If healthcare worker burnout and mental health problems are not addressed, people leaving the profession could worsen widespread workforce shortages.
Exercise can reduce depressive symptoms, burnout, and sick days for healthcare workers (HCWs), according to a new research article.
Burnout and mental health problems among HCWs spiked during the coronavirus pandemic. For example, earlier research found that physicians reporting at least one burnout symptom rose from 38.2% in 2020 to 62.8% in 2021. If HCW burnout and mental health problems are not addressed, people leaving the profession could worsen widespread workforce shortages.
The new research article, which was published by JAMA Psychiatry, is based on data collected from nearly 300 HCWs who were split evenly between an intervention group and a control group. The intervention group was asked to exercise in four 20-minute sessions per week for 12 weeks. The intervention group was given a free, one-year subscription to the Down Dog suite of apps, which included body weight interval training, yoga, barre, and running apps.
The study generated several key findings for the intervention group.
- The treatment effect on depressive symptoms ranged from small to medium by the end of the 12-week trial
- There was a significant reduction in the cynicism and emotional exhaustion burnout measures, but only a very small improvement in the professional efficacy burnout measure
- There was a small reduction in healthcare worker sick days
- Adherence to the 80-minute per week of exercise requirement declined during the 12-week trial, falling from 54.9% of participants in the first week to 23.2% of participants in week 12
- The positive impact of exercise was greatest for intervention group participants who exercised at least 80 minutes per week
- There was no significant impact on depressive symptoms, burnout, or sick days for intervention group participants who exercised less than 20 minutes per week
"Although exercise was able to reduce depressive symptoms among HCWs, adherence was low toward the end of the trial. Optimizing adherence to exercise programming represents an important challenge to help maintain improvements in mental health among HCWs," the study's co-authors wrote.
Interpreting the data
Providing HCWs with exercise apps can have a positive impact as long as HCWs continue to use the apps, the study's co-authors wrote. "Our results suggest that at-home exercise can have meaningful effects on HCWs' well-being and absenteeism when they are given free access to mobile-based exercise apps, provided they continue using these apps."
Exercise adherence is critical, they wrote. "Even though all the participants volunteered and were generally willing, ready, and able to start exercising with the apps at home (and most did so in the first few weeks), adherence was suboptimal among some participants, with older adults more likely to use the apps. While we ruled out baseline depressive symptoms or burnout as causal factors of adherence, it is likely that stressors at home or at work, not measured in the present study, interfered with adherence."
The success of exercise programs in improving HCW well-being likely requires professional support for particular individuals, the study's co-authors wrote. "In our efficacy trial, we sought to support mental health at the individual level, and determined that at-home, app-based exercise improves mental health with some success. The challenge at the individual level, then, is to determine not only for whom providing free apps is effective in promoting new engagement and maintenance of exercise, but also who—based on demographics and baseline characteristics— needs additional behavioral (eg, health coaches trained in motivational interviewing to increase exercise levels) or psychological (eg, psychiatric and/or psychological professionals) supports."
Large-scale trials to gauge the impact of exercise among HCWs has the potential to develop a cost-effective way to boost well-being, they wrote. "Scaled-up effectiveness trials are needed whereby all HCWs from an organization are provided longer opportunities to access the suite of apps to determine interest, uptake, adherence, and mental, physical, and economic effects. Such trials may reveal a potential low-cost, high-reward opportunity for healthcare networks to use at large, embedded within wellness programs, to reduce healthcare's growing mental health crisis."
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Researchers evaluated an intervention that called on healthcare workers to exercise in four 20-minute sessions per week for 12 weeks.
The treatment effect on depressive symptoms ranged from small to medium by the end of the 12-week trial.
There was a significant reduction in the cynicism and emotional exhaustion burnout measures, but only a very small improvement in the professional efficacy burnout measure.