Contribution of a positive psychology-based conceptual framework in reducing physician burnout and improving well-being: a systematic review.
Achievement
Engagement
Meaning
Physician
Positive emotion
Relationship
Well-being; burnout
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
25 Nov 2021
25 Nov 2021
Historique:
received:
12
01
2021
accepted:
17
08
2021
entrez:
26
11
2021
pubmed:
27
11
2021
medline:
30
11
2021
Statut:
epublish
Résumé
The PERMA Model, as a positive psychology conceptual framework, has increased our understanding of the role of Positive emotion, Engagement, Relationships, Meaning, and Achievements in enhancing human potentials, performance and wellbeing. We aimed to assess the utility of PERMA as a multidimensional model of positive psychology in reducing physician burnout and improving their well-being. Eligible studies include peer-reviewed English language studies of randomized control trials and non-randomized design. Attending physicians, residents, and fellows of any specialty in the primary, secondary, or intensive care setting comprised the study population. Eligible studies also involved positive psychology interventions designed to enhance physician well-being or reduce physician burnout. Using free text and the medical subject headings we searched CINAHL, Ovid PsychINFO, MEDLINE, and Google Scholar (GS) electronic bibliographic databases from 2000 until March 2020. We use keywords for a combination of three general or block of terms (Health Personnel OR Health Professionals OR Physician OR Internship and Residency OR Medical Staff Or Fellow) AND (Burnout) AND (Positive Psychology OR PERMA OR Wellbeing Intervention OR Well-being Model OR Wellbeing Theory). Our search retrieved 1886 results (1804 through CINAHL, Ovid PsychINFO, MEDLINE, and 82 through GS) before duplicates were removed and 1723 after duplicates were removed. The final review included 21 studies. Studies represented eight countries, with the majority conducted in Spain (n = 3), followed by the US (n = 8), and Australia (n = 3). Except for one study that used a bio-psychosocial approach to guide the intervention, none of the other interventions in this review were based on a conceptual model, including PERMA. However, retrospectively, ten studies used strategies that resonate with the PERMA components. Consideration of the utility of PERMA as a multidimensional model of positive psychology to guide interventions to reduce burnout and enhance well-being among physicians is missing in the literature. Nevertheless, the majority of the studies reported some level of positive outcome regarding reducing burnout or improving well-being by using a physician or a system-directed intervention. Albeit, we found more favorable outcomes in the system-directed intervention. Future studies are needed to evaluate if PERMA as a framework can be used to guide system-directed interventions in reducing physician burnout and improving their well-being.
Sections du résumé
BACKGROUND
BACKGROUND
The PERMA Model, as a positive psychology conceptual framework, has increased our understanding of the role of Positive emotion, Engagement, Relationships, Meaning, and Achievements in enhancing human potentials, performance and wellbeing. We aimed to assess the utility of PERMA as a multidimensional model of positive psychology in reducing physician burnout and improving their well-being.
METHODS
METHODS
Eligible studies include peer-reviewed English language studies of randomized control trials and non-randomized design. Attending physicians, residents, and fellows of any specialty in the primary, secondary, or intensive care setting comprised the study population. Eligible studies also involved positive psychology interventions designed to enhance physician well-being or reduce physician burnout. Using free text and the medical subject headings we searched CINAHL, Ovid PsychINFO, MEDLINE, and Google Scholar (GS) electronic bibliographic databases from 2000 until March 2020. We use keywords for a combination of three general or block of terms (Health Personnel OR Health Professionals OR Physician OR Internship and Residency OR Medical Staff Or Fellow) AND (Burnout) AND (Positive Psychology OR PERMA OR Wellbeing Intervention OR Well-being Model OR Wellbeing Theory).
RESULTS
RESULTS
Our search retrieved 1886 results (1804 through CINAHL, Ovid PsychINFO, MEDLINE, and 82 through GS) before duplicates were removed and 1723 after duplicates were removed. The final review included 21 studies. Studies represented eight countries, with the majority conducted in Spain (n = 3), followed by the US (n = 8), and Australia (n = 3). Except for one study that used a bio-psychosocial approach to guide the intervention, none of the other interventions in this review were based on a conceptual model, including PERMA. However, retrospectively, ten studies used strategies that resonate with the PERMA components.
CONCLUSION
CONCLUSIONS
Consideration of the utility of PERMA as a multidimensional model of positive psychology to guide interventions to reduce burnout and enhance well-being among physicians is missing in the literature. Nevertheless, the majority of the studies reported some level of positive outcome regarding reducing burnout or improving well-being by using a physician or a system-directed intervention. Albeit, we found more favorable outcomes in the system-directed intervention. Future studies are needed to evaluate if PERMA as a framework can be used to guide system-directed interventions in reducing physician burnout and improving their well-being.
Identifiants
pubmed: 34823509
doi: 10.1186/s12909-021-03021-y
pii: 10.1186/s12909-021-03021-y
pmc: PMC8620251
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
593Informations de copyright
© 2021. The Author(s).
