GHQ: General health questionnaire The loss of participants was mostly low. It could be that it is more difficult to change someone's score on the personal accomplishment subscale with an intervention. Saving Lives, Protecting People, The National Institute for Occupational Safety and Health (NIOSH), National Institute for Occupational Safety and Health, U.S. Department of Health & Human Services. 483 4). (b) If studies compared more than one active intervention we chose the most intensive intervention to enter into the metaanalysis. Where necessary, we sought missing statistical data (means and standard deviations) from authors. We conducted the extraction of data by using a madetomeasure data extraction form filled in independently by two review authors (JR and JV or AM and CS) for each study. 2020;110(10):10109. In addition, we located three ongoing studies (GomezGascon 2013; Niks 2013; Spoor 2010) for which we could not find published outcome data. (p. 425), "At Time 1, 1,173 health care workers in three district health authorities in Nova Scotia and two hospitals in Ontario completed a survey (n 262 in the intervention units and n 911 in the contrast units). (i) Up to one month Two studies (Ali 2011; Lucas 2012) compared only active interventions, that is, different work schedules with one another. Razavi D, Moyle 2013 compared footmassage to silent resting under similar conditions and found resting to be more effective but there were only 19 participants (Analysis 4.1). Twelve of the included studies had been conducted before the year 2000, 22 between the years 2000 and 2010, and 24 in 2010 or later. Christensen JF, Schaufeli WB, The mean stress at 1 6 months in the intervention groups was 1.83 points lower (0.77 to 2.85 lower). (p. 419), "Subjects admitted to the study agreed to random treatment assignment and a 2month commitment to the study. ArroyoMorales M, Larrimore D, Holzhauser K, Li 2011 ( 49 participants) organised a peersupport mentoring scheme among nurses and did not find a substantive difference between the intervention and nointervention control group (SMD 0.35; 95% CI 0.95 to 0.24) (Analysis 5.1). For Norvell 1987, we took the posttreatment values and calculated SDs based on the P value. The https:// ensures that you are connecting to the Keywords: Research that did not involve occupational stress and/burnout and COVID-19. Liao KW, BREATHE: a pilot study of a oneday retreat to reduce burnout among mental health professionals, The impact of cognitive behavioral interventions on SOC, perceived stress and mood states of nurses, The evaluation of a burnout workshop for community nurses, Journal of Health and Human Services Administration. MBI: Maslach burnout inventory Ader H, For CBT versus no intervention with a followup of one month, there were two studies that could be included which showed significant improvements in emotional exhaustion (Analysis 7.1). Organisational interventions that are measures to change resources, the working environment, work tasks or working methods. Evaluation of an intervention programme based on empowerment for eldercare nursing staff. Abstract. One study measured anxiety but did not find a considerable effect on anxiety of CBT compared to an alternative intervention (MD 0.12; 95% CI 1.94 to 1.70; 26 participants) (Analysis 2.3). Redhead 2011 organised special care for managing symptoms in patients but the stress levels in staff were similar in the nointervention control group (SMD 0.08; 95% CI 0.78 to 0.95; 21 participants) (Analysis 5.3). For West 1984 we took the means and SDs that resulted from the post hoc comparisons in the repeated measures analyses. Clusterrandomised trials should adjust their results for the clustering effect and report the clustercoefficients. We think the new categorisation into cognitivebehavioural, mental and physical relaxation and organisational interventions is more informative. Also, this study will include articles that: Involved frontline healthcare workers (doctors, nurses, biomedical scientists, and pharmacists). They agree with our conclusions that the design of stress interventions should be more driven by theory. Campbell JK, Smith J, Formal power calculations are often missing and the personnel of one single department are randomised into an intervention and a control group. Russo G. Evaluation and art therapy treatment of the burnout syndrome in oncology units, Effectiveness of a stress management program in