JMIR Publications

ABSTRACT

Background:

Internationally, the impact of continued exposure to workplace environmental and psychological stressors on the mental health of healthcare professionals has been associated with increased depression, substance misuse, sleep disorders, and post-traumatic stress. Across healthcare settings, this can lead to staff burnout, poorer quality healthcare and reduced patient safety outcomes. These challenges have intensified since the COVID-19 pandemic. The development of strategies to improve the psychological health and wellbeing of healthcare staff have been highlighted as a critical priority. The concept of resilience for healthcare professionals as a tool for negotiating workplace adversity has gained increasing prominence.

Objective:

This systematic review aimed to examine the effectiveness of online interventions to enhance resilience in healthcare professionals.

Methods:

We searched PubMed, CINAHL, PsycINFO, and OVID-SP databases for relevant records published after 1990. We included records focusing on internet-delivered interventions aiming at enhancing resilience. The quality of the included studies was assessed with the Risk of Bias 2 and the Joanna Briggs Institute critical appraisal tools. The protocol was registered on PROSPERO (CRD42021253190). The PRISMA guidelines were followed.

Results:

Eight studies, including 1573 healthcare workers, were included in the review. One was a mixed-method design, and the other seven were quantitative in design. All studies aimed to evaluate the impact of online interventions on resilience or related symptoms in healthcare professionals involved in patient-facing care. Interventions included a variety of formats and therapeutic approaches over a variable time frame, from one week to one month. Four studies directly measured resilience, whilst four used other proxy outcome measures to measure psychological concepts linked to resilience. All studies found that resilience levels or proxy resilience levels were enhanced in healthcare workers following the implementation of the online intervention. The overall risk of bias of the included studies was low.

Conclusions:

Our findings indicate that online interventions designed to enhance resilience in healthcare professionals may be effectively and successfully implemented in clinical practice settings across a range of healthcare professional groups. This highlights the potential of online resilience enhancement interventions for providing support to healthcare professionals experiencing prolonged workplace stress. The interventions included were tested on healthcare professionals directly involved in clinical care, demonstrating their applicability to clinicians working at the frontline. The findings appear generalisable, as overall the included studies had a low risk of bias, were carried out across a range of international settings and included a wide range of healthcare professional disciplines.