Balint groups for improving the ability of doctors and medical students to manage the doctor-patient relationship: a systematic review, quantitative meta-analysis and qualitative meta-synthesis of intervention studies.

OBJECTIVE: Balint groups are a crucial method for improving the relationship between medical students/doctors and patients. Nevertheless, no review has examined the effects of Balint groups in this regard. This study aimed to conduct quantitative meta-analyses and qualitative meta-syntheses based on a systematic review to provide references for improving doctor‒patient relationships. METHODS: We searched six databases from inception through October 2024. Two reviewers independently conducted screening and quality assessment. Quantitative data were analyzed using meta-analysis methods with standard mean differences (SMDs) and 95% confidence intervals (CI) in RevMan 5.4.1, while qualitative results were summarized using meta-synthesis methods. RESULTS: A total of 56 studies were included, including 45 quantitative studies and 11 qualitative studies. Two, fifty-one, and three studies were rated as having a low risk of bias, unclear risk or some concerns, and high risk of bias, respectively. Thirteen quantitative studies were included in the meta-analyses. Compared with those in the control group, participants in the Balint group had higher communication scores and empathy scores and lower anxiety scores (SMD = 1.26, 95% CI 0.97 to 1.56, I2 = 0%, five studies; SMD = 2.40, 95% CI 1.31 to 3.49, I2 = 96%, six studies; SMD = -0.79, 95% CI -1.39 to -0.19, I2 = 71%, three studies). Participants who received the Balint intervention had significantly lower burnout scores in emotional exhaustion and reduced personal accomplishment among healthcare workers post-intervention compared with pre-intervention (SMD = -1.62, 95% CI -3.21 to -0.03, I2 = 88%, three studies; SMD = -1.22, 95% CI -2.26 to -0.17, I2 = 74%, three studies), while no significant change was saw in cynicism (SMD = -0.90, 95%, CI -1.91 to 0.10, I2 = 75%, three studies). The meta-synthesis results of 11 qualitative studies show that Balint groups have a positive effect on doctors' doctor-patient communication, empathy, psychological adjustment, and team cooperation abilities. CONCLUSION: Balint groups may contribute to improving doctor‒patient relationships. We suggest caution and advocate for multicenter large-sample randomized controlled trials with low risk-of-bias design to avoid evidence bias.