Interventions for individual healthcare workers may help reduce work-related stress for up to a year later

Interventions aimed at reducing work-related stress for individual healthcare workers may lead to improvements in how people deal with stress up to a year later. Findings from a Cochrane review of the latest available evidence build on the conclusions of an earlier review in 2015 that found low-quality evidence that interventions such as cognitive behavioral training (CBT), mental and physical relaxation, were better than nothing.

The researchers included 117 studies on the effects of various interventions on stress relief in the current review, of which 89 were new studies. These 89 studies were published between 2013 and 2022. A total of 11,119 healthcare workers worldwide were randomized to different interventions, and stress was assessed through questionnaires measuring symptoms of stress in the short term (up to three months after the intervention ended). , medium-term (between three and 12 months) and long-term (follow-up after more than a year).

The review from Cochrane, a collaboration of independent international experts, looked at interventions at the level of an individual healthcare worker that focused attention either on the experience of stress, or away from the experience of stress. Strategies for focusing attention on stress included cognitive-behavioral therapy and training in assertiveness, coping, and communication skills. Interventions that focus attention away from stress include relaxation, mindfulness meditation, exercise such as yoga and tai chi, massage, Acupuncture, and listen to music. The researchers wanted to see if different types of interventions were better than no intervention at reducing stress.

The health care workers in the studies were experiencing low to moderate levels of stress and burnout, which can lead to physical symptoms such as headaches, muscle tension or pain, but also mental symptoms, such as depression, anxiety, poor concentration, and emotional and relationship problems. .

“Health care workers often deal with stressful and emotional situations in patient care, human suffering, and stress from relationships with patients and family members,” said Setke Taminga, assistant professor of public and occupational health at the University of Amsterdam Medical Centre, Amsterdam, Netherlands, who led the research. and employers, as well as high job requirements and long working hours.

“We found that health care workers may be able to reduce their stress with interventions at the individual level such as cognitive behavior training, exercise or listening to music. This may be beneficial for health care workers themselves and may extend to the patients they care for, and the organizations they care for. The effect may last for up to a year, and a combination of interventions may also be beneficial, at least in the short term. Employers should not hesitate to facilitate a combination of stress management interventions for employees. The long-term effects of stress management interventions are still unknown.” .

The researchers say that larger and better-quality studies are needed to look at the short- and long-term effects of interventions at the individual level in order to increase certainty in the evidence.

We need more studies of interventions that address work-related risk factors at both the individual and organizational levels. It may be better to improve working conditions themselves, rather than just helping individuals cope better with heavy psychological and social burdens. For example, employers can address issues of understaffing, overwork, and antisocial shift patterns. If you are committed to change, you need to change the underlying risk factors rather than focusing on the symptoms.”

Dr.. Setke Taminga, MD, Assistant Professor of Public and Occupational Health, University of Amsterdam Medical Center, Amsterdam, Netherlands

Research limitations include: estimates of the effects of stress management interventions at the individual level may be biased by lack of blinding of participants in the included studies; Many of the studies were small; And there have been very few studies that have focused on specific factors that can cause stress in the workplace.

Studies have reported that between 30% to 70% of doctors and nurses and 56% of anesthesiologists experience symptoms of burnout as a result of their work. Previous research has tended to focus on a specific type of intervention in specific groups of healthcare workers. The authors of this Cochrane review write: “To our knowledge, there are no recent reviews examining the effectiveness of different types of interventions at the individual level aimed at reducing stress in different healthcare workers to provide a more complete overview.”

“There is already a shortage of healthcare workers due to high turnover rates, and effective prevention of stress and burnout may help reduce this,” concluded Dr. Taminga.