Azizoddin Desiree R, Kvaternik Noelia, Beck Meghan, Zhou Guohai, Hasdianda Mohammad Adrian, Jones Natasha, Johnsky Lily, Im Dana, Chai Peter R, Boyer Edward W
Department of Emergency Medicine Brigham and Women's Hospital Boston Massachusetts USA.
Department of Psychosocial Oncology and Palliative Care Dana-Farber Cancer Institute Boston Massachusetts USA.
J Am Coll Emerg Physicians Open. 2021 Dec 29;2(6):e12619. doi: 10.1002/emp2.12619. eCollection 2021 Dec.
Emergency clinicians face elevated rates of burnout that result in poor outcomes for clinicians, patients, and health systems. The objective of this single-arm pilot study was to evaluate the feasibility of a Transcendental Meditation (TM) intervention for emergency clinicians during the coronavirus disease 2019 (COVID-19) pandemic and to explore the potential effectiveness in improving burnout, sleep, and psychological health.
Emergency clinicians (physicians, nurses, and physician-assistants) from 2 urban hospitals were recruited to participate in TM instruction (8 individual or group in-person and remote sessions) for 3 months. Session attendance was the primary feasibility outcome (prespecified as attending 6/8 sessions), and burnout was the primary clinical outcome. Participant-reported measures of feasibility and validated measures of burnout, depression, anxiety, sleep disturbance, and stress were collected at baseline and the 1-month and 3-month follow-ups. Descriptive statistics and linear mixed-effects models were used.
Of the 14 physicians (46%), 7 nurses (22%), and 10 physician-assistants (32%) who participated, 61% were female ( = 19/32). TM training and at-home meditation practice was feasible for clinicians as 90.6% ( = 29/32) attended 6/8 training sessions and 80.6% self-reported meditating at least once a day on average. Participants demonstrated significant reductions in burnout ( < .05; effect sizes, Cohen's = 0.43-0.45) and in symptoms of depression, anxiety, stress, and sleep disturbance ( values < .001; Cohen's = 0.70-0.87).
TM training was feasible for emergency clinicians during the COVID-19 pandemic and led to significant reductions in burnout and psychological symptoms. TM is a safe and effective meditation tool to improve clinicians' well-being.
急诊临床医生面临较高的职业倦怠率,这对临床医生、患者和医疗系统都会产生不良后果。这项单臂试点研究的目的是评估超觉静坐(TM)干预措施在2019冠状病毒病(COVID-19)大流行期间对急诊临床医生的可行性,并探讨其在改善职业倦怠、睡眠和心理健康方面的潜在效果。
招募了来自2家城市医院的急诊临床医生(医生、护士和医师助理)参加为期3个月的TM指导(8次个人或小组面对面及远程课程)。课程出席情况是主要的可行性结果(预先设定为参加6/8次课程),职业倦怠是主要的临床结果。在基线以及1个月和3个月随访时收集参与者报告的可行性指标以及经过验证的职业倦怠、抑郁、焦虑、睡眠障碍和压力指标。使用描述性统计和线性混合效应模型。
参与的14名医生(46%)、7名护士(22%)和10名医师助理(32%)中,61%为女性(n = 19/32)。TM训练和在家冥想练习对临床医生是可行的,因为90.6%(n = 29/32)的人参加了6/8次训练课程,80.6%的人自我报告平均每天至少冥想一次。参与者的职业倦怠显著降低(P <.05;效应量,科恩d = 0.43 - 0.45),抑郁、焦虑、压力和睡眠障碍症状也显著减轻(P值 <.001;科恩d = 0.70 - 0.87)。
在COVID-19大流行期间,TM训练对急诊临床医生是可行的,并能显著降低职业倦怠和心理症状。TM是一种改善临床医生幸福感的安全有效的冥想工具。