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必修纵向压力管理和弹性训练课程对医学生一年级的影响。

The Impact of a Required Longitudinal Stress Management and Resilience Training Course for First-Year Medical Students.

机构信息

Department of Medicine, Mayo Clinic, Rochester, MN, USA.

Department of Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA.

出版信息

J Gen Intern Med. 2017 Dec;32(12):1309-1314. doi: 10.1007/s11606-017-4171-2. Epub 2017 Aug 31.

Abstract

BACKGROUND

Although psychological distress is common among medical students, little remains known about effective interventions. One promising individual-focused approach is mindfulness-based stress management interventions; however, studies to date have relied on volunteers.

OBJECTIVE

To determine whether a required longitudinal stress management and resilience course improves well-being among first-year medical students.

DESIGN

A quasi-experimental study.

PARTICIPANTS

Two cohorts of medical students who participated in a required stress management and resilience course and completed pre and post questionnaires.

MAIN MEASURES

Validated instruments were used to examine the effects on burnout, quality of life (QOL), stress, resilience, happiness, and empathy. Paired analysis was conducted to explore changes from baseline.

KEY RESULTS

On paired analysis of individual students, mean mental QOL and happiness declined (mental QOL: -5.63 [P < 0.001] and -5.15 [P = 0.015] and happiness: -0.31 [P = 0.02] and -0.4 [P = 0.01], cohorts 1 and 2, respectively) over the course of the year. Similarly, stress scores increased by 4.22 (P < 0.0001) and 3.62 (P = 0.03) in cohorts 1 and 2, respectively. Cognitive and emotive empathy declined in both cohorts but was only statistically significant for cohort 1 (-1.64 and -2.07, P < 0.01). No statistically significant differences in burnout or resilience were seen.

CONCLUSIONS

The required longitudinal mindfulness-based stress management course tested in first-year medical students did not lead to measurable improvements in medical student well-being or empathy. These findings contrast with those of studies using volunteer medical students or physicians, which suggested a reduction in burnout and stress using a similar curriculum. Medical schools should consider offering a variety of effective options so that students can select activities they want to engage in.

摘要

背景

尽管医学生普遍存在心理困扰,但对于有效的干预措施仍知之甚少。一种有前途的个体为中心的方法是基于正念的压力管理干预;然而,迄今为止的研究依赖于志愿者。

目的

确定必修的纵向压力管理和适应力课程是否能提高一年级医学生的幸福感。

设计

准实验研究。

参与者

参加必修压力管理和适应力课程并完成预问卷和后问卷的两批医学生。

主要措施

使用验证工具来检查倦怠、生活质量(QOL)、压力、适应力、幸福感和同理心的影响。进行配对分析以探索从基线的变化。

主要结果

对个别学生的配对分析显示,心理健康 QOL 和幸福感呈下降趋势(心理健康 QOL:-5.63 [P<0.001] 和-5.15 [P=0.015],以及幸福感:-0.31 [P=0.02] 和-0.4 [P=0.01],第 1 组和第 2 组)。同样,第 1 组和第 2 组的压力评分分别增加了 4.22(P<0.0001)和 3.62(P=0.03)。两组的认知和情感同理心均下降,但仅第 1 组有统计学意义(-1.64 和-2.07,P<0.01)。倦怠或适应力没有统计学上的显著差异。

结论

在一年级医学生中测试的必修纵向基于正念的压力管理课程并没有导致医学生幸福感或同理心的可衡量改善。这些发现与使用志愿医学生或医生的研究结果形成对比,这些研究使用类似的课程表明倦怠和压力减轻。医学院应考虑提供各种有效的选择,以便学生可以选择他们想要参与的活动。

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