Psychological interventions to foster resilience in healthcare professionals

Publikationstyp:
Zeitschriftenaufsatz
Metadaten:
Autoren
  • Angela M Kunzler
  • Isabella Helmreich
  • Andrea Chmitorz
  • Jochem Koenig
  • Harald Binder
  • Michele Wessa
  • Klaus Lieb
Autoren-URL
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=fis-test-1&SrcAuth=WosAPI&KeyUT=WOS:000568666400016&DestLinkType=FullRecord&DestApp=WOS_CPL
DOI
10.1002/14551858.CD012527.pub2
eISSN
1361-6137
Externe Identifier
  • Clarivate Analytics Document Solution ID: NN3BJ
ISSN
1469-493X
Ausgabe der Veröffentlichung
7
Zeitschrift
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
Artikelnummer
ARTN CD012527
Datum der Veröffentlichung
2020
Status
Published
Titel
Psychological interventions to foster resilience in healthcare professionals
Sub types
  • Review

Datenquelle: Web of Science (Lite)

Andere Metadatenquellen:
Autoren
  • Angela M Kunzler
  • Isabella Helmreich
  • Andrea Chmitorz
  • Jochem König
  • Harald Binder
  • Michèle Wessa
  • Klaus Lieb
DOI
10.1002/14651858.cd012527.pub2
eISSN
1465-1858
Ausgabe der Veröffentlichung
7
Zeitschrift
Cochrane Database of Systematic Reviews
Sprache
en
Online publication date
2020
Status
Published online
Herausgeber
Wiley
Herausgeber URL
http://dx.doi.org/10.1002/14651858.cd012527.pub2
Datum der Datenerfassung
2022
Titel
Psychological interventions to foster resilience in healthcare professionals
Ausgabe der Zeitschrift
2020

Datenquelle: Crossref

Abstract
<h4>Background</h4>Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes.<h4>Objectives</h4>To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists).<h4>Search methods</h4>We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results.<h4>Selection criteria</h4>Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors.<h4>Data collection and analysis</h4>Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only).<h4>Main results</h4>We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence).<h4>Authors' conclusions</h4>For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.
Addresses
  • Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
Autoren
  • Angela M Kunzler
  • Isabella Helmreich
  • Andrea Chmitorz
  • Jochem König
  • Harald Binder
  • Michèle Wessa
  • Klaus Lieb
DOI
10.1002/14651858.cd012527.pub2
eISSN
1469-493X
Externe Identifier
  • PubMed Identifier: 32627860
  • PubMed Central ID: PMC8121081
Open access
false
ISSN
1469-493X
Zeitschrift
The Cochrane database of systematic reviews
Schlüsselwörter
  • Humans
  • Occupational Diseases
  • Stress, Psychological
  • Adult
  • Middle Aged
  • Health Personnel
  • Allied Health Personnel
  • Female
  • Male
  • Randomized Controlled Trials as Topic
  • Resilience, Psychological
  • Mindfulness
  • Cognitive Behavioral Therapy
Sprache
eng
Medium
Electronic
Online publication date
2020
Paginierung
CD012527
Datum der Veröffentlichung
2020
Status
Published
Datum der Datenerfassung
2020
Titel
Psychological interventions to foster resilience in healthcare professionals.
Sub types
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review
  • systematic-review
  • Journal Article
Ausgabe der Zeitschrift
7

Files

https://europepmc.org/articles/PMC8121081?pdf=render

Datenquelle: Europe PubMed Central

Abstract
BACKGROUND: Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES: To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists). SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA: Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS: We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence). AUTHORS' CONCLUSIONS: For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.
Autoren
  • Angela M Kunzler
  • Isabella Helmreich
  • Andrea Chmitorz
  • Jochem König
  • Harald Binder
  • Michèle Wessa
  • Klaus Lieb
Autoren-URL
https://www.ncbi.nlm.nih.gov/pubmed/32627860
DOI
10.1002/14651858.CD012527.pub2
eISSN
1469-493X
Externe Identifier
  • PubMed Central ID: PMC8121081
Ausgabe der Veröffentlichung
7
Zeitschrift
Cochrane Database Syst Rev
Schlüsselwörter
  • Adult
  • Allied Health Personnel
  • Cognitive Behavioral Therapy
  • Female
  • Health Personnel
  • Humans
  • Male
  • Middle Aged
  • Mindfulness
  • Occupational Diseases
  • Randomized Controlled Trials as Topic
  • Resilience, Psychological
  • Stress, Psychological
Sprache
eng
Country
England
Paginierung
CD012527
Datum der Veröffentlichung
2020
Status
Published online
Datum, an dem der Datensatz öffentlich gemacht wurde
2020
Titel
Psychological interventions to foster resilience in healthcare professionals.
Sub types
  • Journal Article
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review
Ausgabe der Zeitschrift
7

Datenquelle: PubMed

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