Kuhlmann Sophie Merle, Bürger Arne, Esser Günter, Hammerle Florian
Department for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Department of Psychology, University of Potsdam, Karl-Liebknecht-Straße 24/25, 14476, Potsdam, Germany.
Trials. 2015 Feb 8;16:40. doi: 10.1186/s13063-014-0533-9.
Medical training is very demanding and associated with a high prevalence of psychological distress. Compared to the general population, medical students are at a greater risk of developing a psychological disorder. Various attempts of stress management training in medical school have achieved positive results on minimizing psychological distress; however, there are often limitations. Therefore, the use of a rigorous scientific method is needed. The present study protocol describes a randomized controlled trial to examine the effectiveness of a specifically developed mindfulness-based stress prevention training for medical students that includes selected elements of cognitive behavioral strategies (MediMind).
METHODS/DESIGN: This study protocol presents a prospective randomized controlled trial, involving four assessment time points: baseline, post-intervention, one-year follow-up and five-year follow-up. The aims include evaluating the effect on stress, coping, psychological morbidity and personality traits with validated measures. Participants are allocated randomly to one of three conditions: MediMind, Autogenic Training or control group. Eligible participants are medical or dental students in the second or eighth semester of a German university. They form a population of approximately 420 students in each academic term. A final total sample size of 126 (at five-year follow-up) is targeted. The trainings (MediMind and Autogenic Training) comprise five weekly sessions lasting 90 minutes each. MediMind will be offered to participants of the control group once the five-year follow-up is completed. The allotment is randomized with a stratified allocation ratio by course of studies, semester, and gender. After descriptive statistics have been evaluated, inferential statistical analysis will be carried out with a repeated measures ANOVA-design with interactions between time and group. Effect sizes will be calculated using partial η-square values.
Potential limitations of this study are voluntary participation and the risk of attrition, especially concerning participants that are allocated to the control group. Strengths are the study design, namely random allocation, follow-up assessment, the use of control groups and inclusion of participants at different stages of medical training with the possibility of differential analysis.
This trial is recorded at German Clinical Trials Register under the number DRKS00005354 (08 November 2013).
医学培训要求极高,且心理困扰的发生率很高。与普通人群相比,医学生患心理障碍的风险更大。医学院校进行的各种压力管理培训尝试在将心理困扰降至最低方面取得了积极成果;然而,这些尝试往往存在局限性。因此,需要采用严谨的科学方法。本研究方案描述了一项随机对照试验,以检验专门为医学生开发的基于正念的压力预防培训的有效性,该培训包括认知行为策略的选定要素(MediMind)。
方法/设计:本研究方案提出了一项前瞻性随机对照试验,涉及四个评估时间点:基线、干预后、一年随访和五年随访。目的包括使用经过验证的测量方法评估对压力、应对方式、心理疾病和人格特质的影响。参与者被随机分配到三种情况之一:MediMind、自生训练或对照组。符合条件的参与者是德国大学第二或第八学期的医学或牙医学学生。每个学期他们构成约420名学生的群体。目标是最终总样本量为126(在五年随访时)。培训(MediMind和自生训练)包括每周一次的五次课程,每次持续90分钟。五年随访完成后,将向对照组的参与者提供MediMind。分配是随机的,按学习课程、学期和性别进行分层分配。在评估描述性统计数据后,将采用重复测量方差分析设计进行推断性统计分析,包括时间和组之间的相互作用。效应大小将使用偏η平方值计算。
本研究的潜在局限性是自愿参与和失访风险,特别是对于分配到对照组的参与者。优点是研究设计,即随机分配、随访评估、使用对照组以及纳入医学培训不同阶段的参与者,有可能进行差异分析。
本试验在德国临床试验注册中心注册,注册号为DRKS00005354(2013年11月8日)。