Systematic review of interventions for reducing occupational stress in health care workers

OBJECTIVES: This study evaluated the effectiveness of interventions in reducing stress at work among health care workers. METHODS: A systematic search was conducted of the literature on reducing stress or burnout in health care workers. The quality of the studies found was then appraised and the results combined. A meta-analysis was performed when appropriate. RESULTS: Altogether 14 randomized controlled trials, three cluster-randomized trials, and two crossover trials, comprising 2812 participants, were included. Only two trials were of high quality. The following comparisons were possible: person-directed interventions versus no intervention, person-work interface interventions versus no intervention, and organizational interventions versus no intervention. Person-directed interventions can reduce stress [standardized mean difference (SMD) -0.85, 95% confidence interval (95% CI) -1.21 - -0.49] and burnout, measured as emotional exhaustion [weighted mean difference (WMD) -5.82, 95% CI -11.02 - -0.63) and lack of personal accomplishment (WMD -3.61; 95% CI -4.65 - -2.58). They also reduce anxiety, measured as state anxiety (WMD -9.42, 95% CI -16.92 - -1.93) and trait anxiety (WMD -6.91, 95% CI -12.80 - -1.01). Person-work interface interventions can reduce burnout, measured as depersonalization [mean difference (MD) -1.14, 95% CI -2.18 - -0.10]. Organizational interventions can also reduce stress symptoms (MD -0.34; 95% CI -0.62 - -0.06) and general symptoms (MD -2.90, 95% CI -5.16 - -0.64). No harmful effects were reported. CONCLUSIONS: Limited evidence is available for a small, but probably relevant reduction in stress levels from person-directed, person-work interface, and organizational interventions among health care workers. This finding should lead to a more-active stress management policy in health care institutions. Before large-scale implementation can be advised, larger and better quality trials are needed.     

Self-perceived mental health and job satisfaction among Lithuanian dentists

The aim of this study was to document dentists' self-perceived mental health complaints and job satisfaction, and to assess any correlations between the two. A postal questionnaire survey was mailed to all (N=2,449) licensed dentists registered with the Lithuanian Dental Association. The questionnaire investigated dentists' mental health and job satisfaction during the previous year (overall response rate: 68.2%). The majority of respondents (80.7%) reported being satisfied with their job. Self-perceived lack of self-esteem (OR: 0.59, 95% CI: 0.43-0.82), loneliness (OR: 0.72, 95% CI: 0.53-0.98), and especially depression (OR: 0.52, 95% CI: 0.35-0.77) had a high negative impact on dentists' job satisfaction. Nervousness (89.2%) and burnout (83.6%) were the most prevalent mental complaints and they also tended to be the most chronic of all reported mental disorders. Increasing age significantly reduced the possibility of nervousness or depression and increased the possibility of being satisfied with dental practice. Increasing working hours increased the risk of burnout, anxiety and loneliness. Overall, this study suggests that the majority of Lithuanian dentists are satisfied with their job and also enjoy their professional lives. However, a considerable proportion still reported impairment of mental health which influenced their levels of job satisfaction.     

An exploratory study on the factors affecting the mental health and well‐being of frontline workers in homeless services

Frontline workers in homeless services work in a high‐intensity, emotionally consuming environment, with frequent exposure to traumatic material with potentially significant consequences for their own mental health. This, in turn, may have a negative impact on the quality of care provided to homeless service users. Prevention of this trajectory may be achieved through psychologically informed environments for staff. This study aimed to explore factors that may influence the development of burnout, secondary traumatic stress (STS), depression, anxiety and stress in this population. Elevated levels of burnout and STS were predicted, as was an association between the predictor variables of professional experience, educational background, continuing professional development, access to organisational support structures and the outcome measures of compassion satisfaction, burnout, STS, depression, anxiety and stress. An online cross‐sectional survey design using the Professional Quality of Life Scale (Version V) and the Depression Anxiety and Stress Scale‐21 and scales designed for this study capturing occupational variables were distributed via email and national networks to a wide range of services across Scotland and the rest of the UK. Over 4 months in 2017, 112 frontline homelessness workers in health, social care and third sector organisations completed the survey. Results did not indicate elevated levels of burnout or STS, though depression and stress were found to be significantly elevated compared to population norms and were associated with burnout, compassion satisfaction and secondary traumatic stress. High levels of various types of supervision support and CPD were identified. There was no association between these and burnout or stress. We highlight the elevated levels of stress and depression and make a research recommendation to parse types of supervision to assess for optimal effectiveness and efficiency in ensuring that staff working in high‐stress homelessness settings receive optimal support to deliver high quality services.     

