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治愈医者:一项试点研究,评估超觉静坐干预措施在2019年冠状病毒病大流行期间对急诊临床医生的可行性、可接受性及探索性疗效。

Heal the Healers: A pilot study evaluating the feasibility, acceptability, and exploratory efficacy of a Transcendental Meditation intervention for emergency clinicians during the coronavirus disease 2019 pandemic.

作者信息

Azizoddin Desiree R, Kvaternik Noelia, Beck Meghan, Zhou Guohai, Hasdianda Mohammad Adrian, Jones Natasha, Johnsky Lily, Im Dana, Chai Peter R, Boyer Edward W

机构信息

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.

出版信息

J Am Coll Emerg Physicians Open. 2021 Dec 29;2(6):e12619. doi: 10.1002/emp2.12619. eCollection 2021 Dec.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a535/8716568/3afd2b9796f9/EMP2-2-e12619-g003.jpg

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