Healthcare workers’ occupational stress can be prevented

Press release, 20 Nov 2014, Kuopio, Finland

The latest Cochrane review found evidence that occupational stress and burnout among healthcare workers can be prevented or decreased through cognitive-behavioural techniques (CBT), relaxation exercises or changing work schedules. The results are based on 58 international studies, in which 7188 people participated.

Prolonged occupational stress can lead to burnout, psychosomatic illnesses, deterioration in quality of life, a lower level of care provision, and eventually even to having to change jobs. Eight per cent of the respondents of the Work and Health in Finland 2012 study had experienced either a fair amount or a great deal of occupational stress. Thirty-two per cent had experienced only a slight amount of stress.

Occupational stress is the second most common work-related health problem in Europe, straight after musculoskeletal diseases. About half of workers consider it common at their workplace. Healthcare workers’ experienced occupational stress may be due to an imbalance between the high demands of the profession, and individual skills and support from the community.

Cognitive-behavioural techniques moderately alleviate stress

Six studies found evidence that CBT decreased stress by 18 per cent compared to no intervention. Follow-up was one month to two years. However, it is unclear whether CBT helps stressed people enough. The results were similar when CBT was combined with relaxation. According to three studies, CBT did not decrease symptoms any more than alternative techniques.

Relaxation also helps

Seventeen studies found evidence that mental and physical relaxation decreased stress by 23 per cent compared to no intervention.

Work shift arrangements somewhat diminish stress

Organizational interventions included changes to working conditions, health care content and work shifts, as well as improving social support and communication skills. Stress diminished when work shifts were changed from working throughout the week to weekend breaks or from a four-week to two-week schedule. Other organizational measures did not decrease stress.

Further research needed

The research evidence to date is mainly of poor quality. In order to determine the effects of different methods on decreasing occupational stress, we need more well-planned and executed studies. This Cochrane review recommends randomized controlled studies, with at least 120 participants, which compare active interventions to placebo-like interventions. Organizational interventions should focus more on the reduction of specific stress-causing factors.

Cognitive-behavioural techniques mean new ways of thinking, dealing with feelings, and acting in stressful situations. Mental and physical relaxation in turn can direct attention away from unpleasant, stressful thoughts and feelings. Reorganizing work can help prevent the emergence of stressful situations, and help achieve a better balance between the demands of work and individuals’ skills.

Further information on the review:

Jani Ruotsalainen, Specialist Researcher, FIOH, +358 30 474 334, jani.ruotsalainen@ttl.fi
Cochrane Occupational Safety and Health Review Group (http://osh.cochrane.org)

Review:

Ruotsalainen JH, Verbeek JH, Mariné A, Serra C. Preventing occupational stress in healthcare workers. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD002892. DOI: 10.1002/14651858.CD002892.pub3.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002892.pub3/abstract

See also

Cochrane library
Cochrane network
Cochrane Occupational Safety and Health Review Group

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The Cochrane Collaboration was established in 1993 and is an international, independent, non-profit researcher network, with members in over 120 countries. The Collaboration produces syntheses of medical research, called Cochrane reviews. Each review collects and summarizes the best available high quality evidence of a given intervention that aims to address a particular health issue. Cochrane reviews are used in, for example, clinical and health-political decision making. Occupational safety and health reviews are intended to influence guidance and procedures at workplaces and occupational health services so that harmful exposures can be reduced and work-related diseases can be prevented and treated as effectively as possible.

The Finnish Institute of Occupational Health researches, develops and specializes in well-being at work. It promotes occupational health and safety and the well-being of workers. It is an independent institution under public law, working under the administrative sector of the Ministry of Social Affairs and Health. It has six regional offices, and its headquarters are in Helsinki. It employs about 730 people.