Feasibility of Formal Mindfulness-Based Stress-Resilience Training Among Surgery Interns: A Randomized Clinical Trial.

摘要: Importance Among surgical trainees, burnout and distress are prevalent, but mindfulness has been shown to decrease the risk of depression, suicidal ideation, burnout, overwhelming stress. In other high-stress populations, formal training improve mental health, yet this approach not tried in surgery. Objective To test feasibility acceptability modified Mindfulness-Based Stress Reduction (MBSR) during residency. Design, Setting, Participants A pilot randomized clinical trial MBSR vs an active control was conducted with 21 interns a residency program at tertiary academic medical center, from April 30, 2016, December 2017. Interventions Weekly 2-hour, classes 20 minutes suggested daily home practice over 8-week period. Main Outcomes Measures Feasibility assessed along 6 domains (demand, implementation, practicality, acceptability, adaptation, integration), using focus groups, interviews, surveys, attendance, time, subjective self-report experience. Results Of residents included analysis, 13 were men (62%). Mean (SD [range]) age intervention group 29.0 (2.4 [24-31]) years, mean 27.4 (2.1 [27-33]) years. Formal stress-resilience feasible through cultivation stakeholder support. Modified acceptable as evidenced by no attrition; high attendance (12 96 absences [13%] 11 72 [15%] group); significant difference days per week practiced between groups; similar (SD) time groups differences only 1 (control, 28.15 [12.55] minutes; intervention, 15.47 [4.06] minutes;P = .02), 2 23.89 [12.93] 12.61 [6.06] minutes;P = .03), 4 26.26 [13.12] 15.36 [6.13] minutes;P = .04); course satisfaction (based on interviews feedback); posttraining-perceived credibility 18.00 [4.24]; 20.00 [6.55];P = .03). Mindfulness skills integrated into personal professional settings independent continued 12 months follow-up (mean [SD] practice, 3 [1.0]). Conclusions Relevance is center. Interns found concepts useful both personally professionally participation had detrimental effect their or patient care. Trial Registration ClinicalTrials.gov identifier:NCT03141190