Mindfulness based stress reduction on empathy fatigue among medical staff in laminar flow wards under the unaccompanied management model
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摘要:
目的 探讨无陪护管理模式下正念减压对层流病房医护人员共情能力的影响，为优化层流病房医护人员心理干预策略、提升其心理健康水平提供科学依据。 方法 选取2023年11月—2024年11月在浙江省中医院层流病房工作的44名医护人员为研究对象，按照随机数字表法将其分为对照组(22名)和干预组(22名)。对照组除日常工作外不增加任何活动，干预组采取正念减压辅助层流病房医护人员共情能力的训练，通过专业培训的正念导师带领干预组研究对象进行正念练习，包括正念呼吸、身体扫描、正念冥想、正念行走等，为期8周。通过使用压力感知量表、匹兹堡睡眠质量指数与中文版共情疲劳量表来对比层流病房医护人员的干预前后的表现，以此衡量其影响并观察成效。 结果 干预后，干预组的失控感、紧迫感和压力知觉总分[(4.36±1.09)分、(4.41±1.05)分、(8.77±1.66)分]均低于对照组[(5.77±1.90)分、(5.77±1.74)分、(11.64±2.44)分]，匹兹堡睡眠质量指数量表总分低于对照组，差异均有统计学意义(P < 0.05)，干预组共情疲劳中的职业倦怠和二次创伤得分低于对照组，共情满意得分[(48.41±2.22)分]高于对照组[(36.59±4.83)分]，差异有统计学意义(P < 0.001)。 结论 正念减压疗法能有效降低层流病房医护人员的共情疲劳，提高工作效率，增加自我认同感，提升医护人员心理健康水平，具有推广价值。 Abstract:Objective To explore the effect of mindfulness decompression on theempathy ability of medical staf in laminar flow ward under the management modewithout accompanying, so as to provide a scientific basis for optimizing thepsychological intervention strategy of medical staff in laminar flow ward andimproving their mental health level in the future. Methods From November 2023 to November 2024, 44 medical staff in the laminar flow wards of Zhejiang Provincial Hospital of Traditional Chinese Medicine were selected as the research subjects and randomly divided into a control group (n=22) and an intervention group (n=22) using a random number table method. The control group did not engage in any activities other than daily work, while the intervention group received mindfulness-based stress reduction and empathy training for 8 weeks. A trained mindfulness instructor led the intervention group in a series of mindfulness practices, which included mindful breathing, body scan, mindful meditation, and mindful walking. By using the stress perception questionnaire, Pittsburgh sleep quality index, and the Chinese version of the empathy fatigue scale to compare the performance of medical staff in laminar flow hospitals before and after intervention, the impact was measured, and the effectiveness was observed. Results After the intervention, the total scores of sense of control, sense of urgency and pressure perception in the intervention group [(4.36±1.09) points, (4.41±1.05) points, (8.77±1.66) points] were lower than those in the control group [(5.77±1.90) points, (5.77±1.74) points, (11.64±2.44) points], and the total score of Pittsburgh sleep quality index was lower than that in the control group, with statistical significance (P < 0.05). The job burnout and secondary trauma in the intervention group were lower than those in the control group, and empathic satisfaction [(48.41±2.22) points] was significantly higher than that of the control group [(36.59±4.83)points, P < 0.001]. Conclusion Mindfulness-based stress relief therapy can effectively reduce empathy fatigue among medical staff in laminar flow wards, enhance work efficiency, increase self-identity, and improve their psychological well-being, thus possessing promotion value. -
表 1 2组层流病房医护人员一般资料比较
Table 1. Comparison of general data of medical staff in two laminar flow wards
组别 人数 性别(名) 年龄(x±s，岁) 婚姻状况(名) 文化程度(名) 工作年限(名) 职称(名) 聘用类型(名) 男性 女性 已婚 未婚 大专 本科及以上 ＜5年 ≥5年 初级 中级 高级 正式编制 人事代理 合同 对照组 22 7 15 32.31±6.96 10 12 2 20 7 15 4 15 3 4 15 3 干预组 22 8 14 31.77±7.30 12 10 4 18 6 16 5 14 3 5 14 3 统计量 0.101a 0.253b 0.364a 0.193a 0.109a -0.266c -0.384a P值 0.750 0.871 0.546 0.660 0.741 0.790 0.701 注：a为χ2值，b为t值，c为Z值。 
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表 2 2组医护人员干预前后PSS评分比较(x±s，分)
Table 2. Comparison of PSS scores before and after intervention by two groups of medical staff(x±s, points)
组别 人数 失控感 紧迫感 总分 干预前 干预后 干预前 干预后 干预前 干预后 对照组 22 5.50±1.82 5.77±1.90b 5.68±1.83 5.77±1.74b 11.68±2.78 11.64±2.44b 干预组 22 5.91±1.57 4.36±1.09b 5.68±1.55 4.41±1.05b 11.59±1.99 8.77±1.66b 统计量 0.798a 9.086c < 0.001a 9.854c 0.125a 20.708c P值 0.429 0.005 0.999 0.003 0.901 ＜0.001 注：a为t值, c为F值；与同组干预前比较, bP＜0.05。
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表 3 2组医护人员干预前后PSQI评分比较[M(P25, P75)，分]
Table 3. Comparison of PSQI scores before and after intervention by two groups of medical staff[M(P25, P75), points]
组别 人数 干预前 干预后 干预前后差值 对照组 22 7.00(6.75, 9.00) 8.00(5.75, 9.00) 0.50(-1.25, 1.25) 干预组 22 7.00(6.00, 9.00) 3.00(2.00, 4.00) 4.50(3.00, 6.25) Z值 -0.263 -5.466 -5.542 P值 0.793 ＜0.001 ＜0.001
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表 4 2组医护人员干预前后C-CFSS评分比较(x±s, 分)
Table 4. Comparison of C-CFSS scores before and after intervention by two groups of medical staff(x±s, points)
组别 人数 共情满意 职业倦怠 二次创伤 干预前 干预后 干预前 干预后 干预前 干预后 对照组 22 36.18±5.30 36.59±4.83b 25.14±4.79 24.50±3.95b 29.36±4.74 29.23±5.34b 干预组 22 36.00±5.17 48.41±2.22b 27.09±4.75 20.95±3.55b 28.05±3.63 21.50±2.04b 统计量 0.115a 108.882c 1.358a 9.802c 1.036a 40.251c P值 0.909 ＜0.001 0.182 0.003 0.306 ＜0.001 注：a为t值, c为F值；与同组干预前比较，bP＜0.05。
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