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一种基于正念-慈悲艺术的新型疗法,用于减轻医护人员的职业倦怠并增强其恢复力:来自候补名单随机对照试验的结果。

A Novel Mindful-Compassion Art-Based Therapy for Reducing Burnout and Promoting Resilience Among Healthcare Workers: Findings From a Waitlist Randomized Control Trial.

作者信息

Ho Andy Hau Yan, Tan-Ho Geraldine, Ngo Thuy Anh, Ong Grace, Chong Poh Heng, Dignadice Dennis, Potash Jordan

机构信息

Action Research for Community Health Laboratory, Psychology Programme, School of Social Sciences, Nanyang Technological University, Singapore, Singapore.

Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.

出版信息

Front Psychol. 2021 Oct 21;12:744443. doi: 10.3389/fpsyg.2021.744443. eCollection 2021.

Abstract

Protecting the mental health of healthcare workers is an urgent global public health priority. Healthcare workers, especially those immersed in palliative care, are prone to burnout due to the intense emotions associated with end-of-life caregiving. This study examines the efficacy of a novel, multimodal, and group-based Mindful-Compassion Art-based Therapy (MCAT) that integrates reflective self-awareness with creative emotional expression for protecting healthcare workers' mental health. A dual-arm open-label waitlist randomized controlled trial was conducted. A total of 56 healthcare workers were recruited from the largest homecare hospice in Singapore and randomized to the immediate-treatment condition of a standardized 6-week, 18-hours MCAT intervention (=29), or the waitlist-control condition (=27). Self-administered outcome measures on burnout, resilience, emotional regulation, self-compassion, death attitudes, and quality of life were collected at baseline, post-intervention/second-baseline at 6weeks, and follow-up/post-intervention at 12weeks. Results from mixed model ANOVAs reveal that treatment group participants experienced significant reduction in mental exhaustion, as well as significant improvements in overall emotional regulation, nonreactivity to intrusive thoughts, approach acceptance of death, and afterlife belief as compared to waitlist-control immediately after MCAT completion. Effect sizes of these impacts ranged from medium to large ( =0.65 to 0.170). Results from one-way ANOVAs further reveal that the treatment gains of reduced mental exhaustion and increased emotional regulation were maintained among treatment group participants at 12-weeks follow-up compared to baseline, with new benefits identified. These include increased ability to observe and describe one's experiences, elevated overall self-compassion, greater mindful awareness, enhanced common humanity, and better quality of life. Effect sizes of these impacts were large ( =0.128 to 0.298). These findings reflect the robust effectiveness and positive residual effects of MCAT for reducing burnout, building resilience, nurturing compassion, fostering collegial support, and promoting mental wellness among healthcare workers. The clinical model and applicability of MCAT in larger and more diverse caregiving contexts, such as family dementia care, are discussed. ClinicalTrials.gov # NCT03440606, #NCT04548089.

摘要

保护医护人员的心理健康是一项紧迫的全球公共卫生重点事项。医护人员,尤其是那些专注于姑息治疗的人员,由于临终护理所伴随的强烈情感,容易产生职业倦怠。本研究考察了一种新型的、多模式的、基于团体的正念慈悲艺术疗法(MCAT)的功效,该疗法将反思性自我认知与创造性情感表达相结合,以保护医护人员的心理健康。开展了一项双臂开放标签等待列表随机对照试验。从新加坡最大的家庭护理临终关怀机构招募了56名医护人员,并将他们随机分为接受为期6周、共18小时标准化MCAT干预的即时治疗组(n = 29)或等待列表对照组(n = 27)。在基线、干预后/6周时的第二次基线以及12周时的随访/干预后,收集了关于职业倦怠、心理韧性、情绪调节、自我慈悲、死亡态度和生活质量的自我报告结局指标。混合模型方差分析的结果显示,与等待列表对照组相比,治疗组参与者在MCAT完成后立即出现精神耗竭显著降低,以及在总体情绪调节、对侵入性思维的无反应性、对死亡的接纳态度和来世信念方面有显著改善。这些影响的效应大小从中等到较大(Cohen's d = 0.65至0.170)。单因素方差分析的结果进一步显示,与基线相比,治疗组参与者在12周随访时保持了精神耗竭减轻和情绪调节增强的治疗效果,且发现了新的益处。这些益处包括观察和描述自身经历的能力增强、总体自我慈悲提高、正念意识增强、共同人性增强以及生活质量改善。这些影响的效应大小较大(Cohen's d = 0.128至0.298)。这些发现反映了MCAT在减少职业倦怠、培养心理韧性、培育慈悲心、促进同事支持以及促进医护人员心理健康方面的强大有效性和积极的残留效应。讨论了MCAT在更大且更多样化的护理环境(如家庭痴呆护理)中的临床模式和适用性。ClinicalTrials.gov # NCT03440606,#NCT04548089。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05a1/8566679/70c7ca3f7ee3/fpsyg-12-744443-g001.jpg

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