Faculty of Medicine, University of Toronto, Toronto, ON; Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON.
Faculty of Medicine, University of Toronto, Toronto, ON.
J Obstet Gynaecol Can. 2021 Apr;43(4):490-496. doi: 10.1016/j.jogc.2020.12.011. Epub 2020 Dec 26.
Obstetricians and gynaecologists are among the highest risk specialties for burnout. There is growing evidence that physician burnout can be both prevented and reduced. We sought to characterize the evidence base for interventions related to the prevention and treatment of burnout in obstetrics and gynaecology DATA SOURCES: We conducted a scoping review following PRISMA guidelines of 5 databases: (Medline-OVID, EMBASE, CINAHL, ClinicalTrials.gov, and PsycInfo) from inception to March 17, 2020. Citations of relevant articles were hand-searched to maximize sensitivity.
All interventional study designs were included. The target study population was obstetrics and gynaecology residents, learners, or staff. Published conference posters, papers, and abstracts were eligible for inclusion.
All extraction and descriptive analysis was completed by two independent reviewers. Outcomes were summarized descriptively. Appraisal was completed using the Cochrane Risk of Bias tool and Risk of Bias Assessment tool for Non-randomized Studies.
Of the 1540 original database citations, 20 studies met our inclusion criteria. A total of 589 obstetrics/gynaecology participants were included. While there was an overall a lack of research in the field, there were several promising interventions that target residents. There were a combination of preventative interventions (e.g. yoga, nutritional programs, or narrative medicine initiatives) as well as treatments (e.g. counselling appointments or debrief sessions). The vast majority of these interventions focused on individual-specific interventions rather than structural changes. In addition, the majority of interventions appeared to be "proof of concept" and feasability-related studies, with many studies published as conference abstracts rather than peer-reviewed journal publications.
Institutions should continue to implement interventions that address burnout in obstetrics and gynaecology. Further research is required on long-term outcomes of interventions as well as structural strategies.
妇产科医生是职业倦怠风险最高的专业之一。越来越多的证据表明，医生倦怠既可以预防，也可以减轻。我们旨在描述妇产科预防和治疗倦怠的干预措施的证据基础。
我们根据 PRISMA 指南，对从成立到 2020 年 3 月 17 日的 5 个数据库（Medline-OVID、EMBASE、CINAHL、ClinicalTrials.gov 和 PsycInfo）进行了范围综述。检索了相关文章的参考文献，以最大限度地提高敏感性。
所有干预性研究设计都包括在内。目标研究人群为妇产科住院医师、学习者或工作人员。已发表的会议海报、论文和摘要都有资格入选。
所有提取和描述性分析均由两名独立评审员完成。结果以描述性方式总结。使用 Cochrane 偏倚风险工具和非随机研究偏倚风险评估工具进行评估。
在最初的 1540 个数据库引用中，有 20 项研究符合我们的纳入标准。共有 589 名妇产科参与者入选。尽管该领域的研究总体上缺乏，但有一些针对住院医师的有希望的干预措施。既有预防干预措施（如瑜伽、营养计划或叙事医学倡议），也有治疗干预措施（如咨询预约或汇报会议）。这些干预措施绝大多数都集中在个体特定的干预措施上，而不是结构变化上。此外，大多数干预措施似乎是“概念验证”和可行性相关研究，许多研究发表为会议摘要，而不是经过同行评审的期刊出版物。
各机构应继续实施针对妇产科倦怠的干预措施。需要进一步研究干预措施的长期结果以及结构性策略。
