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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Article info
Publication history
Published online: December 26, 2020
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated they meet the journal's requirements for authorship.
Identification
Copyright
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
