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Interventions to Prevent and Treat Burnout in Obstetrics/Gynaecology: A Scoping Review

Published:December 26, 2020DOI:https://doi.org/10.1016/j.jogc.2020.12.011

      ABSTRACT

      Objective

      Obstetricians and gynaecologists are among the highest risk specialties for burnout. There is growing evidence that physician burnout can be both prevented and reduced. We sought to characterize the evidence base for interventions related to the prevention and treatment of burnout in obstetrics and gynaecology

      Data sources

      We conducted a scoping review following PRISMA guidelines of 5 databases: (Medline-OVID, EMBASE, CINAHL, ClinicalTrials.gov, and PsycInfo) from inception to March 17, 2020. Citations of relevant articles were hand-searched to maximize sensitivity.

      Study selection

      All interventional study designs were included. The target study population was obstetrics and gynaecology residents, learners, or staff. Published conference posters, papers, and abstracts were eligible for inclusion.

      Data extraction and synthesis

      All extraction and descriptive analysis was completed by two independent reviewers. Outcomes were summarized descriptively. Appraisal was completed using the Cochrane Risk of Bias tool and Risk of Bias Assessment tool for Non-randomized Studies.

      Results

      Of the 1540 original database citations, 20 studies met our inclusion criteria. A total of 589 obstetrics/gynaecology participants were included. While there was an overall a lack of research in the field, there were several promising interventions that target residents. There were a combination of preventative interventions (e.g. yoga, nutritional programs, or narrative medicine initiatives) as well as treatments (e.g. counselling appointments or debrief sessions). The vast majority of these interventions focused on individual-specific interventions rather than structural changes. In addition, the majority of interventions appeared to be “proof of concept” and feasability-related studies, with many studies published as conference abstracts rather than peer-reviewed journal publications.

      Conclusions

      Institutions should continue to implement interventions that address burnout in obstetrics and gynaecology. Further research is required on long-term outcomes of interventions as well as structural strategies.

      RÉSUMÉ

      Objectif

      Les obstétriciens et gynécologues forment une des spécialités médicales ayant le plus haut risque d’épuisement professionnel. De plus en plus de données probantes indiquent que les médecins peuvent prévenir l’épuisement professionnel et en réduire le risque. Nous avons cherché à caractériser les données appuyant les interventions en matière de traitement et de prévention de l’épuisement professionnel en obstétrique et gynécologie.

      Sources de données

      En suivant la stratégie PRISMA, nous avons effectué une revue de portée dans 5 bases de données : Medline-OVID, EMBASE, CINAHL, ClinicalTrials.gov et PsycInfo, de leur création jusqu'au 17 mars 2020. Les citations d'articles pertinents ont été récupérées manuellement pour maximiser la sensibilité.

      Sélection des études

      Toutes les études interventionnelles ont été incluses. La population cible de l’étude était composée de résidents, d'apprenants et de membres du personnel en obstétrique et gynécologie. Les présentations sur affiche, les articles et les résumés publiés étaient admissibles.

      Extraction et synthèse des données

      L'extraction des données et la synthèse descriptive ont été effectuées par deux examinateurs indépendants. Les résultats ont été résumés de façon descriptive. L’évaluation a été effectuée à l'aide des outils de Cochrane d’évaluation du risque de biais et d’évaluation du biais pour les études non randomisées.

      Résultats

      Parmi les 1 540 citations originales des bases de données, 20 études répondaient à nos critères d'inclusion. Un total de 589 participants en obstétrique/gynécologie ont été inclus. Bien qu'il y ait un manque global de recherches sur le terrain, plusieurs interventions prometteuses ciblent les résidents. Il y avait une combinaison d'interventions préventives (par exemple, le yoga, les programmes nutritionnels ou les initiatives de médecine narrative) et de traitements (par exemple, des rendez-vous de conseil ou des séances de débriefing). La grande majorité de ces interventions sont axées sur des interventions individualisées plutôt que sur des changements structurels. En outre, la majorité des interventions semblent être des études de "validation de principe" et de faisabilité, de nombreuses études étant publiées sous forme de résumés de conférences plutôt que de publications dans des revues à comité de lecture.

      Conclusions

      Les établissements devraient continuer à mettre en œuvre des interventions qui s'attaquent à l’épuisement en obstétrique et gynécologie. D'autres recherches seront nécessaires relativement aux résultats à long terme des interventions et aux stratégies structurelles.

      Keywords

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