A randomised controlled trial of the effects of mindfulness practice on medical student stress levels

Medical Education 2011: 45 : 381–388 Objective This study aimed to determine whether the practice of mindfulness reduces the level of stress experienced by senior medical students. Methods We 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). Results Mean 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. Conclusions Mindfulness 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.     

领悟社会支持在新冠肺炎疫情期间护理本科生正念水平与心理健康间的中介效应

  目的  调查新冠肺炎疫情期间护理本科生心理健康现状,探讨正念水平、领悟社会支持对其心理健康的影响。
  方法  选取北京市某高等院校护理学院240名在读护理本科生为研究对象,采用抑郁-焦虑-压力量表、中文简洁版五因素正念度量表、领悟社会支持量表、匹兹堡睡眠质量指数量表进行调查,使用SAS软件进行统计描述,使用Mplus软件检验中介效应。
  结果  18.8%的护理本科生存在抑郁症状;27.9%的护理本科生存在焦虑症状;13.3%的护理本科生存在压力症状;31.7%的护理本科生睡眠质量欠佳。正念水平对睡眠障碍（β = - 0.242,P < 0.01）、压力（β = - 0.397,P < 0.01）、焦虑（β = - 0.350,P < 0.01）、抑郁（β = - 0.484,P < 0.01）均有直接影响,也可通过领悟社会支持对睡眠障碍（β = - 0.171,P < 0.01）、压力（β = - 0.105,P = 0.029）、焦虑（β = - 0.102,P = 0.034）、抑郁（β = - 0.180,P < 0.01）产生间接影响,中介效应占比分别为41.40%、20.92%、22.52%、37.19%。
  结论  正念水平可以通过直接作用和领悟社会支持的中介作用改善护理本科生的心理健康,护理教育者可考虑将正念减压训练融入日常教学中,并给予护理本科生足够的心理、情感支持和鼓励,提高其心理健康水平。
     

基层公共卫生防治人员身心健康与职业倦怠的关系研究

目的 分析基层公共卫生防治人员身心健康与职业倦怠的关系, 为该人群心理健康干预提供参考。
方法 随机抽取深圳市宝安区560名基层公共卫生防治人员作为对象, 实施问卷调查, 并对回收问卷的调查结果进行分析。
结果 基层公共卫生人员焦虑、抑郁、精神病性、呼吸系统及心血管系统的得分高于全国常模, 差异有统计学意义(P < 0.05);身心健康量表中的焦虑、抑郁、眼和耳、生殖及内分泌系统、心血管系统得分和情绪耗竭呈正相关, 焦虑、抑郁、精神病、消化系统得分和消极怠慢呈正相关, 抑郁、神经系统得分和专业低效能感呈正相关; 回归模型决定系数R2分别为0.985 6、0.964 8、0.958 9, 且整体回归效果均有统计学意义(P < 0.01)。
结论 身心健康和职业倦怠存在较强的相关性, 降低基层公共卫生防治人员的职业倦怠感, 提高该类人群的身心健康水平至关重要。
     

中小学教师社会支持与心理健康的关系:工作家庭冲突的中介作用

目的 了解中小学教师工作家庭冲突在社会支持与心理健康间的作用机制。方法 采用工作家庭冲突、社会支持以及心理健康量表对565名中小学教师进行调查。结果 （1）控制了性别、学校类型与职称的影响后,社会支持与自我肯定存在统计学意义上的正性关系,与忧郁及焦虑存在统计学意义上的负性关系;工作家庭冲突与自我肯定存在统计学意义的负性关系,与忧郁及焦虑存在统计学意义上的正性关系;社会支持与工作家庭冲突存在统计学意义上的负性关系。（2）控制了性别、学校类型与职称的影响后,工作家庭冲突在社会支持与自我肯定和忧郁之间发挥着部分中介作用(ab自我肯定 = 0.198, 95%CI = [0.130, 0.265];ab忧郁 = -0.265, 95%CI = [-0.348, -0.182]),并在社会支持与焦虑之间发挥着完全中介作用（ab焦虑 = -0.308, 95%CI = [-0.405, -0.212])。结论 中小学教师的社会支持水平越高,工作家庭冲突对他们造成的负面影响越小,心理越健康。     

