目的 探讨压力管理和韧性训练(stress management and resilience training,SMART )在新型冠状病毒肺炎(简称新冠肺炎)疫情期间对护理学专业留学生的心理韧性和焦虑水平的影响。方法 采用试验对照方法。2020年2月至2020年7月,选取在爱尔兰特拉立理工学院留学的130名护理学专业学生为研究对象。采用计算机随机序号法将其随机分为试验组和对照组,每组65人。试验组学生进行SMART,对照组学生进行常规心理健康干预,每周1次,共12周。干预前和干预后1个月分别对两组学生采用心理弹性量表(connor-davidson resilience scale,CD-RISC)和焦虑自评量表(self-rating anxiety scale,SAS)进行评估。结果 CD-RISC评分,干预前试验组[(65.43±5.58)分]和对照组[(64.22±5.07)分]的差异无统计学意义(t=1.185,P=0.238);干预后试验组[(73.97±6.19)分]高于对照组[(66.45±4.91)分],其差异具有统计学意义(t=7.064,P<0.01)。SAS评分,干预前试验组[(47.18±6.80)分]和对照组[(48.85±5.39)分]的差异无统计学意义(t=-1.429,P=0.156);干预后试验组[(27.91±6.54)分]低于对照组[(34.55±6.82)分],其差异具有统计学意义(t=-5.214,P＜0.01)。结论 SMART可以提升护理专业留学生的心理韧性水平,降低其焦虑水平。
Objective To evaluate the impact of SMART program on resilience and anxiety potentially present in the international nursing students in Ireland during COVID-19 pandemic. Methods Experimental control method was used in this study. From February 2020 to July 2020,one hundred and thirty international nursing students in Institute Technology of Tralee were randomly divided into experimental group and control group with 65 in each. A 12-week SMART program was implemented in the experimental group, and the control group accepted only college regular psychological course. Resilience and anxiety level were measured by CD-RISC(connor-davidson resilience scale)and SAS(self-rating anxiety scale)before and after intervention. Follow-up assessments for two groups were conducted one month after intervention. Results Before the intervention,CD-RISC score of experimental group and control group were [(65.43±5.58)vs.(64.22±5.07)](t =1.185,P=0.238)and there was no statistic difference. After the intervention, CD-RISC score of the experimental group(73.97±6.19) was significantly higher than that of control group(66.45±4.91)(t=7.064,P<0.01). Before intervention,SAS scores of experimental group and control group were [(47.18±6.80)vs.(48.85±5.39)] and there was no significant difference(t=-1.429,P=0.156). After intervention the SAS score of experimental(27.91±6.54) was lower than that of the control group (34.55±6.82).The difference was statistically significant(t=-5.241,P<0.01). Conclusions The resilience of international nursing students in Ireland is enhanced and anxiety level is reduced by SMART program.
[1] Peak CM, Kahn R, Grad YH, et al. Individual quarantine versus active monitoring of contacts for the mitigation of COVID-19: a modelling study[J]. Lancet Infect Dis, 2020,20(9):1025-1033. DOI: 10.1016/S1473-3099(20)30361-3.
[2] Qiu J, Shen B, Zhao M, et al. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations[J]. Gen Psychiatry, 2020,33(2):e100213. DOI: 10.1136/gpsych-2020-100213.
[3] Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China[J]. Psychiatry Research, 2020,287: 112934.DOI:org/10.1016/j.psychres.2020.112934.
[4] Zhai Y, Du X. Mental health care for international Chinese students affected by the COVID-19 outbreak[J] Lancet Psychiatry, 2020, 7:e22. DOI:10.1016/S2215-0366(20)30089-4.
[5] UNESCO. COVID-19educational disruption and response[EB/OL].[2020-04-25].https://en.unesco.org/themes/education-emergencies/coronavirus-school-closures.
[6] Al-Rabiaah A, Temsah MH, Al-Eyadhy AA, et al. Middleeast respiratory syndrome-corona virus (MERS-CoV) associated stress among medical students at a university teaching hospital in Saudi Arabia[J].Infect Public Health, 2020,13(5):687-691. DOI: 10.1016/j.jiph.2020.01.005.
[7] White B,Driver S,Warren AM. Considering resilience in the rehabilitation of people with traumatic disabilities[J]. Rehabilitation Psychology, 2008, 53(1):9-17. DOI:org/10.1037/0090-5550.53.1.9.
