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Interventions to reduce occupational stress and burn out within neonatal intensive care units: a systematic review
  1. Ilia Bresesti1,2,
  2. Laura Folgori1,3,
  3. Paola De Bartolo2,4
  1. 1Department of Pediatrics, Luigi Sacco University Hospital, Milano, Italy
  2. 2Department of Human Science, Guglielmo Marconi University, Roma, Italy
  3. 3Pediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George’s University of London, London, UK
  4. 4Laboratory of Experimental Neurofisiology, IRCCS Fondazione Santa Lucia, Roma, Italy
  1. Correspondence to Dr Ilia Bresesti, Department of Pediatrics, Luigi Sacco University Hospital, Milano 20157, Italy; ilia_bresesti{at}


Occupational stress is an emerging problem among physician and nurses, and those working in intensive care settings are particularly exposed to the risk of developing burnout. To verify what types of interventions to manage occupational stress and burn out within neonatal intensive care units (NICUs) have been introduced so far and to verify their efficacy among caregivers. PsycINFO (PsycINFO 1967–July week 3 2019), Embase (Embase 1996–2019 week 29) e Medline (Ovid MEDLINE(R) without revisions 1996–July week 2 2019) were systematically searched combining MeSH and free text terms for “burn out” AND “healthcare provider” AND “NICU”. Inclusion criteria were interventions directed to healthcare providers settled in NICUs. Only English language papers were included. Six articles were included in the final analysis. All the studies reported an overall efficacy of the interventions in reducing work-related stress, both when individual focused and organisation directed. The analysis revealed low quality of the studies and high heterogeneity in terms of study design, included populations, interventions and their evaluation assessment. There is currently very limited evidence regarding the management of occupational stress and burn out within NICUs. The quality of available studies was suboptimal. The peculiarities of the NICUs should be considered when developing strategies for occupational stress management. Training self-awareness of workers regarding their reactions to the NICU environment, also from the pre-employment stage, could be an additional approach to prevent and manage stress.

  • burnout
  • psychology
  • stress
  • healthcare workers

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  • Contributors IB and PDB conceived the study. IB and LF designed the search strategy and selection criteria. IB and LF reviewed all titles and abstracts for potentially eligible articles, and all studies meeting the inclusion criteria. IB and LF extracted relevant data according to prespecified criteria. IB wrote the initial paper. LF and PDB reviewed the paper. All authors approved the study as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.