The researchers analysed 117 studies, published in the last decade, of the effects of different interventions on stress alleviation. A total of 11,119 healthcare workers worldwide were randomised to different interventions, and stress was assessed by questionnaires measuring stress symptoms in the short term (up to three months after an intervention ended), in the medium term (between three and 12 months) and long-term (follow-up after more than a year).
In the Cochrane report, a collaboration of independent, international experts, looked at interventions for individual healthcare workers that focused attention either on the experience of stress, or away from the experience of stress. With the goal of seeing which interventions could reduce stress.
The healthcare workers in the studies were experiencing low to moderate levels of stress, which can lead to physical symptoms such as headaches, muscle tension or pain, but also mental symptoms, such as depression, anxiety, impaired concentration and emotional and relationship problems.
High work demands and long working hours
Sietske Tamminga, assistant professor in public and occupational health at Amsterdam UMC who led the research notes that “Healthcare workers often deal with stressful and emotional situations in patient care, human suffering, and pressure from relationships with patients, family members and employers, as well as high work demands and long working hours."
Strategies for focusing attention on stress included cognitive behavioural training, and training on assertiveness, coping and communication skills. Interventions that focus attention away from the stress included relaxation, mindfulness meditation, exercise such as yoga and tai chi, massage, acupuncture, and playing or listening to music. "We found that they may be beneficial for the healthcare workers themselves and it may spill over to the patients they care for, and the organisations they work for,” says Tamminga.
Range of stress interventions
The effect may last for up to a year and a combination of interventions may be beneficial as well, at least in the short term. Employers should not hesitate to facilitate a range of stress interventions for their employees. The long-term effects of stress management interventions remain unknown.”
For this more research is necessary, per intervention with larger groups. “We need more studies on interventions addressing work-related risk factors both at the individual and organisational level,” says Tamminga.
“It might be even more beneficial to improve working conditions themselves, instead of only helping individuals to deal better with heavy psychosocial burdens. For example, employers could address problems of understaffing, over-work and anti-social shift patterns. If you’re dedicated to change, you need to change the underlying risk factors rather than focusing on the symptoms,” adds Tamminga.
Studies have reported that between 30% to 70% of physicians and nurses and 56% of anaesthesiologists experience burnout symptoms as a result of their work. Previous research has tended to focus on a particular type of intervention in specific groups of healthcare workers. The authors of this Cochrane review write: “To the best of our knowledge there are no up-to-date reviews that examine the effectiveness of various types of individual-level interventions aimed at reducing stress in various healthcare workers to provide a more complete overview.”
“There is already a shortage of healthcare workers due to high turnover rates, and effective prevention of stress and burnout may help to reduce this,” Tamminga concludes.