Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Department of Medicine, University College London, London, United Kingdom.
World Neurosurg. 2022 Aug;164:e446-e457. doi: 10.1016/j.wneu.2022.04.128. Epub 2022 May 6.
Burnout is prevalent among neurosurgeons and can negatively impact both technical and nontechnical skills and subsequent patient care. Mindfulness training has previously been shown to ameliorate the effects of burnout and improve performance in health care workers and high-stress occupations, but no such evaluation has been formally conducted for neurosurgeons. We aimed to determine the effectiveness and feasibility of a virtual mindfulness-based intervention (MBI) in neurosurgeons.
A prospective trial of an MBI was implemented and hosted from our tertiary academic unit, running virtually from October to December 2020. Practicing neurosurgeons of all grades were recruited from 9 neurosurgical centers. Participants underwent 8 weeks of 90-minute MBI classes and suggested daily practice. Psychometric measures related to burnout, stress, wellbeing, and mindfulness competencies were assessed at baseline and on course completion.
Twenty-one neurosurgeons participated in the study (attendings = 2, residents = 18, interns = 1, mean age = 30.3 [standard deviation 3.9] years). Significant improvements after intervention were present in perceived stress (Z = -2.54, P = 0.04) and emotional exhaustion (Z = -2.41, P = 0.04). Mindfulness training was associated with improved mindfulness skills (Z = -2.58, P = 0.006), self-compassion (t = -4.4, P = 0.002), resilience (Z = -3.18, P = 0.004), and choice response times (Z = -2.13, P = 0.03). All neurosurgeons who completed the postintervention assessment stated they would recommend the course and agreed that it was relevant to their surgical practice.
Preliminary evidence from this trial cautiously supports the effectiveness and feasibility of a virtual MBI for dealing with stress, burnout, and improving dexterity among young neurosurgeons. Further research is warranted to validate these findings.
脑外科医生中普遍存在倦怠现象，这可能会对技术和非技术技能产生负面影响，并对后续的患者护理产生影响。正念训练先前已被证明可以改善倦怠的影响，并提高医疗保健工作者和高压力职业的表现，但尚未对脑外科医生进行正式评估。我们旨在确定虚拟正念干预（MBI）在脑外科医生中的有效性和可行性。
我们在我们的三级学术单位实施了一项前瞻性 MBI 试验，并从 2020 年 10 月至 12 月进行了虚拟试验。从 9 个神经外科中心招募了各级别的执业脑外科医生。参与者接受了 8 周的 90 分钟 MBI 课程和建议的日常练习。在基线和课程结束时评估与倦怠、压力、幸福感和正念能力相关的心理测量学指标。
21 名脑外科医生参加了这项研究（主治医生 2 名，住院医师 18 名，实习医生 1 名，平均年龄 30.3[标准差 3.9]岁）。干预后，感知压力（Z=-2.54，P=0.04）和情绪衰竭（Z=-2.41，P=0.04）显著改善。正念训练与正念技能的提高相关（Z=-2.58，P=0.006）、自我同情（t=-4.4，P=0.002）、恢复力（Z=-3.18，P=0.004）和选择反应时间（Z=-2.13，P=0.03）。所有完成干预后评估的神经外科医生都表示他们会推荐该课程，并同意该课程与他们的手术实践相关。
本试验的初步证据谨慎地支持了虚拟 MBI 用于处理年轻神经外科医生的压力、倦怠和提高灵活性的有效性和可行性。需要进一步的研究来验证这些发现。
