Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review

Clough, Bonnie A. and March, Sonja and Chan, Raymond J. and Casey, Leanne M. and Phillips, Rachel and Ireland, Michael J. (2017) Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review. Systematic Reviews, 6 (1).

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Abstract

Background: Occupational stress and burnout are highly prevalent among medical doctors and can have adverse effects on patient, doctor, and organisational outcomes. The purpose of the current study was to review and evaluate evidence on psychosocial interventions aimed at reducing occupational stress and burnout among medical doctors.

Method: A systematic review was conducted for original research articles reporting on psychosocial interventions targeting occupational stress or burnout among medical doctors, published in the English language, and with data collected at a minimum of two time points. Searches were conducted across five electronic databases, as well as by manual search of Google Scholar. Data was extracted relating to study characteristics and outcomes, quality and rigour, as well as modes of delivery and engagement. Studies were appraised using the Strength of Recommendation Taxonomy (SORT) and Critical Appraisal Skills Programme (CASP).

Results: Twenty-three articles were reviewed, which reported on interventions utilising cognitive-behavioural, relaxation, and supportive discussion strategies. Only 12 studies allowed estimation of pre- to post-intervention effects. Cognitive behavioural interventions demonstrated the strongest evidence, particularly for reducing stress. Some evidence was identified to support the efficacy of relaxation-based approaches, but no such evidence was found for the efficacy of discussion-based interventions, such as Balint groups. There was a lack of quality among reviewed studies, with no studies receiving a quality rating of 1, and the overall body of evidence being rated as level B, according to the SORT. Effect sizes were not pooled due to a lack of quality among the study sample.

Conclusion: This review found that despite increased scientific attention, the quality of research examining the benefits of psychosocial/behavioural interventions for occupational stress and burnout in medical doctors remains low. Despite this, interventions focused on cognitive and behavioural principles appear to show promise in reducing doctor stress and burnout. Limitations of the current review include a lack of risk of bias assessment or pooling of analyses. Recommendations for improving the quality of research in this area, as well as implications of the current body of evidence are discussed.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Faculty / Department / School: Current - Faculty of Health, Engineering and Sciences - School of Psychology and Counselling
Date Deposited: 04 Feb 2018 23:50
Last Modified: 06 Feb 2018 05:43
Uncontrolled Keywords: stress, burnout, doctors, physician, medical practitioner
Fields of Research : 11 Medical and Health Sciences > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified
17 Psychology and Cognitive Sciences > 1701 Psychology > 170199 Psychology not elsewhere classified
17 Psychology and Cognitive Sciences > 1701 Psychology > 170106 Health, Clinical and Counselling Psychology
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111714 Mental Health
Socio-Economic Objective: C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920410 Mental Health
C Society > 92 Health > 9202 Health and Support Services > 920299 Health and Support Services not elsewhere classified
Identification Number or DOI: 10.1186/s13643-017-0526-3
URI: http://eprints.usq.edu.au/id/eprint/32781

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