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基于正念的干预措施对重症监护病房护士心理社会幸福感及职业相关结局的有效性：一项系统评价与荟萃分析。

Effectiveness of mindfulness-based interventions on psychosocial well-being and occupational-related outcomes among nurses in the intensive care unit: A systematic review and meta-analysis.

作者信息

Liu Meilin, Guo Ya, Bai Jing, Wang Zhuoling, Han Jiming, Zhu Jiayu, Wang Jin

机构信息

Yan'an Medical College of Yan'an University, Yan'an, Shaanxi Province, China.

Yan'an Medical College of Yan'an University, Yan'an, Shaanxi Province, China.

出版信息

Aust Crit Care. 2025 Jul;38(4):101255. doi: 10.1016/j.aucc.2025.101255. Epub 2025 May 26.

DOI:10.1016/j.aucc.2025.101255
PMID:40424849
Abstract

BACKGROUND

Mindfulness-based interventions may contribute to the mental health status and well-being of nurses. Current results are inconsistent, and there are no systematic review and meta-analyses for intensive care unit (ICU) nurses.

AIM

The aim of this study was to assess the effectiveness of mindfulness-based interventions on psychosocial well-being and occupational-related outcomes among nurses in the ICU.

METHODS

We conducted a comprehensive literature search across 12 electronic databases, including PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, CNKI, Wanfang, VIP, SinoMed, ClinicalTrials.gov, and preprint repositories (bioRxiv and medRxiv). Additionally, we screened the reference lists of included studies to identify other potentially relevant research. The search covered records from the inception of each database up to July 2024. Two researchers independently screened studies and extracted data. ReviewManager (version 5.3 was used to conduct the meta-analysis.

RESULTS

A total of 29 studies were included in the meta-analysis to evaluate the effects of mindfulness-based interventions across different timeframes: immediate-term effects (within 10 days post intervention), short-term effects (10 days-3 months), medium-term effects (3-6 months), and long-term effects (beyond 6 months). The results showed that mindfulness-based interventions significantly alleviated anxiety (mean difference [MD]: -10.80, 95% confidence interval [CI]: [-16.76, -4.83], I = 78%, P < 0.001) and depression (MD: -12.02, 95% CI: [-12.43, -11.61], I = 0%, P < 0.001) in the medium term for ICU nurses. Significant immediate-term effects were observed on well-being (standardised mean difference [SMD]: 0.58, 95% CI: [0.40, 0.76], I = 0%, P < 0.001), resilience (MD: 14.41, 95% CI: [9.71, 19.11], I = 91%, P < 0.001), and death anxiety (MD: -2.35, 95% CI: [-4.39, -0.31], I = 30%, P = 0.02). Mindfulness-based interventions also showed significant short-term effects on well-being (SMD: 0.54, 95% CI: [0.10, 0.99], I = 43%, P = 0.02), sleep quality (MD: -1.19, 95% CI: [-2.32, -0.05], I = 50%, P = 0.04), and stress (SMD: -0.75, 95% CI: [-1.34, -0.17], I = 79%, P = 0.01). Significant effects were observed across immediate-term, short-term, and medium-term timeframes for stress reduction (medium-term effects: MD: -9.69, 95% CI: [-10.18, -9.21], I = 0%, P < 0.001) and mindfulness improvement (medium-term effects: MD: 9.28, 95% CI: [7.20, 11.37], I = 0%, P < 0.001). Additionally, mindfulness-based interventions significantly reduced burnout in the immediate term (SMD: -1.28, 95% CI: [-2.31, -0.25], I = 92%, P = 0.01).

CONCLUSIONS

Mindfulness-based interventions have a positive effect in improving psychosocial well-being and occupational-related outcomes for ICU nurses. Nursing managers may consider integrating mindfulness-based interventions into ICU nurses' practice to enhance their well-being.

REGISTRATION

The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42024572633 (available at https://www.crd.york.ac.uk/PROSPERO/view/CRD42024572633.).

摘要

背景

基于正念的干预措施可能有助于改善护士的心理健康状况和幸福感。目前的研究结果并不一致，且尚无针对重症监护病房（ICU）护士的系统评价和荟萃分析。

目的

本研究旨在评估基于正念的干预措施对ICU护士心理社会幸福感和职业相关结局的有效性。

方法

我们对12个电子数据库进行了全面的文献检索，包括PubMed、Web of Science、Embase、CINAHL、PsycINFO、Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库、ClinicalTrials.gov以及预印本库（bioRxiv和medRxiv）。此外，我们还筛选了纳入研究的参考文献列表，以识别其他潜在相关研究。检索涵盖了每个数据库自创建至2024年7月的记录。两名研究人员独立筛选研究并提取数据。使用ReviewManager（版本5.3）进行荟萃分析。

结果

共有29项研究纳入荟萃分析，以评估基于正念的干预措施在不同时间框架内的效果：即时效应（干预后10天内）、短期效应（10天至3个月）、中期效应（3至6个月）和长期效应（6个月以上）。结果显示，基于正念的干预措施在中期显著减轻了ICU护士的焦虑（平均差[MD]：-10.80，95%置信区间[CI]：[-16.76，-4.83]，I² = 78%，P < 0.001）和抑郁（MD：-12.02，95% CI：[-12.43，-11.61]，I² = 0%，P < 0.001）。在即时效应方面，观察到对幸福感（标准化平均差[SMD]：0.58，95% CI：[0.40，0.76]，I² = 0%，P < 0.001）、心理韧性（MD：14.41，95% CI：[9.71，19.11]，I² = 91%，P < 0.001）和死亡焦虑（MD：-2.35，95% CI：[-4.39，-0.31]，I² = 30%，P = 0.02）有显著影响。基于正念的干预措施在短期对幸福感（SMD：0.54，95% CI：[0.10，0.99]，I² = 43%，P = 0.02）、睡眠质量（MD：-1.19，95% CI：[-2.32，-0.05]，I² = 50%，P = 0.04）和压力（SMD：-0.75，95% CI：[-1.34，-0.17]，I² = 79%，P = 0.01）也有显著影响。在即时、短期和中期时间框架内，观察到对减轻压力（中期效应：MD：-9.69，95% CI：[-10.18，-9.21]，I² = 0%，P < 0.001）和提高正念（中期效应：MD：9.28，95% CI：[7.20，11.37]，I² = 0%，P < 0.001）有显著影响。此外，基于正念的干预措施在即时效应方面显著降低了倦怠（SMD：-1.28，95% CI：[-2.31，-0.25]，I² = 92%，P = 0.01）。

结论

基于正念的干预措施对改善ICU护士的心理社会幸福感和职业相关结局有积极作用。护理管理者可考虑将基于正念的干预措施纳入ICU护士的实践中，以提高他们的幸福感。

注册情况

该研究方案已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为CRD42024572633（可在https://www.crd.york.ac.uk/PROSPERO/view/CRD42024572633.查询）。

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