Stressmestringsintervensjon utprøvd på legestudenter og turnusleger : - hva har blitt prøvd og med hvilke resultater?

Abstract

Introduction: Various studies show that medical students suffer from a lot of stress, both academic and in coping with patients and situations occurring in a hospital. Many find that their social life is impaired due to the workload. Also stress is associated with depression, anxiety, increased alcohol consumption and drug abuse. A Norwegian study show that medical students content with life in general decreases during medical school. In 2000 Shapiro et. al. did a systematic review of clinical studies providing empirical data on stress-management programs in medical training. They found promising results, but the studies had many limitations. 8 years later, we want to see if there has been done more research on this topic. Purpose: To review systematically clinical studies providing empirical data on stress-management programs/intervention in medical training. We want to answer following questions: (1) what stress-coping interventions have been tried by medical students and junior doctors, (2) what are the results of the interventions and (3) is it possible to generalise this results to all medical students and junior doctors. Method: We searched PubMed and PsycInfo from 1999 to 2008. Studies were included if they evaluated stress-management programs/interventions for medical trainees (medical students, junior doctors, residents, interns), reported empirical data and were written in English or Scandinavian. We also included a study that had been missed by Shapiro et. al. Results: We found 250 studies who addressed stress in medical training, but only 8 studies that reported intervention programs. Results revealed that the students/residents participating in the interventions (1) found the intervention helpful to lower stress, (2) felt more able to cope with stress, (3) appreciated the positive group support, (4) decreased anxiety level, (5) felt less doubt and more content with themselves, (6) decreased depression and (7) lowered feeling of fatigue and tiredness. Conclusion: The 8 studies had promising results but it is impossible to make generalised conclusions. It is not possible to decide one intervention that is more effective than the others or which intervention that works best on whom.