Mindfulness-Based stress reduction in early palliative care for people with metastatic cancer: A mixed-method study
Mindfulness-Based stress reduction in early palliative care for people with metastatic cancer: A mixed-method study
复制标题
DOI：
10.1016/j.ctim.2019.102218
复制
发表时间：
2019-12-01
影响因子：
3.6
通讯作者：
Bandieri, Elena
中科院分区：
文献类型：
--
作者：
Poletti, Stefano;Razzini, Giorgia;Bandieri, Elena
目的：探讨基于正念的减压 (MBSR) 干预措施对纳入早期姑息治疗 (EPC) 的转移性癌症患者的影响。设计：混合方法研究。设置/地点：2017 年 1 月至 10 月，EPC 服务与意大利卡皮总医院肿瘤科整合。MBSR 干预在医院内进行。受试者：向转介至 EPC 服务的连续 25 名患者提供研究参与。纳入标准：18岁至75岁之间患有转移性癌症的人；知情同意。排除标准：根据卡莫夫斯基量表，绩效状态 < 60%；活动性精神障碍。该研究纳入了 20 名患者。 干预：调整后的计划包括每周一次 8 次每次 2.5 小时的会议、第 6 周和第 7 周之间的 4.5 小时会议以及每天 0.5 小时的家庭练习。培训期间包括以下正念练习：正式静坐冥想、身体扫描、轻瑜伽、步行冥想和合气道练习。为参与者提供了家庭练习材料。一名合格的 MBSR 讲师主持了该计划。参加会议的有一名临床心理学家和一名接受过冥想培训的医生，以及作为协调员的姑息护士。 结果衡量：对 16 名参与者进行了可行性和可接受性评估。此外，还收集了癌症疼痛和情绪状态的前后测量结果。研究结束时，对 8 名参与者进行了半结构化、深入访谈，并使用解释现象学方法进行了分析。结果：MBSR 参加会议和遵守家庭实践的比例为 75%。 MBSR 干预帮助参与者对转移性癌症疾病形成接受态度，帮助他们面对焦虑和癌症疼痛。 MBSR 改善情绪状态的自我调节，产生同情心 MBSR 项目支持参与者质疑并重新连接他们的价值观和精神信仰。结论：将正念干预纳入 EPC 环境是可行的，被广泛接受，可以帮助转移性癌症患者控制癌症疼痛，并提供情感和精神缓解的机会。
Objectives: To explore the impact of a Mindfulness-Based Stress Reduction (MBSR) intervention for people with metastatic cancer integrated in Early Palliative Care (EPC). Design: Mixed-method study.Settings/Location: EPC Service integrated with Oncology Unit, Carpi General Hospital, Italy from January to October 2017. The MBSR intervention took place inside the hospital.Subjects: Study participation was offered to 25 consecutive people referred to the EPC service. Inclusion criteria: people with metastatic cancer between 18 and 75 years old; informed consent. Exclusion criteria: Performance Status < 60% according to Kamofsky scale; active psychiatric disorder. 20 patients were included in the study.Intervention: The adapted program consists of 8 meetings for 2.5 h once a week, a 4.5 h session between the 6th and 7th weeks and 0.5 h home practice daily. The following mindfulness practices were included during the training: formal sitting meditation, body scan, light yoga, walking meditation, and Aikido exercises. Participants were provided with materials for home practice. A qualified MBSR instructor conducted the program. Sessions were attended by a clinical psychologist and a physician trained in meditation, together with the palliative nurse as facilitators.Outcome Measures: Feasibility and acceptability were assessed on 16 participants. In addition, pre-post measures of cancer pain and mood state were collected. Semi-structured, in-depth interviews were conducted on a subset of 8 participants at the end of the study and analysed using the Interpretative-Phenomenological approach.Results: MBSR attendance to meetings and adherence to home practice were 75%. MBSR intervention helped participants to develop an accepting attitude in respect to metastatic cancer disease helping them to face anxiety and cancer pain. MBSR improves self-regulation of mood state engendering feelings of compassion MBSR program supports participants in questioning and reconnecting with their values and spiritual beliefs.Conclusions: A Mindfulness intervention integrated into EPC setting is feasible, well accepted and could help metastatic cancer patients to control cancer pain together with an opportunity of emotional and spiritual relief.