Specialty School of Occupational Medicine, U.R. Occupational Medicine, Sapienza University of Rome, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2020 Jan;24(2):821-830. doi: 10.26355/eurrev_202001_20065.
Work-related stress (WRS) is widespread among medical doctors. WRS not only affects the physician's mental and physical well-being, but also patient care quality and the overall efficiency of the healthcare system. The aim of this study is to conduct a systematic review of the current preventive measures against mental disorders, work-related stress, and burnout among physicians.
The presentation of this systematic review is in accordance with the PRISMA statement. The methodological quality of the selected studies was assessed with specific rating tools: INSA, Newcastle Ottawa Scale, JADAD scale, and AMSTAR. English publications only were selected. No restrictions applied for publication type. Reviewers excluded articles not concerning the following topics: WRS prevention, WRS risk factors and mental disorders among physicians. Reviewers also excluded findings of less academic significance, editorial articles, individual contributions, purely descriptive studies published in scientific conferences.
Online search returned 4748 references on the following databases: PubMed (1638), Scopus (3108) and Cochrane Library (2). 36 studies were included in this review (thereof, 13 reviews and 23 original articles). Narrative reviews were rated on the INSA scale. The mean, median, and modal rating was 6. This indicates an intermediate-high quality of these studies. Systematic reviews were rated on the AMSTAR scale. The mean and median rating was 9, and the modal rating was 8. This indicates a high quality of these studies. The scores assigned to the original articles have a mean, median, and modal rating of 7. This also indicates an intermediate-high quality of these studies.
Work-related stress and mental disorders seem to be widespread among medical practitioners. It is already a priority to adopt preventive measures against these phenomena. However, there is still no consensus on what the most effective measures are. Additional research is needed to formulate evidence-based recommendations.
工作相关压力(WRS)在医生中普遍存在。WRS 不仅影响医生的身心健康,还影响患者的护理质量和医疗保健系统的整体效率。本研究旨在对当前预防医生精神障碍、工作相关压力和倦怠的措施进行系统回顾。
本系统评价的报告符合 PRISMA 声明。使用特定的评分工具评估所选研究的方法学质量:INSA、纽卡斯尔-渥太华量表、JADAD 量表和 AMSTAR。仅选择英文出版物。对出版物类型没有限制。审查员排除了以下主题的文章:WRS 预防、WRS 风险因素和医生中的精神障碍。审查员还排除了学术意义较小、社论文章、个人贡献、仅在科学会议上发表的描述性研究的发现。
在以下数据库中在线搜索返回了 4748 条参考文献:PubMed(1638)、Scopus(3108)和 Cochrane Library(2)。共有 36 项研究纳入本综述(其中 13 项综述和 23 项原始文章)。叙述性综述根据 INSA 量表进行评分。平均、中位数和模态评分均为 6. 这表明这些研究的质量处于中等偏高水平。系统评价根据 AMSTAR 量表进行评分。平均和中位数评分为 9,模态评分为 8. 这表明这些研究的质量较高。分配给原始文章的分数的平均、中位数和模态评分为 7. 这也表明这些研究的质量处于中等偏高水平。
工作相关压力和精神障碍在医疗从业者中似乎很普遍。采取预防这些现象的措施已经是当务之急。然而,对于最有效的措施仍没有共识。需要进一步研究来制定基于证据的建议。