A systematic review of interventions to foster physician resilience

2017 ◽  
Vol 94 (1109) ◽  
pp. 162-170 ◽  
Author(s):  
Susan Fox ◽  
Sinéad Lydon ◽  
Dara Byrne ◽  
Caoimhe Madden ◽  
Fergal Connolly ◽  
...  

This review aimed to synthesise the literature describing interventions to improve resilience among physicians, to evaluate the quality of this research and to outline the type and efficacy of interventions implemented. Searches were conducted in April 2017 using five electronic databases. Reference lists of included studies and existing review papers were screened. English language, peer-reviewed studies evaluating interventions to improve physician resilience were included. Data were extracted on setting, design, participant and intervention characteristics and outcomes. Methodological quality was assessed using the Downs and Black checklist. Twenty-two studies were included. Methodological quality was low to moderate. The most frequently employed interventional strategies were psychosocial skills training and mindfulness training. Effect sizes were heterogeneous. Methodologically rigorous research is required to establish best practice in improving resilience among physicians and to better consider how healthcare settings should be considered within interventions.

2014 ◽  
Vol 5 (2) ◽  
pp. 131-148 ◽  
Author(s):  
Lotte Nygaard Andersen ◽  
Maria Kohberg ◽  
Birgit Juul-Kristensen ◽  
Lene Gram Herborg ◽  
Karen Søgaard ◽  
...  

AbstractBackground and objectiveChronic pain is a growing phenomenon worldwide. It is considered a medical problem because, besides the socio-economic issues involved, pain is often accompanied by psychosocial problems. Apart from the physical pain, living with chronic pain has many additional consequences. People living with chronic pain generally suffer from other physical and psychological consequences. The impact of chronic pain varies enormously between individuals, but the suffering is frequently pervasive and detrimental. The objective of this study was to review the evidence concerning, ways in which people living with chronic pain are affected in their everyday lives.MethodsElectronic databases Scopus, Cinahl and PsycINFO were searched from 2008 to September 2012 using a ‘building blocks’ approach and reference lists were scanned. PubMed was also searched and checked for duplicates compared to Scopus, Cinahl and PsycINFO. Data were extracted from included studies and methodological quality assessed with a view to exploring quality differences. To guide the review and interpretation, individual components of methodological quality were compared against a checklist. A narrative synthesis was formulated involving three categories: (1) clinical aspects, (2) everyday life aspects and (3) interpersonal aspects.ResultsThe search strategy identified 1140 citations; one study was found during the preliminary searching through references, and a search of reference lists provided five publications. Of these, 24 publications, representing 23 populations, met the inclusion criteria. In total, there were 22 cross-sectional studies and 2 cohort studies. Study populations ranged from 74 to 3928 participants and were heterogeneous in nature across studies with respect to age, duration and localisations of pain and outcome measures. We found a general consensus that life with chronic pain was associated with higher prevalence and higher levels of depression and diagnoses of widespread pain and nonspecific pain are more clearly associated with depression than is specific pain. The results of link between chronic pain and anxiety and stress were not obvious. Overall, there is plausible evidence to suggest a positive relationship between chronic pain and disability and the evidence is stronger for a significant positive association between nonspecific pain and disability, compared to specific pain. It can be summarized that there is a lack of evidence for a relationship between intensity of pain and quality of life. However, there is evidence that nonspecific pain is more compellingly associated with low quality of life than is specific pain.The evidence of a positive relation between pain and problems in close relations is not convincing but there is an indication to suggest that there is a pain-related issue regarding participation in many social aspects of everyday life.ConclusionBesides the pain itself, people living with chronic pain are affected in other aspects of life. In particular, it is evident that they experience challenges with respect to depressive thoughts, disability, lower quality of life and conflicts in close relationships.ImplicationsWhen designing interventions for people with chronic pain, it is essential to take into consideration the fact that living with chronic pain has far-reaching consequences beyond the pain suffered.


2020 ◽  
Vol 36 (4) ◽  
pp. 356-362
Author(s):  
Esther Z. Barsom ◽  
Ewout van Hees ◽  
Willem A. Bemelman ◽  
Marlies P. Schijven

BackgroundVideo consultation (VC) is considered promising in delivering healthcare closer to the patient and improving patient satisfaction. Indeed, providing care-at-distance via VC is believed to be promising for some situations and patients, serving their needs without associated concomitant costs. In order to assess implementation and perceived benefits, patient satisfaction is frequently measured. Measuring patient satisfaction with VC in healthcare is often performed using quantitative and qualitative outcome analysis. As studies employ different surveys, pooling of data on the topic is troublesome. This systematic review critically appraises, summarizes, and compares available questionnaires in order to identify the most suitable questionnaire for qualitative outcome research using VC in clinical outpatient care.MethodsPubMed, Embase, and Cochrane were searched for relevant articles using predefined inclusion criteria. Methodological quality appraisal of yielded questionnaires to assess VC was performed using the validated COSMIN guideline.ResultsThis systematic search identified twelve studies that used ten different patient satisfaction questionnaires. The overall quality of nine questionnaires was rated as “inadequate” to “doubtful” according to the COSMIN criteria. None of the questionnaires retrieved completed a robust validation process for the purpose of use.Conclusion and recommendationsAlthough high-quality studies on measurement properties of these questionnaires are scarce, the questionnaire developed by Mekhjian has the highest methodological quality achieving validity on internal consistency and the use of a large sample size. Moreover, this questionnaire can be used across healthcare settings. This finding may be instrumental in further studies measuring patient satisfaction with VC.


