Department of Clinical Korean Medicine, Graduate School, Dong-eui University, 52-57 Yangjeong-ro, Busanjin-gu, Busan, Republic of Korea.
KM Science Research Division, Korea Institute of Oriebtal Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea.
Medicine (Baltimore). 2022 Jun 24;101(25):e29125. doi: 10.1097/MD.0000000000029125.
Mental health problems, including burnout among nurses, are common and important. With the rapid development of information and communication technologies and the rise in use of smartphones, the use of e-mental health strategies is increasing in public and clinical settings, and initial clinical trials using this intervention have been conducted. This systematic review evaluated whether e-healthcare interventions improve burnout and other mental health aspects in nurses.
Six electronic databases including MEDLINE (via PubMed), EMBASE (via Elsevier), the Cochrane Library Central Register of Controlled Trials, the Cumulative Index of Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and PsycARTICLES were searched to collect relevant randomized controlled trials up to January 28, 2021, using e-healthcare interventions for mental health in nurses. The e-healthcare intervention was classified as web-based, smartphone-based, and real-time online interventions. The primary outcome was burnout in this population. Due to the heterogeneity of the interventions used in the included studies, quantitative synthesis was not performed, but included studies were analyzed qualitatively. Also, the details of e-healthcare for the mental health of nurses were analyzed. The methodological quality of included studies was assessed using Cochrane's Risk of Bias tool.
Seven randomized controlled trials were included in this study. The 20-minute session of an online form of the emotional freedom technique was reported to significantly improve burnout severity compared to no intervention (P < .001). Other outcomes, such as career identity, quality of work life, workplace bullying, job stress, turnover intention, distress, anxiety, and resilience in nurses, were also reported to be improved by e-healthcare interventions. The methodological quality of the included studies was generally poor.
In conclusion, there was some evidence that e-healthcare interventions may improve mental health outcomes, including burnout in nurses, compared with no intervention. However, due to the poor methodological quality and wide heterogeneity of the interventions and outcomes in the included studies, we were not able to reach sufficiently reliable conclusions. E-healthcare intervention for nurses in the new coronavirus disease era was discussed. High-quality clinical trials in this area should be conducted in the future.
心理健康问题，包括护士的职业倦怠，是常见且重要的。随着信息和通信技术的快速发展以及智能手机的广泛应用，电子心理健康策略在公共和临床环境中的使用不断增加，并且已经进行了初步的临床试验。本系统评价评估了电子医疗干预措施是否可以改善护士的职业倦怠和其他心理健康方面。
检索了 6 个电子数据库，包括 MEDLINE（通过 PubMed）、EMBASE（通过 Elsevier）、Cochrane 图书馆对照试验中心注册库、护理学和联合健康文献累积索引、联合与补充医学数据库以及 PsycARTICLES，以收集截至 2021 年 1 月 28 日有关护士心理健康的电子医疗干预措施的相关随机对照试验。将电子医疗干预措施分为基于网络、基于智能手机和实时在线干预措施。主要结局是该人群中的职业倦怠。由于纳入研究中使用的干预措施存在异质性，因此未进行定量综合，但对纳入研究进行了定性分析。同时，还分析了护士心理健康的电子医疗详细信息。使用 Cochrane 偏倚风险工具评估纳入研究的方法学质量。
本研究纳入了 7 项随机对照试验。与无干预相比，在线形式的情感自由技术 20 分钟疗程报告显示职业倦怠严重程度显著改善（P<0.001）。其他结果，如护士的职业认同、工作生活质量、工作场所欺凌、工作压力、离职意向、困扰、焦虑和恢复力，也报告通过电子医疗干预得到改善。纳入研究的方法学质量普遍较差。
总之，有一些证据表明，与无干预相比，电子医疗干预措施可能会改善心理健康结果，包括护士的职业倦怠。然而，由于纳入研究中干预措施和结果的方法学质量差且异质性大，我们无法得出足够可靠的结论。讨论了在新冠病毒疾病时代对护士的电子医疗干预。未来应在该领域进行高质量的临床试验。
