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Burnout in the emergency department: Randomized controlled trial of an attention-based training program

Journal of Integrative Medicine 2019年第3期17卷 173-180页

作者： Pádraic J.Dunne Julie Lynch Lucia Prihodova Caoimhe O'Leary atiyeh ghoreyshi Sharee A.Basdeo Donal J.Cox Rachel Breen Ali Sheikhi áine Carroll Cathal Walsh Geraldine McMahon Barry White Trinity Translational Medicine Institute Trinity College Research Department Royal College of Physicians of Ireland Department of Innovation Fitbit Inc. Health Research Institute Main BuildingUniversity of Limerick Health Service Executive Dr Steevens' Hospital Department of Emergency Medicine St.James' s Hospital National Centre for Hereditary Coagulation Disorders St.James' s Hospital

Background: Burnout(encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.Objective: The aim of this study was to apply an attention-based training(ABT) program to reduce burnout among emergency multidisciplinary team(MDT) members from a large urban hospital.Design, setting, participants and interventions: Emergency MDT members were randomized to either a notreatment control or an intervention group. Intervention group participants engaged in a four session(4 h/session) ABT program over 7 weeks with a practice target of 20 min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device.Main outcome measures: The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters.Results: The ABT program resulted in a significant reduction(P < 0.05; T1 [one week before intervention]vs T3 [follow-up at two months after intervention]) in burnout, specifically, emotional exhaustion, with an effect size(probability of superiority) of 59%. Similar reductions were observed for stress(P < 0.05) and anxiety(P < 0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression.Conclusion: This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group.

关键词： Burnout Emotional exhaustion Meditation Healthcare professional Sleep Stress Cytokines Cortisol Randomized controlled trial

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