Psychological interventions to foster resilience in healthcare professionals.

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.

authors

Kunzler AM,Helmreich I,Chmitorz A,König J,Binder H,Wessa M,Lieb K

doi

10.1002/14651858.CD012527.pub2

subject

Has Abstract

pub_date

2020-07-05 00:00:00

pages

CD012527

issn

1469-493X

journal_volume

7

pub_type

杂志文章,meta分析
  • Bile acids for primary sclerosing cholangitis.

    abstract:BACKGROUND:Bile acids have been used for treating primary sclerosing cholangitis, but their beneficial and harmful effects remain unclear. OBJECTIVES:To assess the beneficial and harmful effects of bile acids for patients with primary sclerosing cholangitis. SEARCH STRATEGY:We searched The Cochrane Hepato-Biliary Gro...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003626

    authors: Chen W,Gluud C

    更新日期:2003-01-01 00:00:00

  • Multicomponent fortification of human breast milk for preterm infants following hospital discharge.

    abstract:BACKGROUND:Preterm infants are usually growth restricted at hospital discharge. Feeding preterm infants after hospital discharge with nutrient-fortified breast milk (rather than unfortified breast milk) may facilitate more rapid catch-up growth and improve neurodevelopmental outcomes. OBJECTIVES:To determine the effec...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004866.pub2

    authors: Henderson G,Fahey T,McGuire W

    更新日期:2007-10-17 00:00:00

  • WITHDRAWN: Interventions for guttate psoriasis.

    abstract:BACKGROUND:Guttate psoriasis is a distinctive acute form of psoriasis which characteristically occurs in children and young adults. Very little specific evidence-based guidance is available in standard texts to help make rational decisions about treatment options. OBJECTIVES:To assess the effectiveness of treatments f...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001213.pub2

    authors: Chalmers R,O'Sullivan T,Owen CM,Griffiths CE

    更新日期:2019-04-09 00:00:00

  • Methods of preventing bacterial sepsis and wound complications after liver transplantation.

    abstract:BACKGROUND:Bacterial sepsis and wound complications after liver transplantation increase mortality, morbidity, or hospital stay and are likely to increase overall transplant costs. All liver transplantation patients receive antibiotic prophylaxis. This is an update of our 2008 Cochrane systematic review on the same top...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006660.pub3

    authors: Gurusamy KS,Nagendran M,Davidson BR

    更新日期:2014-03-05 00:00:00

  • Planned Caesarean section for term breech delivery.

    abstract:BACKGROUND:Routine use of caesarean section for breech presentation is widespread. However, poor outcomes after breech birth might be the result of underlying conditions causing breech presentation rather than damage during delivery. OBJECTIVES:The objective of this review was to assess the effects of planned caesarea...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000166

    authors: Hofmeyr GJ,Hannah ME

    更新日期:2001-01-01 00:00:00

  • Effectiveness of intermediate care in nursing-led in-patient units.

    abstract:BACKGROUND:The Nursing led inpatient Unit (NLU) is one of a range of services that have been considered in order to manage more successfully the transition between hospital and home for patients with extended recovery times. OBJECTIVES:To determine whether nursing-led inpatient units are effective in preparing patient...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002214.pub2

    authors: Griffiths PD,Edwards MH,Forbes A,Harris RL,Ritchie G

    更新日期:2004-10-18 00:00:00

  • Cervical assessment by ultrasound for preventing preterm delivery.

    abstract:BACKGROUND:Measurement of cervical length by ultrasound is predictive of preterm birth (PTB). There are three methods of ultrasound cervical assessment: transvaginal (TVU), transabdominal (TAU), and transperineal (TPU, also called translabial). Cervical length measured by TVU is a relatively new screening test, and has...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD007235.pub4

    authors: Berghella V,Saccone G

    更新日期:2019-09-25 00:00:00

  • Aerobic physical exercise for adult patients with haematological malignancies.

