College of Nursing, Brigham Young University, Provo, UT, United States.
Senda LLC, Seattle, WA, United States.
JMIR Nurs. 2024 Feb 16;7:e54561. doi: 10.2196/54561.
Health care is highly complex and can be both emotionally and physically challenging. This can lead health care workers to develop compassion fatigue and burnout (BO), which can negatively affect their well-being and patient care. Higher levels of resilience can potentially prevent compassion fatigue and BO. Strategies that enhance resilience include gratitude, exercise, and mindfulness.
The purpose of this study was to determine if a 3-week daily resiliency practice, prompted via a gratitude, exercise, and mindfulness smartphone app, impacted the professional quality of life, physical activity, and happiness level of health care workers in a newborn intensive care unit setting.
In total, 65 participants from a level III newborn intensive care unit at a regional hospital in the western United States completed this study. The Professional Quality of Life Scale, Physical Activity Vital Sign, and Subjective Happiness Score instruments were used to evaluate the effects of the mobile health (mHealth) intervention. Further, 2-tailed dependent paired t tests were used to evaluate participant pre- and postintervention instrument scores. Multiple imputation was used to predict scores of participants who practiced an intervention but did not complete the 3 instruments post intervention.
Dependent t tests using the original data showed that participants, as a whole, significantly improved in BO (t=2.30, P=.03), secondary trauma stress (STS; t=2.11, P=.04), and happiness (t=-3.72, P<.001) scores. Compassion satisfaction (CS; t=-1.94, P=.06) and exercise (t=-1.71, P=.10) were trending toward, but did not reach, significance. Using the original data, only the gratitude intervention group experienced significant improvements (CS, BO, and happiness), likely due to the higher number of participants in this group. Analysis using imputed data showed that participants, as a whole, had significant improvements in all areas: CS (t=-4.08, P<.001), BO (t=3.39, P=.001), STS (t=4.08, P<.001), exercise (t=-3.19, P=.002), and happiness (t=-3.99, P<.001). Looking at the intervention groups separately using imputed data, the gratitude group had significant improvements in CS, BO, STS, and happiness; the exercise group had significant improvements in STS and exercise; and the mindfulness group had significant improvements in CS and happiness.
Phone app delivery of resilience-enhancing interventions is a potentially effective intervention model for health care workers. Potential barriers to mHealth strategies are the technical issues that can occur with this type of intervention. Additional longitudinal and experimental studies with larger sample sizes need to be completed to better evaluate this modality.
医疗保健非常复杂，可能会在身体和情感上带来挑战。这可能会导致医护人员产生同情疲劳和倦怠（BO），从而对他们的健康和患者护理产生负面影响。更高的适应力可以潜在地预防同情疲劳和 BO。增强适应力的策略包括感恩、锻炼和正念。
本研究旨在确定在新生儿重症监护病房环境中，通过一个感恩、锻炼和正念的智能手机应用程序每天进行 3 周的弹性练习，是否会影响医护人员的职业生活质量、身体活动和幸福感。
共有 65 名来自美国西部一家三级新生儿重症监护病房的参与者完成了这项研究。使用专业生活质量量表、身体活动重要标志和主观幸福感量表来评估移动健康（mHealth）干预的效果。此外，使用双尾依赖配对 t 检验评估参与者在干预前后的仪器评分。使用多重插补来预测练习干预但未在 3 次干预后完成所有 3 个仪器的参与者的得分。
使用原始数据进行的依赖 t 检验表明，作为一个整体，参与者在倦怠（t=2.30，P=.03）、二次创伤应激（STS；t=2.11，P=.04）和幸福感（t=-3.72，P<.001）方面的得分显著提高。同情满足（CS；t=-1.94，P=.06）和锻炼（t=-1.71，P=.10）的得分呈上升趋势，但没有达到显著水平。使用原始数据，只有感恩干预组的参与者在 CS、倦怠和幸福感方面经历了显著的改善，这可能是因为该组的参与者人数较多。使用插补数据进行分析表明，作为一个整体，参与者在所有方面都有显著的改善：CS（t=-4.08，P<.001）、倦怠（t=3.39，P=.001）、STS（t=4.08，P<.001）、锻炼（t=-3.19，P=.002）和幸福感（t=-3.99，P<.001）。使用插补数据分别查看干预组，感恩组在 CS、倦怠、STS 和幸福感方面有显著改善；锻炼组在 STS 和锻炼方面有显著改善；而正念组在 CS 和幸福感方面有显著改善。
通过智能手机应用程序提供增强适应力的干预措施是一种针对医护人员的潜在有效干预模式。移动健康策略的潜在障碍是这种干预类型可能出现的技术问题。需要完成更多具有更大样本量的纵向和实验研究，以更好地评估这种模式。
