Interventions to reduce the consequences of stress in physicians: a review and meta-analysis
Cheryl Regehr1, Dylan Glancy, Annabel Pitts
1*Factor-Inwentash Faculty of Social Work, and †Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; ‡Queens University, Kingston, Ontario, Canada; §Wilson Centre, Toronto, Ontario, Canada; and ∥Faculty of Dentistry and Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Abstract:
A significant proportion of physicians and medical trainees experience stress-related anxiety and burnout resulting in increased absenteeism and disability, decreased patient satisfaction, and increased rates of medical errors. A review and meta-analysis was conducted to examine the effectiveness of interventions aimed at addressing stress, anxiety, and burnout in physicians and medical trainees. Twelve studies involving 1034 participants were included in three meta-analyses. Cognitive, behavioral, and mindfulness interventions were associated with decreased symptoms of anxiety in physicians (standard differences in means [SDM], -1.07; 95% confidence interval [CI], -1.39 to -0.74) and medical students (SDM, -0.55; 95% CI, -0.74 to -0.36). Interventions incorporating psychoeducation, interpersonal communication, and mindfulness meditation were associated with decreased burnout in physicians (SDM, -0.38; 95% CI, -0.49 to -0.26). Results from this review and meta-analysis provide support that cognitive, behavioral, and mindfulness-based approaches are effective in reducing stress in medical students and practicing physicians. There is emerging evidence that these models may also contribute to lower levels of burnout in physicians.
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