Maternal symptoms of stress, depression, and anxiety are related to nonresponsive feeding styles in a statewide sample of WIC participants

Parenting, including nonresponsive feeding styles, has been related to under- or overweight among young children. The relationship between maternal mental health and feeding styles has not been examined. We hypothesized that mothers who report more symptoms of stress, depression, or anxiety report less responsive (e.g. more controlling, indulgent, and uninvolved) feeding styles than mothers who report fewer symptoms of stress, depression, or anxiety. Our analyses included 702 mother-infant pairs from a statewide sample of Special Supplemental Nutrition Program for Women, Infants, and Children mothers. We assessed maternal mental health and feeding styles by a telephone survey. After adjusting for potential confounding variables, maternal stress symptomatology was significantly associated with forceful (beta = 0.03; 95% CI = 0.02, 0.05) and uninvolved (OR = 1.4; 95% CI = 1.1, 1.7) feeding style scores, maternal depression symptomatology was significantly associated with forceful (beta = 0.03; 95% CI = 0.004, 0.05), indulgent (beta = 0.03; 95% CI = 0.004, 0.06), and uninvolved (OR = 1.5; 95% CI = 1.001, 2.2) feeding styles scores, and maternal anxiety symptomatology was significantly related to restrictive (beta = 0.11; 95% CI = 0.01, 0.21), forceful (beta = 0.04; 95% CI = 0.02, 0.06), and uninvolved (OR = 1.4; 95% CI = 1.01, 1.9) feeding style scores. Among mothers who perceived their infant as temperamentally fussy, there was a significant positive relationship between restrictive feeding styles scores and 3 indices of maternal mental health (stress, beta = 0.18; 95% CI = 0.07, 0.28; depression, beta = 0.21; 95% CI = 0.04, 0.38; and cumulative mental health symptomatology, beta = 0.29; 95% CI = 0.10, 0.48). Mothers who report stress, depression, or anxiety symptoms are at risk for nonresponsive feeding styles. These findings provide support for broadening the focus of existing child nutrition programs to include strategies that recognize how issues of maternal mental health can affect feeding styles.     

Association of COVID-19 impact with outcomes of an integrated obesity and depression intervention: Posthoc analysis of an RCT

ObjectiveTo examine the association between COVID-19 impact and clinical outcomes of an integrated collaborative care intervention for adults with obesity and comorbid depression.MethodsLatent class analysis identified clusters of self-reported COVID-19 impact. Cluster characteristics were examined using Fishers’ least significant difference method and canonical discriminant analysis. Intervention vs. usual care effects on primary (body mass index [BMI], depressive symptoms) and secondary (anxiety symptoms and other psychosocial) outcomes stratified by cluster were examined using linear mixed models.ResultsThree clusters were identified: mental health and sleep impact (cluster 1, n = 37), economic impact (cluster 2, n = 18), and less overall impact (cluster 3, n = 20). Clusters differed in age, income, diet, and baseline coping skills. The intervention led to improvements across several health outcomes compared with usual care, with medium to large effects on functional impairments (standardized mean difference, ?0.7 [95% CI: ?1.3, ?0.1]) in cluster 1, depressive symptoms (?1.1 [95% CI: ?2.0, ?0.1]) and obesity-related problems (?1.6 [95% CI: ?2.8, ?0.4]) in cluster 2, and anxiety (?1.1 [95% CI: ?1.9, ?0.3]) in cluster 3.ConclusionsPeople with obesity and comorbid depression may have varied intervention responses based on COVID-19 impact. Interventions tailored to specific COVID-19 impact clusters may restore post-pandemic health.     

