Measurement of doctor wellbeing prior to the Covid pandemic: a methodological systematic review

ObjectivesAttention has been focused on health professional during and after the Covid-19 pandemic, but relatively little is known about wellbeing before the pandemic struck. We therefore wised to describe which wellbeing outcomes had been measured in doctors and which wellbeing outcome measurement instruments had been used with doctors, prior to 2020. DesignA methodological review of existing literature. SettingMEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, and the International Bibliography of Social Science were searched for all study types, in all languages. Outcome measuresWellbeing outcomes were categorised as being defined/operationalised in the aims, the methods or the results,Error! Reference source not found. and by whether the outcome used to represent wellbeing included the word wellbeing, another positive concept, a pathological symptom, a pathology, and were work-specific or doctor-specific. The outcome measurement instruments used were then categorised as published or unpublished and the frequency of use was collected. ResultsA total of 218 studies were included in this review. The majority of studies were not interventional (83.9%). The total number of unique outcomes used to capture wellbeing in the eligible studies was 57, with 369 non-unique outcomes. The percentage of outcomes used that contained the word wellbeing, its components and other positive concepts, was 69.9% (258/369). The percentage of negative concept use such as negative work context outcomes, symptoms of pathologies, or pathologies, was 30.1% (111/369). For the outcome "general wellbeing" alone, 92 different measurement tools were used. The Maslach Burnout Inventory was the most frequently used measurement tool for all outcomes, used in 16.3% of studies. ConclusionsWellbeing has been measured heterogeneously in doctors in terms of the outcomes and the outcome measurement instruments used. In approximately one-third of the times it was measured, the best that could be achieved was an absence of pathological symptoms, as a negative concept was used to operationalise it. Strengths and limitations of this studyStrengths O_LIThis methodological review includes 218 studies on doctor wellbeing C_LIO_LIThis study utilised a novel methodology for determining eligibility and identifying outcomes for poorly defined concepts, such as wellbeing that reduces reviewer bias C_LI Limitations O_LIThis study relates only to the methods used in studies of doctor wellbeing C_LIO_LIThe findings are based on studies published prior to the Covid-19 pandemic C_LIO_LIIt was not possible to double extract all data C_LI