[8] Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidsonresilience scale (CD-RISC)[J]. Depress Anxiety, 2003,18(2):76-82. DOI: 10.1002/da.10113.
[9] McCarthy G, Fitzpatrick JJ. Nursing concept analysis: applications to research and practice[M]. New York, NY: Springer Publishing Company,2016:237-240
[10] Southwick SM, Charney DS. The science of resilience: implications for the prevention and treatment of depression[J]. Science, 2012,338(6103):79-82. DOI: 10.1126/science.1222942.
[11] Chesak SS, Bhagra A, Schroeder DR, et al. Enhancing resilience among new nurses: feasibility and efficacy of a pilot intervention[J]. Ochsner J, 2015,15(1):38-44.
[12] Sood A, Prasad K, Schroeder D, et al. Stress management and resilience training amongdepartment of medicine faculty: a pilot randomized clinical trial[J]. J Gen Intern Med, 2011,26(8):858-861. DOI: 10.1007/s11606-011-1640-x.
[13] Sood A, Sharma V, Schroeder DR, et al. Stressmanagement and resiliency training (SMART) program among department of radiology faculty: a pilot randomized clinical trial[J]. Explore (NY), 2014,10(6):358-363. DOI: 10.1016/j.explore.2014.08.002.
[14] Loprinzi CE, Prasad K, Schroeder DR, et al. Stressmanagement and resilience training (SMART) program to decrease stress and enhance resilience among breast cancer survivors: a pilot randomized clinical trial[J]. Clin Breast Cancer, 2011,11(6):364-368. DOI: 10.1016/j.clbc.2011.06.008.
[15] Werneburg BL, Jenkins SM, Friend JL, et al. Improving resiliency in healthcare employees[J]. Am J Health Behaviour, 2018,42(1):39-50. DOI: 10.5993/AJHB.42.1.4.
[16] Werneburg BL, Herman LL, Preston HR, et al. Effectiveness of a multidisciplinary worksite stress reduction programme for women[J]. Stress & Health, 2011, 27(5):356-364. DOI:org/10.1002/smi.1380.
[17] Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidsonresilience scale (CD-RISC)[J]. Depress Anxiety, 2003,18(2):76-82. DOI: 10.1002/da.10113.
[18] Ramirez SZ, Lukenbill J . Psychometricproperties of the zung self-rating anxiety scale for adults with intellectual disabilities (SAS-ID)[J]. Journal of Developmental & Physical Disabilities, 2008, 20(6):573-580. DOI:org/10.1007/s10882-008-9120-x
[19] Zung WW. A rating instrument for anxiety disorders[J]. Psychosomatics, 1971,12(6):371-379. DOI: 10.1016/S0033-3182(71)71479-0.
[20] McAllister M, McKinnon J. The importance of teaching and learning resilience in the health disciplines: a critical review of the literature[J]. Nurse Educ Today, 2009,29(4):371-379. DOI: 10.1016/j.nedt.2008.10.011.
[21] Martineau FP. People-centred health systems: building more resilient health systems in the wake of the Ebola crisis[J]. Int Health, 2016,8(5):307-309. DOI: 10.1093/inthealth/ihw029.
[22] Steinberg BA, Klatt M, Duchemin AM. Feasibility of amindfulness-based intervention for surgical intensive care unit personnel[J]. Am J Crit Care, 2016,26(1):10-18. DOI: 10.4037/ajcc2017444.
[23] Legido-Quigley H, Asgari N, Teo YY, et al. Are high-performing health systems resilient against the COVID-19 epidemic?[J]. Lancet, 2020,395(10227):848-850. DOI: 10.1016/S0140-6736(20)30551-1.
[24] Abdollahi A, Abu Talib M, Yaacob SN, et al. Hardiness as a mediator between perceived stress and happiness in nurses[J]. J Psychiatry Mental Health Nurse, 2014,21(9):789-796. DOI: 10.1111/jpm.12142.
[25] Arrogante O, Aparicio-Zaldivar E. Burnout and health among critical care professionals:the mediational role of resilience[J]. Intensive Crit Care Nurs, 2017,42:110-115. DOI: 10.1016/j.iccn.2017.04.010.
[26] Kutluturkan S, Sozeri E, Uysal N, et al. Resilience and burnout status among nurses working in oncology[J]. Ann Gen Psychiatry, 2016,15:33. DOI: 10.1186/s12991-016-0121-3.
