正念减压与心理健康教育对新冠肺炎隔离病房医护人员心理干预效果的比较

Comparison of Psychological Intervention Effects of Mindfulness-Based Stress Reduction and Mental Health Education on Medical Staff in COVID-19 Isolation Ward

目的探索正念减压(MBSR)与心理健康教育对新冠肺炎隔离病房工作的一线医护人员心理干预的效果比较。方法选取2020年3月12-22日武汉市第五医院新冠肺炎隔离病房参与防疫工作的医护人员118名,随机分成心理健康教育组(n=60)和MBSR组(n=58),心理健康教育组采用系统的应激相关心理健康教育,MBSR组采用系统的MBSR训练,干预前后分别运用应激(压力)反应量表(SRQ)、广泛性焦虑量表(GAD-7)、抑郁调查量表(PHQ-9)和特质应对方式问卷(TCSQ)进行评估。结果两组医护人员在年龄、性别、婚姻状况、学历、工龄、科室类型等基本资料及干预前应激反应、焦虑抑郁、应对方式得分上差异无统计学意义(P>0.05)。两组医护人员在应激反应总分、躯体反应因子得分、行为反应因子得分较干预前差异有统计学意义(P<0.05),且MBSR组上述指标得分低于心理健康教育组,差异有统计学意义(P<0.05);情绪反应因子得分中,MBSR组干预前后差异有统计学意义(P<0.05),而心理健康教育组干预前后差异无统计学意义(P>0.05)。干预后MBSR组医务人员焦虑、抑郁人数少于心理健康教育组,差异有统计学意义(P<0.05);干预后MBSR组医务人员积极应对得分高于心理健康教育组,消极应对得分低于心理健康教育组,差异有统计学意义(P<0.05)。结论心理健康教育和MBSR用于新冠肺炎隔离病房医护人员均能降低应激反应,改善情绪,转变应对方式,且MBSR效果优于心理健康教育。

Objective To explore the difference between mindfulness-based stress reduction(MBSR)and mental health education on psychological intervention of front-line medical staff in COVID-19 isolation ward.Methods A total of 118 medical staff who participated in epidemic prevention in COVID-19 isolation ward of the Fifth Hospital of Wuhan City from March 12 to 22,2020 were randomly divided into mental health education group(n=60)and MBSR group(n=58).The mental health education group received systematic stress-related mental health education,while the MBSR group received systematic mindfulness decompression training.The Stress Response Questionnaire(SRQ),Generalized Anxiety Disorder 7(GAD-7),Patient Health Questionnaire 9(PHQ-9)and Trait Coping Style Questionnaire(TCSQ)were used for evaluation before and after the intervention.Results There was no statistically significant difference between the mental health education group and the MBSR group in terms of age,gender,marital status,educational background,length of service,department type,stress response,anxiety and depression,and coping style scores before intervention(P>0.05).There were statistically significant differences of the two groups in the total score of stress response,somatic response factor score and behavioral response factor score compared with those before intervention(P<0.05),and the scores of the above indicators of MBSR group were lower than those of the mental health education group,the difference was statistically significant(P<0.05).There were statistically significant differences in emotional response factor scores of MBSR group before and after intervention(P<0.05),while there was no statistically significant difference in emotional response factor scores of mental health education group before and after intervention(P>0.05).The number of medical workers suffering from anxiety and depression in MBSR group was less than that in mental health education group,and the difference was statistically significant(P<0.05).After intervention,the positive response score of MBSR group was higher than that of the mental health education group,while the negative response score was lower than that of the mental health education group,and the differences were statistically significant(P<0.05).Conclusion Both mental health education and MBSR for medical staff in COVID-19 isolation wards can reduce stress response,improve mood and change coping styles.And MBSR is more effective than mental health education.