    abstract:BACKGROUND:Although people with haematological malignancies have to endure long phases of therapy and immobility, which is known to diminish their physical performance level, the advice to rest and avoid intensive exercises is still common practice. This recommendation is partly due to the severe anaemia and thrombocyt...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD009075.pub3

    authors: Knips L,Bergenthal N,Streckmann F,Monsef I,Elter T,Skoetz N

    更新日期:2019-01-31 00:00:00

  • Chemotherapy for second-stage Human African trypanosomiasis.

    abstract:BACKGROUND:Human African trypanosomiasis, or sleeping sickness, is a painful and protracted disease affecting people in the poorest parts of Africa and is fatal without treatment. Few drugs are currently available for second-stage sleeping sickness, with considerable adverse events and variable efficacy. OBJECTIVES:To...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006201.pub2

    authors: Lutje V,Seixas J,Kennedy A

    更新日期:2010-08-04 00:00:00

  • Acellular vaccines for preventing whooping cough in children.

    abstract:BACKGROUND:Routine use of whole-cell pertussis (wP) vaccines was suspended in some countries in the 1970s and 1980s because of concerns about adverse effects. Following such action, there was a resurgence of whooping cough. Acellular pertussis (aP) vaccines, containing purified or recombinant Bordetella pertussis (B. p...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001478.pub5

    authors: Zhang L,Prietsch SO,Axelsson I,Halperin SA

    更新日期:2012-03-14 00:00:00

  • Olanzapine for schizophrenia.

    abstract:BACKGROUND:Olanzapine is an atypical antipsychotic that is reported to be effective without producing the disabling extrapyramidal side effects associated with the older, typical antipsychotic drugs. OBJECTIVES:To determine the clinical effects and safety of olanzapine as compared with placebo, typical and other atypi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001359

    authors: Duggan L,Fenton M,Dardennes RM,El-Dosoky A,Indran S

    更新日期:2000-01-01 00:00:00

  • Hospitalisation and bed rest for multiple pregnancy.

    abstract:BACKGROUND:Bed rest used to be widely advised for women with a multiple pregnancy. OBJECTIVES:The objective was to assess the effect of bed rest in hospital for women with a multiple pregnancy for prevention of preterm birth and other fetal, neonatal and maternal outcomes. SEARCH STRATEGY:We searched the Cochrane Pre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000110.pub2

    authors: Crowther CA,Han S

    更新日期:2010-07-07 00:00:00

  • Dietary fibre for the prevention of colorectal adenomas and carcinomas.

    abstract:BACKGROUND:Colorectal cancer (CRC) is a major cause of morbidity and mortality in industrialized countries. Experimental evidence has supported the hypothesis that dietary fibre may be protective for the development of CRC, although epidemiologic data have been inconclusive. OBJECTIVES:We have conducted a systematic r...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003430

    authors: Asano T,McLeod RS

    更新日期:2002-01-01 00:00:00

  • Treatment for ulnar neuropathy at the elbow.

    abstract:BACKGROUND:Ulnar neuropathy at the elbow is the second most common entrapment neuropathy after carpal tunnel syndrome. Treatment may be conservative or surgical but optimal management remains controversial. This is an update of a review first published in 2010. OBJECTIVES:To determine the effectiveness and safety of c...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006839.pub3

    authors: Caliandro P,La Torre G,Padua R,Giannini F,Padua L

    更新日期:2012-07-11 00:00:00

  • Combined inhaled anticholinergic agents and beta-2-agonists for initial treatment of acute asthma in children.

    abstract:BACKGROUND:Anti-cholinergic agents and beta2-agonist drugs are both bronchodilators used to reverse acute bronchospasm in children with asthma. These drugs have different modes of action, so may have complementary or additive effects. OBJECTIVES:The objective of this review was to assess the effects of adding inhaled ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000060

    authors: Plotnick LH,Ducharme FM

    更新日期:2000-01-01 00:00:00

  • Antithrombotic agents for preventing thrombosis after infrainguinal arterial bypass surgery.

