Table 9 Confidence in estimates of healthcare professionals’ emotional burden associated with the practice of CDS
Outcome | No of studies | Risk of bias | Imprecision | Heterogeneity | Applicability | Confidencea |
|---|---|---|---|---|---|---|
0 | 0 | −1 | −1 | +ooo; low | ||
CDS-related burden in physicians | 1, Morita T, 2002 [37] | Confounding: Physicians’ concerns regardless of patients characteristics and other confounders | Physicians’ burden related to choose CDS as treatment option for specific vignettes Low response rate 49.6% | Variability in mean scores within and between Maslach Burnout Inventory subscales of emotional exhaustion and depersonalization Variability in prevalence of physicians’ concerns ranging from 1.6-48% | Population: Japanese oncologists and palliative care specialists with experience in sedation for cancer patients Intervention: CDS for cancer patients in vignettes with family support and clinical survival prediction of less than 3 weeks Comparator: Physicians choosing CDS as strong treatment option vs. others Outcome: Self-reported Not clear, if patient-specific No long-term associations possible | |
−1 | 0 | −1 | 0 | +ooo; low | ||
CDS-related burden in nurses | 2, Morita T, 2004 [38] Rietjens JAC, 2007 [39] | Study limitations: Validity of outcome measures Confounding: Stressors influencing general wish to leave current work, R2 = .24 Selection Bias: Study does not include burdened nurses who already left their current work due to CDS Recall Bias: A memorable case up to 5 years in the past | Nurses’ wish to leave current work as single item questions | Heterogeneity in targeted psychological outcome Variability in prevalence on single item level and across outcomes | Population: Japanese & Dutch oncology and palliative care nurses with experience in the practice of CDS Intervention: CDS for cancer patients predominantly Comparator: Nurses with low-level burden vs. high-level burden Outcome: Self-reported Overall burden No long-term associations possible |