PDF(Pubmed)
Abstract：
BACKGROUND: Burnout is a multidimensional psychological syndrome that arises from chronic workplace stress. Health care workers (HCWs), who operate in physically and emotionally exhausting work contexts, constitute a vulnerable group. This, coupled with its subsequent impact on patients and public economic resources, makes burnout a significant public health concern. Various self-care practices have been suggested to have a positive effect on burnout among HCWs. Of these, physical activity stands out for its ability to combine psychological, physiological, and biochemical mechanisms. In fact, it promotes psychological detachment from work and increases self-efficacy by inhibiting neurotransmitters and neuromodulators, increasing endorphin levels, enhancing mitochondrial function, and attenuating the hypothalamic pituitary-adrenal axis response to stress.
OBJECTIVE: Our objective was to conduct a systematic review of the evidence on the association between physical activity and burnout among HCWs.
METHODS: We considered HCWs, physical activity, and burnout, framing them as population, exposure, and outcome, respectively. We searched APA PsycArticles, MEDLINE, and Scopus until July 2022. We extracted relevant data on study design, methods to measure exposure and outcome, and statistical approaches.
RESULTS: Our analysis encompassed 21 independent studies. Although 10% (2/21) of the studies explicitly focused on physical activity, the remaining investigations were exploratory in nature and examined various predictors, including physical activity. The most commonly used questionnaire was the Maslach Burnout Inventory. Owing to the heterogeneity in definitions and cutoffs used, the reported prevalence of burnout varied widely, ranging from 7% to 83%. Heterogeneity was also observed in the measurement tools used to assess physical activity, with objective measures rarely used. In total, 14% (3/21) of the studies used structured questionnaires to assess different types of exercise, whereas most studies (18/21, 86%) only recorded the attainment of a benchmark or reported the frequency, intensity, or duration of exercise. The reported prevalence of physically active HCWs ranged from 44% to 87%. The analyses, through a variety of inferential approaches, indicated that physical activity is often associated with a reduced risk of burnout, particularly in the domains of emotional exhaustion and depersonalization. Furthermore, we compiled and classified a list of factors associated with burnout.
CONCLUSIONS: Our comprehensive overview of studies investigating the association between physical activity and burnout in HCWs revealed significant heterogeneity in definitions, measurements, and analyses adopted in the literature. To address this issue, it is crucial to adopt a clear definition of physical activity and make thoughtful choices regarding measurement tools and methodologies for data analysis. Our considerations regarding the measurement of burnout and the comprehensive list of associated factors have the potential to improve future studies aimed at informing decision-makers, thus laying the foundation for more effective management measures to address burnout.
OBJECTIVE: Our objective was to conduct a systematic review of the evidence on the association between physical activity and burnout among HCWs.
METHODS: We considered HCWs, physical activity, and burnout, framing them as population, exposure, and outcome, respectively. We searched APA PsycArticles, MEDLINE, and Scopus until July 2022. We extracted relevant data on study design, methods to measure exposure and outcome, and statistical approaches.
RESULTS: Our analysis encompassed 21 independent studies. Although 10% (2/21) of the studies explicitly focused on physical activity, the remaining investigations were exploratory in nature and examined various predictors, including physical activity. The most commonly used questionnaire was the Maslach Burnout Inventory. Owing to the heterogeneity in definitions and cutoffs used, the reported prevalence of burnout varied widely, ranging from 7% to 83%. Heterogeneity was also observed in the measurement tools used to assess physical activity, with objective measures rarely used. In total, 14% (3/21) of the studies used structured questionnaires to assess different types of exercise, whereas most studies (18/21, 86%) only recorded the attainment of a benchmark or reported the frequency, intensity, or duration of exercise. The reported prevalence of physically active HCWs ranged from 44% to 87%. The analyses, through a variety of inferential approaches, indicated that physical activity is often associated with a reduced risk of burnout, particularly in the domains of emotional exhaustion and depersonalization. Furthermore, we compiled and classified a list of factors associated with burnout.
CONCLUSIONS: Our comprehensive overview of studies investigating the association between physical activity and burnout in HCWs revealed significant heterogeneity in definitions, measurements, and analyses adopted in the literature. To address this issue, it is crucial to adopt a clear definition of physical activity and make thoughtful choices regarding measurement tools and methodologies for data analysis. Our considerations regarding the measurement of burnout and the comprehensive list of associated factors have the potential to improve future studies aimed at informing decision-makers, thus laying the foundation for more effective management measures to address burnout.
