正念疗法改善护理人员共情疲劳的meta分析

摘要/Abstract

摘要： 目的分析正念疗法对改善护理人员共情疲劳的效果。方法计算机检索中国知网、万方数据库、中国生物医学文献库数据库、PubMed、Cochrane Library、WOS、EMbase等,搜索正念疗法对护理人员共情疲劳影响的对照试验研究,检索时限为建库至2022年3月25日。由两名分析人员独立筛选文献,提取相关资料并评估纳入文献的方法学质量,采用RevMan 5.4对纳入研究进行meta分析。结果共纳入11篇对照临床试验（controlled clinical trial,CCT）和随机对照试验（randomized controlled trial,RCT）,包括689例护理人员。Meta 分析结果显示,正念干预组共情满意评分（MD=3.03,95%CI：1.06~4.99）、职业倦怠评分（MD=-2.79,95%CI：-3.44~-2.15）、继发性创伤应激评分（MD=-2.66,95%CI：-3.26~-2.06）指标的改善均优于对照组。亚组分析发现,在不同研究类型、干预时间、科室、结局量表中,正念疗法组共情满意评分升高,职业倦怠评分和继发性创伤应激评分降低,正念干预组与对照组比较差异均有统计学意义（均P<0.05）。结论正念干预可明显改善护理人员共情疲劳症状。

关键词: 正念疗法, 护理人员, 共情疲劳

Abstract: Objective To evaluate the effect of mindfulness therapy on compassion fatigue of nurses. Methods The China knowledge Network,Wanfang Database,Chinese Biomedical Literature Database,PubMed,Cochrane Library,WOS and EMbase were searched by computer to retrieve the control test of the effect of mindfulness therapy on compassion fatigue of nurses. The search time limit was from database establishment to March 25,2022. Two researchers independently screened the literature,extracted data and evaluated the bias risk included in the study. RevMan 5.4 was used to perform the meta analysis. Results A total of 11 controlled clinical trial（CCT） and randomized controlled trial（RCT） were included,involving 689 nurses. The results of meta analysis showed that the improvement of empathy satisfaction score（MD=3.03,95%CI：1.06-4.99）,job burnout score（MD= -2.79,95%CI：-3.44--2.15）] and secondary trauma stress score（MD=-2.66,95%CI：-3.26--2.06） in the mindfulness intervention group were better than those in the control group. The subgroup analysis showed that,in different research types,intervention times,departments and outcome scales,the empathy satisfaction score in the mindfulness intervention group increased,while the job burnout score and secondary trauma stress score decreased,and the differences were statistically significant between the mindfulness intervention group and the control group（all P<0.05）. Conclusion The mindfulness intervention can obviously improve the symptoms of compassion fatigue of nurses.

Key words: Mindfulness therapy, Nursing staff, Compassion fatigue

中图分类号:

R181.2

于健, 常雅茹, 李月, 郭红玉, 曹虹. 正念疗法改善护理人员共情疲劳的meta分析. [J]职业与健康, 2023, 39(15): 2123-2128.

YU Jian, CHANG Yaru, LI Yue, GUO Hongyu, CAO Hong. Meta analysis of mindfulness therapy in improving compassion fatigue of nurses. [J]OCCUPATION AND HEALTH, 2023, 39(15): 2123-2128.

