正念减压疗法对医务人员职业倦怠和心理健康的干预效果分析  

Analysis of the intervention effect of mindfulness-based stress reduction therapy on job burnout and mental health of medical staff

作　　者：孙玉静 杨洁[1] 林梓洵 宋东峰[2] 高桂凤[3] 李竞[4] 沈怡[5] SUN Yujing;YANG Jie;LIN Zixun;SONG Dongfeng;GAO Guifeng;LI Jing;SHEN Yi(Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong Province,510260,PRC)

机构地区：[1]广州医科大学附属第二医院,广东省广州市510260 [2]陕西省人民医院,陕西省西安市710068 [3]内蒙古自治区巴彦淖尔市医院,内蒙古巴彦淖尔015002 [4]深圳市第二人民医院,广东省深圳市518035 [5]广州医科大学附属第二医院神经内科,广东省深圳市518035

出　　处：《中国医院》2022年第5期52-55,共4页Chinese Hospitals

基　　金：国家自然科学基金项目(81801304);广州医科大学附属第二医院新技术、新业务临床研究项目(2020-LCYJ-XJS-06)。

摘　　要：目的:探讨正念减压疗法对某三甲综合医院医务人员心理健康和职业倦怠的应用效果。方法:通过开展正念减压课程(MBSR),对49名医务人员进行干预,课程前后分别使用广泛性焦虑量表(GAD-7)、知觉压力量表(CPSS)、正念注意觉知量表(MAAS)和马斯勒倦怠量表(MBI)进行调查,课程后进行质性访谈,深入了解课程效果和经验。结果:课程后参与者的GAD-7和CPSS得分明显低于课程前(P<0.05);MAAS课程前后得分没有明显变化(P>0.05);职业倦怠率较前有明显改善(P<0.05),在职业倦怠的3个维度中,情感衰竭和个人成就感得分较前明显变化(P<0.05),去人格化维度的得分没有明显变化(P>0.05)。参与者的MAAS得分与GAD-7、CPSS得分呈明显负相关关系(r=-0.303、-0.307,P<0.05),与职业倦怠中的情感耗竭和去人格化维度得分也呈明显负相关关系(r=-0.417、-0.395,P<0.05),但与个人成就感维度得分的相关性不明显(r=0.142,P>0.05)。质性访谈结果显示,参与者在课程中学习到方法,培育正念的态度,改善人际关系,促进成就感提升,正念课程宣传推广还需要进一步多样化持续发展。结论:MBSR课程可以用于综合三甲医院工作人员减轻压力,预防职业倦怠。MBSR课程在医院开展具有很大的发展空间,值得进一步探索和实践。Objective:To explore the effect of Mindfulness-Based Stress Reduction (MBSR) on mental health and job burnout of medical staff in a Grade III Level A general hospital.Methods:49 medical staff were intervened through MBSR courses,Generalized Anxiety Disorder 7-item scale (GAD-7),Chinese Version Perceived Stress Scale (CPSS),Mindful Attention Awareness Scale (MAAS),and Maslach Burnout Inventory (MBI) were used to investigate the changes of these 49 medical staff before and after the course.Qualitative interviews were conducted at the end of all courses to gain an in-depth understanding of the effects and experiences of these courses.Results:The scores of GAD-7 and CPSS of participants after the course were significantly lower than those before the course (P< 0.05);there was no significant change in the score before and after MAAS course (P>0.05);the rate of job burnout was significantly improved (P<0.05).Among the three dimensions of job burnout,the score of Emotional Exhaustion and Personal Accomplishment were significantly changed (P<0.05),while there was no significant change in the scores of Depersonalization (P>0.05).There was a significant negative correlation between the scores of MAAS and GAD-7,CPSS,Emotional Exhaustion,Depersonalization in job burnout (r=-0.303,-0.307,-0.417,-0.395,P<0.05),but there was no significant correlation with the scores of Personal Accomplishment (r=0.142,P> 0.05).The results of qualitative interviews show that participants learned the methods and attitudes to cultivate mindfulness in the course,improved interpersonal relationships and enhanced their sense of achievement.Therefore,the publicity and promotion of mindfulness courses need further diversification and sustainable development.Conclusion:MBSR course can help medical staff in Grade III Level A general hospitals reduce stress and prevent job burnout.And MBSR course has great development space in hospitals,which is worthy of further exploration and practice.

关 键 词：医务人员 正念减压疗法 职业倦怠 知觉压力 

分 类 号：R192[医药卫生—卫生事业管理]