A system for objective diagnosis of psychoemotional disorders and social maladaptation to assess the effectiveness of non-pharmacological interventions for healthcare workers prone to professional burnout

Objective. To develop and validate a comprehensive system for objective diagnosis of psychoemotional disorders and social maladjustment in healthcare workers with professional burnout, as well as to evaluate the effectiveness of non-pharmacological technologies based on original system. Material and methods. A prospective, controlled, randomized study involved 180 healthcare workers (28—62 years old) with signs of professional burnout. All patients received basic interventions (physical exercise and psychological correction). They were randomized into six groups by 30 participants each: control group (basic correction only), comparison groups 1—4 (basic correction plus one physiotherapeutic method: whole-body air cryotherapy, whole-body magnetic therapy, intermittent hypoxic-hyperoxic training or hydrogen therapy), and main group (basic correction plus all four physiotherapy methods). We assessed psychometric properties of diagnostic complex (reliability, validity, diagnostic accuracy), dynamics of professional burnout (MBI), anxiety-depressive disorders (HADS, DASS-21), somatization (PHQ-15), social maladjustment (SASS), and heart rate variability. Results. Original diagnostic complex demonstrated high psychometric properties: internal consistency (α=0.79—0.89), construct validity (CFI=0.94, RMSEA=0.058), diagnostic accuracy (AUC=0.92). Three clinical and psychopathological variants of professional maladjustment were identified: somatoform (32.2%), anxious-dysphoric (40.0%), and asthenodepressive ones (27.8%). The greatest therapeutic effect was achieved in the main group: integral index of burnout decreased by 31.0%, anxiety by 41.8%, depression by 46.2%, somatization by 43.4%, and social maladjustment by 33.3% (p<0.001). Combination of four physiotherapeutic methods significantly outperformed all monotherapy methods across all parameters (p<0.001). The combined effect is not a simple sum because we found supra-additive synergism (reliable change index 76.7—80.0% in the study group versus 46.7—53.3% in the comparison groups). There were significant correlations between reduced professional burnout and improved social functioning (r=0.68—0.72), as well as restoration of autonomic regulation (SDNN increase by 46.1%, LF/HF decrease by 47.5%). Conclusion. A comprehensive diagnostic system for psychoemotional disorders and social maladjustment associated with professional burnout in healthcare workers was developed and validated. Combination of physiotherapeutic methods (cryotherapy, magnetic therapy, hypoxic-hyperoxic therapy, and hydrogen therapy) effectively reduces symptoms of burnout and social maladjustment. Synergistic nature of physical factors was confirmed. There was a correlation between reduction of burnout and restoration of social functioning and autonomic regulation. This necessitates a comprehensive assessment of psychoemotional status and social adaptation when treating professional burnout.