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内科教员的压力管理和适应力训练:一项试点随机临床试验。

Stress management and resilience training among Department of Medicine faculty: a pilot randomized clinical trial.

机构信息

Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA

出版信息

J Gen Intern Med. 2011 Aug;26(8):858-61. doi: 10.1007/s11606-011-1640-x. Epub 2011 Jan 29.

Abstract

BACKGROUND

Physician distress is common and related to numerous factors involving physicians' personal and professional lives. The present study was designed to assess the effect of a Stress Management and Resiliency Training (SMART) program for increasing resiliency and quality of life, and decreasing stress and anxiety among Department of Medicine (DOM) physicians at a tertiary care medical center.

PARTICIPANTS

Forty DOM physicians were randomized in a wait-list controlled clinical trial to either the SMART intervention or a wait-list control group for 8 weeks. The intervention involved a single 90 min one-on-one training in the SMART program. Primary outcome measures assessed at baseline and week 8 included the Connor Davidson Resilience Scale (CDRS), Perceived Stress Scale (PSS), Smith Anxiety Scale (SAS) and Linear Analog Self Assessment Scale (LASA).

RESULTS

Thirty-two physicians completed the study. A statistically significant improvement in resiliency, perceived stress, anxiety, and overall quality of life at 8 weeks was observed in the study arm compared to the wait-list control arm: CDRS: mean ± SD change from baseline +9.8 ± 9.6 vs. -0.8 ± 8.2, t(30) = 3.18, p = 0.003; PSS: -5.4 ± 8.1 vs. +2.2 ± 6.1, t(30) = -2.76, p = 0.010; SAS: -11.8 ± 12.3 vs.+ 2.9 ± 8.9, t(30) = -3.62, p = 0.001; and LASA: +0.4 ± 1.4 vs. -0.6 ± 1.0, t(30) = 2.29, p = 0.029.

CONCLUSIONS

A brief training to enhance resilience and decrease stress among physicians using the SMART program was feasible. Further, the intervention provided statistically significant improvement in resilience, stress, anxiety, and overall quality of life. In the future, larger clinical trials with longer follow-up and possibly wider dissemination of this intervention are warranted.

摘要

背景

医生压力是常见的,与涉及医生个人和职业生活的众多因素有关。本研究旨在评估应激管理和韧性训练(SMART)计划对提高韧性和生活质量、降低医学系(DOM)医生压力和焦虑的影响,该计划在一家三级保健医疗中心进行。

参与者

40 名 DOM 医生随机分为等待名单对照临床试验组,接受 SMART 干预或等待名单对照组 8 周。干预措施包括单次 90 分钟一对一的 SMART 计划培训。基线和第 8 周评估的主要结果测量包括 Connor-Davidson 韧性量表(CDRS)、感知压力量表(PSS)、Smith 焦虑量表(SAS)和线性模拟自我评估量表(LASA)。

结果

32 名医生完成了研究。与等待名单对照组相比,研究组在第 8 周时的韧性、感知压力、焦虑和整体生活质量均有统计学显著改善:CDRS:从基线的平均 ± 标准差变化 +9.8 ± 9.6 vs. -0.8 ± 8.2,t(30) = 3.18,p = 0.003;PSS:-5.4 ± 8.1 vs. +2.2 ± 6.1,t(30) = -2.76,p = 0.010;SAS:-11.8 ± 12.3 vs. + 2.9 ± 8.9,t(30) = -3.62,p = 0.001;和 LASA:+0.4 ± 1.4 vs. -0.6 ± 1.0,t(30) = 2.29,p = 0.029。

结论

使用 SMART 计划提高医生韧性和降低压力的简短培训是可行的。此外,干预措施在韧性、压力、焦虑和整体生活质量方面提供了统计学上的显著改善。未来需要进行更大规模的临床试验,随访时间更长,并可能更广泛地推广这种干预措施。

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