参考文献

[1] PETERS E.Compassion fatigue in nursing:A concept analysis[J].Nurs Forum,2018,53(4):466-480.
[2] GREINACHER A,DEREZZA-GREEVEN C,HERZOG W,et al.Secondary traumatization in first responders:A systematic review[J].Eur J Psychotraumato 2019,10(1):1562840.
[3] 姚颖,魏万宏,王忠祥,等.河南省某肿瘤专科医院护士组织支持感与共情疲劳的相关性研究[J].医学与社会,2020,33(4):114-117.
[4] JIN M,WANG J,ZENG L,et al.Prevalence and factors of compassion fatigue among nurse in China:A protocol for systematic review and meta-analysis[J].Medicine (Baltimore),2021,100(3):e24289.
[5] 宋亚杰,王丽娜.临床护士共情疲劳研究进展[J].新乡医学院学报,2021,38(12):1189-1192.
[6] 中国心理学会临床与咨询心理学专业委员会正念学组,中国心理卫生协会认知行为治疗专业委员会正念学组.正念干预专家共识[J].中华行为医学与脑科学杂志,2019,28(9):771-777.
[7] 陈华英,王卫红.中文版同情疲劳量表的信度、效度研究[J].中国护理管理,2013,13(4):39-41.
[8] 洪晓彤,丁梅,黄婷,等.护理人员共情疲劳现状的研究进展[J].赣南医学院学报,2021,41(3):323-326.
[9] 罗娟,王桂梅,吉晓燕,等.正念减压疗法对精神科护士共情疲劳的影响[J].齐鲁护理杂志,2018,24(23):30-33.
[10] 王蓉,郭晓娟,张瑜.正念减压疗法联合磁性关怀对重症监护病房护士的干预研究[J].江苏卫生事业管理,2021,32(9):1231-1235.
[11] 张池,常超,李淑英,等.正念减压疗法对ICU护士职业认同感和同情心疲劳的影响[J].当代护士(下旬刊),2020,27(4):154-156.
[12] 赵楚艺,梁伍今.正念疗法对肿瘤科护士共情疲劳的效果分析[J].长春中医药大学学报,2020,36(1):152-154,160.
[13] 赵明月,刘冬英,陈静.正念干预对肿瘤科护士同情心疲乏的影响[J].全科护理,2020,18(31):4345-4347.
[14] ABERNATHY S,MARTIN R.Reducing compassion fatigue with self-care and mindfulness[J].Nurs Critical Care,2019,14(5):38-44.
[15] DUARTE J,PINTO-GOUVEIA J.Effectiveness of a mindfulness-based intervention on oncology nurses’ burnout and compassion fatigue symptoms:A non-randomized study[J].Int J Nurs Studies,2016, 64:98-107.
[16] OWENS R A,ALFES C,EVANS S,et al.An exploratory study of a 3-minute mindfulness intervention on compassion fatigue in Nurses[J].Holistic Nurs Pract,2020,34(5):274-281.
[17] QUALLS B W,PAYTON E M,AIKENS L G,et al.Mindfulness for outpatient oncology nurses:A Pilot study[J].Holistic Nurs Practice,2022, 36(1):28-36.
[18] SLATYER S,CRAIGIE M,HERITAGE B,et al.Evaluating the effectiveness of a brief mindful self-care and resiliency(MSCR) Intervention for Nurses:A Controlled Trial[J].Mindfulness,2018,9(2):534-546.
[19] WATTS K J,O’CONNOR M,JOHNSON C E,et al.Mindfulness-based compassion training for health professionals providing end-of-life care:Impact,feasibility,and acceptability[J].J Palliative Med 2021, 24(9):1364-1374.
[20] NAJJAR N,DAVIS L W,BECK-COON K,et al.Compassion fatigue:A review of the research to date and relevance to cancer-care providers[J].J Health Psychol,2009,14(2):267-277.
[21] DECETY J,YANG C-Y,CHENG Y.Physicians down-regulate their pain empathy response:An event-related brain potential study[J].NeuroImage,2010,50(4):1676-1682.
[22] CHIESA A,SERRETTI A,JAKOBSEN J C.Mindfulness:Top-down or bottom-up emotion regulation strategy?[J].Clin Psychol Rev,2013, 33(1):82-96.
[23] DESBORDES G,NEGI L T,PACE T W W,et al.Effects of mindful-attention and compassion meditation training on amygdala response to emotional stimuli in an ordinary,non-meditative state[J].Fron Hum Neurosci,2012,6:292.
[24] NYKL??EK I,MOMMERSTEEG P M C,VAN BEUGEN S,et al.Mindfulness-based stress reduction and physiological activity during acute stress:A randomized controlled trial[J].Health Psychol,2013, 32(10):1110-1113.
[25] BHATNAGAR R,PHELPS L,RIETZ K,et al.The effects of mindfulness training on post-traumatic stress disorder symptoms and heart rate variability in combat veterans[J].J Altern Complementary Med,2013,19(11):860-861.
[26] BASAR U,BASIM N.A cross-sectional survey on consequences of nurses’ burnout:Moderating role of organizational politics[J].J Advanced Nurs,2016,72(8):1838-1850.
[27] WEIGL M,STAB N,HERMS I,et al.The associations of supervisor support and work overload with burnout and depression:A cross-sectional study in two nursing settings[J].J Adv Nurs,2016,72(8):1774-1788.