基于正念的干预措施对护士压力和职业倦怠的影响：一项系统评价和荟萃分析。
Effects of a mindfulness-based interventions on stress, burnout in nurses: a systematic review and meta-analysis.
作者信息
Wang Qi, Wang Fang, Zhang Shurong, Liu Chaofan, Feng Yue, Chen Junzhu
机构信息
School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Guang'an Hospital of Traditional Chinese Medicine, Guang'an, Sichuan, China.
出版信息
Front Psychiatry. 2023 Aug 3;14:1218340. doi: 10.3389/fpsyt.2023.1218340. eCollection 2023.
BACKGROUND
Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure on medical staff globally, highlighting the potential benefits of mindfulness-based interventions in reducing nurses' stress levels. Despite numerous studies exploring the effect of mindfulness-based training on nurses, the results remain inconclusive.
OBJECTIVE
To systematically evaluate the impact of mindfulness training on nurse's performance and increase the certainty of existing evidence.
METHODS
This study searched various databases, including EBSCO, Embase, Web of Science, PubMed, ProQuest, Scopus, Cochrane Online Library, Wanfang, SinoMed, CNKI, and VIP, for randomized controlled trials on the impact of mindfulness-based interventions for nurses up until 02 December 2022. Two investigators independently screened and extracted data from the articles, while also assessing the risk of bias. The data was analyzed using RevMan 5.4 software.
RESULTS
This review identified 15 studies out of the 2,171 records retrieved, consisting of a total of 1,165 participants who were randomized. Post-intervention analysis provided very-low certainty evidence of moderate effectiveness of mindfulness-based training in reducing stress [standardized mean difference (SMD) = -0.81; 95% confidence interval (CI) = -1.11 to -0.52], with no significant effect on anxiety (SMD = -0.30; 95% CI = -0.72 to 0.13) or depression (SMD = -0.24; 95% CI = -0.55 to 0.07). However, the training was effective in reducing burnout, as demonstrated by the lower scores for emotional exhaustion (SMD = -4.27; 95% CI = -5.94 to -2.59) and depersonalization (SMD = -2.89; 95% CI = -4.24 to -1.54) and higher scores for personal accomplishment (SMD = 2.81; 95% CI = 0.12 to 5.50). There was a sustained improvement in stress levels in the short-term (≤3 months), with delayed benefits for burnout. However, only two studies were available for later follow-ups, and there was no significant evidence of long-term effects.
CONCLUSION
Mindfulness-based training may be a viable intervention for improving the psychological wellbeing of nurses, including reducing stress, burnout.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023387081.
背景
医疗环境中的压力会给护士带来负面影响，如职业倦怠、焦虑和抑郁。新冠疫情导致全球医护人员压力增大，凸显了基于正念的干预措施在降低护士压力水平方面的潜在益处。尽管有大量研究探讨基于正念的培训对护士的影响，但结果仍无定论。
目的
系统评估正念训练对护士绩效的影响，并提高现有证据的确定性。
方法
本研究检索了多个数据库，包括EBSCO、Embase、科学网、PubMed、ProQuest、Scopus、Cochrane在线图书馆、万方、中国生物医学文献数据库、中国知网和维普，以查找截至2022年12月2日关于基于正念的干预措施对护士影响的随机对照试验。两名研究者独立筛选并从文章中提取数据，同时评估偏倚风险。使用RevMan 5.4软件对数据进行分析。
结果
本综述从检索到的2171条记录中确定了15项研究，共有1165名参与者被随机分组。干预后分析提供了非常低确定性的证据，表明基于正念的训练在减轻压力方面具有中等效果[标准化均数差（SMD）=-0.81；95%置信区间（CI）=-1.11至-0.52]，对焦虑（SMD=-0.30；95%CI=-0.72至0.13）或抑郁（SMD=-0.24；95%CI=-0.55至0.07）无显著影响。然而，该训练在减轻职业倦怠方面是有效的，表现为情感耗竭得分较低（SMD=-4.27；95%CI=-5.94至-2.59）和去个性化得分较低（SMD=-2.89；95%CI=-4.24至-1.54），个人成就感得分较高（SMD=2.81；95%CI=0.12至5.50）。短期（≤3个月）内压力水平持续改善，职业倦怠的益处出现延迟。然而，仅有两项研究进行了后期随访，且没有显著的长期影响证据。
结论
基于正念的训练可能是改善护士心理健康的一种可行干预措施，包括减轻压力、职业倦怠。
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