同伴教育对青春期中小学生心理健康干预效果评价

了解同伴教育干预方式对改善青春期中小学生心理健康状况的效果,为促进青春期中小学生心理健康发展提供依据.方法 采用非随机对照试验的方法,在重庆某区选取2所小学和2所初中学校,将1所小学(四至五年级)和1所中学(七至八年级)作为同伴教育干预组,由接受培训的同伴教育者对学生进行干预;另1所小学和1所中学相同年级作为对照组,不采取任何干预措施.用《中学生心理健康自评量表》(Mental Health Inventroy of Middle-SchoolStudents,MMHI-60)和一般情况调查问卷进行基线调查和随访调查.结果 同伴教育干预校学生总心理健康状况、强迫症状、偏执、敌对、人际关系紧张与敏感、抑郁、焦虑、学习压力、情绪不平衡和心理不平衡问题检出率由干预前的39.9%,55.3%,38.8%,37.9%,43.9%,40.5%,42.7%,48.0%,52.5%,32.1%降低到干预后的36.8%,46.1%,36.6%,33.3%,37.2%,38.8%,40.9%,45.7%,49.2%,30.3%,干预后适应不良的检出率(39.8%)高于干预前(37.7%),差异均有统计学意义(P值均<0.05).二元Logistic回归分析结果显示,干预后干预校青春期中小学生的总心理健康、强迫症状、偏执、敌对、人际关系紧张与敏感、抑郁、焦虑和学习压力检出率分别是对照校学生的0.63(95%CI=0.49~0.81)、0.73(95% CI=0.58~ 0.91)、0.75(95%CI=0.60~0.95)、0.60(95%CI=0.47~0.76)、0.67(95%CI=0.53~ 0.86)、0.72(95% CI=0.56~0.91)、0.68(95%CI=0.54~0.86)和0.71 (95%CI=0.56~ 0.91)倍(P值均<0.05).结论 同伴教育能有效改善青春期中小学生的强迫症状、偏执、敌对、人际关系紧张与敏感、抑郁、焦虑和学习压力.     

Cross-Cultural Adaptation, Reliability, Internal Consistency and Validation of the Spinal Function Sort (SFS) for French- and German-Speaking Patients with Back Complaints

Introduction Functional subjective evaluation through questionnaire is fundamental, but not often realized in patients with back complaints, lacking validated tools. The Spinal Function Sort (SFS) was only validated in English. We aimed to translate, adapt and validate the French (SFS-F) and German (SFS-G) versions of the SFS. Methods Three hundred and forty-four patients, experiencing various back complaints, were recruited in a French (n?=?87) and a German-speaking (n?=?257) center. Construct validity was estimated via correlations with SF-36 physical and mental scales, pain intensity and hospital anxiety and depression scales (HADS). Scale homogeneities were assessed by Cronbach??s ??. Test?Cretest reliability was assessed on 65 additional patients using intraclass correlation (IC). Results For the French and German translations, respectively, ?? were 0.98 and 0.98; IC 0.98 (95% CI: [0.97; 1.00]) and 0.94 (0.90; 0.98). Correlations with physical functioning were 0.63 (0.48; 0.74) and 0.67 (0.59; 0.73); with physical summary 0.60 (0.44; 0.72) and 0.52 (0.43; 0.61); with pain ?0.33 (?0.51; ?0.13) and ?0.51 (?0.60; ?0.42); with mental health ?0.08 (?0.29; 0.14) and 0.25 (0.13; 0.36); with mental summary 0.01 (?0.21; 0.23) and 0.28 (0.16; 0.39); with depression ?0.26 (?0.45; ?0.05) and ?0.42 (?0.52; ?0.32); with anxiety ?0.17 (?0.37; ?0.04) and ?0.45 (?0.54; ?0.35). Conclusions Reliability was excellent for both languages. Convergent validity was good with SF-36 physical scales, moderate with VAS pain. Divergent validity was low with SF-36 mental scales in both translated versions and with HADS for the SFS-F (moderate in SFS-G). Both versions seem to be valid and reliable for evaluating perceived functional capacity in patients with back complaints.     