reducing anxiety and depression in nursing students, Effect of organizational intervention on job burnout of the Plateau nurses in Tibet. There was no effect in one study of CBT plus relaxation on the General Health Questionnaire score compared to no intervention (Gardner CBT 2005) (MD 0.29; 95% CI 1.96 to 2.54; 27 participants) (Analysis 1.6). The effect of foot massage on longterm care staff working with older people with dementia: a pilot, parallel group, randomized controlled trial. Occupational stress is a harmful response particularly physical and emotional, due to a mismatch between job requirements and the qualifications, resources, and worker's needs; its . The title of this review has changed from Effectiveness of occupational stress management programmes to Preventing occupational stress in healthcare workers. A narrative synthesis will be conducted, and a summary of the findings reported. Von Baeyer 1983 reported the results of the first period separately and we included these. VB and DK reviewed the manuscript and made critical revisions. Grtner FR, International Occupational Safety and Health - Ludwig-Maximilians-Universitt (LMU) Mnchen - study in Munich, Germany Development and implementation of a participative intervention to improve the psychosocial work environment and mental health in an acute care hospital, Longterm effects of an intervention on psychosocial work factors among healthcare professionals in a hospital setting, The effect of chair massage on stress perception of hospital bedside, Journal of Bodywork and Movement Therapies. (p. 940). Employees who described their position as temporary (Time 1, n 8; Time 2, n 13) were dropped from the analysis." The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Hanna GB, Another study (Bourbonnais 2011) compared an intervention programme aimed at reducing psychosocial stressors at work with no intervention in a nonrandomised controlled design and found a lower level of stress at three years' followup (SMD 0.38; 95% CI 0.56 to 0.20; 488 participants) (Analysis 5.3). "All subjects were randomly assigned to Group A or Group B (mean 10.6 subjects/group) based upon the crossover design." With the MBI (Maslach 1996), for example, there is no generally accepted change that would be regarded as clinically relevant. government site. Klatt M, The same study found an increase on The Short Form Health Survey (SF36) score (MD 7.40; 95% CI 0.79 to 14.01) (Analysis 5.4). Comparison 14 Relaxation vs. no intervention (SUBGROUPS) (SMD), Outcome 2 Any stress outcome (followup 1 6 months). POMS: Profile of Mood States When the above eight studies are combined, cognitivebehavioural intervention with or without relaxation reduces stress when compared to no intervention (SMD 0.38; 95% CI 0.59 to 0.16) at one to six months followup (Analysis 1.2). Reina Alonso CN. Jones M, Despite trying to contact the authors, we were not able to get enough information to include this study in the metaanalysis. Comparison 5 Organisational intervention vs. no intervention (SMD), Outcome 3 Any stressrelated outcome (followup more than 6 months). There is no intervention aimed at preventing or treating stress or burnout. 2023 Feb 27;20(5):4230. doi: 10.3390/ijerph20054230. Borges TP, Followup time should be at least one year, to be sure that results of the intervention are lasting. Vinet A, Short Communication: Association of psychological and physiological measures of stress in healthcare professionals during an 8week mindfulness meditation program: mindfulness in practice, A career counseling program for dentists: Effects on burnout, Reducing occupational psychological distress: a randomized controlled trial of a mailed intervention. The effect of a biofeedbackbased stress management tool on physician stress: a randomized controlled clinical trial, The effect of a peermentoring strategy on student nurse stress reduction in clinical practice, Impact of management change and an intervention program on health care personnel, Psychophysiological concomitants of organizational change in health care personnel: effects of a controlled intervention study. Ketelaar SM, "It is performed while the practitioner is using intent to remove blockages from the energy channels, as well as pressure on designated "points" or areas of the body." Thus self efficacy may increase and jobs may be perceived as more rewarding. Burnout and occupational stress are both considered to result from