A randomised controlled trial of the effects of mindfulness practice on medical student stress levels
A randomised controlled trial of the effects of mindfulness practice on medical student stress levels
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DOI：
10.1111/j.1365-2923.2010.03877.x
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发表时间：
2011-04-01
影响因子：
6
通讯作者：
Nelson, Mark R.
中科院分区：
文献类型：
--
作者：
Warnecke, Emma;Quinn, Stephen;Nelson, Mark R.
这项研究的目的是确定是否正念的做法减少了高级医学生所经历的压力的水平。MethodsWe进行了多中心，单盲，随机对照试验与意向治疗分析，在三个临床附属学校的塔斯马尼亚大学，霍巴特，塔斯马尼亚。参与者包括2009年最后两年学习的66名医学生。参与者被随机分为干预组或常规护理对照组。干预使用了为这项试验设计和制作的指导正念练习的音频CD。建议参与者在试验的8周内每天使用干预措施。所有参与者分别在基线和第8周完成两份自我报告问卷。干预组还在16周时完成了一份问卷，以提供随访数据。主要结果测量是感知压力量表（PSS）评分随时间的差异。次要结局指标指的是随着时间的推移，在抑郁，焦虑和压力量表（DASS）的子量表上的分数的差异。结果平均基线分数的PSS和压力组件的DASS分别为15.7（最大得分为40）和13.2（最大得分为42），这两个都超过了年龄匹配的正常对照数据的分数。使用多变量分析，干预组的参与者在PSS（-3.44，95%置信区间[CI]-6.20至-0.68; p < 0.05）和DASS的焦虑成分（-2.82，95% CI-4.99至-0.64; p < 0.05）上的得分显着降低。证明了对DASS的应力分量的临界显著影响（-3.69，95%CI- 7.38至0.01; p = 0.05）。在8周后的后续试验表明，效果maintained.ConclusionsMindfulness实践减少了高年级医学生的压力和焦虑。压力在医学生中很普遍，对学生和病人的健康都有不利影响。一个简单的，自我管理的，以证据为基础的干预措施，现在存在的管理压力，在这个高危人群，应该被广泛使用。
ObjectiveThis study aimed to determine whether the practice of mindfulness reduces the level of stress experienced by senior medical students.MethodsWe carried out a multicentre, single-blinded, randomised controlled trial with intention-to-treat analysis in three clinical schools attached to the University of Tasmania, Hobart, Tasmania. Participants included 66 medical students in their final 2 years of study in 2009. Participants were block-randomised to either an intervention or a usual care control group. The intervention used an audio CD of guided mindfulness practice designed and produced for this trial. Participants were advised to use the intervention daily over the 8 weeks of the trial. All participants completed two self-report questionnaires, at baseline and at 8 weeks, respectively. The intervention group also completed a questionnaire at 16 weeks to provide follow-up data. The primary outcome measure was the difference over time in scores on the Perceived Stress Scale (PSS). The secondary outcome measure referred to differences over time in scores on the subscales of the Depression, Anxiety and Stress Scale (DASS).ResultsMean baseline scores on the PSS and the stress component of the DASS were 15.7 (maximal score of 40) and 13.2 (maximal score of 42), respectively, both of which exceed scores in age-matched normative control data. Using multivariable analysis, participants in the intervention group demonstrated significant reductions in scores on the PSS (- 3.44, 95% confidence interval [CI] - 6.20 to - 0.68; p < 0.05) and the anxiety component of the DASS (- 2.82, 95% CI - 4.99 to - 0.64; p < 0.05). A borderline significant effect was demonstrated on the stress component of the DASS (- 3.69, 95% CI - 7.38 to 0.01; p = 0.05). Follow-up at 8 weeks post-trial revealed that the effect was maintained.ConclusionsMindfulness practice reduced stress and anxiety in senior medical students. Stress is prevalent in medical students and can have adverse effects on both student health and patients. A simple, self-administered, evidence-based intervention now exists to manage stress in this at-risk population and should be widely utilised.