Rosa William E, Pessin Hayley, Gilliland Jaime, Behrens Mia R, Foxwell Anessa M, McAndrew Natalie S, Schlak Amelia E, Applebaum Allison J, Lichtenthal Wendy G, Saracino Rebecca M, Breitbart William, Roberts Kailey E
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10017, USA.
School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA.
Transl Behav Med. 2025 Jan 16;15(1). doi: 10.1093/tbm/ibae071.
Healthcare providers (HCPs) face high rates of distress, experienced as burnout, moral distress, compassion fatigue, and grief. HCPs are also experiencing a crisis in meaning whereby distress is associated with disconnection from meaning in work and, in turn, a lack of meaning in work can further perpetuate distress for HCPs. Although scalable systems-level solutions are needed to tackle multidimensional HCP distress, it is also necessary to address HCP suffering at individual, team, and institutional levels. Targeted interventions to alleviate HCP distress are limited. Meaning-centered psychotherapy (MCP), a brief, evidence-based, intervention first developed for persons with advanced cancer, holds promise to mitigate HCP distress. This study adapted MCP for HCPs through feedback from a multidisciplinary sample of clinicians trained in MCP and working in healthcare settings. A survey was distributed electronically between November and December 2023 to HCPs previously trained in MCP assessing quantitative and qualitative feedback on the appropriateness of MCP for HCPs, the relevance of MCP session topics and exercises, and implementation barriers and facilitators. Descriptive statistics on relevant participant ratings were calculated; a matrix analysis approach was used for qualitative data. Forty participants, primarily mental health providers, expressed that MCP principles were highly relevant for HCPs and offered key insights on appropriate intervention modifications, including the need for a primary focus on meaning in professional life, reduced intervention length, and delivery in group format. Feedback informed critical adjustments to promote appropriateness and acceptability of MCP-HCP which is poised for pilot testing to determine its feasibility and preliminary efficacy for HCPs.
医疗保健提供者（HCPs）面临着高比例的困扰，表现为职业倦怠、道德困扰、同情疲劳和悲伤。HCPs也正经历一场意义危机，即困扰与工作意义的脱节相关，反过来，工作意义的缺失会进一步使HCPs的困扰持续存在。尽管需要可扩展的系统层面解决方案来应对多维度的HCP困扰，但在个人、团队和机构层面解决HCP的痛苦也很有必要。缓解HCP困扰的针对性干预措施有限。以意义为中心的心理治疗（MCP）是一种简短的、基于证据的干预方法，最初是为晚期癌症患者开发的，有望减轻HCP的困扰。本研究通过来自多学科样本的临床医生的反馈，对HCPs的MCP进行了调整，这些临床医生接受过MCP培训并在医疗环境中工作。2023年11月至12月期间，通过电子方式向之前接受过MCP培训的HCPs发放了一份调查问卷，评估关于MCP对HCPs的适用性、MCP课程主题和练习的相关性以及实施障碍和促进因素的定量和定性反馈。计算了相关参与者评分的描述性统计数据；对定性数据采用了矩阵分析方法。40名参与者，主要是心理健康提供者，表示MCP原则与HCPs高度相关，并就适当的干预调整提供了关键见解，包括需要主要关注职业生活中的意义、缩短干预长度以及采用小组形式进行干预。反馈为促进MCP-HCP的适用性和可接受性提供了关键调整，MCP-HCP准备进行试点测试，以确定其对HCPs的可行性和初步疗效。