exposure to stressors at work, the effects of which are mediated by personal coping or the ability to deal with environmental stressors at a personal level (Cooper 2001; Schaufeli 2003). In addition to the database searches, we will manually search the reference list of included articles as well as the World Health Organizations website for relevant papers. Comparison 2 Cognitivebehavioural intervention vs. nonstress management intervention (SMD), Outcome 2 Any stress scale (followup more than 6 months). Helping the helpers: mindfulness training for burnout in pediatric oncologya pilot program. (p. 487), "No blinding was applied to the participants and the researchers." Smeets O, We categorised relaxation interventions as: physical: Bittman 2003; Brennan 2006; Griffith 2008; Hansen 2006; Kurebayashi 2012; Lai 2011; Lemaire 2011; McElligott 2003; Palumbo 2012; Saganha 2012; Tsai 1993; Yazdani 2010; Yung 2004; and mental relaxation: CohenKatz 2005; Klatt 2012; Mackenzie 2006; Moody 2013; Oman 2006; Shapiro 2005; Stanton 1988. It seems therefore that no review has covered all recent studies on stress management in healthcare staff published after 2010. 1) Experimental: 4 weeks of Stress Inoculation (SI) training divided as: MBI (used frequency and intensity separately for each subscale); we used Emotional Exhaustion intensity scores. Some healthcare workers report symptoms consistent with post-traumatic stress disorder related to the pandemic. Language, publication type, and study design limitations will be removed; however, the search will be limited to humans and date (from January 2020 to the search date in 2023). When the above two studies are combined, cognitivebehavioural intervention with or without relaxation appears to reduce stress when compared to no intervention (SMD 1.04; 95% CI 1.37 to 0.70) at more than six months followup (Analysis 1.3). As a result of the additional occupational stress and burnout HCWs are potentially experiencing in this era of COVID-19 [7], the quality of care healthcare delivery or services may be affected if left unchecked, especially in lower-and-middle-income countries including African countries with inadequate healthcare professionals. However, the subjects did not know whether they would receive treatment or control procedures during that time." Provided by the Springer Nature SharedIt content-sharing initiative. Chi-square and logistic regression analyses were conducted. Farvacques C, No imputation of data, 131 healthcare workers who scored above the 75th percentile on the exhaustion dimension of the Oldenburg Burnout Inventory. Effects on Healthcare Workers and on Healthcare Systems. (p. S51), "Missing values on items that were part of a scale or subscale were replaced according to the "mean value of valid subtests" principle (i.e. 2022 Dec 1;17(12):e0278459. Our findings suggest that HCWPs working with vulnerable populations need specialized interventions that bolster their mental health and well-being as the pandemic continues to unfold. (p. 480). Bookshelf Participants were physicians, nurses and radiotherapy assistants. Toniolo D, Takamiya T, We calculated a tvalue and subsequent SDs by taking the square root of the Fvalue as the tvalue. 40 staff physicians practising in an urban tertiary care centre, 1) Experimental: Biofeedbackbased stress management (n = 21). 1) Experimental: Fullbody massage: 6 consecutive weekly 90minute fullbody aromatherapy massages. There were no differences in effect between the subgroups but the power of the test to detect these differences is low. MBI: Maslach burnout inventory. 1) Experimental: MindfulnessBased Stress Reduction programme: 8 weekly 2hour training sessions about employing the techniques involved in sitting meditation, body scan, hatha yoga, 3minute breathing space (a "minimeditation") and a "loving kindness" meditation. 