Abstract
BackgroundThe health of doctors who work in primary care is threatened by workforce and workload issues. There is a need to find and appraise ways in which to protect their mental health, including how to achieve the broader, positive outcome of well-being. Our primary outcome was to evaluate systematically the research evidence regarding the effectiveness of interventions designed to improve General Practitioner (GP) well-being across two continua; psychopathology (mental ill-health focus) and ‘languishing to flourishing’ (positive mental health focus). In addition we explored the extent to which developments in well-being research may be integrated within existing approaches to design an intervention that will promote mental health and prevent mental illness among these doctors.MethodsMedline, Embase, Cinahl, PsychINFO, Cochrane Register of Trials and Web of Science were searched from inception to January 2015 for studies where General Practitioners and synonyms were the primary participants. Eligible interventions included mental ill-health prevention strategies (e.g. promotion of early help-seeking) and mental health promotion programmes (e.g. targeting the development of protective factors at individual and organizational levels). A control group was the minimum design requirement for study inclusion and primary outcomes had to be assessed by validated measures of well-being or mental ill-health. Titles and abstracts were assessed independently by two reviewers with 99 % agreement and full papers were appraised critically using validated tools.ResultsOnly four studies (with a total of 997 GPs) from 5392 titles met inclusion criteria. The studies reported statistically significant improvement in self-reported mental ill-health. Two interventions used cognitive-behavioural techniques, one was mindfulness-based and one fed-back GHQ scores and self-help information.ConclusionThere is an urgent need for high quality, controlled studies in GP well-being. Research on improving GP well-being is limited by focusing mainly on stressors and not giving systematic attention to the development of positive mental health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0431-1) contains supplementary material, which is available to authorized users.
Highlights
The health of doctors who work in primary care is threatened by workforce and workload issues
Murray et al BMC Family Practice (2016) 17:36. How this fits in: This review has identified a research gap in terms of mental health promotion and disease prevention interventions aimed at General Practitioner (GP) especially those that focus on improving the positive or ‘flourishing’ concept of well-being
Selection criteria As we aimed to evaluate research evidence for the effectiveness of GP well-being interventions a control group was the minimum design requirement for a study to be included and only studies in which GPs were the primary participants were eligible
Summary
The health of doctors who work in primary care is threatened by workforce and workload issues. Our primary outcome was to evaluate systematically the research evidence regarding the effectiveness of interventions designed to improve General Practitioner (GP) well-being across two continua; psychopathology (mental ill-health focus) and ‘languishing to flourishing’ (positive mental health focus). In addition we explored the extent to which developments in well-being research may be integrated within existing approaches to design an intervention that will promote mental health and prevent mental illness among these doctors. As the volume and complexity of clinical work increases, with concomitant rising administrative and bureaucratic burden, there are reports of rising levels of work-related stress and falling job satisfaction that raise concern about the future of primary care [2]. Most GPs report this workload as generally manageable they describe it as negatively impacting on the quality of patient care [3]. The proportion of GPs intending to quit direct patient contact in the five years continues to increase annually with 60.9 % of GPs over 50 years age reporting this intention in a recent UK survey [2]
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