网络的认知行为疗法类(MoodGYM、Stress Gym)以及自杀预防应用程序类(Stay Alive、Virtual Hope Box)。
这份清单可作为医学生或医疗保健专业人员增强应对压力源能力的起点,以帮助减轻倦怠、抑郁和自杀倾向。接下来的步骤包括调整数字健康策略以特别满足医疗保健提供者的需求,最终目标是在必要时促进面对面护理。