온라인 마음챙김 자기연민(SCHC) 프로그램 참여에 관한 외과 수련의 마음챙김과 자기연민 경험: 합의적 질적 분석
Mindfulness and Self-compassion Experiences of Surgical Trainees on Participation in an Online Self-Compassion for Healthcare Communities(SCHC) program: a Consensual Qualitative Analysis
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초록
본 연구는 외과 수련의들이 의료현장에서 경험하는 심리적 고통의 순간을 이해하고, ‘온라인 마음챙김 자기연민(Self-Compassion for Healthcare Communities: SCHC)’ 프로그램 참여에 관한 외과 수련의 마음챙김과 자기연민 경험을 탐색하여 추후 SCHC 프로그램 수정과 적용을 위한 기초자료를 제공하고자 하였다. 이를 위해 경기도 소재의 3차 의료기관에서 전공의 또는 전임의로 근무 중이며 SCHC 프로그램에 참여한 8명에게 면접을 실시하였다. 자료는 합의적 질적 분석 방법(CQR)으로 분석하였고, 그 결과 총 6개의 영역과 31개의 하위범주가 도출되었다. 첫 번째 영역은 ‘마음챙김-자기연민이 도움이 되었던 스트레스와 심리적 고통의 순간’으로, 환자의 상태가 나빠질까 불안, 압박감을 경험할 때, 환자가 사망했을 때 도움된 것으로 나타났다. 두 번째 영역은 ‘SCHC 프로그램 참여 동안의 인식 변화’로 프로그램 참여 동안 참여자들은 고통의 순간 멈추어 자신의 감정과 상황을 명확히 보고, 여유를 찾는 중요성을 알게 되었으며, 자신을 친절히 대하는 대처방법을 알게 된 것으로 나타났다. 세 번째 영역은 ‘SCHC 프로그램 후 일상생활에서의 변화’로 스트레스 상황에서도 위로, 진정됨, 이완됨을 경험한 것으로 나타났다. 네 번째 영역은 ‘수련의가 지각한 도움이 된 세부 프로그램’으로 고통의 순간을 알아차리고 잠시 멈추어 여유를 되찾는 프로그램이 도움된 것으로 나타났다. 다섯 번째 영역은 ‘수련의가 지각한 어려움이나 저항이 생겼던 세부 프로그램’에 대한 것으로 ‘평정심’ 실습이 포함되었다. 여섯 번째 영역은 ‘프로그램 운영에 대한 제안’으로 주로 구성원, 시간, 장소에 대한 의견들이 나타났다.
Abstract
This study aimed understand the moments of psychological distress experienced by surgical trainees in healthcare settings and, to explore the mindfulness and self-compassion experiences of surgical trainees participating in an online ‘Self-Compassion for the Healthcare Communities (SCHC)’ program. Eight surgical trainees working as residents or fellows in tertiary medical institutions in Gyeonggi-do who participated in the SCHC were interviewed. Data analysis followed the Consensus Qualitative Analysis Method (CQR), resulting in six domains and 31 categories. The first domain focused on moments of psychological distress where mindfulness and self-compassion helped. The second domain examined changes in awareness during the SCHC. the third domain explored changes in daily life after the SCHC. The fourth domain discussed helpful program details. The fifth domain addressed program details where difficulties or resistance arose. The sixth domain provided operational suggestions. Finally, the study discussed the significance and limitations, along with suggestions for follow-up studies.
