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Abstract：
BACKGROUND: Stress and coping influence performance. In this study, we evaluate a novel stress management intervention for surgeons.
METHODS: A randomized control group design was used. Sixteen surgeons were allocated to either the intervention or control group. The intervention group received training on coping strategies, mental rehearsal, and relaxation. Performance measures were obtained during simulated operations and included objective-structured assessment of technical skill, observational teamwork assessment for surgery, and end product assessment rated by experts. Stress was assessed using the state-trait-anxiety-inventory, observer rating, coefficient of heart rate variability (C_HRV), and salivary cortisol. The number of applied surgical coping strategies (number of coping strategies [NC]) was assessed using a questionnaire. A t test for paired samples investigated any within-subject changes, and multiple linear regression analysis explored between-subject effects. Interviews explored surgeons\' perceptions of the intervention.
RESULTS: The intervention group showed enhanced observational teamwork assessment for surgery performance (t = -2.767, P < 0.05), and increased coping skills (t = -4.690, P < 0.01), and reduced stress reflected inheart rate variability (t = -4.008, P < 0.01). No significant changes were identified in the control group. Linear regression analysis confirmed a significant effect on NC (β = -0.739, P < 0.01). Qualitative data analysis revealed improved technical skills, decision making, and confidence.
CONCLUSIONS: The intervention had beneficial effects on coping, stress, and nontechnical skills during simulated surgery.
METHODS: A randomized control group design was used. Sixteen surgeons were allocated to either the intervention or control group. The intervention group received training on coping strategies, mental rehearsal, and relaxation. Performance measures were obtained during simulated operations and included objective-structured assessment of technical skill, observational teamwork assessment for surgery, and end product assessment rated by experts. Stress was assessed using the state-trait-anxiety-inventory, observer rating, coefficient of heart rate variability (C_HRV), and salivary cortisol. The number of applied surgical coping strategies (number of coping strategies [NC]) was assessed using a questionnaire. A t test for paired samples investigated any within-subject changes, and multiple linear regression analysis explored between-subject effects. Interviews explored surgeons\' perceptions of the intervention.
RESULTS: The intervention group showed enhanced observational teamwork assessment for surgery performance (t = -2.767, P < 0.05), and increased coping skills (t = -4.690, P < 0.01), and reduced stress reflected inheart rate variability (t = -4.008, P < 0.01). No significant changes were identified in the control group. Linear regression analysis confirmed a significant effect on NC (β = -0.739, P < 0.01). Qualitative data analysis revealed improved technical skills, decision making, and confidence.
CONCLUSIONS: The intervention had beneficial effects on coping, stress, and nontechnical skills during simulated surgery.
摘要：
背景：压力和应对影响绩效。在这项研究中,我们评估了一种针对外科医生的新型压力管理干预措施.
方法：采用随机对照设计。16名外科医生被分配到干预组或对照组。干预组接受应对策略培训，心理排练,和放松。绩效指标是在模拟操作期间获得的，包括对技术技能的客观结构化评估，观察性的手术团队合作评估，以及由专家评定的最终产品评估。使用状态-特质-焦虑清单评估压力，观察者评级,心率变异性系数(C_HRV)，和唾液皮质醇.使用问卷评估了应用的外科应对策略的数量（应对策略的数量[NC]）。配对样本的t检验调查了受试者内部的任何变化，多元线性回归分析探讨了主体间的影响。访谈探讨了外科医生对干预的看法。
结果：干预组对手术表现的观察性团队合作评估增强（t=-2.767，P<0.05），应对能力提高(t=-4.690,P<0.01),压力降低反映了心率变异性（t=-4.008，P<0.01）。在对照组中没有发现显著的变化。线性回归分析证实对NC有显著影响(β=-0.739,P<0.01)。定性数据分析显示技术技能得到了提高，决策,和信心。
结论：干预对应对有有益作用，压力，模拟手术期间的非技术技能。
方法：采用随机对照设计。16名外科医生被分配到干预组或对照组。干预组接受应对策略培训，心理排练,和放松。绩效指标是在模拟操作期间获得的，包括对技术技能的客观结构化评估，观察性的手术团队合作评估，以及由专家评定的最终产品评估。使用状态-特质-焦虑清单评估压力，观察者评级,心率变异性系数(C_HRV)，和唾液皮质醇.使用问卷评估了应用的外科应对策略的数量（应对策略的数量[NC]）。配对样本的t检验调查了受试者内部的任何变化，多元线性回归分析探讨了主体间的影响。访谈探讨了外科医生对干预的看法。
结果：干预组对手术表现的观察性团队合作评估增强（t=-2.767，P<0.05），应对能力提高(t=-4.690,P<0.01),压力降低反映了心率变异性（t=-4.008，P<0.01）。在对照组中没有发现显著的变化。线性回归分析证实对NC有显著影响(β=-0.739,P<0.01)。定性数据分析显示技术技能得到了提高，决策,和信心。
结论：干预对应对有有益作用，压力，模拟手术期间的非技术技能。
