Research Department of Medical Education, UCL Medical School, London, UK.
Birkbeck Centre for Medical Humanities, Birkbeck, University of London, London, UK.
Psychiatry Res. 2019 Apr;274:383-390. doi: 10.1016/j.psychres.2019.02.075. Epub 2019 Mar 1.
Prevalence studies show high levels of burnout, anxiety, fatigue and other symptoms of distress among medical doctors. However, there are very few randomized controlled trials testing interventions against these problems. This randomized controlled trial (NCT02838290; ClinicalTrials.gov, 2016) tested interventions teaching 227 doctors about the psychology of burnout, stress, coping with patient death, and managing distress, as well as giving them information about prevalence rates among doctors. Primary outcomes included burnout, anxiety, insomnia, grief, alcohol/drug use, binge eating, physical symptoms, and psychiatric morbidity. The outcomes were tested before and after the interventions with a 7-day time-lag. The intervention significantly decreased doctors' levels of burnout (e.g. emotional exhaustion and depersonalization) and anxiety. Doctors in the control group had no significant changes in these signs of distress. The intervention did not significantly reduce other health and habit-related outcomes potentially because these need a longer time-lag than 7 days. Interventions teaching doctors about the psychology of work-related distress reduce burnout and anxiety by helping doctors realize that distress is a normal, human reaction to external stressors, common in medicine, and solvable by learning about psychological coping strategies.
流行性病学研究表明，医生群体中存在较高水平的倦怠、焦虑、疲劳和其他痛苦症状。然而，针对这些问题进行干预的随机对照试验却非常少。这项随机对照试验（NCT02838290；ClinicalTrials.gov，2016）测试了针对 227 名医生的干预措施，这些措施涉及倦怠、压力、应对患者死亡和管理痛苦的心理学知识，以及有关医生中流行率的信息。主要结果包括倦怠、焦虑、失眠、悲伤、酒精/药物使用、暴食、身体症状和精神疾病。在干预前后进行了 7 天的时间滞后测试。干预显著降低了医生的倦怠水平（例如情绪衰竭和去人性化）和焦虑。对照组的医生在这些痛苦迹象上没有显著变化。干预并没有显著降低其他与健康和习惯相关的结果，可能是因为这些结果需要比 7 天更长的时间滞后。通过向医生传授与工作相关的痛苦心理学知识，干预措施可以帮助医生认识到，痛苦是对外界压力源的正常、人类反应，在医学中很常见，并且可以通过学习心理应对策略来解决。
