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简短正念干预对初级保健临床医生的工作满意度、生活质量和同情心的影响:一项试点研究。

Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study.

机构信息

Meriter Medical Group, Madison, Wisconsin.

出版信息

Ann Fam Med. 2013 Sep-Oct;11(5):412-20. doi: 10.1370/afm.1511.

Abstract

PURPOSE

Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians.

METHODS

A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months postintervention), participants completed a set of online measures assessing burnout, anxiety, stress, resilience, and compassion. We used a linear mixed-effects model analysis to assess changes in outcome measures.

RESULTS

Participants had improvements compared with baseline at all 3 follow-up time points. At 9 months postintervention, they had significantly better scores (1) on all Maslach Burnout Inventory burnout subscales-Emotional Exhaustion (P =.009), Depersonalization (P = .005), and Personal Accomplishment (P <.001); (2) on the Depression (P =.001), Anxiety (P =.006), and Stress (P = .002) subscales of the Depression Anxiety Stress Scales-21; and (3) for perceived stress (P = .002) assessed with the Perceived Stress Scale. There were no significant changes on the 14-item Resilience Scale and the Santa Clara Brief Compassion Scale.

CONCLUSIONS

In this uncontrolled pilot study, participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clinician health and well-being, which may have implications for patient care.

摘要

目的

初级保健医生的倦怠、离职和低工作满意度日益令人担忧,可能对医疗保健产生负面影响。改善临床医生工作生活平衡的干预措施很少,也理解不足。我们进行这项研究是为了初步探讨缩短的正念干预是否可以提高初级保健临床医生的工作满意度、生活质量和同情心。

方法

共有 30 名初级保健医生参加了缩短的正念课程。我们使用了单样本、前后设计。在 4 个时间点(基线和干预后 1 天、8 周和 9 个月),参与者完成了一套在线评估量表,评估倦怠、焦虑、压力、韧性和同情心。我们使用线性混合效应模型分析来评估结果测量的变化。

结果

与基线相比,所有 3 个随访时间点的参与者都有改善。在干预后 9 个月,他们在所有 Maslach 倦怠量表的倦怠子量表上的得分都显著提高:(1)情绪衰竭(P=.009)、去人格化(P=.005)和个人成就感(P<.001);(2)抑郁(P=.001)、焦虑(P=.006)和压力(P=.002)的抑郁焦虑压力量表-21 子量表;以及(3)感知压力量表(P=.002)。14 项韧性量表和圣克拉拉简要同情心量表没有显著变化。

结论

在这项非对照的初步研究中,参加适应初级保健医生的缩短正念培训课程与降低职业倦怠、抑郁、焦虑和压力的指标有关。修改后的正念训练可能是一种时间有效的工具,可以帮助支持临床医生的健康和幸福感,这可能对患者护理产生影响。

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