Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis - A randomized trial
Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis - A randomized trial
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DOI：
10.1001/jama.281.14.1304
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发表时间：
1999-04-14
影响因子：
120.7
通讯作者：
Kaell, A
中科院分区：
文献类型：
--
作者：
Smyth, JM;Stone, AA;Kaell, A
在慢性病患者的治疗中，非药物治疗的患者成本或风险很小，是药物治疗的有益补充。研究表明，写下情感创伤经历对症状报告、幸福感、目的采用标准化定量结果测量方法，确定书写压力性生活经历是否影响哮喘或类风湿性关节炎患者的疾病状态。设计1996年10月至1999年12月进行的随机对照试验研究对象：1997年，以门诊社区居民为研究对象，随机抽取112例哮喘（n = 61）和类风湿性关节炎（n = 51）患者作为研究对象。107人完成了研究，哮喘组58例，类风湿性关节炎组49例。他们的生活（n = 71; 39支哮喘，32支类风湿性关节炎）或关于情绪中性的话题（n = 41; 22支哮喘，19支类风湿性关节炎）（对照干预）;主要结果测量哮喘患者用肺活量测定法评估，类风湿性关节炎患者由风湿病学家进行临床检查。在基线、书写后2周、2个月和4个月进行评估，对实验条件不知情。实验组中的哮喘患者显示肺功能改善（1秒用力呼气量[FEV 1]预测值的平均百分比从基线时的63.9%改善至4- 10分钟时的76.3%）。随访1个月; P
Context Nonpharmacological treatments with little patient cost or risk are useful supplements to pharmacotherapy in the treatment of patients with chronic illness. Research has demonstrated that writing about emotionally traumatic experiences has a surprisingly beneficial effect on symptom reports, well-being, and health care use in healthy individuals.Objective To determine if writing about stressful life experiences affects disease status in patients with asthma or rheumatoid arthritis using standardized quantitative outcome measures.Design Randomized controlled trial conducted between October 1996 and December 1997.Setting Outpatient community residents drawn from private and institutional practice.Patients Volunteer sample of 112 patients with asthma (n = 61) or rheumatoid arthritis (n = 51) received the intervention; 107 completed the study, 58 in the asthma group and 49 in the rheumatoid arthritis group.Intervention Patients were assigned to write either about the most stressful event of their lives (n = 71; 39 asthma, 32 rheumatoid arthritis) or about emotionally neutral topics (n = 41; 22 asthma, 19 rheumatoid arthritis) (the control intervention);Main Outcome Measures Asthma patients were evaluated with spirometry and rheumatoid arthritis patients were clinically examined by a rheumatologist. Assessments were conducted at baseline and at 2 weeks and 2 months and 4 months after writing and were done blind to experimental condition.Results Of evaluable patients 4 months after treatment, asthma patients in the experimental group showed improvements in lung function (the mean percentage of predicted forced expiratory volume in 1 second [FEV1] improved from 63.9% at baseline to 76.3% at the 4-month follow-up; P