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一项比较正念和自我关怀四节课程方案与八节课程方案在减少家庭和社区医学医师和护士工作压力和倦怠方面有效性的对照临床试验:MINDUUDD 研究方案。

Controlled clinical trial comparing the effectiveness of a mindfulness and self-compassion 4-session programme versus an 8-session programme to reduce work stress and burnout in family and community medicine physicians and nurses: MINDUUDD study protocol.

机构信息

Clinical and Epidemiological Research Group in Primary Care (GICEAP), IMIBIC/Reina Sofía University Hospital/University of Córdoba, Primary Care Prevention and Health Promotion Research Network (RedIAPP), Family and Community Medicine Teaching Unit of Córdoba, Córdoba, Spain.

Comuneros Health Center, Research Network on Communication and Health (RICyS) of the Communication and Health program (semFYC), Burgos, Spain.

出版信息

BMC Fam Pract. 2019 Feb 6;20(1):24. doi: 10.1186/s12875-019-0913-z.

Abstract

BACKGROUND

Health personnel are susceptible to high levels of work stress and burnout due to the psychological and emotional demands of their work, as well as to other aspects related to the organisation of that work. This paper describes the rationale and design of the MINDUUDD study, the aim of which is to evaluate the effectiveness of a mindfulness and self-compassion 4-session programme versus the standard 8-session programme to reduce work stress and burnout in Family and Community Medicine and Nursing tutors and residents.

METHODS

The MINDUDD study is a multicentre cluster randomised controlled trial with three parallel arms. Six Teaching Units will be randomised to one of the three study groups: 1) Experimental Group-8 (EG8); 2) Experimental Group-4 (EG4) Control group (CG). At least 132 subjects will participate (66 tutors/66 residents), 44 in the EG8, 44 in the EG4, and 44 in the CG. Interventions will be based on the Mindfulness-Based Stress Reduction (MBSR) program, including some self-compassion practices of the Mindful Self-Compassion (MSC) programme. The EG8 intervention will be implemented during 8 weekly face-to-face sessions of 2.5 h each, while the EG4 intervention will consist of 4 sessions of 2.5 h each. The participants will have to practice at home for 30 min/day in the EG8 and 15 min/day in the EG4. The Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale (SCS), Perceived Stress Questionnaire (PSQ), Maslach Burnout Inventory (MBI), Jefferson Scale of Physician Empathy (JSPE), and Goldberg Anxiety-Depression Scale (GADS) will be administered. Measurements will be taken at baseline, at the end of the programs, and at three months after completion. The effect of the interventions will be evaluated by bivariate and multivariate analyses (Multiple Linear Regression).

DISCUSSION

If the abbreviated mindfulness programme is at least as effective as the standard program, its incorporation into the curriculum and training plans will be easier and more appropriate. It will also be more easily applied and accepted by primary care professionals because of the reduced resources and means required for its implementation, and it may also extend beyond care settings to academic and teaching environments as well.

TRIAL REGISTRATION

The study has been registered at ClinicalTrials.gov ( NCT03629457 ; date of registration: 13.08.2018).

摘要

背景

由于工作中的心理和情绪需求,以及与工作组织相关的其他方面,卫生人员容易承受高水平的工作压力和倦怠。本文介绍了 MINDUDD 研究的原理和设计,该研究的目的是评估 4 节正念和自我同情课程与标准 8 节课程相比,对减少家庭医学和社区医学以及护理教师和住院医师的工作压力和倦怠的有效性。

方法

MINDUDD 研究是一项多中心集群随机对照试验,有三个平行组。将六个教学单位随机分为三组之一:1)实验组-8(EG8);2)实验组-4(EG4)对照组(CG)。至少有 132 名受试者参加(66 名教师/66 名居民),44 名在 EG8,44 名在 EG4,44 名在 CG。干预措施将基于正念减压(MBSR)方案,包括正念自我同情(MSC)方案中的一些自我同情实践。EG8 干预将在每周 8 次面对面的 2.5 小时课程中进行,而 EG4 干预将包括 4 次 2.5 小时的课程。参与者将不得不每天在家中练习 30 分钟,在 EG8 中练习 15 分钟,在 EG4 中练习 15 分钟。将实施五因素正念问卷(FFMQ)、自我同情量表(SCS)、感知压力问卷(PSQ)、马斯拉赫倦怠量表(MBI)、杰斐逊医师同理心量表(JSPE)和戈德堡焦虑抑郁量表(GADS)。测量将在基线时、课程结束时和完成后三个月进行。干预的效果将通过双变量和多变量分析(多元线性回归)进行评估。

讨论

如果简短的正念方案至少与标准方案一样有效,那么将其纳入课程和培训计划将更容易和更合适。由于实施所需的资源和手段减少,它也更容易被初级保健专业人员应用和接受,并且它也可能扩展到医疗保健环境之外,还可以扩展到学术和教学环境。

试验注册

该研究已在 ClinicalTrials.gov 注册(NCT03629457;注册日期:2018 年 8 月 13 日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ce7/6364464/a2e3ab66bdcb/12875_2019_913_Fig1_HTML.jpg

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