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一项针对初级保健医生的基于正念的简短干预措施:一项试点随机对照试验。

A Brief Mindfulness-Based Intervention for Primary Care Physicians: A Pilot Randomized Controlled Trial.

作者信息

Schroeder David A, Stephens Elizabeth, Colgan Dharmakaya, Hunsinger Matthew, Rubin Dan, Christopher Michael S

机构信息

Providence Heart Clinic, Portland, OR (DAS).

Endocrinology-Medical Education, Providence Medical Center, Portland, OR (ES).

出版信息

Am J Lifestyle Med. 2016 Feb 4;12(1):83-91. doi: 10.1177/1559827616629121. eCollection 2018 Jan-Feb.

Abstract

Primary care physicians experience high rates of burnout, which results in diminished quality of life, poorer quality of care, and workforce attrition. In this randomized controlled trial, our primary aim was to examine the impact of a brief mindfulness-based intervention (MBI) on burnout, stress, mindfulness, compassion, and resilience among physicians. A total of 33 physicians completed the baseline assessment and were randomized to the Mindful Medicine Curriculum (MMC; n = 17) or waitlist control group (n = 16). Participants completed self-report measures at baseline, post-MBI, and 3-month follow-up. We also analyzed satisfaction with doctor communication (DCC) and overall doctor rating (ODR) data from patients of the physicians in our sample. Participants in the MMC group reported significant improvements in stress (P < .001), mindfulness (P = .05), emotional exhaustion (P = .004), and depersonalization (P = .01) whereas in the control group, there were no improvements on these outcomes. Although the MMC had no impact on patient-reported DCC or ODR, among the entire sample at baseline, DCC and ODR were significantly correlated with several physician outcomes, including resilience and personal achievement. Overall, these findings suggest that a brief MBI can have a positive impact on physician well-being and potentially enhance patient care.

摘要

基层医疗医生职业倦怠率很高,这导致生活质量下降、医疗质量变差以及劳动力流失。在这项随机对照试验中,我们的主要目的是研究一种基于正念的简短干预措施(MBI)对医生职业倦怠、压力、正念、同情心和恢复力的影响。共有33名医生完成了基线评估,并被随机分为正念医学课程组(MMC;n = 17)或候补对照组(n = 16)。参与者在基线、MBI后和3个月随访时完成了自我报告测量。我们还分析了样本中医生的患者对医生沟通(DCC)和总体医生评分(ODR)的数据满意度。MMC组的参与者报告说,压力(P < .001)、正念(P = .05)、情感耗竭(P = .004)和去个性化(P = .01)有显著改善,而对照组在这些结果上没有改善。尽管MMC对患者报告的DCC或ODR没有影响,但在基线时的整个样本中,DCC和ODR与包括恢复力和个人成就在内的几个医生结果显著相关。总体而言,这些发现表明,简短的MBI可以对医生的幸福感产生积极影响,并可能改善患者护理。

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