Willingness to use mental health counseling and antidepressants in older Korean Americans: the role of beliefs and stigma about depression

Objectives: Despite a high prevalence of mental health problems, racial/ethnic minorities are often reluctant to seek mental health services. Their reluctance may be shaped by cultural beliefs and stigma about mental health. The present study examined how beliefs and stigma about depression (e.g. disbelief in depression as a health-related condition, perception of depression as a normal part of aging, and/or depression as a sign of personal weakness/family shame) pose barriers to older Korean Americans’ willingness to use mental health counseling and antidepressants.

Method: Data were drawn from surveys with 420 Korean American older adults (M_age=?71.6, SD?=?7.6) living in the New York City metropolitan area in 2010. Using a separate logistic regression model, the role of beliefs and stigma about depression in predicting participants’ willingness to receive mental health counseling and to take antidepressants was tested. Based on Andersen’s behavioral health service use model, the analysis was conducted in consideration of predisposing characteristics (age, gender, marital status, education, and acculturation), mental health needs (anxiety, depressive symptoms, and self-rated mental health), and enabling/hindering factors (beliefs and stigma).

Results: Similar proportions of the sample (69–70%) indicated their willingness to use mental health counseling or antidepressants. Willingness was more likely among participants who had beliefs about depression as a health-related concern (OR?=?1.94, 95% CI?=?1.15?3.27 for mental health counseling; OR?=?4.47, 95% CI?=?2.59?7.70 for antidepressants) and less likely among those who associated depression with family shame (OR?=?.55, 95% CI?=?0.33?0.91 for mental health counseling; OR?=?.56, 95% CI?=?0.33?0.95 for antidepressants).

Conclusion: In addressing mental health problems and promoting the use of mental health services, cultural beliefs and stigma shared within an ethnic community should be considered. Given that disbelief in the medical model of depression and family shame reduced willingness to use mental health counseling and antidepressants, promoting mental health literacy for older immigrants could be beneficial.     

Mental health interventions by lay counsellors: a systematic review and meta-analysis

ObjectiveTo investigate the effectiveness of community-based mental health interventions by professionally trained, lay counsellors in low- and middle-income countries.MethodsWe searched PubMed®, Cochrane Central Register of Controlled Trials, PROSPERO and EBSCO databases and professional section publications of the United States National Center for PTSD for randomized controlled trials of mental health interventions by professionally trained, lay counsellors in low- and middle-income countries published between 2000 and 2019. Studies of interventions by professional mental health workers, medical professionals or community health workers were excluded because there are shortages of these personnel in the study countries. Additional data were obtained from study authors. The primary outcomes were measures of post-traumatic stress disorder, depression, anxiety and alcohol use. To estimate effect size, we used a random-effects meta-analysis model.FindingsWe identified 1072 studies, of which 19 (involving 20 trials and 5612 participants in total) met the inclusion criteria. Hedges'' g for the aggregate effect size of the interventions by professionally trained, lay counsellors compared with mostly either no intervention or usual care was −0.616 (95% confidence interval: −0.866 to −0.366). This result indicates a significant, medium-sized effect. There was no evidence of publication bias or any other form of bias across the studies and there were no extreme outliers among the study results.ConclusionThe use of professionally trained, lay counsellors to provide mental health interventions in low- and middle-income countries was associated with significant improvements in mental health symptoms across a range of settings.     

艾滋病扩大治疗策略下未治疗者的心理健康研究

目的 了解在新的治疗策略扩大之际，广州市尚未开始抗病毒治疗的艾滋病病毒（human immunodeficiency virus，HIV）阳性者的抑郁症和焦虑症现状，并按感染时间分层分析社会支持、社会歧视和自我歧视对其的影响作用。方法 在广州市六个区对尚未开始抗病毒治疗的HIV阳性者进行横断面调查，收集调查对象的社会人口学特征，HIV相关健康状况，抑郁，焦虑，从外界领悟的社会支持、社会歧视及自我歧视情况信息，以抑郁和焦虑分别做因变量，其他信息做自变量进行二分类Logistic回归分析。结果 452名调查对象中，66.2%（299/452）和52.9%（239/452）的阳性者分别被评定为抑郁和焦虑。多因素分析结果显示，在感染时间<1个月的阳性者中，家庭支持（OR=0.80，95%CI:0.63~1.00，P=0.049）与自我歧视（OR=2.15，95%CI:1.36~2.44，P=0.001）会影响抑郁，重要他人支持（OR=0.68，95%CI:0.53~0.87，P=0.003）和自我歧视（OR=2.31，95%CI:1.55~3.43，P<0.001）会影响焦虑；在感染时间 ≥ 1个月的阳性者中，自我歧视（OR=2.72，95%CI:1.74~4.25，P<0.001）会影响焦虑。结论 广州市的HIV阳性者存在较高的抑郁和焦虑患病率，自我歧视是影响焦虑和抑郁发生的重要因素，不同来源支持对不同感染时间的HIV阳性者的抑郁和焦虑的影响作用不同，故应针对性地提供社会支持。     