摘要：
背景：倦怠是一种由工作场所慢性压力引起的多维心理综合征。卫生保健工作者（HCWs），在身心疲惫的工作环境中工作，构成了一个弱势群体。这个,加上其对患者和公共经济资源的后续影响，使倦怠成为一个重大的公共卫生问题。各种自我护理实践被认为对医护人员的倦怠有积极影响。其中,身体活动因其结合心理的能力而脱颖而出，生理,和生化机制。事实上,它促进心理脱离工作，并通过抑制神经递质和神经调质来提高自我效能，增加内啡肽水平，增强线粒体功能，减轻下丘脑-垂体-肾上腺轴对应激反应。
目的：我们的目的是对HCWs中体力活动与职业倦怠之间关联的证据进行系统评价。
方法：我们考虑了HCWs，身体活动,和倦怠,把他们描绘成人口，暴露,和结果，分别。我们搜索了APAPsycarticles,MEDLINE,和Scopus，直到2022年7月。我们提取了研究设计的相关数据，测量暴露和结果的方法，和统计方法。
结果：我们的分析包括21项独立研究。尽管10%(2/21)的研究明确关注身体活动，其余的调查是探索性的，检查了各种预测因素，包括体力活动。最常用的问卷是Maslach倦怠量表。由于使用的定义和截止的异质性，报告的倦怠患病率差异很大，从7%到83%不等。在用于评估身体活动的测量工具中也观察到异质性，很少使用客观措施。总的来说,14%(3/21)的研究使用结构化问卷来评估不同类型的运动，而大多数研究(18/21，86%)只记录了达到基准或报告了频率，强度,或锻炼的持续时间。据报道，体力活动性HCWs的患病率从44%到87%不等。分析，通过各种推理方法，表明体力活动通常与倦怠风险降低有关，特别是在情绪衰竭和人格解体领域。此外，我们编制并分类了与倦怠相关的因素列表.
结论：我们对调查体力活动与职业倦怠之间关联的研究的全面概述揭示了定义上的显著异质性，测量,以及文献中采用的分析。为了解决这个问题，采用明确的身体活动定义并对测量工具和数据分析方法做出深思熟虑的选择至关重要。我们关于倦怠的测量和相关因素的综合列表的考虑因素有可能改善旨在告知决策者的未来研究，从而为更有效的解决职业倦怠的管理措施奠定基础。
目的：我们的目的是对HCWs中体力活动与职业倦怠之间关联的证据进行系统评价。
方法：我们考虑了HCWs，身体活动,和倦怠,把他们描绘成人口，暴露,和结果，分别。我们搜索了APAPsycarticles,MEDLINE,和Scopus，直到2022年7月。我们提取了研究设计的相关数据，测量暴露和结果的方法，和统计方法。
结果：我们的分析包括21项独立研究。尽管10%(2/21)的研究明确关注身体活动，其余的调查是探索性的，检查了各种预测因素，包括体力活动。最常用的问卷是Maslach倦怠量表。由于使用的定义和截止的异质性，报告的倦怠患病率差异很大，从7%到83%不等。在用于评估身体活动的测量工具中也观察到异质性，很少使用客观措施。总的来说,14%(3/21)的研究使用结构化问卷来评估不同类型的运动，而大多数研究(18/21，86%)只记录了达到基准或报告了频率，强度,或锻炼的持续时间。据报道，体力活动性HCWs的患病率从44%到87%不等。分析，通过各种推理方法，表明体力活动通常与倦怠风险降低有关，特别是在情绪衰竭和人格解体领域。此外，我们编制并分类了与倦怠相关的因素列表.
结论：我们对调查体力活动与职业倦怠之间关联的研究的全面概述揭示了定义上的显著异质性，测量,以及文献中采用的分析。为了解决这个问题，采用明确的身体活动定义并对测量工具和数据分析方法做出深思熟虑的选择至关重要。我们关于倦怠的测量和相关因素的综合列表的考虑因素有可能改善旨在告知决策者的未来研究，从而为更有效的解决职业倦怠的管理措施奠定基础。