참고문헌 (61)
- 고은미, "마음챙김 척도 비교고찰", 한국심리학회지:일반, 40(1), pp.33~74 (2021), 한국심리학회[DOI]
- 김새롬, "한국 전공의들의 근무환경, 건강, 인식된 환자안전: 2014 전공의 근무환경조사", 보건사회연구, 35(2), pp.584~607 (2015), 한국보건사회연구원[DOI]
- "전공의 10명 중 7명 “피로·과도한 업무 때문에 올바른 진료 못 했다”" (2018)[URL]
- 류석진, "온라인 마음챙김-자비 프로그램(MLCP)이 대학생의 사회불안에 미치는 효과에 대한 질적 분석", 한국명상학회지, 10(1), pp.65~95 (2020), 사단법인 한국명상학회[DOI]
- 박세란, "자존감, 자기자비와 심리적 부적응 및 안녕감의 관계", Korean Journal of Clinical Psychology, 32(1), pp.123~139 (2013), 한국임상심리학회[DOI]
- 서지현, "의과대학 교수들의 탈진: 부산ㆍ경남지역 3개 의과대학 교수 탈진 빈도와 양상", 의학교육논단, 16(2), pp.67~76 (2014), 연세대학교 의과대학
- 신성준, "수련의 성격 유형에 따른 소진 양상", 동국의학, 16(1), pp.185~192 (2009)
- 이금호, "의과대학생의 정신건강과 스트레스 대처방식", Korean Journal of Medical Education, 24(1), pp.55~63 (2012), 한국의학교육학회
- 이수민, "자기자비가 부적응적 완벽주의와 삶의 만족, 우울간의 관계에 미치는 영향", 청소년상담연구, 26(1), pp.343~363 (2018), 한국청소년상담복지개발원[DOI]
- 이수현, "의과대학생의 학업적 자기효능감과 학업 소진의 관계", Korean Journal of Medical Education, 27(1), pp.27~35 (2015), 한국의학교육학회[DOI]
- 이은솔, "과도한 책임감과 강박적 확인행동의 관계에서 불안과 분노억제의 매개효과", 인지행동치료, 20(3), pp.323~343 (2020), 한국인지행동치료학회[DOI]
- 정은경, "전공의의 직무만족도와 관련 요인", Korean Journal of Medical Education, 25(1), pp.39~46 (2013), 한국의학교육학회[DOI]
- 정주리, "의미발견을 통한 의미추구와 주관적 안녕감의 모형 검증: 문제해결 책임감과 긍정적 재해석을 매개로", 상담학연구, 8(4), pp.1309~1321 (2007), 한국상담학회[DOI]
- 조재식, "교육학", 교육과정 연구에서 질적 연구자가 고려해야하는 타당도 이슈들: 그 다양한 접근들의 이해, 2006, pp.24(1), 61~96[DOI]
- 지은, "COVID-19 이후 비대면 심리교육 프로그램에 참여한 대학생의 경험과 인식에 대한 합의적 질적 연구: 스트레스 및 감정관리 프로그램을 중심으로", 아시아교육연구, 22(2), pp.431~457 (2021), 교육연구소
- Amutio-Kareaga, A., "Improving communication between physicians and their patients through mindfulness and compassion-based strategies : a narrative review", Journal of clinical medicine, 6(3), pp.33~ (2017)
- Babenko, O., "Association of physicians’ self-compassion with work engagement, exhaustion, and professional life satisfaction", Medical Sciences, 7(2), pp.29~ (2019)
- Backus, B. E., "Rebuild resilience in emergency physicians to prevent burnout during COVID-19 pandemic", European Journal of Emergency Medicine, 28(4), pp.262~263 (2021)
- Bartholomew, A. J., "Meta-analysis of surgeon burnout syndrome and specialty differences", Journal of surgical education, 75(5), pp.1256~1263 (2018)
- Bluth, K., "Making friends with yourself : A mixed methods pilot study of a mindful self-compassion program for adolescents", Mindfulness, 7(2), pp.479~492 (2016)
- Bluth, K., "Self-compassion training for certified nurse assistants in nursing homes", Journal of the American Geriatrics Society, 69(7), pp.1896~1905 (2021)
- Braehler, C., "Emotion in posttraumatic stress disorder: Etiology, assessment, neurobiology, and treatment", pp.567~596 (2020), Elsevier Academic Press
- Burks, D. J., "The legacy of altruism in health care : The promotion of empathy, prosociality and humanism", Medical Education, 46(3), pp.317~325 (2012)
- Conversano, C., "Mindfulness, compassion, and self-compassion among health care professionals : what's new? A systematic review", Frontiers in psychology, 11, pp.1683~ (2020)
- Danhauer, S. C., "Physician suicide—Reflections on relevance and resilience", JAMA surgery, 155(8), pp.721~722 (2020)
- Dimou, F. M., "Surgeon burnout : a systematic review", Journal of the American College of Surgeons, 222(6), pp.1230~ (2016)
- Dyrbye, L., "A narrative review on burnout experienced by medical students and residents", Medical education, 50(1), pp.132~149 (2016)
- Ellis, R. J., "Comprehensive characterization of the general surgery residency learning environment and the association with resident burnout", Annals of surgery, 274(1), pp.6~11 (2021)
- Elmore, L. C., "National survey of burnout among US general surgery residents", Journal of the American College of Surgeons, 223(3), pp.440~451 (2016)
- Figley, C. R, "Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators", pp.3~28 (1995), The Sidran Press
- Figley, C. R., "Compassion fatigue : Psychotherapists' chronic lack of self care", Journal of clinical psychology, 58(11), pp.1433~1441 (2002)
- Galaiya, R., "Factors associated with burnout syndrome in surgeons : a systematic review", The Annals of The Royal college of surgeons of England, 102(6), pp.401~407 (2020)
- Henry, J. D., "The short-form version of the Depression Anxiety Stress Scales(DASS-21) : Construct validity and normative data in a large non-clinical sample", British journal of clinical psychology, 44(2), pp.227~239 (2005)
