放松呼吸联合心脏生物反馈对危急模拟情境下表现和放松的影响：一项前瞻性随机对照试验。
Effects of relaxing breathing paired with cardiac biofeedback on performance and relaxation during critical simulated situations: a prospective randomized controlled trial.
机构信息
Research on Healthcare Performance (RESHAPE), INSERM U1290, Claude Bernard Lyon 1 University, Lyon, France.
Claude Bernard Lyon 1 University, Centre Lyonnais d'Enseignement par Simulation en Santé (CLESS, high fidelity medical simulation center), SAMSEI, Lyon, France.
出版信息
BMC Med Educ. 2022 Jun 2;22(1):422. doi: 10.1186/s12909-022-03420-9.
BACKGROUND
Active participation in high-fidelity simulation remains stressful for residents. Increased stress levels elicited during such simulation impacts performance. We tested whether relaxing breathing, paired or not with cardiac biofeedback, could lead to enhanced performance of residents during simulation.
METHODS
This randomized pilot study involved the fifth-year anesthesiology and critical care residents who participated in high-fidelity at Lyon medical simulation center in 2019. Residents were randomized into three parallel interventions: relaxing breathing, relaxing breathing paired with cardiac biofeedback, and control. Each intervention was applied for five minutes immediately after the scenario briefing. The primary endpoint was the overall performance during the simulation rated by two blinded independent investigators. The secondary endpoints included component scores of overall performance and changes in psychological states.
RESULTS
Thirty-four residents were included. Compared to the control group, residents in the relaxing breathing (+ 7%, 98.3% CI: 0.3 to 13.7, P = 0.013) and relaxing breathing paired with cardiac biofeedback (+ 8%, 98.3% CI: 0.82 to 14.81, P = 0.009) groups had a higher overall performance score. Following the interventions, compared to the control group, stress level was lower when participants had performed relaxing breathing alone (P = 0.029) or paired with biofeedback (P = 0.035). The internal relaxation level was higher in both the relaxing breathing alone (P = 0.016) and paired with biofeedback groups (P = 0.035).
CONCLUSIONS
Performing five minutes of relaxing breathing before the scenario resulted in better overall simulation performance. These preliminary findings suggest that short breathing interventions are effective in improving performance during simulation.
TRIAL REGISTRATION
The study protocol was retrospectively registered on clinicaltrials.gov ( NCT04141124 , 28/10/2019).
背景
高保真模拟对住院医师来说仍然是有压力的。在这种模拟中引起的压力水平升高会影响表现。我们测试了放松呼吸，是否与心脏生物反馈相结合，是否可以提高住院医师在模拟中的表现。
方法
这是一项随机试点研究，涉及 2019 年在里昂医学模拟中心参加高保真模拟的第五年麻醉学和重症监护住院医师。住院医师被随机分为三组平行干预：放松呼吸、放松呼吸与心脏生物反馈相结合、对照组。每个干预措施在情景介绍后立即应用 5 分钟。主要终点是由两位盲法独立研究者评定的模拟过程中的整体表现。次要终点包括整体表现的组成部分评分和心理状态的变化。
结果
共纳入 34 名住院医师。与对照组相比，放松呼吸组（+7%，98.3%CI：0.3 至 13.7，P=0.013）和放松呼吸与心脏生物反馈相结合组（+8%，98.3%CI：0.82 至 14.81，P=0.009）的整体表现评分更高。干预后，与对照组相比，单独进行放松呼吸时（P=0.029）或与生物反馈相结合时（P=0.035），参与者的压力水平较低。单独进行放松呼吸（P=0.016）或与生物反馈相结合时（P=0.035），内部放松水平更高。
结论
在情景介绍前进行 5 分钟的放松呼吸可提高整体模拟表现。这些初步发现表明，短暂的呼吸干预可有效提高模拟过程中的表现。
试验注册
研究方案在 clinicaltrials.gov 上进行了回顾性注册（NCT04141124，2019 年 10 月 28 日）。
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