    abstract:BACKGROUND:Peripheral arterial disease (PAD) is frequently treated by either an infrainguinal autologous (using the patient's own veins) or synthetic graft bypass. The rate of occlusion of the graft after one year is between 12% and 60%. To prevent occlusion, patients are treated with an antiplatelet or antithrombotic ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000536.pub2

    authors: Geraghty AJ,Welch K

    更新日期:2011-06-15 00:00:00

  • Interventions to facilitate return to work in adults with adjustment disorders.

    abstract:BACKGROUND:Adjustment disorders are a frequent cause of sick leave and various interventions have been developed to expedite the return to work (RTW) of individuals on sick leave due to adjustment disorders. OBJECTIVES:To assess the effects of interventions facilitating RTW for workers with acute or chronic adjustment...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006389.pub2

    authors: Arends I,Bruinvels DJ,Rebergen DS,Nieuwenhuijsen K,Madan I,Neumeyer-Gromen A,Bültmann U,Verbeek JH

    更新日期:2012-12-12 00:00:00

  • Oral 5-aminosalicylic acid for maintenance of remission in ulcerative colitis.

    abstract:BACKGROUND:Oral 5-aminosalicylic (5-ASA) preparations were intended to avoid the adverse effects of sulfasalazine (SASP) while maintaining its therapeutic benefits. Previously, it was found that 5-ASA drugs were more effective than placebo but had a statistically significant therapeutic inferiority relative to SASP. Th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000544.pub3

    authors: Feagan BG,Macdonald JK

    更新日期:2012-10-17 00:00:00

  • Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age.

    abstract:BACKGROUND:Treatment for lower respiratory tract infections (LRTIs) includes administering complementary oxygen. The effectiveness of oxygen therapy and of different delivery methods remains uncertain. OBJECTIVES:To determine the effectiveness and safety of oxygen therapy and oxygen delivery methods in the treatment o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005975.pub3

    authors: Rojas-Reyes MX,Granados Rugeles C,Charry-Anzola LP

    更新日期:2014-12-10 00:00:00

  • Drugs for treating Schistosoma mansoni infection.

    abstract:BACKGROUND:Schistosoma mansoni is a parasitic infection common in the tropics and sub-tropics. Chronic and advanced disease includes abdominal pain, diarrhoea, blood in the stool, liver cirrhosis, portal hypertension, and premature death. OBJECTIVES:To evaluate the effects of antischistosomal drugs, used alone or in c...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000528.pub2

    authors: Danso-Appiah A,Olliaro PL,Donegan S,Sinclair D,Utzinger J

    更新日期:2013-02-28 00:00:00

  • Treatment of Lennox-Gastaut syndrome.

    abstract:BACKGROUND:The Lennox-Gastaut syndrome is an age-specific disorder, characterised by epileptic seizures, a characteristic electroencephalogram (EEG), psychomotor delay and behaviour disorders. It occurs more frequently in males and onset is usually before the age of eight, with a peak between three and five years. Late...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003277.pub2

    authors: Hancock EC,Cross HH

    更新日期:2009-07-08 00:00:00

  • Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular hemorrhage in preterm infants.

    abstract:BACKGROUND:Preterm birth is known to constitute the major risk factor for development of germinal matrix-intraventricular hemorrhage (GM-IVH). Head position may affect cerebral hemodynamics and thus may be involved indirectly in development of GM-IVH. Turning the head toward one side may functionally occlude jugular ve...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD012362.pub2

    authors: Romantsik O,Calevo MG,Bruschettini M

    更新日期:2017-07-20 00:00:00

  • Antiviral prophylactic intervention for chronic hepatitis C virus in patients undergoing liver transplantation.

