Программы по борьбе с эмоциональным выгоранием у врачей

Введение. Синдром эмоционального выгорания – состояние, вызванное чрезмерным стрессом на рабочем месте. Врачи и другие медицинские работники входят в группу риска из-за множества профессиональных факторов, связанных с их деятельностью. Исследования, в которых сравнивается уровень выгорания у врачей и специалистов других профессий, показывают, что у врачей он стабильно выше. Наблюдаемая высокая распространенность данной проблемы подчеркивает необходимость разработки методов повышения стрессоустойчивости и снижения уровня профессионального выгорания врачей. Цель настоящей работы – анализ иностранной литературы, содержащей описания эффективных программ, направленных против выгорания медицинских работников и способствующих улучшению их психического здоровья. Материалы и методы. Поиск научной литературы осуществлялся в международной базе данных PubMed/MEDLINE. Были отобраны статьи, опубликованные за последние 5 лет, в которых содержится описание программ по борьбе с эмоциональным выгоранием у медицинских работников. Результаты показали, что существует множество методов улучшения психического здоровья врачей, в том числе индивидуальные подходы, такие как физическое и психологическое воздействия, обучение осознанности, различные техники йоги, коучинг и обсуждение в малых группах. Клинические исследования с контрольными группами подтвердили их эффективность. Специальная адаптация данных методов и использование цифровых технологий делает занятия доступными и удобными к применению у медицинских работников.

1. Rubin B., Goldfarb R., Satele D. et al. Burnout and Distress Among Physicians in a Cardiovascular Centre of a Quaternary Hospital Network: A Cross-Sectional Survey. CMAJ Open. 2021;9(1):E10-E18. https://doi.org/10.9778/cmajo.20200057

2. Jelen A., Goldfarb R., Rosart J. et al. A Qualitative Co-Design-Based Approach to Identify Sources of Workplace-Related Distress and Develop Well-Being Strategies for Cardiovascular Nurses, Allied Health Professionals, and Physicians. BMC Health Services Research. 2024;24(1):246. https://doi.org/10.1186/s12913-024-10669-x

3. Ryan E., Hore K., Power J. et al. The Relationship Between Physician Burnout and Depression, Anxiety, Suicidality and Substance Abuse: A Mixed Methods Systematic Review. Frontiers in Public Health. 2023;11:1133484. https://doi.org/10.3389/fpubh.2023.1133484

4. Hoying J., Terry A., Kelly S. et al. A Cognitive-Behavioral Skills Building Program Improves Mental Health and Enhances Healthy Lifestyle Behaviors in Nurses and Other Hospital Employees. Worldviews on Evidence-Based Nursing. 2023;20(6):542-549. https://doi.org/10.1111/wvn.12686

5. Wahrman A.D. Uncaring: How the Culture of Medicine Kills Doctors & Patients. Plastic and Reconstructive Surgery. 2022;149(5):1280-1281. https://doi.org/10.1097/PRS.0000000000009065

6. Goyal P., Rustagi N., Belkić K. Physicians’ Total Burden of Occupational Stressors: More than Threefold Increased Odds of Burnout. Southern Medical Journal. 2021;114(7):409-415. https://doi.org/10.14423/SMJ.0000000000001277

7. Zhou A.Y., Panagioti M., Esmail A. et al. Factors Associated with Burnout and Stress in Trainee Physicians: A Systematic Review and Meta-analysis. JAMA Network Open. 2020;3(8):e2013761. https://doi.org/10.1001/jamanetworkopen.2020.13761

8. Belkić K., Rustagi N. Job Stressors in Relation to Burnout and Compromised Sleep Among Academic Physicians in India. Work. 2024;78(2):505-525. https://doi.org/10.3233/WOR-230383

9. Jelen A., Rodin G., Graham L. et al. Prevalence and Drivers of Nurse and Physician Distress in Cardiovascular and Oncology Programmes at a Canadian Quaternary Hospital Network During the COVID-19 Pandemic: A Quality Improvement Initiative. BMJ Open. 2024;14(2):e079106. https://doi.org/10.1136/bmjopen-2023-079106

