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在 COVID-19 大流行期间全科医生的幸福感:系统评价。

GP wellbeing during the COVID-19 pandemic: a systematic review.

机构信息

Department of Health Sciences, University of York, York.

出版信息

Br J Gen Pract. 2022 Apr 28;72(718):e325-e333. doi: 10.3399/BJGP.2021.0680. Print 2022 May.

Abstract

BACKGROUND

Doctors' organisations in the UK have reported worrying levels of work-related stress and burnout in the GP workforce for some time, and the COVID-19 pandemic has presented clear new challenges.

AIM

To synthesise international evidence exploring the impact of COVID-19 on primary care doctors' mental health and wellbeing, and identify risk factors associated with their psychological wellbeing during this time.

DESIGN AND SETTING

Mixed-methods systematic review.

METHOD

Six bibliographic databases, Google Scholar, and were searched on 19 November 2020 and 3 June 2021 to identify studies of GP psychological wellbeing during the pandemic. Reference checking was also conducted. Two reviewers selected studies, extracted data, and assessed the quality of studies using standardised tools. Heterogeneity in outcomes, setting, and design prohibited statistical pooling; studies were combined using a convergent integrated thematic synthesis.

RESULTS

Thirty-one studies were included. Multiple sources of stress were identified including changed working practices; risk, exposure, and inadequate personal protective equipment (PPE); information overload; pandemic preparedness; and cohesion across sectors. Studies demonstrated an impact on psychological wellbeing, with some GPs experiencing stress, burnout, anxiety, depression, fear of COVID-19, lower job satisfaction, and physical symptoms. Studies reported gender and age differences: women GPs had poorer psychological outcomes across all domains, and older GPs reported greater stress and burnout. Use of outcome measures and reporting practice varied greatly.

CONCLUSION

This review of international evidence demonstrates that the COVID-19 pandemic has adversely affected GPs' wellbeing around the world. Further research could explore gender and age differences, identifying interventions targeted to these groups.

摘要

背景

英国的医生组织报告称,一段时间以来,全科医生队伍的工作压力和倦怠感一直令人担忧,而 COVID-19 大流行带来了明显的新挑战。

目的

综合国际证据,探讨 COVID-19 对初级保健医生心理健康和幸福感的影响,并确定在此期间与他们心理健康相关的风险因素。

设计和设置

混合方法系统评价。

方法

于 2020 年 11 月 19 日和 2021 年 6 月 3 日在六个文献数据库、Google Scholar 和 上搜索了有关大流行期间全科医生心理健康的研究,还进行了参考文献检查。两位评审员选择研究、提取数据,并使用标准工具评估研究质量。由于结果、研究环境和设计存在异质性,因此禁止进行统计学汇总;使用收敛综合主题合成法对研究进行合并。

结果

共纳入 31 项研究。确定了多种压力源,包括工作方式的改变;风险、暴露和不足的个人防护设备 (PPE);信息过载;大流行准备;以及各部门之间的凝聚力。研究表明,心理健康受到了影响,一些全科医生经历了压力、倦怠、焦虑、抑郁、对 COVID-19 的恐惧、工作满意度降低和身体症状。研究报告了性别和年龄差异:女性全科医生在所有领域的心理健康结果都较差,而年长的全科医生报告的压力和倦怠感更大。使用的结果衡量标准和报告实践差异很大。

结论

本综述国际证据表明,COVID-19 大流行对全球全科医生的幸福感产生了不利影响。进一步的研究可以探讨性别和年龄差异,确定针对这些群体的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59a9/11189056/e38585db6659/bjgpmay-2022-72-718-e325-1.jpg

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