Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
PLoS One. 2022 Apr 22;17(4):e0267240. doi: 10.1371/journal.pone.0267240. eCollection 2022.
The Stress Management and Resilience Training (SMART) program is an evidence-based intervention designed to build resilience in physicians in clinical practice. The objective of the current study was to assess the impact of the SMART program on academic physicians' levels of resilience, subjective happiness, stress, and anxiety, and specifically during the implementation of a new hospital-wide Health Information System (HIS).
A total of 40 physicians in a tertiary care academic hospital were randomized (allocation ratio 1:1) to either the SMART intervention or the control condition. The SMART intervention consisted of one mandatory two-hour in-person workshop and an optional 24-week online program, designed to support the materials delivered in the workshop. Outcome measures were assessed using validated scales administered online at baseline and at 3-months and 6-months follow-up.
After adjusting for baseline levels of each outcome, no statistically significant intervention effect was observed for resilience, subjective happiness, stress or anxiety at 3-months or 6-months follow-up. However, physicians in the intervention group demonstrated improvements in resilience, stress and anxiety at follow-up that were within the range of clinically relevant differences.
The findings of this exploratory study provide modest support that the SMART intervention may be beneficial for proactively addressing physician wellness during the implementation of a new HIS and that larger randomized trials are warranted.
NCT04384861.
应激管理和韧性训练（SMART）计划是一种基于证据的干预措施，旨在培养临床实践中的医生的韧性。本研究的目的是评估 SMART 计划对学术医师的韧性、主观幸福感、压力和焦虑水平的影响，特别是在实施新的全院健康信息系统（HIS）期间。
共有 40 名三级保健学术医院的医生被随机分配（分配比例为 1:1）到 SMART 干预组或对照组。SMART 干预包括一次强制性的两小时面对面研讨会和一个可选的 24 周在线计划，旨在支持研讨会中提供的材料。使用在线评估的经过验证的量表在基线和 3 个月及 6 个月随访时评估结果。
在调整了每个结局的基线水平后，在 3 个月或 6 个月随访时，韧性、主观幸福感、压力或焦虑均未观察到统计学上显著的干预效果。然而，干预组的医生在随访时在韧性、压力和焦虑方面的改善处于临床相关差异范围内。
这项探索性研究的结果提供了适度的支持，表明 SMART 干预可能有助于在实施新的 HIS 期间主动解决医生的健康问题，并且需要进行更大规模的随机试验。
NCT04384861。
