Errazuriz Antonia, Schmidt Kristin, Undurraga Eduardo A, Medeiros Sebastián, Baudrand Rene, Cussen Diego, Henriquez Marcela, Celhay Pablo, Figueroa Rodrigo A
Department of Psychiatry, School of Medicine, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, Santiago, 8330077, Chile; Millennium Science Initiative /Millennium Institute for Research on Depression and Personality-MIDAP, Vicuña Mackenna 4860, Santiago, 7820436, Chile.
Department of Psychiatry, School of Medicine, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, Santiago, 8330077, Chile.
J Psychiatr Res. 2022 Jan;145:284-293. doi: 10.1016/j.jpsychires.2020.11.011. Epub 2020 Nov 6.
Mindfulness-based Stress Reduction (MBSR) has shown good efficacy for improving wellbeing in employees experiencing occupational stress. However, comparisons with other interventions, longer-term follow-up, and data from varying sociocultural contexts are lacking. This three-arm, parallel randomised controlled trial (RCT) examined the effects of MBSR on psychological distress in non-physician health workers in direct contact with patients. 105 participants were randomly allocated to either: (1) MBSR (N = 35), (2) Stress Management Course (SMC; N = 34) or (3) wait-list (N = 36). Participants and those assessing outcomes were blinded to group assignment. Participants completed questionnaires pre- and post-intervention and four months after the intervention. Psychological distress was measured using the General Health Questionnaire (GHQ-12) and Outcome Questionnaire (OQ-45). Secondary outcomes included perceived stress, job satisfaction, mindfulness skills and changes in salivary cortisol. 77 participants completed measures post-intervention and 52 at 4-month follow-up. MBSR showed a post-intervention effect in reducing GHQ-12 (ß = -0.80 [SE = 1.58] p < 0.01) and OQ-45 (ß = -0.72, [SE = 5.87] p < 0.05) psychological distress, compared to SMC and in reducing GHQ-12 (ß = -1.30 [SE = 1.38] p < 0.001) and OQ-45 (ß = -0.71, [SE = 5.58] p < 0.01) psychological distress compared to wait-list condition. In our secondary outcome, only MBSR was associated with a decrease in the cortisol awaking response by 23% (p < 0.05). At follow-up, only effects of MBSR on the psychological distress 'social role' subscale (ß = -0.76 [SE = 1.31] p < 0.05) remained significant, compared to SMC. In conclusion, MBSR appears useful in reducing short-term psychological distress in healthcare workers, but these effects were not maintained at follow-up. Trial registration: ISRCTN12039804.
基于正念减压疗法（MBSR）已被证明在改善职业压力员工的幸福感方面具有良好疗效。然而，缺乏与其他干预措施的比较、长期随访以及来自不同社会文化背景的数据。这项三臂平行随机对照试验（RCT）研究了MBSR对直接接触患者的非医师医护人员心理困扰的影响。105名参与者被随机分配到以下三组之一：（1）MBSR组（N = 35），（2）压力管理课程（SMC；N = 34）或（3）等待名单组（N = 36）。参与者和评估结果的人员对分组情况不知情。参与者在干预前、干预后以及干预后四个月完成问卷调查。使用一般健康问卷（GHQ - 12）和结果问卷（OQ - 45）测量心理困扰。次要结果包括感知压力、工作满意度、正念技能以及唾液皮质醇的变化。77名参与者在干预后完成了测量，52名在4个月随访时完成测量。与SMC相比，MBSR在干预后对降低GHQ - 12（β = -0.80 [标准误 = 1.58] p < 0.01）和OQ - 45（β = -0.72，[标准误 = 5.87] p < 0.05）心理困扰有效果，与等待名单组相比，MBSR在降低GHQ - 12（β = -1.30 [标准误 = 1.38] p < 0.001）和OQ - 45（β = -0.71，[标准误 = 5.58] p < 0.01）心理困扰方面有效果。在我们的次要结果中，只有MBSR与皮质醇觉醒反应降低23%相关（p < 0.05）。在随访时，与SMC相比，只有MBSR对心理困扰“社会角色”子量表的影响（β = -0.76 [标准误 = 1.31] p < 0.05）仍然显著。总之，MBSR似乎有助于降低医护人员的短期心理困扰，但这些效果在随访时未得到维持。试验注册号：ISRCTN12039804。
