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正念改善医护人员职业倦怠:焦虑和抑郁的调节作用。

Mindfulness improves health worker's occupational burnout: the moderating effects of anxiety and depression.

机构信息

School of Nursing and Rehabilitation, Shandong University, No. 44 Wenhua West Road, Jinan, 250012, Shandong, People's Republic of China.

Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong, People's Republic of China.

出版信息

Int Arch Occup Environ Health. 2021 Aug;94(6):1297-1305. doi: 10.1007/s00420-021-01685-z. Epub 2021 Mar 31.

Abstract

OBJECTIVE

This study aims to test whether health workers experiencing both depression, anxiety and burnout would show severer burnout symptoms, and the potential moderating effect of anxiety and depression on mindfulness improving burnout.

METHODS

This study was conducted in a comprehensive hospital of China in 2016. A total of 924 healthcare professionals were included in this cross-sectional study with a response rate of 82.0%. Maslach Burnout Inventory, Patient Health Questionnaire-9, Generalized Anxiety Disorder, Perceived Stress Scale and Short Inventory of Mindfulness Capability were used to measure burnout, depression, anxiety, perceived stress and mindfulness. Univariate analysis, correlation analysis, mediation analysis and moderated mediation analysis were conducted.

RESULTS

Burnout and anxiety group (BA) and burnout and depression group (BD) reported significantly higher burnout scores compared to the burnout-only group (BO) (59.90 ± 15.700, 56.20 ± 13.190, and 49.99 ± 11.955, respectively). Perceived stress was a mediator between mindfulness and occupational burnout, and depression and anxiety significantly moderated the mediation path between mindfulness and occupational burnout (β for stress in moderated mediation models with depression and anxiety respectively: β = 1.8088, p < 0.001, and β = 1.7908, p < 0.001). For participants who experienced a high level of depression, less occupational burnout was reduced as mindfulness increased. Indirect effect of mindfulness reducing occupational burnout was greater among participants who experienced less anxiety.

CONCLUSIONS

Depression and anxiety weakened the mindfulness ability on relieving occupational burnout, which could be the potential mechanism of the worsening effect of depression and anxiety.

摘要

目的

本研究旨在检验同时患有抑郁、焦虑和倦怠的卫生工作者是否会表现出更严重的倦怠症状,以及焦虑和抑郁对正念改善倦怠的潜在调节作用。

方法

本研究于 2016 年在中国的一家综合医院进行。共有 924 名医护人员参与了这项横断面研究,应答率为 82.0%。采用职业倦怠量表、患者健康问卷-9、广泛性焦虑障碍量表、感知压力量表和正念能力简式量表测量倦怠、抑郁、焦虑、感知压力和正念。进行单变量分析、相关分析、中介分析和调节中介分析。

结果

倦怠伴焦虑组(BA)和倦怠伴抑郁组(BD)的倦怠得分明显高于仅倦怠组(BO)(59.90±15.700、56.20±13.190 和 49.99±11.955)。感知压力是正念与职业倦怠之间的中介,抑郁和焦虑显著调节了正念与职业倦怠之间的中介路径(抑郁和焦虑的调节中介模型中压力的 β 值分别为:β=1.8088,p<0.001 和β=1.7908,p<0.001)。对于经历较高抑郁水平的参与者,随着正念的增加,职业倦怠的减少幅度较小。在经历较少焦虑的参与者中,正念对减轻职业倦怠的间接效应更大。

结论

抑郁和焦虑削弱了正念缓解职业倦怠的能力,这可能是抑郁和焦虑恶化作用的潜在机制。

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