College of Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA.
David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
BMC Med Educ. 2021 Nov 25;21(1):593. doi: 10.1186/s12909-021-03021-y.
The PERMA Model, as a positive psychology conceptual framework, has increased our understanding of the role of Positive emotion, Engagement, Relationships, Meaning, and Achievements in enhancing human potentials, performance and wellbeing. We aimed to assess the utility of PERMA as a multidimensional model of positive psychology in reducing physician burnout and improving their well-being.
Eligible studies include peer-reviewed English language studies of randomized control trials and non-randomized design. Attending physicians, residents, and fellows of any specialty in the primary, secondary, or intensive care setting comprised the study population. Eligible studies also involved positive psychology interventions designed to enhance physician well-being or reduce physician burnout. Using free text and the medical subject headings we searched CINAHL, Ovid PsychINFO, MEDLINE, and Google Scholar (GS) electronic bibliographic databases from 2000 until March 2020. We use keywords for a combination of three general or block of terms (Health Personnel OR Health Professionals OR Physician OR Internship and Residency OR Medical Staff Or Fellow) AND (Burnout) AND (Positive Psychology OR PERMA OR Wellbeing Intervention OR Well-being Model OR Wellbeing Theory).
Our search retrieved 1886 results (1804 through CINAHL, Ovid PsychINFO, MEDLINE, and 82 through GS) before duplicates were removed and 1723 after duplicates were removed. The final review included 21 studies. Studies represented eight countries, with the majority conducted in Spain (n = 3), followed by the US (n = 8), and Australia (n = 3). Except for one study that used a bio-psychosocial approach to guide the intervention, none of the other interventions in this review were based on a conceptual model, including PERMA. However, retrospectively, ten studies used strategies that resonate with the PERMA components.
Consideration of the utility of PERMA as a multidimensional model of positive psychology to guide interventions to reduce burnout and enhance well-being among physicians is missing in the literature. Nevertheless, the majority of the studies reported some level of positive outcome regarding reducing burnout or improving well-being by using a physician or a system-directed intervention. Albeit, we found more favorable outcomes in the system-directed intervention. Future studies are needed to evaluate if PERMA as a framework can be used to guide system-directed interventions in reducing physician burnout and improving their well-being.
PERMA 模型作为一种积极心理学概念框架，增加了我们对积极情绪、投入、人际关系、意义和成就在增强人类潜力、表现和幸福感方面的作用的理解。我们旨在评估 PERMA 作为积极心理学的多维模型在减少医生倦怠和改善其幸福感方面的效用。
合格的研究包括同行评议的英语随机对照试验和非随机设计研究。研究人群包括初级、二级或重症监护环境中的任何专业的主治医生、住院医师和研究员。合格的研究还包括旨在增强医生幸福感或减少医生倦怠的积极心理学干预。使用自由文本和医学主题词，我们从 2000 年到 2020 年 3 月在 CINAHL、Ovid PsychINFO、MEDLINE 和 Google Scholar（GS）电子书目数据库中进行了搜索。我们使用了三个通用术语或术语块的组合的关键词（卫生人员或卫生专业人员或医生或实习和住院医师或医务人员或研究员）和（倦怠）和（积极心理学或 PERMA 或幸福感干预或幸福感模型或幸福感理论）。
我们的搜索检索到 1886 项结果（1804 项通过 CINAHL、Ovid PsychINFO、MEDLINE 和 82 项通过 GS），在去除重复项之前，去除重复项后为 1723 项。最终审查包括 21 项研究。研究代表了八个国家，其中西班牙（n=3）的研究最多，其次是美国（n=8）和澳大利亚（n=3）。除了一项研究使用生物心理社会方法来指导干预外，本综述中的其他干预措施均未基于概念模型，包括 PERMA。然而，回顾性地，有十项研究使用了与 PERMA 成分相吻合的策略。
考虑到 PERMA 作为积极心理学的多维模型在指导减少医生倦怠和提高幸福感方面的效用，文献中存在缺失。然而，大多数研究报告说，通过使用医生或系统导向的干预，在减少倦怠或提高幸福感方面取得了一定程度的积极结果。尽管如此，我们发现系统导向的干预有更有利的结果。需要进一步的研究来评估 PERMA 是否可以作为一个框架来指导系统导向的干预，以减少医生倦怠和提高他们的幸福感。