10. Belkić K. Toward Better Prevention of Physician Burnout: Insights from Individual Participant Data Using the MD-Specific Occupational Stressor Index and Organizational Interventions. Frontiers in Public Health. 2025;13:1514706. https://doi.org/10.3389/fpubh.2025.1514706

11. Khalafallah A.M., Lam S., Gami A. et al. A National Survey on the Impact of the COVID-19 Pandemic Upon Burnout and Career Satisfaction Among Neurosurgery Residents. Journal of Clinical Neuroscience. 2020;80:137-142. https://doi.org/10.1016/j.jocn.2020.08.012

12. Fainstad T., Mann A., Suresh K. et al. Effect of a Novel Online Group-Coaching Program to Reduce Burnout in Female Resident Physicians: A Randomized Clinical Trial. JAMA Network Open. 2022;5(5):e2210752. https://doi.org/10.1001/jamanetworkopen.2022.10752

13. Eliyas S., Gressel O., Ben-Arye E. et al. Coming out of the Integrative Oncology Comfort Zone: Addressing Healthcare Providers’ Wartime-Related Concerns. Psycho-Oncology. 2024;33(12):e70042. https://doi.org/10.1002/pon.70042

14. Brubaker J.R., Swan A., Beverly E.A. A Brief Intervention to Reduce Burnout and Improve Sleep Quality in Medical Students. BMC Medical Education. 2020;20(1):345. https://doi.org/10.1186/s12909-020-02263-6

15. Boden L.M., Rodriguez C., Kelly J.D. 4th et al. Mindfulness Applications: Can They Serve as a Stress, Anxiety, and Burnout Reduction Tool in Orthopaedic Surgery Training? A Randomized Control Trial. JBJS Open Access. 2023;8(3):e22.00114. https://doi.org/10.2106/JBJS.OA.22.00114

16. Scheid A., Dyer N.L., Dusek J.A. et al. A Yoga-Based Program Decreases Physician Burnout in Neonatologists and Obstetricians at an Academic Medical Center. Workplace Health & Safety. 2020;68(12):560-566. https://doi.org/10.1177/2165079920930720

17. Jammes C., Heiman I., Amri H. A Pilot Intervention to Reduce Burnout and Enhance Resilience Through Transcendental Meditation Among Georgetown University Medical Students. BMC Medical Education. 2025;25(1):478. https://doi.org/10.1186/s12909-025-07004-1

18. Loiselle M., Brown C., Travis F. et al. Effects of Transcendental Meditation on Academic Physician Burnout and Depression: A Mixed Methods Randomized Controlled Trial. Journal of Continuing Education in the Health Professions. 2023;43(3):164-171. https://doi.org/10.1097/CEH.0000000000000472

19. Joshi S.P., Wong A.I., Brucker A. et al. Efficacy of Transcendental Meditation to Reduce Stress Among Health Care Workers: A Randomized Clinical Trial. JAMA Network Open. 2022;5(9):e2231917. https://doi.org/10.1001/jamanetworkopen.2022.31917

20. Nestor M.S., Lawson A., Fischer D. Improving the Mental Health and Well-Being of Healthcare Providers Using the Transcendental Meditation Technique During the COVID-19 Pandemic: A Parallel Population Study. PLoS ONE. 2023;18(3):e0265046. https://doi.org/10.1371/journal.pone.0265046

21. Korkmaz A., Bernhardsen G.P., Cirit B. et al. Sudarshan Kriya Yoga Breathing and a Meditation Program for Burnout Among Physicians: A Randomized Clinical Trial. JAMA Network Open. 2024;7(1):e2353978. https://doi.org/10.1001/jamanetworkopen.2023.53978

