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四十五件好事:美国医护人员情绪疲惫、抑郁、工作生活平衡和幸福感的“三件好事”幸福干预的前瞻性试点研究。

Forty-five good things: a prospective pilot study of the Three Good Things well-being intervention in the USA for healthcare worker emotional exhaustion, depression, work-life balance and happiness.

机构信息

Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina, USA.

Psychiatry, Duke University School of Medicine, Durham, North Carolina, USA.

出版信息

BMJ Open. 2019 Mar 20;9(3):e022695. doi: 10.1136/bmjopen-2018-022695.

Abstract

OBJECTIVES

High rates of healthcare worker (HCW) burn-out have led many to label it an 'epidemic' urgently requiring interventions. This prospective pilot study examined the efficacy, feasibility and evaluation of the 'Three Good Things' (3GT) intervention for HCWs, and added burn-out and work-life balance to the set of well-being metrics.

METHODS

228 HCWs participated in a prospective, repeated measures study of a web-based 15-day long 3GT intervention. Assessments were collected at baseline and 1, 6 and 12-month post-intervention. The primary measure of efficacy was a derivative of the emotional exhaustion subscale of the Maslach Burnout Inventory. The secondary measures were validated instruments assessing depression symptoms, subjective happiness, and work-life balance. Paired samples t-tests and Cohen's d effect sizes for correlated samples were used to examine the efficacy of the intervention.

RESULTS

3GT participants exhibited significant improvements from baseline in emotional exhaustion, depression symptoms and happiness at 1 month, 6 months and 12 months, and in work-life balance at 1 month and 6 months (effect sizes 0.16-0.52). Exploratory subgroup analyses of participants meeting 'concerning' criteria at baseline revealed even larger effects at all assessment points (0.55-1.57). Attrition rates were similar to prior 3GT interventions.

CONCLUSION

3GT appears a promising low-cost and brief intervention for improving HCW well-being.

ETHICS AND DISSEMINATION

This study is approved by the Institutional Review Board of Duke University Health System (Pro00063703). All participants are required to give their informed consent prior to any study procedure.

摘要

目的

医护人员(HCW) burnout 率居高不下,许多人将其称之为一场“亟待干预的流行病”。本前瞻性试点研究旨在检验“三件好事”(3GT)干预对 HCW 的效果、可行性和评估,并在现有的幸福感衡量标准中加入 burnout 和工作生活平衡。

方法

228 名 HCW 参与了一项为期 15 天的基于网络的 3GT 干预前瞻性重复测量研究。基线、干预后 1、6 和 12 个月时收集评估结果。主要疗效衡量指标为 Maslach Burnout Inventory 情绪衰竭子量表的衍生指标。次要衡量指标是评估抑郁症状、主观幸福感和工作生活平衡的经过验证的工具。采用配对样本 t 检验和相关样本 Cohen's d 效应量检验来评估干预效果。

结果

3GT 干预组在情绪衰竭、抑郁症状和幸福感方面的得分在干预后 1 个月、6 个月和 12 个月均显著改善,工作生活平衡在 1 个月和 6 个月时也显著改善(效应量 0.16-0.52)。基线时符合“关注”标准的参与者的探索性亚组分析显示,所有评估点的效果更大(0.55-1.57)。流失率与之前的 3GT 干预相似。

结论

3GT 似乎是一种有前途的、低成本和简洁的干预措施,可以提高 HCW 的幸福感。

伦理和传播

本研究已获得杜克大学卫生系统机构审查委员会的批准(Pro00063703)。所有参与者在参与任何研究程序前都需要签署知情同意书。

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