Références
PLoS Med. 2009 Jul 21;6(7):e1000100
pubmed: 19621070
J Intern Med. 2018 Jun;283(6):516-529
pubmed: 29505159
Acad Emerg Med. 2009 Nov;16(11):1120-3
pubmed: 20053231
BMJ. 2019 Aug 28;366:l4898
pubmed: 31462531
J Grad Med Educ. 2014 Jun;6(2):256-63
pubmed: 24949128
Am J Respir Crit Care Med. 2011 Oct 1;184(7):803-8
pubmed: 21719756
J Pediatr (Rio J). 2011 Nov-Dec;87(6):493-8
pubmed: 22170452
Mayo Clin Proc. 2015 Apr;90(4):432-40
pubmed: 25796117
Behav Med. 2005 Spring;31(1):18-27
pubmed: 16078523
JAMA. 2009 Sep 23;302(12):1338-40
pubmed: 19773573
Sci Eng Ethics. 2018 Apr;24(2):809-810
pubmed: 29249022
Eur J Cancer. 2010 Oct;46(15):2708-15
pubmed: 20627537
CMAJ. 2015 Mar 17;187(5):321-9
pubmed: 25667258
Acad Pediatr. 2017 May - Jun;17(4):456-458
pubmed: 28087366
Med Teach. 2005 Nov;27(7):613-8
pubmed: 16332553
BMJ. 2008 Mar 1;336(7642):488-91
pubmed: 18258931
Psychother Psychosom. 2014;83(1):10-28
pubmed: 24281296
J Gen Intern Med. 2017 Jul;32(7):739-746
pubmed: 28168540
J Contin Educ Health Prof. 2015 Fall;35(4):255-60
pubmed: 26953856
Annu Rev Psychol. 2001;52:397-422
pubmed: 11148311
BMC Med. 2004 Aug 18;2:29
pubmed: 15317650
Med Teach. 2009 Apr;31(4):338-41
pubmed: 19156563
Acad Psychiatry. 2018 Feb;42(1):94-108
pubmed: 28913621
J Occup Environ Med. 2018 Jul;60(7):589-593
pubmed: 29608542
J Contin Educ Health Prof. 2014 Winter;34(1):4-12
pubmed: 24648359
Arch Intern Med. 2011 Jul 11;171(13):1207-9
pubmed: 21747018
J Educ Health Promot. 2019 Aug 30;8:160
pubmed: 31544125
JAMA. 2012 Dec 5;308(21):2199-207
pubmed: 23212497
Int J Nurs Stud. 2013 May;50(5):587-92
pubmed: 23159157
J Health Psychol. 2010 Oct;15(7):1075-81
pubmed: 20453053
Sports Med. 2019 Oct;49(10):1515-1528
pubmed: 31187453
Health Care Manage Rev. 2007 Jul-Sep;32(3):203-12
pubmed: 17666991
Lancet. 2016 Nov 5;388(10057):2272-2281
pubmed: 27692469
Eur J Cancer Care (Engl). 2019 May;28(3):e13094
pubmed: 31090179
Acad Med. 2012 Nov;87(11):1481
pubmed: 23111270
Health Educ Res. 2006 Aug;21(4):501-7
pubmed: 16436459
JAMA. 2018 Sep 18;320(11):1131-1150
pubmed: 30326495
Surgery. 2001 Oct;130(4):696-702; discussion 702-5
pubmed: 11602901
Psychol Bull. 2005 Nov;131(6):856-97
pubmed: 16351327
Arch Surg. 2012 Feb;147(2):168-74
pubmed: 22351913
Lancet. 2009 Nov 14;374(9702):1714-21
pubmed: 19914516
Physician Leadersh J. 2015 May-Jun;2(3):22-5
pubmed: 26214946
Mayo Clin Proc. 2017 Mar;92(3):415-422
pubmed: 28189341
J Pers Soc Psychol. 2008 Nov;95(5):1045-1062
pubmed: 18954193
Epidemiol Rev. 2003;25:65-76
pubmed: 12923991
Acad Med. 2014 Mar;89(3):443-51
pubmed: 24448053
Ann Surg. 2010 Jun;251(6):995-1000
pubmed: 19934755
Am Psychol. 2000 Jan;55(1):5-14
pubmed: 11392865
Br J Gen Pract. 2016 Feb;66(643):e99-105
pubmed: 26823271
JAMA Intern Med. 2014 Apr;174(4):527-33
pubmed: 24515493
Clin Obstet Gynecol. 2019 Sep;62(3):480-490
pubmed: 31344003
J Gen Intern Med. 2015 Aug;30(8):1105-11
pubmed: 25724571
J Am Coll Surg. 2010 Nov;211(5):609-19
pubmed: 20851643
N Engl J Med. 2005 Jun 16;352(24):2473-6
pubmed: 15958803
Ann Behav Med. 2008 Jun;35(3):358-62
pubmed: 18633685
Am J Respir Crit Care Med. 2012 Apr 1;185(7):738-43
pubmed: 22246176
Australas Psychiatry. 2019 Jun;27(3):255-261
pubmed: 30854868
Postgrad Med J. 2015 Apr;91(1074):182-7
pubmed: 25755266
Ann Fam Med. 2014 Nov-Dec;12(6):573-6
pubmed: 25384822
Sports Med. 2010 Oct 1;40(10):841-58
pubmed: 20836582
Acad Med. 2011 Nov;86(11):e15
pubmed: 22030663
Mayo Clin Proc. 2013 Dec;88(12):1435-42
pubmed: 24290117
Anesth Analg. 2013 Jul;117(1):182-93
pubmed: 23687232
Mayo Clin Proc. 2016 Jul;91(7):836-48
pubmed: 27313121
Front Psychol. 2016 May 20;7:686
pubmed: 27242600
Acad Med. 2015 Apr;90(4):494-9
pubmed: 25607940
Semin Perinatol. 2020 Jun;44(4):151243
pubmed: 32248955
Mayo Clin Proc. 2017 Jan;92(1):129-146
pubmed: 27871627