Wooldridge Jennalee S, Soriano Emily C, Chu Gage, Shirazi Anaheed, Shapiro Desiree, Patterson Marta, Kim Hyun-Chung, Herbert Matthew S
Mental Health Service, VA San Diego Healthcare System, San Diego, CA, United States.
Department of Psychiatry, University of California San Diego, San Diego, CA, United States.
JMIR Form Res. 2024 Nov 26;8:e60670. doi: 10.2196/60670.
While structured compassion training programs have shown promise for increasing compassion among medical trainees, a major challenge is applying the concepts and practices taught during the program into the complex, dynamic, time-pressured, and often hectic hospital workplace.
The purpose of this pilot study was to examine the feasibility, acceptability, and preliminary effects of Compassion Coach, a mobile health (mHealth) smartphone app designed to bolster a 6-week mindfulness and self-compassion training program for medical trainees.
In Compassion Coach, notifications to remind, encourage, and measure the perceived impact of informal mindfulness and compassion practices taught during the program were delivered at 7 AM, 12 PM, and 7 PM, respectively, 3 times per week over the course of the training program. The app also contained a library of guided audio formal mindfulness and compassion practices to allow quick and easy access. In this pilot study, we collected data from 29 medical students and residents who downloaded Compassion Coach and completed surveys assessing perceived effectiveness and acceptability. Engagement with the Compassion Coach app was passively tracked through notification response rate and library resource access over time.
The average response rate to notifications was 58% (SD 29%; range 12%-98%), with a significant decline over time (P=.009; odds ratio 0.98, 95% CI 0.96-0.99). Across all participants and occasions, the majority agreed the informal practices prompted by Compassion Coach helped them feel grounded and centered (110/150, 73%), improved compassion (29/41, 71%), reduced burnout (106/191, 56%), and improved their mood (133/191, 70%). In total, 16 (55%) of the 29 participants accessed guided audio recordings on average 3 (SD 3.4) times throughout the program. At the posttreatment time point, most participants (13/18, 72%) indicated that Compassion Coach helped them engage in compassion practices in daily life, and half (9/18, 50%) indicated that Compassion Coach helped improve interactions with patients.
Overall, preliminary results of Compassion Coach are encouraging and suggest the integration of a smartphone app with an ongoing mindfulness and self-compassion training program may bolster the effects of the program on medical trainees. However, there was variability in engagement with Compassion Coach and perceived helpfulness. Additional research is indicated to optimize this novel mHealth approach and conduct a study powered to formally evaluate effects.
虽然结构化的同情心培训项目已显示出有望提高医学实习生的同情心，但一个主要挑战是将项目中教授的概念和实践应用到复杂、动态、时间紧迫且通常很忙碌的医院工作环境中。
本试点研究的目的是检验“同情心教练”（Compassion Coach）这款移动健康（mHealth）智能手机应用程序的可行性、可接受性和初步效果，该应用程序旨在为医学实习生加强为期6周的正念和自我同情心培训项目。
在“同情心教练”应用程序中，分别在每天上午7点、中午12点和晚上7点发送通知，以提醒、鼓励并衡量项目中教授的非正式正念和同情心实践的感知影响，在培训项目期间每周发送3次。该应用程序还包含一个引导音频的正式正念和同情心实践库，以便快速轻松访问。在这项试点研究中，我们收集了29名下载了“同情心教练”应用程序并完成了评估感知有效性和可接受性的调查的医学生和住院医师的数据。通过通知回复率和随时间推移的库资源访问情况被动跟踪与“同情心教练”应用程序的互动。
通知的平均回复率为58%（标准差29%；范围12% - 98%），且随时间显著下降（P = 0.009；优势比0.98，95%置信区间0.96 - 0.99）。在所有参与者和所有场合中，大多数人认为“同情心教练”促使的非正式实践帮助他们感到踏实和专注（110/150，73%），提高了同情心（29/41，71%），减少了职业倦怠（106/191，56%），并改善了情绪（133/191，70%）。在29名参与者中，共有16名（55%）在整个项目中平均访问引导音频记录3（标准差3.4）次。在治疗后时间点，大多数参与者（13/18，72%）表示“同情心教练”帮助他们在日常生活中践行同情心实践，一半（9/18，50%）表示“同情心教练”有助于改善与患者的互动。
总体而言，“同情心教练”的初步结果令人鼓舞，表明将智能手机应用程序与正在进行的正念和自我同情心培训项目相结合可能会增强该项目对医学实习生的效果。然而与“同情心教练”的互动以及感知到的帮助存在差异。需要进一步研究以优化这种新颖的移动健康方法并开展一项有足够效力来正式评估效果的研究。