50 employees of the Denver Veterans Affairs Medical Center. Both state and trait anxiety decreased in the CBT plus relaxation intervention studies (Jones 2000a; Von Baeyer 1983; West 1984; 135 participants) more than after no intervention: mean difference (MD) 11.07; 95% CI 18.39 to 3.75 and MD 8.36; 95% CI 10.02 to 6.70 at one month followup (Analysis 1.4). In addition, strategies described as having an interface/organisational focus were included. Arksey and OMalleys methodological framework will be used to guide this scoping review. This included interventions directed at healthcare workers officially employed in any healthcare setting or at student nurses or physicians otherwise in training to become a professional who were also doing clinical work. Twentytwo studyarms examined relaxation interventions. Paesmans M. The effects of a 24h psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study. Training occurred over 20 weeks, with group sessions every 2 weeks, and each session lasting 2 hours. Bezjak A, 5.1.4 Changing working conditions vs. no intervention. There is some evidence that the emotional exhaustion scale of the MBI can be replaced by a singleitem question on selfdefined burnout (Rohland 2004). Because the characteristics of interventions designed for healthcare workers may be different from those of other occupations, the aim of this review is to determine the effectiveness of interventions to reduce stress specifically in healthcare workers. Bredart A, 3 Publication bias detected with funnel plot. (p. 146). Toniolo D, PubMed Central An official website of the United States government. One study (McElligott 2003) did not find a significant difference in anxiety between participants who had received AMMA therapeutic massage and those who had received the control procedure where the practitioners only held their hands on certain areas of the participants' bodies (SMD 0.17; 95% CI 1.15 to 0.82; 18 participants) (Analysis 4.2). Uchiyama A, Organisational interventions showed mixed evidence of benefit. When compared to older reviews such as Mimura 2003, our review, even though it used more rigorous inclusion criteria, only accepting randomised controlled trials for persondirected interventions, found 51 more trials. We thank the Cochrane Occupational Safety and Health Review Group's Trials Search Coordinator Leena Isotalo for conducting the many rounds of update searches. Only for relaxation versus no intervention was the evidence of moderate quality. In the 2nd session participants were taught cognitive strategies for reducing stress (e.g. The other outcome measures were each used by one study only: 4dimension complaint checklist (Ketelaar 2013), Brief Job Stress Questionaire (Yamagishi 2008), Depression Anxiety Stress Scale (Yazdani 2010), Derogatis Stress Profile (Jones 2000a), Effort Reward Imbalance Questionnaire (Uchiyama 2013), Job Stress Questionnaire (Hansen 2006), The Mental Health Professional Stress Scale (Gardner CBT 2005), Nurse Stress Checklist (see Benoliel 1990) (Tsai 1993), Occupational Stress Indicator (see Cooper 1988) (Proctor 1998), Organisation and Stress Scale (Finnema 2005), The General Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic) (Peterson 2008), Symptom Checklist90 (see Derogatis 1976; Derogatis 1983) (Heaney 1995), Somatic Stress (Kwok 2012), Stress Profile (Stanton 1988), Stress Symptom Checklist (Kurebayashi 2012), Structured Stress Questionnaire (Lkk 2000), and Stress Visual Analogue Scale (Lai 2011). Perry BL, Aronson B, Pescosolido BA. For Martins 2011, we imputed the average of the SDs from the other studies in the same comparison. Study designs (p. 5). Even though only a fraction of all the studies could be included, this analysis showed similar results. Toomingas A. "Of the 65 participants, 35 were randomly assigned to the experimental condition and the remaining 30 were put to the control condition. There is lowquality evidence that changing working schedules reduces stress levels. Copyright 2021 Salgado de Snyder, Villatoro, McDaniel, Ocegueda, Garcia and Parra-Medina. Trick W, Hoffmann SP, Bormann JE, "[N]o significant changes were found in either of the intervention arms in the Maslach Burnout Inventory, the Setterlind stress scores, or the rating of social support (data not shown)" (p. 1765), 79 student nurses reporting significant levels of affective distress at screen. Oman D, Occupational stress leads to emotional burnout, can cause anxiety, depression and other psychopathological symptoms, influencing the quality of medical care. ShanerMcRae H, Davenport MC, Every time 20 nurses were enrolled, the nurses were randomly allocated to a training group (TG) or to a control group (CG). Represent Interv. Razavi D, Nieuwenhuijsen K, Dirks KR, Altogether we excluded 56 studies, leaving a total of 14 new studies. Mental relaxation (e.g. Moyle W, volume12, Articlenumber:34 (2023) "The study population was composed of all careproviding personnel in the experimental (n = 674) andcontrolhospitals(n = 894),bothofwhich offer general and