Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review

“As a result, participation in healthy lifestyle behaviors are often given a low priority.(4) Besides personal factors, there are multiple healthcare system challenges that contribute to clinician burnout and depression, including poor staffing patterns, ongoing challenges with electronic medical records that result in…”

“population health of clinicians and ensure health-care quality and safety.(2) Findings from a recent systematic review indicate that over 50% of physicians and nurses are experiencing burnout.”

“Twelve studies provided a mindfulness-based stress reduction (MBSR) type intervention (see Table 1).(14,15,20,31-36,39,41,42) The duration of studies was between 4 weeks to 9 months with total time in intervention sessions ranging from 10 to 53 hours plus home practice.”

“Three studies that used a program called Stress Management and Resiliency Training, comprised of a brief 90-minute session that focused on attention and interpretation therapy that aimed to decrease stress and increase resiliency along with the use of deep breathing techniques, was found to lessen physician anxiety.(3…”

“Eight studies provided stress reduction programs that included a variety of interventions, such as journaling, web-based stressed management, breathing exercises, and yoga.(17,18,22,23,27,29,37,38) Duration of interventions in these studies were between 4 weeks and 12 to 18 months with time ranging between 1 and 12 ho…”

“Seven studies assessed a measure of anxiety.(18,25,31,32,34,37,38) Three (43%) studies identified a significant between-group difference with sample sizes ranging between 26 and 40, and duration was between 1.”

“In 2017, the National Academy of Medicine (NAM) launched the Action Collaborative on Clinician Well-being and Resilience because of epidemic levels of burnout, depression, and suicide in physicians, nurses, and other healthcare providers.(1) Burnout is a syndrome characterized by a high degree of emotional exhaustion…”

“Value of investment also increases as clinicians who perceive they practice in a healthcare system that is supportive of their well-being tend to be in better physical and mental health, more engaged, and have higher levels of job satisfaction.(3) Findings from this systematic review indicate an urgent need for more r…”

“Twelve studies provided a mindfulness-based stress reduction (MBSR) type intervention (see Table 1).(14,15,20,31-36,39,41,42) The duration of studies was between 4 weeks to 9 months with total time in intervention sessions ranging from 10 to 53 hours plus home practice.”

“Seven studies assessed a measure of anxiety.(18,25,31,32,34,37,38) Three (43%) studies identified a significant between-group difference with sample sizes ranging between 26 and 40, and duration was between 1.”

“Emphasis of the interventions included MBSR22 and mindfulness-based CBT.35”

“Three studies that used a program called Stress Management and Resiliency Training, comprised of a brief 90-minute session that focused on attention and interpretation therapy that aimed to decrease stress and increase resiliency along with the use of deep breathing techniques, was found to lessen physician anxiety.(3…”

“Other stress tools included the Coping with Stress Scale, the Nursing Stress Scale, and the Post-traumatic Diagnostic Scale.(17,18,22,23,25,27-29,31-33,36-38,42) The most common instruments used to assess mindfulness were Records iden fied through database searching (n = 11,513)”

“Twelve studies provided a mindfulness-based stress reduction (MBSR) type intervention (see Table 1).(14,15,20,31-36,39,41,42) The duration of studies was between 4 weeks to 9 months with total time in intervention sessions ranging from 10 to 53 hours plus home practice.”

“Seven studies measured anxiety, which was captured with the Generalized Anxiety Disorder-7 Scale, the Smith anxiety scale, the Symptoms Checklist-90-Revised, and the Depression, Anxiety, and Stress Scale (DASS-21).(18,25,31,32,34,37,38) Tools to measure mood in 8 studies included the Profile of Mood States, symptoms o…”

“5 and 53 hours.(14,15,18,35,36,38,41) One study reported only a correlation of mindfulness with subscales of the DASS and the Maslach’s Burnout Inventory.”

“Nine studies assessed a measure of well-being.(20,21,24,25,29,32,37,39) Five (56%) studies identified a significant between-group difference.”

“Besides personal factors, there are multiple healthcare system challenges that contribute to clinician burnout and depression, including poor staffing patterns, ongoing challenges with electronic medical records that result in less time with patients, and pressure to increase caseloads.(5) Leaders must address these h…”

“Other stress tools included the Coping with Stress Scale, the Nursing Stress Scale, and the Post-traumatic Diagnostic Scale.(17,18,22,23,25,27-29,31-33,36-38,42) The most common instruments used to assess mindfulness were Records iden fied through database searching (n = 11,513)”

“Three studies assessed a measure of fat.(16,30,40) None identified a significant between-group difference.”

“A recent RCT of an 8-session manualized CBT-based intervention entitled MINDSTRONG delivered by a nurse to new nurse residents also demonstrated decreases in depression, anxiety, and stress as well as improvements in job satisfaction up to 6 months following the intervention.(43,44) Three studies that used a program c…”

“A recent RCT of an 8-session manualized CBT-based intervention entitled MINDSTRONG delivered by a nurse to new nurse residents also demonstrated decreases in depression, anxiety, and stress as well as improvements in job satisfaction up to 6 months following the intervention.(43,44) Three studies that used a program c…”

“However, without building a culture of well-being in healthcare systems that makes healthy choices, the norm or the easy choices for clinicians to make, those behaviors are not likely to sustain.(47) It is also important to target system-based interventions that are known to adversely affect clinician well-being (eg,…”

“Two studies targeted overall well-being with interventions that included an eMental Health program utilizing cognitive behavior therapy (CBT) components and an online 10-week intervention that included asking physicians to complete microtasks designed to cultivate professional satisfaction and well-being.(21,25) Studi…”

“Three studies assessed a measure of fat.(16,30,40) None identified a significant between-group difference.”

“Six studies included either body mass index (BMI) or weight.(16,19,26,28,30,40) Three studies included a measure of percent body fat.”

“Tools to measure mood in 8 studies included the Profile of Mood States, symptoms of distress, the Brief Symptom Index, the DASS, and mental health questions from the Short Form 36.(15,19,20,23,24,26,29,30) Stress was most commonly measured with the Perceived Stress Scale and the DASS 12-item stress subscale.”

“5 and 53 hours.(14,15,18,35,36,38,41) One study reported only a correlation of mindfulness with subscales of the DASS and the Maslach’s Burnout Inventory.”

“Nine studies assessed a measure of depression.(17,25,29-34,42) Four (44%) studies identified a significant between-group difference.”

“Three studies measured physical activity with a pedometer or reported physical activity.(19,28,40) Six studies included either body mass index (BMI) or weight.”

“Blood pressure was measured in 2 studies with none identifying a significant between-group difference.(16,19)”

“Although evidence based psychological interventions are available for this population [12], there is a paucity of evidence about interventions for the MH of HSCWs during pandemics.”

“behavioral therapy intervention programs (Alikhani et al., 2020; Greenberg et al., 2020; Melnyk et al., 2020).”