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正念训练在健康职业教育中的可持续益处。

Sustainable benefits of mindfulness training in health professions education.

作者信息

Sköld Camilla, Steen Anton, Niemi Maria, Vinnars Bo, Kiessling Anna

机构信息

Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, 182 88, Sweden.

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

BMC Med Educ. 2025 Mar 27;25(1):451. doi: 10.1186/s12909-025-06998-y.

Abstract

BACKGROUND

Healthcare work and even studies towards a healthcare profession is associated with a high prevalence of distress. According to recent meta-analyses, half of the medical students worldwide suffer from burn out prior to residency, and 34% of nursing students suffer from depression. The aim of this study was to investigate healthcare students' long-term experiences of mindfulness training, and whether, how and why students were continuing their mindfulness practice after graduation. Further, to assess if background characteristics were associated with continuing mindfulness practice.

METHODS

A mixed method survey study based on predetermined and open-ended questions. Qualitative and quantitative data were analysed concurrently to assess effects on, and a deepened understanding of stress management, use of mindfulness in relation to patients, oneself and others, and continued practice of mindfulness.

RESULTS

Two hundred one of the 380 (52,8%) students completing the mindfulness based stress management course (MBSM) answered the questionnaire. Of all, 175 (87,1%) students also answered free text questions. The qualitative analysis identified five themes: "Positive" Experiences, "Negative" Experiences, "Origin and development of interest in mindfulness" and "Continuing practice of mindfulness". A considerable proportion of the participants experienced increased acceptance, relaxation, ability to face difficulties, self-compassion and better interaction with patients, but some participants also experienced negative experiences such as aversiveness and ineffectiveness of the course. Those continuing to practice mindfulness after graduation were more likely (85.3%) to say that the gained competence helped in their relationship with patients, compared to those who did not continue to practice (57.1%); (chi2 = 18.13; df = 2; p < 0.001). Among those who had previous mindfulness or similar experience, 84% continue to practice mindfulness after the course, compared to 50% of those who had no previous experience (chi2 = 26; df = 1; p < 0.001).

CONCLUSION

The long-term follow-up of mindfulness training for healthcare students shows that participants maintain a sustained capability to handle stressful work situations in their professional practice and develop a more compassionate relationship with themselves. We argue that skills to care for one's inner environment, such as learning mindfulness as a student, can contribute to a sustainable future professional life. However, further research is needed to confirm the transferability of the results.

摘要

背景

医疗工作乃至对医疗职业的学习都与高患病率的困扰相关。根据最近的荟萃分析,全球一半的医学生在住院医师培训前就出现职业倦怠,34%的护理专业学生患有抑郁症。本研究的目的是调查医学生正念训练的长期体验,以及学生毕业后是否、如何以及为何继续进行正念练习。此外,评估背景特征是否与持续的正念练习相关。

方法

一项基于预定问题和开放式问题的混合方法调查研究。同时分析定性和定量数据,以评估对压力管理的影响、对正念在与患者、自身及他人关系中的应用的深入理解,以及正念的持续练习情况。

结果

完成基于正念的压力管理课程(MBSM)的380名学生中有201名(52.8%)回答了问卷。其中,175名(87.1%)学生还回答了自由文本问题。定性分析确定了五个主题:“积极”体验、“消极”体验、“对正念兴趣的起源与发展”以及“正念的持续练习”。相当一部分参与者体验到接受度提高、放松、面对困难的能力增强、自我同情以及与患者的互动改善,但一些参与者也经历了负面体验,如对课程的厌恶和无效感。毕业后继续练习正念的人更有可能(85.3%)表示所获得的能力有助于他们与患者的关系,而未继续练习的人这一比例为57.1%;(卡方 = 18.13;自由度 = 2;p < 0.001)。在有过正念或类似体验的人中,84%在课程结束后继续练习正念,而没有此类经历的人中这一比例为50%(卡方 = 26;自由度 = 1;p < 0.001)。

结论

对医学生正念训练的长期随访表明,参与者在专业实践中保持了应对压力工作情境的持续能力,并与自己建立了更具同情心的关系。我们认为,关注自身内心环境的技能,比如在学生时期学习正念,有助于实现可持续的未来职业生涯。然而,需要进一步研究来证实结果的可转移性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f86/11951767/826977d07414/12909_2025_6998_Fig1_HTML.jpg

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