上海市青少年社会支持、亲子关系与情绪的关系

【目的】探讨青少年社会支持、亲子关系与青少年抑郁、焦虑、孤独的关系,为改善青少年心理健康问题提供参考。【方法】采用分层随机整群抽样法,调查上海市2个区的11 596名中学生。采用患者健康问卷2条目中文版、广泛性焦虑量表、加利福尼亚大学洛杉矶分校(UCLA)孤独感量表、领悟社会支持量表及亲子亲合问卷进行调查。使用t检验、方差分析、相关分析、logistic回归分析等进行统计推断。【结果】女性、非毕业班、成绩前25%、与父母同住及客观社会地位更高的青少年的社会支持、亲子亲合得分皆高于男性、毕业班、成绩中等或后25%、不与父母同住、客观社会地位较低的青少年(P<0.05)。青少年的亲子亲合、社会支持与各种情绪均呈负相关。亲子亲合是抑郁(OR=0.93,95%CI:0.91～0.94)、孤独(OR=0.94,95%CI:0.94～0.95)、焦虑(OR_轻度=0.98,95%CI:0.98～0.99;OR_中重度=0.96,95%CI:0.95～0.98)的相关因素,但不同维度的支持与情绪的关系差异有统计学意义(P<0.05)。【结论】社会支...     

正念训练对大学生睡眠和焦虑抑郁情绪的干预效果

  目的  探究线上、线下正念训练对改善新冠肺炎疫情后大学生焦虑抑郁情绪和睡眠质量的效果评价,为提高大学生心理健康程度提供参考。  方法  于2020年9月,采用随机整群抽样法选取华北理工大学1 203名大学生进行抑郁自评量表(SDS)、焦虑自评量表(SAS)和匹兹堡睡眠质量指数量表(PSQI)筛查,符合入组标准者103名,随机分为线上组(64名)和线下组(39名),干预后评估大学生焦虑抑郁情绪和睡眠质量改善程度。  结果  线上线下正念训练干预后大学生SAS、SDS、PSQI得分均低于干预前,差异均有统计学意义（t值分别为5.57,5.31,3.99;4.88,5.02,5.88,P值均 < 0.01）。线上、线下两种干预训练,对睡眠质量改善程度差异有统计学意义（t=-2.55,P < 0.05）。大学生焦虑、抑郁、睡眠3种症状合并越少,正念干预症状缓解率越高,3种症状并存缓解率≤25%,2种症状并存缓解率 < 40%,仅有1种症状缓解率100%。  结论  线上、线下正念训练皆可作为干预睡眠、焦虑和抑郁情绪的有效手段;线下正念训练对于改善大学生睡眠质量优于线上;正念训练对于单一症状者缓解效果更为明显。     

A preliminary comparison of the efficacy of online Acceptance and Commitment Therapy (ACT) and Cognitive Behavioural Therapy (CBT) stress management interventions for social and healthcare workers

Social and healthcare workers have been shown to experience greater levels of illness, depression and burnout as a result of chronic workplace stress. The purpose of this study was to examine whether brief online ACT and CBT interventions could reduce the experience of stress and burnout in employees, while also improving mental health and psychological flexibility. A total of 42 individuals working within the social and healthcare professions were randomly assigned to either a 2-week online ACT or CBT intervention. Recruitment was undertaken internationally, although the majority of participants were based in Ireland at the time of their participation (79%). Participants’ perceived stress, burnout, mental health and work-related psychological flexibility were assessed at baseline and post-treatment. Intent-to-treat analyses were conducted on all data. Outcomes indicated that both interventions resulted in significant improvements in stress, burnout and mental health scores from baseline to post-treatment. No significant differences were observed between ACT and CBT conditions, or in psychological flexibility scores from baseline to post-treatment. Reliable Change Index (RCI) scores indicated that clinically significant improvements in stress and mental health were seen in 42% and 19% of programme-completers, respectively. These results provide preliminary evidence for the usefulness of brief internet-delivered ACT and CBT interventions for the treatment of occupational stress and its comorbid symptoms. Online programmes with a longer duration and additional therapist support should be evaluated, as these may improve the outcomes of future interventions.     