specialised shortterm care. Ebadi A. For studies with a crossover design we judged if a sufficient washout period was used in the study design. Google Scholar. We deemed an I value of more than 50% to indicate considerable heterogeneity. MBI, Perceived Stress Scale, Brief Symptom Inventory, "Participants were randomly assigned to an 8week MBSR group or a waitlist control group." They conclude that many strategies to prevent burnout that are mentioned in the literature have not been evaluated, such as the introduction of competitive salaries, financial and nonfinancial incentives, opportunities for promotion and career advancement, increased staffing levels, clear job descriptions or expectations, and opendoor policies with management. (p. 397), "the participants were randomly assigned to two groups; experiment and control. Carretero Romn J, The same study (Yung 2004) also found a difference in State Anxiety between participants in the control group and participants that received a stretchrelease relaxation intervention (Analysis 3.4), but again not on Trait Anxiety (Analysis 3.5). Comparison 10 Relaxation vs. no intervention (MD), Outcome 1 Maslach Burnout Inventory (followup 1 6 months). Other sources resulted in another six potential studies. Comparison 13 Cognitivebehavioural intervention vs. no Intervention (SUBGROUPS) (SMD), Outcome 1 Any Stressrelated Outcome (followup up to 1 month). We assumed that outcomes that were measured by questionnaire were reported blind to the researchers but we could not be certain about this assumption. Gilbody 2006 reviewed interventions to improve the morale of staff, restricted to mental healthcare workers only. Gershwin M, At more than six months' followup, organisational interventions again yielded favourable effects on the emotional exhaustion and depersonalisation subscales but not on lack of personal accomplishment (Analysis 11.3). Doenitz C, The General Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic), Oldenburg Burnout Inventory, The Hospital Anxiety and Depression Scale, The Short Form Health Survey (SF36), "The randomization procedure was performed by a statistician using the Statistical Analysis Software, version 8.2." We switched the forest plot labels around and corrected the text, thus fixing the problem. All authors commented on the draft. Louie AM, Kurebayashi LF, Moody K, Take care! AugustoLanda J, In the USA alone, over 250,000 health workers were reported to have been infected, and nearly 1000 deaths have occurred [6]. Mba B, The occupational categories with the highest response rates included registered nurses (RNs; n 607, 51.7%), registered psychiatric nurses (RPNs; n 74, 6.3%), ward clerks (n 52, 4.4%), physicians (n 46, 3.9%) and licensed practical nurses (LPNs; n 42, 3.6%). Now it says: "Another study (Bourbonnais 2011) compared an intervention programme aimed at reducing psychosocial stressors at work with no intervention in a nonrandomised controlled design and found a lower level of stress at three years' followup (SMD 0.38; 95% CI 0.56 to 0.20; 488 participants) (Analysis 5.3).". Visit the Training and Resources Page to find more information on preventing potential adverse mental health outcomes. Cooke M, et al. Evaluated R. A. Karasek's (1979, 1981) model of occupational stress which incorporates control and socialization effects. Cavagin J, This metaanalysis was back transformed to the EE subscale of the MBI by using the median SD of the EE scale across control groups. Two reviews (AG, YB) will extract the data from the included studies independently using a piloted tested form. "The study intervention was a single 90min session training in the SMART program. This proportion was higher among nurse compared to doctor (8.0% vs. 2.2%); among those with diploma literacy compared to bachelor and above (10.6% and 2.3%). This was followed by training in relaxation and deep breathing. Many healthcare workers place thewell-being of others before self. Eijkman M. Burnout intervention among Dutch dentists: longterm effects, The evaluation of an individual burnout intervention program: the role of inequity and social support. This site needs JavaScript to work properly. Because in many cases different instruments were used to measure stress, we transformed the means into standardised mean differences (SMDs) or effect sizes. The study results are reported only as regression coefficients and thereby could not be entered into metaanalysis.