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干预措施以支持住院医师和研究员在 COVID-19 大流行期间的健康:一项范围综述。

Interventions to Support Resident and Fellow Well-Being During the COVID-19 Pandemic: A Scoping Review.

机构信息

is Associate Professor of Medicine, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates, and Associate Editor, Journal of Graduate Medical Education, Chicago, Illinois, USA.

is Associate Professor of Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates, and Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA.

出版信息

J Grad Med Educ. 2024 Oct;16(5):545-556. doi: 10.4300/JGME-D-24-00016.1. Epub 2024 Oct 15.

Abstract

The COVID-19 pandemic led to rapid and wide-scale changes in graduate medical education and impacted the well-being of frontline physicians, including residents and fellows. While institutions and programs implemented initiatives to support the unique needs of trainees during the pandemic, there remains a gap in the literature in examining the approaches used, the domains of well-being addressed, and the effectiveness of these efforts. To review the literature on interventions designed to promote resident and fellow well-being during the COVID-19 pandemic. The authors conducted a scoping review of the literature published between January 1, 2020, and November 30, 2023, in PubMed, Scopus, Embase, PsycINFO, CINAHL, and ERIC to identify interventions to promote the well-being of trainees during the COVID-19 pandemic. Eighteen articles met inclusion criteria, mainly studies conducted in the United States (14 of 18, 77.8%). Most interventions targeted psychological well-being (16 of 18, 88.9%), with only a few studies that included interventions in the physical or social domains. Interventions entailed redeployment, schedule modifications, communication strategies, and expanded mental health support. Most interventions were limited to a few weeks' duration in the first surge phase of the pandemic. Only 11 studies (61%) reported outcome measures, and only 2 (11%) used instruments with validity evidence. Most studies did not report sufficient data to evaluate study quality. While longer-term outcome data were often lacking, studies described a range of interventions to support resident well-being. Future research should focus on the effectiveness of well-being interventions and include cohorts from more diverse clinical settings.

摘要

COVID-19 大流行导致研究生医学教育迅速广泛地改变,并影响了一线医生(包括住院医师和研究员)的健康。虽然各机构和项目在疫情期间实施了各种举措来支持学员的特殊需求,但在检查所使用的方法、关注的健康领域以及这些努力的有效性方面,文献中仍存在空白。本文旨在回顾旨在促进 COVID-19 大流行期间住院医师和研究员健康的文献。作者对 2020 年 1 月 1 日至 2023 年 11 月 30 日期间在 PubMed、Scopus、Embase、PsycINFO、CINAHL 和 ERIC 上发表的文献进行了范围性回顾,以确定在 COVID-19 大流行期间促进学员健康的干预措施。有 18 篇文章符合纳入标准,主要是在美国进行的研究(18 篇中的 14 篇,77.8%)。大多数干预措施针对心理健康(18 篇中的 16 篇,88.9%),只有少数研究包括身体或社会领域的干预措施。干预措施包括重新部署、调整时间表、沟通策略和扩大心理健康支持。大多数干预措施仅在大流行的第一波高峰期持续数周。只有 11 项研究(61%)报告了结果指标,只有 2 项研究(11%)使用了具有有效性证据的工具。大多数研究没有报告足够的数据来评估研究质量。尽管长期结果数据往往缺乏,但研究描述了一系列支持住院医师健康的干预措施。未来的研究应重点关注幸福感干预措施的有效性,并纳入来自更多样化临床环境的队列。

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