- Hill, C. E., "합의적 질적 연구: 사회과학현상 탐구의 실질적 접근" (2016), 학지사
- Hill, C. E., "Consensual qualitative research : An update", Journal of counseling psychology, 52(2), pp.196~ (2005)
- Hill, C. E., "A guide to conducting consensual qualitative research", The counseling psychologist, 25(4), pp.517~572 (1997)
- Huberty, J., "Efficacy of the mindfulness meditation mobile app “calm” to reduce stress among college students: Randomized controlled trial", JMIR mHealth and uHealth, 7(6), pp.e14273~ (2019)
- Imo, U. O., "Burnout and psychiatric morbidity among doctors in the UK : a systematic literature review of prevalence and associated factors", BJPsych bulletin, 41(4), pp.197~204 (2017)
- Ireland, M. J., "A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners", Medical Teacher, 39(4), pp.409~414 (2017)
- Jain, S., "A randomized controlled trial of mindfulness meditation versus relaxation training : effects on distress, positive states of mind, rumination, and distraction", Annals of behavioral medicine, 33(1), pp.11~21 (2007)
- Keng, S. L., "Mechanisms of change in mindfulness-based stress reduction : Self-compassion and mindfulness as mediators of intervention outcomes", Journal of Cognitive Psychotherapy, 26(3), pp.270~280 (2012)
- Lebares CC, "Enhanced stress resilience training in surgeons : iterative adaptation and biopsychosocial effects in 2 small randomized trials", Annals of surgery, 273(3), pp.424~ (2021)
- Lebares, C. C., "Efficacy of mindfulness-based cognitive training in surgery: additional analysis of the mindful surgeon pilot randomized clinical trial", JAMA network open, 2(5), pp.e194108~e194108 (2019)
- Lebares, C. C., "Feasibility of formal mindfulness-based stress-resilience training among surgery interns: a randomized clinical trial", JAMA surgery, 153(10), pp.e182734~e182734 (2018)
- Luton, O. W., "Enhanced stress-resilience training for surgical trainees", BJS open, 5(4) (2021)
- McGaghie, W. C., "Altruism and compassion in the health professions : a search for clarity and precision", Medical teacher, 24(4), pp.374~378 (2002)
- Neff, K. D., "The development and validation of a scale to measure self-compassion", Self and identity, 2(3), pp.223~250 (2003)
- Neff, K. D., "The role of self-compassion in development : A healthier way to relate to oneself", Human development, 52(4), pp.211~ (2009)
- Neff, K. D., "A pilot study and randomized controlled trial of the mindful self-compassion program", Journal of clinical psychology, 69(1), pp.28~44 (2013)
- Neff, K. D., "Self-compassion and psychological resilience among adolescents and young adults", Self and identity, 9(3), pp.225~240 (2010)
- Neff, K. D., "Caring for others without losing yourself : An adaptation of the Mindful Self-Compassion Program for Healthcare Communities", Journal of Clinical Psychology, 76(9), pp.1543~1562 (2020)
- "Medscape physician lifestyle report 2015" (2015)[URL]
- Rimmer A., "Employers must tackle high level of burnout among trainees, says GMC", BMJ (Clinical research ed.), 362, pp.k3018~ (2018)
- Senturk, J. C., "Surgeon burnout : defining, identifying, and addressing the new reality", Clinics in colon and rectal surgery, 32(06), pp.407~414 (2019)
- Shapiro, S. L., "Mindfulness-based stress reduction for health care professionals : results from a randomized trial", International journal of stress management, 12(2), pp.164~ (2005)
- Song, Y., "Can we coach resilience? An evaluation of professional resilience coaching as a well-being initiative for surgical interns", Journal of Surgical Education, 77(6), pp.1481~1489 (2020)
- Van Mol, M. M., "The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review", PloS one, 10(8), pp.e0136955~ (2015)
- Van Wietmarschen, H., "Effects of mindfulness training on perceived stress, self-compassion, and self-reflection of primary care physicians: a mixed-methods study", BJGP open, 2(4) (2018)
- West, C. P., "Physician burnout : contributors, consequences and solutions", Journal of internal medicine, 283(6), pp.516~529 (2018)
- Wiederhold, B. K., "Intervention for physician burnout : a systematic review", Open Medicine, 13(1), pp.253~263 (2018)
- Wiklund Gustin, L., "The butterfly effect of caring–clinical nursing teachers’ understanding of self-compassion as a source to compassionate care", Scandinavian Journal of Caring Sciences, 27(1), pp.175~183 (2013)
