正念减压疗法与巴林特小组对护士压力及职业倦怠效果比较的Meta分析

Comparison of the effects on mindfulness-based stress reduction and Balint group on nurses′stress and job burnout:a Meta-analysis

目的:比较正念减压疗法与巴林特小组对于减轻护士压力、缓解职业倦怠的效果是否有差异,为后期调整护士减压相关课程提供参考依据。方法:计算机检索PubMed、CINAHL、EMbase、PsycINFO、the Cochrane Library、中国生物医学文献数据库、中国知网及万方数据库中有关正念减压疗法和巴林特小组对于护士压力及职业倦怠干预效果的随机对照试验,检索时间为建库至2020年6月。经过初筛、阅读全文及质量评价确定最终纳入的文献。应用RevMan 5.3及ITC软件进行Meta分析。结果:共纳入15篇研究。Meta分析结果显示:正念减压疗法可减轻护士压力[MD=-0.99,95%CI(-1.38,-0.60),P<0.00001],缓解护士职业倦怠[MD=-6.83,95%CI(-11.07,-2.59),P=0.002];巴林特小组可缓解职业倦怠[MD=-10.64,95%CI(-11.79,-9.50),P<0.00001],但在减轻护士压力方面的差异无统计学意义[MD=-0.12,95%CI(-0.47,0.23),P=0.50]。正念减压疗法与巴林特小组在缓解护士职业倦怠的间接比较,差异无统计学意义(P>0.05)。结论:现有证据表明正念减压与巴林特小组均可缓解护士职业倦怠且效果无差异,正念减压疗法对减轻护士压力的效果优于巴林特小组。

Objective:To compare the effectiveness on relieving stress and reducing job burnout of nurses between mindfulness-based stress reduction and Balint group,in order to provide evidence for curriculum on stress relief in the future.Methods:Randomized controlled trials on relieving stress and reducing job burnout,which adopted mindfulness-based stress reduction and Balint group,were searched in PubMed,CINAHL,EMbase,PsycINFO,the Cochrane Library,CBM,CNKI and WanFang database.The retrieval time was from the establishment of the database to June 2020.After pretiminary screening,full-text review and quality appraisal,the studies met the inclusion criteria were included.RevMan 5.3 and ITC software were used for Meta-analysis.Results:A total of 15 studies were included.Meta-analysis results showed that mindfulness-based stress reduction could reduce nurses′stress[SMD=-0.99,95%CI(-1.38,-0.60),P<0.00001],and alleviate nurses′job burnout[MD=-6.83,95%CI(-11.07,-2.59),P=0.002].Balint group could relieve nurses′job burnout[MD=-10.64,95%CI(-11.79,-9.50),P<0.00001],but there was no significant difference in reducing nurses′stress[MD=-0.12,95%CI(-0.47,0.23),P=0.50].There was no significant difference between mindfulness-based stress reduction and Balint group in alleviating nurses′job burnout(P>0.05).Conclusion:Current evidences shows that mindfulness-based stress reduction and Balint group can alleviate nurses′job burnout,and the effects are not different.mindfulness-based stress reduction is better than Balint group in reducing nurses′stress.