Coopersmith Ari S, Shroff Yash V, Wen George A, Berler Michael H, Gonzales Paul A, Ojute Feyisayo M, Lebares Carter C
Department of Surgery, UCSF Center of Mindfulness in Surgery, University of California San Francisco, San Francisco, CA.
Ann Surg. 2025 Apr 1;281(4):542-548. doi: 10.1097/SLA.0000000000006213. Epub 2024 Jan 23.
To review the evidence on mindfulness-based interventions (MBIs) for surgeons.
Health care professionals have alarmingly high rates of burnout, yet little is known about psychological factors that support resilience. MBIs, which involve codified training in specific skills such as self-awareness, emotional regulation, and perspective-taking, have shown benefit to professionals in high-stress environments but have had limited implementation in the health care workplace and in surgery. To our knowledge, there has not been a scoping review of MBIs in surgery to date.
We conducted a scoping review of the evidence for the feasibility and effectiveness of MBIs for surgeons, including evidence on interventions that explicitly train mindfulness, which spans multiple cohorts and settings, utilizing different methodologies and outcome measures.
This scoping review yielded 24 studies, including 2 mixed method/qualitative studies, 9 randomized control trials, 3 nonrandomized interventional studies, and 8 single-arm interventional studies.
We find that MBIs in surgery (1) are feasible in surgical contexts, with implementation science providing insights on sustainability; (2) increase mindfulness, (3) improve well-being in terms of burnout and both psychological and neurophysiological measures of stress, and (4) enhance performance as measured in executive function, surgical skills, and communication skills. These conclusions are supported by psychometric measures, observations of technical skills, and neurophysiological evidence. Future directions include studying MBIs in larger and more diverse populations and iteratively tailoring mindfulness-based interventions to other health care contexts.
回顾针对外科医生的基于正念的干预措施（MBIs）的相关证据。
医护人员职业倦怠率高得惊人，但对于支持恢复力的心理因素却知之甚少。MBIs包括对自我意识、情绪调节和换位思考等特定技能的规范化培训，已显示对处于高压力环境的专业人员有益，但在医疗工作场所和外科手术中的应用有限。据我们所知，迄今为止尚未对外科手术中MBIs进行范围综述。
我们对MBIs对外科医生的可行性和有效性证据进行了范围综述，包括明确训练正念的干预措施的证据，这些证据跨越多个队列和环境，采用不同的方法和结果指标。
该范围综述产生了24项研究，包括2项混合方法/定性研究、9项随机对照试验、3项非随机干预研究和8项单臂干预研究。
我们发现外科手术中的MBIs（1）在手术环境中是可行的，实施科学为可持续性提供了见解；（2）提高正念水平，（3）在职业倦怠以及心理和神经生理压力测量方面改善幸福感，（4）在执行功能、手术技能和沟通技能方面提高表现。这些结论得到了心理测量、技术技能观察和神经生理学证据的支持。未来的方向包括在更大和更多样化的人群中研究MBIs，并反复调整基于正念的干预措施以适用于其他医疗环境。
