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基于同情的医学学生心理困扰减少项目:一项试点随机临床试验。

A compassion-based program to reduce psychological distress in medical students: A pilot randomized clinical trial.

机构信息

Medical School, Complutense University of Madrid, Madrid, Spain.

Virgen de la Victoria Hospital, Málaga, Spain.

出版信息

PLoS One. 2023 Jun 23;18(6):e0287388. doi: 10.1371/journal.pone.0287388. eCollection 2023.

Abstract

OBJECTIVES

Physicians and medical students are subject to higher levels of psychological distress than the general population. These challenges have a negative impact in medical practice, leading to uncompassionate care. This pilot study aims to examine the feasibility of Compassion Cultivation Training (CCT) to reduce psychological distress and improve the well-being of medical students. We hypothesize that the CCT program, as compared to a waitlist control group, will reduce psychological distress (i.e., stress, anxiety, and depression) and burnout symptoms, while improving compassion, empathy, mindfulness, resilience, psychological well-being, and emotion-regulation strategies after the intervention. Furthermore, we hypothesize that these improvements will be maintained at a two-month follow-up.

METHODS

Medical students were randomly assigned to an 8-week CCT or a Waitlist control group (WL). They completed self-report assessments at pre-intervention, post-intervention, and a 2-month follow-up. The outcomes measured were compassion, empathy, mindfulness, well-being, resilience, emotional regulation, psychological distress, burnout, and COVID-19 concern. Mixed-effects models and Reliable Change Index were computed.

RESULTS

Compared with WL, CCT showed significant improvements in self-compassion, mindfulness, and emotion regulation, as well as a significant decrease in stress, anxiety, and emotional exhaustion component of burnout. Furthermore, some of these effects persisted at follow-up. No adverse effects of meditation practices were found.

CONCLUSIONS

CCT enhanced compassion skills while reducing psychological distress in medical students, this being critical to preserving the mental health of physicians while promoting compassionate care for patients. The need for institutions to include this type of training is also discussed.

摘要

目的

医生和医学生比一般人群更容易承受更高水平的心理困扰。这些挑战对医疗实践产生了负面影响,导致缺乏同情心的护理。这项初步研究旨在检验培养同情心训练(CCT)减少医学生心理困扰和改善其幸福感的可行性。我们假设与候补名单对照组相比,CCT 项目将在干预后减少心理困扰(即压力、焦虑和抑郁)和倦怠症状,同时提高同情心、同理心、正念、韧性、心理幸福感和情绪调节策略。此外,我们假设这些改善将在两个月的随访中得到维持。

方法

医学生被随机分配到 8 周的 CCT 或候补名单对照组(WL)。他们在干预前、干预后和两个月随访时完成自我报告评估。测量的结果包括同情心、同理心、正念、幸福感、韧性、情绪调节、心理困扰、倦怠和对 COVID-19 的担忧。计算了混合效应模型和可靠变化指数。

结果

与 WL 相比,CCT 在自我同情、正念和情绪调节方面显示出显著改善,同时在压力、焦虑和倦怠的情绪耗竭成分方面显著降低。此外,其中一些影响在随访中持续存在。没有发现冥想练习的不良反应。

结论

CCT 增强了医学生的同情心技能,同时减轻了他们的心理困扰,这对于保护医生的心理健康和促进对患者的同情心护理至关重要。还讨论了机构需要纳入这种类型培训的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c52d/10289411/2192bdd9c504/pone.0287388.g001.jpg

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