正念減壓課程對醫療人員身心健康之初探

Abstract

背景：隨著世界衛生組織（World Health Organization, WHO）開始推動健康促進醫院，醫療人員之健康（health）和安適或福祉（well-being）開始受到關注，在台灣也逐漸重視提供醫療人員具體的工具來管理壓力和維護自身的健康福祉。過去二十年的研究證實「正念減壓」（Mindfulness-Based Stress Reduction，MBSR） 介入方案有效降低壓力和焦慮，其應用也蓬勃發展至醫療人員。目的：以試探性研究探討正念減壓課程是否有助於促進醫療人員的身心健康並瞭解實施介入之歷程.方法：本研究採介入前後的比較，受試者共12位醫療人員包括護理師、護佐、住院醫師和醫療行政人員，研究工具使用自填的心理健康問卷、自主神經功能檢測及介入後參與者和帶領者的個別深度訪談。結果：8位完成介入前後自填的心理健康問卷、3位接受自主神經功能檢測及5位與研究者進行介入後的深度訪談。結果顯示正向情緒顯著增加（W=4, t=-2.26/P=0.034）；在前後測之BVP、指溫、膚電及EMG皆有明顯改善；顯示受試者在接受正念減壓課程之後，其放鬆程度增加、緊張程度下降，但如何引發參與動機仍需再進一步探討。結論：本初探研究與國外比較，正念減壓課程的確可以培養醫療人員不帶批判的認識醫療環境、自己、與他人快樂體驗和消極事件的客觀存在，進而降低壓力並提升自我照護和抗逆能力。健康促進醫院的落實使醫療人員感受並認同身心健康促進的效益，自助助人。

Introduction: Health Promoting Hospitals (HPH), the concept built upon WHO Ottawa-Charter for Health Promotion is increasingly apparent. In Taiwan, there are more strategies and plans to provide medical personnel a tangible self-care tool to better health and quality of life. For the past 20 years, Meditation-based Stress Reduction (MBSR) program which had been proved significant stress reduce and anxiety that accompanies daily life. Objective: The aim of this pilot study was to examine the effectiveness of the MBSR intervention for medical personnel and to learn the process of implementation. Methods: Full-time medical personnel (n=12) participants include nurses, PGY medical student and medical staff were recruited to participate in an 8-week MBSR program. A self-report mental health questionnaire and Autonomic Nervous System (ANS) were administered pre and post-intervention. In-depth interviews with participants and facilitator were conducted after the interventions. Results: 8 completed the self-report mental health questionnaires, 3 of them had their ANS tested and 5 participants joined the post intervention in-depth interviews. Significant were observed on positive emotions（W=4, t=-2.26/P=0.034）and improvement on post-test of the ANS result. Conclusion: The cultivation of mindfulness could help medical personnel to cope with their work stress by allowing them to face and evaluate problems with greater emotional equilibrium, and by providing a self-care tool to boost resiliency.