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一项针对医院员工的为期4周的基于正念的认知疗法方案的可行性、可接受性和初步有效性

Feasibility, Acceptability, and Preliminary Effectiveness of a 4-week Mindfulness-Based Cognitive Therapy Protocol for Hospital Employees.

作者信息

Luberto Christina M, Wasson Rachel S, Kraemer Kristen M, Sears Richard W, Hueber Carly, Cotton Sian

机构信息

Harvard Medical School/Massachusetts General Hospital, 15 Parkman Street, Boston, MA, 02114-3117.

University of Cincinnati College of Medicine, Department of Family and Community Medicine, Division of Integrative Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0582, USA.

出版信息

Mindfulness (N Y). 2017 Dec;8(6):1522-1531. doi: 10.1007/s12671-017-0718-x. Epub 2017 Apr 1.

Abstract

Hospital employees may experience occupational stress and burnout, which negatively impact quality of life and job performance. Evidence-based interventions implemented within the hospital setting are needed to promote employees' well-being. We offered a 4-week Mindfulness-Based Cognitive Therapy group program for hospital employees, and used a mixed-methods practice-based research approach to explore feasibility, acceptability, and effects on stress and burnout. Participants were 65 hospital employees ( = 44.06; 85% white) who participated between September 2015 and January 2016. Participants completed validated measures of stress and burnout before and after the program, and answered open-ended satisfaction questions after the program. Groups consistently enrolled at least 10 participants, but attendance rates declined across sessions (76% at session 2 vs. 54% at session 4) due primarily to work-related scheduling conflicts. The program content was acceptable as evidenced by high perceived value ( = 9.18 out of 10), homework compliance (51% practicing at least 3 times/week), and qualitative requests for program expansion. There were large, statistically significant decreases in stress (Δ = 2.1, < .001, = .85) and medium decreases in burnout (Δ = .46, = .01, = .57), which were supported by qualitative themes of improved self-regulation and mindfulness skills, stress reduction, emotional well-being, and improved work productivity and patient care skills. Findings suggest that 4-week MBCT is acceptable and useful for hospital employees, though research is needed to identify alternate delivery methods or strategies to enhance session attendance.

摘要

医院员工可能会经历职业压力和倦怠,这会对生活质量和工作表现产生负面影响。需要在医院环境中实施基于证据的干预措施,以促进员工的幸福感。我们为医院员工提供了一个为期4周的基于正念的认知疗法小组项目,并采用了基于实践的混合方法研究途径,以探讨其可行性、可接受性以及对压力和倦怠的影响。参与者为65名医院员工(平均年龄=44.06岁;85%为白人),他们在2015年9月至2016年1月期间参与项目。参与者在项目前后完成了压力和倦怠的有效测量,并在项目结束后回答了开放式满意度问题。各小组始终至少有10名参与者报名,但由于主要是与工作相关的日程安排冲突,各场次的出勤率有所下降(第2场为76%,第4场为54%)。该项目内容是可接受的,高感知价值(满分10分,平均分为9.18)、家庭作业完成情况(51%的人每周至少练习3次)以及对项目扩展的定性需求都证明了这一点。压力有大幅的、具有统计学意义的下降(Δ=2.1,P<.001,Cohen's d=.85),倦怠有中等程度的下降(Δ=.46,P=.01,Cohen's d=.57),自我调节和正念技能的提高、压力减轻、情绪幸福感以及工作效率和患者护理技能的提高等定性主题也支持了这一点。研究结果表明,为期4周的正念减压疗法对医院员工是可接受且有用的,不过需要开展研究以确定替代的授课方式或策略,以提高各场次的出勤率。

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