School of Psychology, University of Leeds, Leeds, United Kingdom.
School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
PLoS One. 2022 Apr 20;17(4):e0266357. doi: 10.1371/journal.pone.0266357. eCollection 2022.
The levels of psychological distress and burnout among healthcare staff are high, with negative implications for patient care. A growing body of evidence indicates that workplace programmes based on Acceptance and Commitment Therapy (ACT) are effective for improving employees' general psychological health. However, there is a paucity of research examining the specific psychological and/or behavioural processes through which workplace ACT programmes transmit their beneficial effects. The aim of this randomised controlled trial was to investigate the outcomes and putative processes of change in a 4-session ACT training programme designed to reduce psychological distress among healthcare staff (n = 98). Ninety-eight employees of a healthcare organisation were randomly allocated to the ACT intervention or to a waiting list control group. Study measures were administered on four occasions (baseline, mid-intervention, post-intervention, and follow-up) over a three-month evaluation period. Results showed that the ACT intervention led to a significant decrease in symptoms of psychological distress and a less pronounced reduction in burnout. These effects were mediated primarily via an improvement in mindfulness skills and values-based behaviour and moderated by participants' initial levels of distress. At four-week post-intervention, 48% of participants who received the ACT intervention showed reliable improvements in psychological distress, with just under half of the aforementioned improvements (46.15%) meeting criteria for clinically significant change. The results advance ACT as an effective stress management intervention for healthcare staff. The findings should be confirmed in a large scale randomised controlled trial with longer follow-up and cost-effectiveness analyses.
医护人员的心理困扰和倦怠水平较高，这对患者护理有负面影响。越来越多的证据表明，基于接受与承诺疗法（ACT）的工作场所计划对于改善员工的整体心理健康是有效的。然而，目前关于工作场所 ACT 计划通过哪些特定的心理和/或行为过程传递其有益效果的研究还很少。本随机对照试验的目的是调查针对减少医护人员心理困扰的 4 节 ACT 培训计划的结果和潜在变化过程（n=98）。将一家医疗机构的 98 名员工随机分配到 ACT 干预组或等待名单对照组。在三个月的评估期间，通过四次（基线、中期干预、干预后和随访）进行研究测量。结果表明，ACT 干预导致心理困扰症状显著减轻，倦怠感减轻程度较低。这些影响主要通过改善正念技能和基于价值观的行为来介导，并且由参与者最初的困扰程度调节。在干预后四周，接受 ACT 干预的参与者中有 48%表现出心理困扰的可靠改善，其中近一半（46.15%）的改善符合临床显著变化的标准。这些结果表明 ACT 是一种有效的医护人员压力管理干预措施。应在具有更长随访期和成本效益分析的大规模随机对照试验中对其进行确认。