22. Kanchibhotla D., Harsora P., Gupte P. et al. Alleviating Work Exhaustion, Improving Professional Fulfillment, and Influencing Positivity Among Healthcare Professionals During COVID-19: A Study on Sudarshan Kriya Yoga. Frontiers in Psychology. 2022;13:670227. https://doi.org/10.3389/fpsyg.2022.670227

23. Bhardwaj P., Pathania M., Bahurupi Y. et al. Efficacy of mHealth Aided 12-Week Meditation and Breath Intervention on Change in Burnout and Professional Quality of Life Among Health Care Providers of a Tertiary Care Hospital in North India: A Randomized Waitlist-Controlled Trial. Frontiers in Public Health. 2023;11:1258330. https://doi.org/10.3389/fpubh.2023.1258330

24. Azizoddin D.R., Kvaternik N., Beck M. et al. Heal the Healers: A Pilot Study Evaluating the Feasibility, Acceptability, and Exploratory Efficacy of a Transcendental Meditation Intervention for Emergency Clinicians During the Coronavirus Disease 2019 Pandemic. Journal of the American College of Emergency Physicians Open. 2021;2(6):e12619. https://doi.org/10.1002/emp2.12619

25. Calarco M.M., Stratton K.J. The Impact of Transcendental Meditation in Reducing Burnout and Enhancing Well-Being in Frontline Healthcare Clinicians during the COVID-19 Pandemic. Online Journal of Issues in Nursing. 2023;28(3). https://doi.org/10.3912/OJIN.Vol28No03PPT55

26. Rojas B., Catalan E., Diez G. et al. A Compassion-Based Program to Reduce Psychological Distress in Medical Students: A Pilot Randomized Clinical Trial. PLoS ONE. 2023;18(6):e0287388. https://doi.org/10.1371/journal.pone.0287388

27. Fairchild A. The Role of Compassion in Ethical Frameworks and Medical Practice. Clinical Ethics. 2020;16(4):302-306. https://doi.org/10.1177/1477750920983572

28. Roca P., Vazquez C., Diez G. et al. Not All Types of Meditation Are the Same: Mediators of Change in Mindfulness and Compassion Meditation Interventions. Journal of Affective Disorders. 2021;283:354-362. https://doi.org/10.1016/j.jad.2021.01.070

29. Guck A.J., Buck K. Reducing Clinician Inefficiency and Restoring Meaning in Practice: A Professional Coaching Approach for Family Medicine Residents. International Journal of Psychiatry in Medicine. 2021;56(5):319-326. https://doi.org/10.1177/00912174211034624

30. Palamara K., Chu J.T., Chang Y. et al. Who Benefits Most? A Multisite Study of Coaching and Resident Well-being. Journal of General Internal Medicine. 2022;37(3):539-547. https://doi.org/10.1007/s11606-021-06903-5

31. Fainstad T., Rodriguez C., Kreisel C. et al. Impact of an Online Group-Coaching Program on Ambulatory Faculty Physician Well-Being: A Randomized Trial. Journal of the American Board of Family Medicine. 2024;37(6):1055-1071. https://doi.org/10.3122/jabfm.2024.240022R1

32. Solms L., van Vianen A., Koen J. et al. Turning the Tide: A Quasi-Experimental Study on a Coaching Intervention to Reduce Burn-Out Symptoms and Foster Personal Resources Among Medical Residents and Specialists in the Netherlands. BMJ Open. 2021;11(1):e041708. https://doi.org/10.1136/bmjopen-2020-041708

33. Kiser S.B., Sterns J.D., Lai P.Y. et al. Physician Coaching by Professionally Trained Peers for Burnout and Well-Being: A Randomized Clinical Trial. JAMA Network Open. 2024;7(4):e245645. https://doi.org/10.1001/jamanetworkopen.2024.5645

34. West C.P., Dyrbye L.N., Satele D.V. et al. Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Groups for Physician Well-Being: A Randomized Clinical Trial. Mayo Clinic Proceedings. 2021;96(10):2606-2614. https://doi.org/10.1016/j.mayocp.2021.02.028