Black Dog Institute, University of New South Wales, Randwick, NSW, 2031, Australia.
School of Psychiatry, University of New South Wales, Sydney, NSW, 2000, Australia.
BMC Psychiatry. 2022 Apr 6;22(1):244. doi: 10.1186/s12888-022-03908-0.
Doctors report high rates of workplace stress and are at increased risk of mental health disorders. However, there are few real-world studies evaluating the effectiveness of interventions aimed at addressing workplace risk factors and improving doctors' mental health in a hospital setting. This study was conducted over two years (2017-2019) to assess the effects of a multi-modal intervention on working conditions doctors' mental health and help-seeking for mental health problems in two Australian teaching hospitals.
The multimodal intervention consisted of organisational changes, such as reducing unrostered overtime, as well as strategies for individual doctors, such as mental health training programs. Hospital-based doctors at all career stages were eligible to participate in two cross-sectional surveys. 279 doctors completed the baseline survey (19.2% response rate) and 344 doctors completed the follow-up survey (31.3% response rate). A range of workplace risk and protective factors, mental health (psychological distress and suicidal ideation) and help-seeking outcomes were assessed.
There were significant improvements in key workplace protective factors, with small effects found for doctors' job satisfaction, stress, work-life balance and perceived workplace support and a significant reduction in workplace risk factors including a moderate reduction in reported bullying behaviour between baseline to follow-up (job satisfaction p < 0.05, all other outcomes p < 0.01). However, no significant changes in doctors' mental health or help-seeking outcomes were found over the intervention period.
Following the implementation of individual and organisational-level strategies in two Australian tertiary hospitals, doctors reported a reduction in some key workplace stressors, but no significant changes to their mental health or help-seeking for mental health problems. Further research is warranted, particularly to determine if these workplace changes will lead to improved mental health outcomes for doctors once maintained for a longer period.
医生报告称工作压力大，患心理健康障碍的风险增加。然而，很少有真实世界的研究评估旨在解决工作场所风险因素和改善医院环境中医务人员心理健康的干预措施的有效性。本研究在两年（2017-2019 年）内进行，以评估一种多模式干预措施对澳大利亚两所教学医院医生工作条件、心理健康和寻求心理健康问题帮助的影响。
多模式干预包括组织变革，如减少无班额外加班，以及针对个别医生的策略，如心理健康培训计划。所有职业阶段的医院医生都有资格参加两项横断面调查。279 名医生完成了基线调查（响应率为 19.2%），344 名医生完成了随访调查（响应率为 31.3%）。评估了一系列工作场所风险和保护因素、心理健康（心理困扰和自杀意念）和寻求帮助的结果。
关键工作场所保护因素有显著改善，医生工作满意度、压力、工作-生活平衡和感知工作场所支持方面有较小的影响，工作场所风险因素显著减少，包括报告的欺凌行为减少（工作满意度 p<0.05，所有其他结果 p<0.01）。然而，在干预期间，医生的心理健康或寻求帮助的结果没有显著变化。
在澳大利亚两所三级医院实施个人和组织层面的策略后，医生报告称一些关键工作场所压力源有所减少，但他们的心理健康或寻求心理健康问题帮助没有显著变化。需要进一步研究，特别是要确定这些工作场所的变化是否会在更长时间内保持下去，从而改善医生的心理健康结果。
