正念干预对护士的影响：关于共情疲劳、职业倦怠和创伤性应激的荟萃分析。
完整摘要 · 中文译文
目的：评估基于正念的干预措施在护士群体中的有效性。 背景：护理实践固有的高强度工作负荷和高情感投入使护士容易罹患同情疲劳、职业倦怠和创伤性应激。 方法：在主要的英文和中文电子数据库中进行系统性文献检索。纳入标准限定为评估基于正念的干预措施对护士同情疲劳、职业倦怠或创伤性应激影响的随机对照试验。检索范围涵盖数据库建库至2025年8月20日的所有文献。在对研究纳入资格进行重新评估后，共7项涉及578名护士的随机对照试验被纳入最终综述和荟萃分析。采用随机效应模型进行定量合成，以考虑研究间预期的临床和方法学异质性。 结果：正念干预与护士的共情疲劳、职业倦怠和创伤应激的显著降低相关。对于共情疲劳，4项研究涉及296名护士纳入合并分析，正念干预与显著较低的共情疲劳评分相关（标准化均数差（SMD）=-1.11，95%置信区间（CI）-1.94至-0.28，p=0.009；I2=91%）。对于职业倦怠，6项研究涉及518名护士显示倦怠评分显著降低（SMD=-0.89，95%CI -1.27至-0.51，p<0.00001；I2=76%）。对于创伤应激，3项研究涉及222名护士显示创伤应激评分显著降低（SMD=-0.99，95%CI -1.27至-0.71，p<0.00001；I2=0%）。由于每项合并分析纳入的研究少于10项，无法可靠评估发表偏倚。 讨论：正念干预似乎可以减轻护士的共情疲劳、职业倦怠和创伤应激。然而，由于可用试验数量有限、方法学问题以及干预方案和结局测量指标的变异性，应谨慎解读这些发现。 结论：正念干预可能是一种有前景的支持性方法，用于改善护士的心理健康。然而，当前证据仍不足以支持将正念干预作为独立的员工干预措施进行常规实施，还需要进一步的高质量多中心随机对照试验。 对护理的启示：基于正念的干预措施可被视为更广泛的职业健康福祉策略中的可选组成部分，其实施应适应当地临床情境，并与解决工作量、人员配置、工作场所条件及心理支持获取途径的组织层面方法相结合。 对护理政策的启示：医疗管理者和护理政策制定者可考虑支持循证心理干预，包括基于正念的方法，作为全面的员工福祉计划的一部分。此类策略应补充而非取代针对职业压力结构性因素的系统层面干预措施。
完整摘要 · 英文原文
AIM: To evaluate the effectiveness of mindfulness-based interventions among nurses. BACKGROUND: The demanding workload and high emotional investment inherent in nursing practice render nurses vulnerable to compassion fatigue, job burnout, and traumatic stress. METHODS: A systematic literature search was conducted across major English and Chinese electronic databases. Eligibility criteria were restricted to randomized controlled trials examining the effects of mindfulness-based interventions on compassion fatigue, job burnout, or traumatic stress among nurses. The search covered all literature from database inception to August 20, 2025. After reassessment of study eligibility, seven randomized controlled trials involving 578 nurses were included in the final review and meta-analysis. Random-effects models were used for the quantitative syntheses to account for anticipated clinical and methodological heterogeneity across studies. RESULTS: Mindfulness-based interventions were associated with significant reductions in compassion fatigue, job burnout, and traumatic stress among nurses. For compassion fatigue, four studies involving 296 nurses contributed to the pooled analysis, with mindfulness-based interventions associated with significantly lower compassion fatigue scores (standardized mean differences (SMD) = -1.11, 95% confidence intervals (CI) -1.94 to -0.28, p = 0.009; I2 = 91%). For job burnout, six studies involving 518 nurses showed a significant reduction in burnout scores (SMD = -0.89, 95% CI -1.27 to -0.51, p < 0.00001; I2 = 76%). For traumatic stress, three studies involving 222 nurses showed a significant reduction in traumatic stress scores (SMD = -0.99, 95% CI -1.27 to -0.71, p < 0.00001; I2 = 0%). Because fewer than ten studies contributed to each pooled analysis, publication bias could not be reliably assessed. DISCUSSION: Mindfulness-based interventions appear to alleviate compassion fatigue, job burnout, and traumatic stress among nurses. However, these findings should be interpreted cautiously because of the limited number of available trials, methodological concerns, and variability in intervention protocols and outcome measures. CONCLUSION: Mindfulness-based interventions may represent a promising supportive approach for improving nurses' psychological well-being. Nevertheless, current evidence remains insufficient to support routine implementation as an independent workforce intervention, and further high-quality multicenter randomized controlled trials are required. IMPLICATIONS FOR NURSING: Mindfulness-based interventions may be considered as an optional component of broader occupational well-being strategies, with implementation adapted to local clinical contexts and combined with organizational approaches addressing workload, staffing, workplace conditions, and access to psychological support. IMPLICATIONS FOR NURSING POLICY: Healthcare administrators and nursing policy-makers may consider supporting evidence-based psychological interventions, including mindfulness-based approaches, as part of comprehensive workforce well-being programs. Such strategies should complement, rather than replace, system-level interventions addressing structural contributors to occupational stress.