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Cited by 499Stress and Burnout ResearchOccupational Health and BurnoutHealthcare professionals’ stress and burnout

The DOI matches its Crossref record; 182 of the 189 references it cites were found in a registry or an index, and 2 are not checked yet.

Preventing occupational stress in healthcare workers

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Marine, Albert, Ruotsalainen, Jani H, Serra, Consol, Verbeek, Jos H·2006·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd002892.pub2PMC PMC6718215
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Abstract

BACKGROUND: Healthcare workers can suffer from occupational stress which may lead to serious mental and physical health problems. OBJECTIVES: To evaluate the effectiveness of work and person-directed interventions in preventing stress at work in healthcare workers. SEARCH STRATEGY: We searched the Cochrane Depression Anxiety and Neurosis Group trials Specialised Register, MEDLINE, PsychInfo and Cochrane Occupational Health Field database. SELECTION CRITERIA: Randomised controlled clinical trials (RCT) of interventions aimed at preventing psychological stress in healthcare workers. For work-directed interventions interrupted time series and prospective cohort were also eligible. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed trial quality. Meta-analysis and qualitative synthesis were performed where appropriate. MAIN RESULTS: We identified 14 RCTs, three cluster-randomised trials and two crossover trials, including a total of 1,564 participants in intervention groups and 1,248 controls. Two trials were of high quality. Interventions were grouped into 1) person-directed: cognitive-behavioural, relaxation, music-making, therapeutic massage and multicomponent; and 2) work-directed: attitude change and communication, support from colleagues and participatory problem solving and decision-making, and changes in work organisation. There is limited evidence that person-directed interventions can reduce stress (standardised mean difference or SMD -0.85; 95% CI -1.21, -0.49); burnout: Emotional Exhaustion (weighted mean difference or WMD -5.82; 95% CI -11.02, -0.63) and lack of Personal Accomplishment (WMD -3.61; 95% CI -4.65, -2.58); and anxiety: state anxiety (WMD -9.42; 95% CI -16.92, -1.93) and trait anxiety (WMD -6.91; 95% CI -12.80, -1.01). One trial showed that stress remained low a month after intervention (WMD -6.10; 95% CI -8.44, -3.76). Another trial showed a reduction in Emotional Exhaustion (Mean Difference or MD -2.69; 95% CI -4.20, -1.17) and in lack of Personal Accomplishment (MD -2.41; 95% CI -3.83, -0.99) maintained up to two years when the intervention was boosted with refresher sessions. Two studies showed a reduction that was maintained up to a month in state anxiety (WMD -8.31; 95% CI -11.49, -5.13) and trait anxiety (WMD -4.09; 95% CI -7.60, -0.58). There is limited evidence that work-directed interventions can reduce stress symptoms (Mean Difference or MD -0.34; 95% CI -0.62, -0.06); Depersonalization (MD -1.14; 95% CI -2.18, -0.10), and general symptoms (MD -2.90; 95% CI -5.16, -0.64). One study showed that the difference in stress symptom level was nonsignificant at six months (MD -0.19; 95% CI -0.49, 0.11). AUTHORS' CONCLUSIONS: Limited evidence is available for the effectiveness of interventions to reduce stress levels in healthcare workers. Larger and better quality trials are needed.

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Research works printed but not linked: 17

  1. Bittman, 2003, Recreational music-making: a cost-effective group interdisciplinary strategy for reducing burnout and improving mood states in long-term care workers, Advances in Mind-Body Medicine, 19, 4
  2. Bradley, 2002, Social support, job stress, health, and job satisfaction among nurses in the United Kingdom, International Journal of Stress Management, 9, 163, 10.1023/A:1015567731248 · DOI
  3. Jones, 1998, Stress and medical malpractice: organizational risc assessment and intervention, Journal of Applied Psychology, 7, 727
  4. Kushnir, 1998, Rational thinking and stress management in health workers: a psychoeducational program, International Journal of Stress Management, 5, 169, 10.1023/A:1022941031900 · DOI
  5. Cooper, 1988, The Occupational Stress Indicator
  6. Cooper, 2001, Organizational stress
  7. Dunnette, 1990, Handbook of industrial and organizational psychology
  8. Cochrane Effective Practice and Organisation of Care Group Including Interrupted Time Series (ITS) Designs in a EPOC Review http://www.epoc.uottawa.ca/methods.htm 1998 1 5
  9. Firth-Cozens, 1999, Stress in health professionals
  10. Goldberg, 1991, A User's Guide to the General Health Questionnaire
  11. Kahn, 1964, Organizational Stress: Studies in role conflict and role ambiguity
  12. Karasek, 1992, Stress prevention through work reorganization: a summary of 19 international case studies, Conditions of Work Digest, 11, 23
  13. Maslach, 1982, Burnout: the cost of caring
  14. Maslach, 1996, Maslach Burnout Inventory manual
  15. Payne, 1987, Stress in health professionals
  16. Schaufeli, 2003, Burnout: An Overview of 25 Years of Research and Theorizing, 383
  17. Spielberger, 1970, Manual for the State-Trait Anxiety Inventory (Self-Evaluation Questionnaire)

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Metadata

Authors
Marine, A., Ruotsalainen, J. H., Serra, C., & Verbeek, J. H.
Affiliations
  • Finnish Institute of Occupational Health (FI)
  • Universitat Pompeu Fabra (ES)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
John Wiley & Sons, Ltd
Published
2006-10-18
Issue
4
Pages
CD002892-CD002892
ISSN
1361-6137 (ISSN-L)
DOI
10.1002/14651858.cd002892.pub2
PMC
PMC6718215
OpenAlex
W1912269944
Cited by
499
References
189
Citations by year
2026: 4 · 2025: 11 · 2024: 36 · 2023: 32 · 2022: 48 · 2021: 58 · 2020: 57 · 2019: 42 · 2018: 24 · 2017: 31 · 2016: 30 · 2015: 20 · 2014: 22 · 2013: 12 · 2012: 17
Type
reference entry
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Keywords
occupational stress, healthcare workers, burnout, stress prevention, relaxation training, organizational interventions, social support, work organization, quality of life, anxiety, intervention effectiveness, meta-analysis update, GRADE quality of evidence
MeSH terms
Health Personnel, Humans, Occupational Diseases, Stress, Psychological, Randomized Controlled Trials as Topic

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