2007 ◽  
Vol 37 (10) ◽  
pp. 1393-1402 ◽  
Author(s):  
MARCELO VALENCIA ◽  
MARIA LUISA RASCON ◽  
FRANCISCO JUAREZ ◽  
ESTHER MUROW

ABSTRACTBackgroundThe effectiveness of a psychosocial skills training (PSST) approach applied to chronic out-patients with schizophrenia was examined. We hypothesized that the PSST programme, which included treatment as usual (TAU), PSST and family therapy (FT), would reduce positive and negative symptoms, prevent relapse and rehospitalization, and improve psychosocial functioning (PSF), global functioning and treatment adherence.MethodEighty-two patients were randomly assigned to receive either TAU [antipsychotic medication (AP); n=39] or the PSST approach (TAU+PSST+FT; n=43). The two groups were assessed at intake and after completion of 1 year of treatment.ResultsThere were statistically significant differences between the two groups. Patients in the PSST group improved their symptomatology, psychosocial and global functioning (symptoms and psychological, social and occupational functioning), showed lower relapse, rehospitalization and drop-out rates, a higher level of compliance with AP medication, and a high level of therapeutic adherence in comparison with TAU patients, whose symptoms also improved although they showed no improvement in any of the clinical or psychosocial variables. A comparison of the standardized effect sizes showed a medium and a large effect size of PSF and global functioning for the PSST group and a non-effect size for the TAU group.ConclusionsA higher level of effectiveness was demonstrated when combining TAU, PSST and FT in comparison with AP medication alone. The PSST approach should be recommended for clinical practice.


2015 ◽  
Vol 40 (6) ◽  
pp. 341-348 ◽  
Author(s):  
Arzu Yıldırım ◽  
Rabia Hacıhasanoğlu Aşılar ◽  
Tuba Hale Camcıoğlu ◽  
Sezgin Erdiman ◽  
Ebru Karaağaç

2021 ◽  
Vol 19 (1) ◽  
pp. 42-48
Author(s):  
Megan Betts

Aims: Stoma formation surgery can affect people socially, psychologically and physically. This literature review aims to explore the factors that affect an adult ostomate's sexuality after stoma formation. Methods: The literature search was conducted on three electronic databases: CINAHL, PsychINFO and Medline complete. The search was limited to peer-reviewed studies published in the past 7 years. The reference lists of the identified literature were also searched. Findings: Stoma formation was found to greatly impact sexuality in adults. The main themes identified were: hygiene; satisfaction and desire; self-perception; companionship and sexual relationships; and physical considerations. It was found that people were dissatisfied with the information provided by health professionals about sexuality. Conclusions: Stoma formation was commonly found to negatively affect adults' sexuality. To improve the quality of life of ostomates, these issues need to be thoroughly addressed in healthcare settings.


2011 ◽  
Vol 26 (S2) ◽  
pp. 2187-2187
Author(s):  
W. Gaebel

One of the recent initiatives inaugurated by the EPA European Platform of Psychiatrists aims at improving quality of mental health care in Europe by providing and implementing evidence-based information and advice and thereby minimizing mental health care gaps. To provide such guidance for schizophrenia, an overview will be given of existing treatment guidelines. This overview will focus firstly on methodological quality, since according to survey from 2005 the methodological quality of most guidelines was at best moderate (Gaebel et al. 2005). Secondly, the focus will be on treatment recommendations regarding core clinical questions like early recognition and intervention, acute and long-term treatment. Accordingly, respective recommendations from well established international guidelines will be presented. In addition, participants hopefully from all over Europe are encouraged to engage in the discussion and to provide information from their national/regional treatment guidelines, especially if not available in English language.


2017 ◽  
Vol 40 (9) ◽  
pp. 1357-1373 ◽  
Author(s):  
Emine Yılmaz ◽  
Ayşe Okanlı

This study was conducted with two groups (training and control) using a pretest/posttest design to determine the effect of mindfulness-based psychosocial skills training for improving insight and functional recovery levels in patients with schizophrenia. The study sample included 45 patients with schizophrenia (21 were in the training group/mindfulness-based psychosocial skills training and 24 were in the control group/standard drug medication). The data were collected using a Personal Information Form, Functional Remission of General Schizophrenia (FROGS) scale, and Beck Cognitive Insight Scale (BCIS). The training group was divided into two groups of 10 to 12 persons on average. Training was given as a group training for a total of 16 sessions, two sessions a week for 8 weeks. The training group scored significantly higher in functional recovery and insight levels than the control group after training ( p < .05). The study determined training has an effect on increasing the levels of insight and functional recovery in schizophrenia.


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