MS quality of life, depression, and fatigue improve after mindfulness training A randomized trial
MS quality of life, depression, and fatigue improve after mindfulness training A randomized trial
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DOI：
10.1212/wnl.0b013e3181f4d80d
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发表时间：
2010-09-01
期刊：
影响因子：
9.9
通讯作者：
Steiner, C.
中科院分区：
文献类型：
--
作者：
Grossman, P.;Kappos, L.;Steiner, C.
目的：多发性硬化症（MS）患者的健康相关生活质量（HRQOL）通常会大大降低，抑郁、疲劳和焦虑的发生率很高。我们研究了基于正念的干预（MBI）与常规护理（UC）相比对复发缓解型或继发性进展型MS成人HRQOL、抑郁和疲劳的影响。方法：共150例患者随机分配至干预组（n = 76）或UC组（n = 74）。MBI包括一个结构化的8周正念训练计划。在基线、干预后和6个月随访时进行评估。主要结局包括疾病特异性和疾病非特异性HRQOL、抑郁和疲劳。焦虑，个人目标的实现，并坚持家庭作业是次要outcome.Results：attimetry低干预组（5%）和出勤率高（92%）。采用意向治疗分析，与UC相比，MBI在干预后和随访时改善了主要结局的非身体维度（p < 0.002）;效应量，治疗后为0.4-0.9，随访时为0.3-0.5。当在干预前抑郁、疲劳或焦虑的临床相关水平的亚组中重复分析时，干预后和随访效应仍然显著，效应量大于总样本。除了HRQOL和幸福感改善的证据外，这些结果还表明，正念训练的MS患者的程序。结果也可能有其他慢性疾病，减少HRQOL.Classification证据的治疗意义：本试验提供了III级证据，MBI与UC相比，改善HRQOL，疲劳，抑郁症长达6个月postintervention。神经病学（R）2010;75：1141-1149
Objective: Health-related quality of life (HRQOL) is often much reduced among individuals with multiple sclerosis (MS), and incidences of depression, fatigue, and anxiety are high. We examined effects of a mindfulness-based intervention (MBI) compared to usual care (UC) upon HRQOL, depression, and fatigue among adults with relapsing-remitting or secondary progressive MS.Methods: A total of 150 patients were randomly assigned to the intervention (n = 76) or to UC (n = 74). MBI consisted of a structured 8-week program of mindfulness training. Assessments were made at baseline, postintervention, and 6 months follow-up. Primary outcomes included disease-specific and disease-aspecific HRQOL, depression, and fatigue. Anxiety, personal goal attainment, and adherence to homework were secondary outcomes.Results: Attrition was low in the intervention group (5%) and attendance rate high (92%). Employing intention-to-treat analysis, MBI, compared with UC, improved nonphysical dimensions of primary outcomes at postintervention and follow-up (p < 0.002); effect sizes, 0.4-0.9 posttreatment and 0.3-0.5 at follow-up. When analyses were repeated among subgroups with clinically relevant levels of preintervention depression, fatigue, or anxiety, postintervention and follow-up effects remained significant and effect sizes were larger than for the total sample.Conclusions: In addition to evidence of improved HRQOL and well-being, these findings demonstrate broad feasibility and acceptance of, as well as satisfaction and adherence with, a program of mindfulness training for patients with MS. The results may also have treatment implications for other chronic disorders that diminish HRQOL.Classification of evidence: This trial provides Class III evidence that MBI compared with UC improved HRQOL, fatigue, and depression up to 6 months postintervention. Neurology (R) 2010;75:1141-1149