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In-hospital stress and patient outcomes: A systematic review and meta-analysis

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  • Daniel M Ford
  • Luke Budworth
  • Rebecca Lawton
  • Elizabeth A Teale
  • Daryl B O’Connor

Abstract

Background: Hospital inpatients are exposed to high levels of stress during hospitalisation that may increase susceptibility to major adverse health events post-hospitalisation (known as post-hospital syndrome). However, the existing evidence base has not been reviewed and the magnitude of this relationship remains unknown. Therefore, the aim of the current systematic review and meta-analysis was to: 1) synthesise existing evidence and to determine the strength of the relationship between in-hospital stress and patient outcomes, and 2) determine if this relationship differs between (i) in-hospital vs post-hospital outcomes, and (ii) subjective vs objective outcome measures. Methods: A systematic search of MEDLINE, EMBASE, PsychINFO, CINAHL, and Web of Science from inception to February 2023 was conducted. Included studies reported a measure of perceived and appraised stress while in hospital, and at least one patient outcome. A random-effects model was generated to pool correlations (Pearson’s r), followed by sub-group and sensitivity analyses. The study protocol was preregistered on PROSPERO (CRD42021237017). Results: A total of 10 studies, comprising 16 effects and 1,832 patients, satisfied the eligibility criteria and were included. A small-to-medium association was found: as in-hospital stress increased, patient outcomes deteriorated (r = 0.19; 95% CI: 0.12–0.26; I2 = 63.6; p

Suggested Citation

  • Daniel M Ford & Luke Budworth & Rebecca Lawton & Elizabeth A Teale & Daryl B O’Connor, 2023. "In-hospital stress and patient outcomes: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 18(3), pages 1-17, March.
    • Handle: RePEc:plo:pone00:0282789
    DOI: 10.1371/journal.pone.0282789
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    References listed on IDEAS

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