Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
STEM, University of South Australia, Adelaide, South Australia, Australia.
BMJ Open. 2023 Jun 29;13(6):e071203. doi: 10.1136/bmjopen-2022-071203.
There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19.
To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals.
Systematic literature review.
Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May-October 2022.
Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included.
Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesised and presented in both quantitative and narrative formats. Meta-analysis was not possible due to variations in study designs and outcomes.
A total of 1663 articles were screened for eligibility, with 33 meeting inclusion criterium. Thirty studies used individually focused interventions, while three were organisationally focused. Thirty-one studies used secondary level interventions (managed stress in individuals) and two were primary level (eliminated stress causes). Mindfulness-based practices were adopted in 20 studies; the remainder used meditation, yoga and acupuncture. Other interventions promoted a positive mindset (gratitude journaling, choirs, coaching) while organisational interventions centred on workload reduction, job crafting and peer networks. Effective outcomes were reported in 29 studies, with significant improvements in well-being, work engagement, quality of life and resilience, and reductions in burnout, perceived stress, anxiety and depression.
The review found that interventions benefitted healthcare workers by increasing well-being, engagement and resilience, and reducing burnout. It is noted that the outcomes of numerous studies were impacted by design limitations that is, no control/waitlist control, and/or no post intervention follow-up. Suggestions are made for future research.
自 COVID-19 爆发以来，对医疗工作者幸福感的干预措施的需求不断增加。
综合自 2015 年以来针对旨在解决医生、护士和医疗保健专业人员幸福感和倦怠问题的干预措施的影响的证据。
系统文献综述。
2022 年 5 月至 10 月，在 Medline、Embase、Emcare、CINAHL、PsycInfo 和 Google Scholar 上进行了搜索。
主要研究倦怠和/或幸福感，并使用经过验证的幸福感措施报告可量化的干预前和干预后结果的研究。
两名研究人员使用医学教育研究研究质量工具独立筛选和评估全文文章。结果以定量和叙述格式呈现。由于研究设计和结果的差异，无法进行荟萃分析。
共筛选出 1663 篇符合入选标准的文章，其中 33 篇符合入选标准。30 项研究采用个体为重点的干预措施，3 项为组织为重点的干预措施。31 项研究采用二级干预措施（个体压力管理），2 项为一级干预措施（消除压力源）。20 项研究采用正念实践；其余的使用冥想、瑜伽和针灸。其他干预措施促进了积极的心态（感恩日记、合唱团、教练），而组织干预措施则侧重于减少工作量、工作重塑和同伴网络。29 项研究报告了有效的结果，幸福感、工作投入、生活质量和韧性显著提高，倦怠、感知压力、焦虑和抑郁显著降低。
该综述发现，干预措施通过提高幸福感、参与度和韧性，降低倦怠感，使医疗工作者受益。需要注意的是，许多研究的结果受到设计限制的影响，即没有对照组/等待组对照，和/或没有干预后随访。为未来的研究提出了建议。
