The effect of physical activity interventions on occupational stress for health personnel: A systematic review

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Abstract

Background

High occupational stress and its implications on health in people who are working in the healthcare sector are well-documented. However, less is known about beneficial effects physical activity interventions might have on occupational stress in healthcare settings.

Objective

This systematic review aims to identify the current evidence on the effect of physical activity interventions on stress outcomes in health personnel.

Design

A systematic review with quality assessment.

Method

PsycINFO, Medline and CINAHL databases were searched in February 2018 using a combination of synonyms of the terms “health personnel”, “physical activity” and “occupational stress”. The search was repeated in March 2019.

Results

N = 18 experimental studies were included, representing three specified physical activity intervention types (yoga, tai chi and qigong) and different non-specific worksite training programs. Nine studies conducted a multi component intervention with a minor part being physical activity. A total of n = 9 studies investigated the effect of a single component physical activity intervention on stress (seven RCTs, two pre-post intervention studies). Stress measurements used were heterogeneous and only five studies specifically assessed occupational stress. None of the nine studies were considered to be of high quality. All of the included studies scored lower than seven (out of a maximum quality score of 14) with risks of performance and attrition bias. Results suggest a stress reducing effect of yoga and qigong interventions, whereas general workplace physical activity programs and tai chi did not show significant effects.

Conclusions

The present review indicates that yoga and qigong might be an effective way of reducing stress in health personnel and could be incorporated into health promotion in the healthcare sector. Nevertheless, further research with appropriate planning and detailed descriptions of the conducted interventions (duration, frequency and intensity) is needed to determine the effect of physical activity interventions on occupational stress.

Section snippets

What is already known about the topic?

  • •

    Occupational stress is exceptionally high in employees of the healthcare sector.

  • •

    Stress in health personnel is associated with many chronic diseases, health impairing behaviors as well as staff turnover and medical errors.

  • •

    Physical activity is being discussed on having a stress reducing or regulating effect.

What this paper adds

  • •

    No systematic review on the effect of physical activity interventions on health personnel has been published yet.

  • •

    This paper identifies physical activity intervention studies aimed at reducing stress in employees of the healthcare sector.

  • •

    Limited evidence is available on the effectiveness of physical activity interventions in reducing health personnel’s stress. Studies especially lack adequate descriptions of the type of physical activity as well as duration and intensity of the conducted

Methods

This systematic review was registered in Prospero (registration number: CRD42018085913). Furthermore, it was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard (Moher et al., 2009).

Results

The search yielded a total of 1257 studies, 90 in PsycINFO, 458 in Medline and 709 in CINAHL. The manual search added one further study (Griffith et al., 2008). All titles and abstracts were screened and 50 full texts were assessed for eligibility criteria, resulting in n = 17 included studies (see Flow Chart in Fig. 1). The remaining n = 33 were excluded for the following reasons:

24 incorporated no physical activity in the intervention (Alexander, 2013; Asuero et al., 2014; Bair and Greenspan,

Discussion

The aim of this study was to systematically review research investigating the effect of physical activity on occupational stress in health personnel in longitudinal intervention studies. The review yielded only 18 intervention studies and only nine studies assessing the effect of single component physical activity on stress in the healthcare sector, even though studies were deliberately not limited to RCT designs. This highlights the need for and the potential of further research in this area

Conclusions

Health personnel need to be supported in their resilience to inevitable occupational stress. This systematic review aimed at investigating whether physical activity interventions might be an effective way in reducing stress.

This review indicates a potential beneficial effect of mind-body practices like yoga or qigong on stress in health professionals. Nevertheless, this review first and foremost highlights the need for further research in this area. Future research should focus on participative

Contributions

LLB and AKO were responsible for data collection and analysis. LLB drafted the manuscript. BW, AKO and CH reviewed the paper for important intellectual content.

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