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一项旨在提高英国新入职医生幸福感的干预措施的系统评价。

A systematic review of interventions aiming to improve newly-qualified doctors' wellbeing in the United Kingdom.

机构信息

Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Psychiatric Liaison Team, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK.

出版信息

BMC Psychol. 2022 Jun 26;10(1):161. doi: 10.1186/s40359-022-00868-8.

Abstract

BACKGROUND

Newly-qualified doctors in the United Kingdom experience a great deal of stress and have poor wellbeing when compared to more senior counterparts. A number of interventions have been put in place to boost healthcare professionals' wellbeing, but little is known about interventions aimed to improve the wellbeing of newly-qualified doctors in the United Kingdom. This study aims to systematically review current evidence of interventions which improved the wellbeing of newly-qualified junior doctors in the United Kingdom.

METHODS

Five key electronic databases were searched. Subsequently, reference scanning and citation search was performed. Studies were included if they were conducted from the commencement of the Foundation Programme in 2004, until 2019. In addition, studies had to be performed on junior doctors: working in the United Kingdom and within their first five years post-qualification and have a quantitative outcome. Studies which did not meet these criteria were excluded. Quality was assessed using the modified Newcastle-Ottawa scale. Bias was not formally assessed using a standardised tool.

RESULTS

Seven papers met the inclusion criteria and identified three main types of interventions: mentorship, mindfulness and clinical preparation interventions. The majority of included studies reported a positive result from the performed intervention, suggesting these to be beneficial in improving junior doctor wellbeing, and thereby reducing anxiety and stress levels. However, most of the studies used small sample sizes.

CONCLUSIONS

This review reveals that there is dearth of evidence on the effectiveness of intervention to improve the wellbeing of newly-qualified doctors in the United Kingdom. Most of the identified interventions focused on relieving stress and anxiety inherent within newly-qualified doctors' training programmes. However, wellbeing interventions need to take into cognisance all the factors which impact on wellbeing, particularly job-related factors. We recommend that future researchers implement large-scale holistic interventions using appropriate research methods.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42019127341.

摘要

背景

与资深同行相比,英国的新入职医生压力很大,整体健康状况不佳。为了提高医疗保健专业人员的健康水平,已经实施了许多干预措施,但对于旨在改善英国新入职医生健康状况的干预措施知之甚少。本研究旨在系统地回顾目前改善英国新入职初级医生健康状况的干预措施的证据。

方法

搜索了五个主要的电子数据库。随后,进行了参考文献扫描和引文搜索。如果研究是在 2004 年开始基础课程以来进行的,并且研究对象是在英国工作、在获得资格后五年内的初级医生,并且有定量结果,则将其纳入研究。此外,研究必须满足以下标准:不符合这些标准的研究被排除在外。使用改良的纽卡斯尔-渥太华量表评估质量。未使用标准化工具正式评估偏差。

结果

有 7 篇论文符合纳入标准,确定了三种主要类型的干预措施:指导、正念和临床准备干预。大多数纳入的研究报告称,所进行的干预措施取得了积极的结果,这表明这些干预措施有利于改善初级医生的健康状况,从而降低焦虑和压力水平。然而,大多数研究都使用了小样本量。

结论

本综述表明,关于干预措施有效性的证据不足,无法改善英国新入职医生的健康状况。大多数确定的干预措施都侧重于缓解新入职医生培训计划中固有的压力和焦虑。然而,健康干预措施需要考虑到影响健康的所有因素,特别是与工作相关的因素。我们建议未来的研究人员使用适当的研究方法实施大规模的整体干预措施。

系统评价注册

PROSPERO CRD42019127341。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c5b/9235154/636b71422790/40359_2022_868_Fig1_HTML.jpg

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