Preventing occupational stress in healthcare workers

Objectives: To evaluate the effectiveness of work and person-directed interventions in preventing stress at work in healthcare workers.  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.  

Main results: In this update of a Cochrane Review we identified 36 RCTs which is 22 more than in the previous version. The trials were small and in general of low quality. Interventions were grouped into 1) person-directed: cognitive-behavioural, physical relaxation and mental relaxation or any of these combined 2) work-directed: attitude change and communication, support from colleagues and participatory problem solving and decision-making, and changes in work organisation.  Cognitive behavioural interventions reduced stress symptoms with an effect size of -0.63 (95% Confidence Interval -0.82 to -0.42) compared to no intervention. Relaxation decreased stress symptoms with an effect-size of -0.97 [95% CI -1.55 to -0.39] compared to no intervention. The effects of organisational interventions were comparable but less clear.  

Conclusions: Moderate evidence is available for the effectiveness of interventions to reduce stress levels in healthcare workers. Larger and better quality trials are needed.