Summary
A compilation of the various interventions and their effects makes it possible to gain knowledge about how healthy and prosperous workplaces can be created in this sector. In this report, interventions are defined as “conscious efforts to bring about the desired change”. Interventions may also be referred to as “actions, efforts, measures or programmes”.
This report compiles research in the form of literature reviews on workplace interventions that aim to achieve a better psychosocial work environment for healthcare professionals. The report comprises a total of 35 reviews. The interventions examined in these reviews have been divided into individual-level interventions and organisational-level interventions. The populations examined vary and have been divided into three categories: registered nurses (nine reviews), physicians (eight reviews), and various healthcare professionals (18 reviews).
In addition to the findings of these reviews, the report also presents the findings of six original Swedish studies included in the reviews. Also, the findings of three original Swedish studies that were not included in the reviews are presented, as well as a report from the grey literature that was identified during an additional search of databases and online resources.
Individual-level interventions
Individual-level interventions were presented in 31 reviews. Individuals are the main focus of these interventions, which primarily aim to promote health and well-being, but also to achieve increased job satisfaction and improved work performance.
Common individual-level interventions included:
• Mindfulness
• Stress management courses
• Relaxation exercises
• Coping strategies
• Cognitive-behavioural therapy
Various forms of mental and psychological exercises, often done in groups, were common. According to several reviews, these interventions produced some positive results for employees’ health and well-being, including reduced stress levels, increased empathy, better self-understanding and understanding others, and greater satisfaction with the workplace. However, many studies
included in the reviews lack comparison groups, and the number of participants was often low. Several reviews also pointed out that short follow-up periods make it difficult to draw conclusions about the long-term effects of the interventions.
Organisational-level interventions
Eight reviews discussed organisational-level interventions. These interventions focused on the organisational and social aspects of the work environment. They had similar goals to the individual-level interventions, and most of them primarily aimed to improve health and well-being.
Organisational-level interventions included:
• Modified working hours and schedules
• Reduced workload
• Improved teamwork and communication
The results of the reviews included lower levels of perceived burnout, improved job satisfaction and reduced stress levels. However, the authors of the reviews were generally cautious in their conclusions, due to methodological shortcomings in the primary studies included in the reviews. Moreover, several reviews contained relatively few organisational-level interventions, which also makes it more difficult to draw conclusions about the effects.
Conclusions
The findings show that both individual-level interventions and organisational-level interventions can promote the health and well-being of healthcare professionals. In general, the effects of both individual-level and organisational-level interventions were negligible. The main outcome in the reviews was the effects of the interventions on the health and well-being of healthcare professionals. Many authors of these reviews emphasise the need for more well-structured studies.
Other types of outcomes, such as consequences at the collective level (e.g., sickness absence and staff turnover) and implications for patients (e.g., patient satisfaction and frequency of adverse events) were more rarely addressed in the included reviews. Here, too, more knowledge is needed about which interventions may prove effective.
This systematic literature review was written by:
Per Nilsen, Professor, Linköping University
Hanna Fernemark, Primary Care Physician, Region Östergötland
Ida Seing, Ph.D., Linköping University
Janna Skagerström, M.D., Region Östergötland.