    abstract:BACKGROUND:It is not clear whether prophylactic antiviral therapy is indicated in patients undergoing liver transplantation for chronic decompensated hepatitis C virus (HCV) infection. OBJECTIVES:To compare the benefits and harms of different prophylactic anti-viral therapies for patients undergoing liver transplantat...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006573.pub2

    authors: Gurusamy KS,Tsochatzis E,Davidson BR,Burroughs AK

    更新日期:2010-12-08 00:00:00

  • Alpha-2 agonists for long-term sedation during mechanical ventilation in critically ill patients.

    abstract:BACKGROUND:Sedation reduces patient levels of anxiety and stress, facilitates the delivery of care and ensures safety. Alpha-2 agonists have a range of effects including sedation, analgesia and antianxiety. They sedate, but allow staff to interact with patients and do not suppress respiration. They are attractive alter...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010269.pub2

    authors: Chen K,Lu Z,Xin YC,Cai Y,Chen Y,Pan SM

    更新日期:2015-01-06 00:00:00

  • Interventions in the workplace to support breastfeeding for women in employment.

    abstract:BACKGROUND:In recent years there has been a rise in the participation rate of women in employment. Some may become pregnant while in employment and subsequently deliver their babies. Most may decide to return early to work after giving birth for various reasons. Unless these mothers get support from their employers and...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006177.pub3

    authors: Abdulwadud OA,Snow ME

    更新日期:2012-10-17 00:00:00

  • Interventions for disorders of eye movement in patients with stroke.

    abstract:BACKGROUND:Eye movement disorders may affect over 70% of stroke patients. These eye movement disorders can result in difficulty maintaining the normal ocular position and difficulty moving the eyes appropriately. The resulting functional disabilities include a loss of depth perception, reduced hand-to-eye co-ordination...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008389.pub2

    authors: Pollock A,Hazelton C,Henderson CA,Angilley J,Dhillon B,Langhorne P,Livingstone K,Munro FA,Orr H,Rowe FJ,Shahani U

    更新日期:2011-10-05 00:00:00

  • Trifluoperazine versus low-potency first-generation antipsychotic drugs for schizophrenia.

    abstract:BACKGROUND:Antipsychotic drugs are the core treatment for schizophrenia. Treatment guidelines state that there is no difference in efficacy between any other antipsychotic compounds, however, low-potency antipsychotic drugs are often perceived as less efficacious than high-potency compounds by clinicians, and they also...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009396.pub2

    authors: Tardy M,Dold M,Engel RR,Leucht S

    更新日期:2014-07-08 00:00:00

  • Ursodeoxycholic acid for primary biliary cirrhosis.

    abstract:BACKGROUND:Primary biliary cirrhosis is a rare autoimmune liver disease and an effective treatment has been difficult to establish. Some randomised clinical trials have found an effect of ursodeoxycholic acid for primary biliary cirrhosis. OBJECTIVES:Evaluate the beneficial effects and adverse effects of peroral ursod...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000551

    authors: Gluud C,Christensen E

    更新日期:2002-01-01 00:00:00

  • Intravenous immunoglobulin for preventing infection in preterm and/or low birth weight infants.

    abstract:BACKGROUND:Nosocomial infections continue to be a significant cause of morbidity and mortality among preterm and/or low birth weight (LBW) infants. Preterm infants are deficient in immunoglobulin G (IgG); therefore, administration of intravenous immunoglobulin (IVIG) may have the potential of preventing or altering the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000361.pub3

    authors: Ohlsson A,Lacy JB

    更新日期:2013-07-02 00:00:00

  • Antibiotic lock for the prevention of catheter-related infection in neonates.

    abstract:BACKGROUND:Use of a central venous catheter (CVC) in neonates is associated with an increase in nosocomial infection. Numerous strategies exist to prevent catheter-related bloodstream infection (CRBSI); however, CRBSI continues to be a major problem. Antibiotic locking catheters is a new and promising treatment that po...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010336.pub2

    authors: Taylor JE,Tan K,Lai NM,McDonald SJ

    更新日期:2015-06-04 00:00:00