Mindfulness-based interventions with social workers and the potential for enhanced patient-centered care: A systematic review of the literature

The use of mindfulness-based interventions (MBIs) is well documented in the mental health, medical, and education literature. There is minimal research on the use of mindfulness with social workers. As demonstrated in other professional and helping fields, mindfulness may enhance clinical skills, reduce burnout, and increase job satisfaction among social workers. In the health care field mindfulness appears integral to patient and family relationships and personal resilience. The evolving and expanding role of hospital social workers may lead to increased work stress and greater demands from both the medical system and patients and families. Research with medical providers, such as physicians and nurses, suggests mindfulness may help in reducing stress, enhancing relationships, and fostering the self-reflection required to provide patient-centered care. We systematically reviewed the existing literature to begin understanding both mindfulness qualities and practices and the effectiveness of MBIs among social workers as well as the relationship of mindfulness to patient-centered care.     

Amigas Latinas Motivando el Alma (ALMA): an Evaluation of a Mindfulness Intervention to Promote Mental Health among Latina Immigrant Mothers

Latina immigrants are at increased risk for poor mental health. Amigas Latinas Motivando el Alma (ALMA) is a group-based intervention to reduce symptoms of depression, anxiety, and stress among Latina immigrants. Based on participants’ feedback and growing evidence supporting mindfulness as a way to reduce stress and improve mental health, additional sessions of the ALMA intervention were developed and pilot tested to provide more training on mindfulness as a coping strategy. The feasibility and potential efficacy were evaluated in a community sample using a pre- and post-test study design. Findings suggested that women were satisfied with the sessions and used mindfulness strategies they learned in their daily lives. The program also reduced symptoms of depression and anxiety (19% reduction in mean depression scores and 26% reduction in mean anxiety scores). Further evaluation is needed to test the efficacy of the intervention.     

Factors influencing self-reported anxiety or depression following stroke or TIA using linked registry and hospital data

Purpose

Approximately 30–50% of survivors experience problems with anxiety or depression post-stroke. It is important to understand the factors associated with post-stroke anxiety or depression to identify effective interventions.

Methods

Patient-level data from the Australian Stroke Clinical Registry (years 2009–2013), from participating hospitals in Queensland (n?=?23), were linked with Queensland Hospital Emergency and Admission datasets. Self-reported anxiety or depression was assessed using the EQ-5D-3L, obtained at 90–180 days post-stroke. Multivariable multilevel logistic regression, with manual stepwise elimination of variables, was used to investigate the association between self-reported anxiety or depression, patient factors and acute stroke processes of care. Comorbidities, including prior mental health problems (e.g. anxiety, depression and dementia) coded in previous hospital admissions or emergency presentations using ICD-10 diagnosis codes, were identified from 5 years prior to stroke event.

Results

2853 patients were included (median age 74; 45% female; 72% stroke; 24% transient ischaemic attack). Nearly half (47%) reported some level of anxiety or depression post-stroke. The factors most strongly associated with anxiety or depression were a prior diagnosis of anxiety or depression [Adjusted Odds Ratio (aOR) 2.37, 95% confidence interval (95% CI) 1.66–3.39; p?<?0.001], dementia (aOR 1.91, 95% CI 1.24–2.93; p?=?0.003), being at home with support (aOR 1.41, 95% CI 1.12–1.69; p?=?<?0.001), and low socioeconomic advantage compared to high (aOR 1.59, 95% CI 1.21–2.10; p?=?0.001). Acute stroke processes of care were not independently associated with anxiety or depression.

Conclusions

Identification of those with prior mental health problems for early intervention and support may help reduce the prevalence of post-stroke anxiety or depression.