This new review sought to assess the effects of interventions to foster resilience in healthcare professionals (i.e. healthcare staff delivering direct medical care, such as nurses, physicians and hospital personnel, and allied healthcare staff such as social workers and psychologists).
Results of the search
The review authors included 44 randomised controlled trials (RCTs); 36 of which were conducted in high-income countries. Participants were mainly women (68%), aged between 27 and 52 years old. Of the studies, 39 focused solely on healthcare professionals (6892 participants), four investigated mixed samples (1000 participants) of healthcare and nonhealthcare professionals, and one assessed training for emergency personnel in volunteers from the general population (82 participants).
Most studies (37/44) were conducted in a hospital setting, and investigated group-based interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies).
Nineteen studies compared a combined resilience intervention (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list control receiving the training after a waiting period). Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains.
The included studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify a potential funder, one study received no funding support.
The review authors found evidence that, compared to control, resilience training may increase resilience (12 studies, n = 690), but lower levels of depression (14 studies, n = 788), and stress or stress perception (17 studies, n = 997) at post-intervention. They found little to no evidence of any effect of resilience training on anxiety (5 studies, n = 231), and well-being or quality of life (13 studies, n = 1494) at post-intervention, compared to control. All very-low certainty evidence.
Only three studies reported data on adverse effects; there were none (very-low certainty evidence).
The authors concluded that there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression and stress or stress perception, but that it may have little to no evidence of an effect on anxiety and well-being or quality of life at post-intervention. The uncertainty of the evidence means that future research could change the findings. More research of greater methodological quality is needed.
The evidence is current to June 2019.
Read the full review here on the Cochrane Library.