Mindfulness-based stress reduction for people living with HIV/AIDS: preliminary review of intervention trial methodologies and findings
Mindfulness-based stress reduction for people living with HIV/AIDS: preliminary review of intervention trial methodologies and findings
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DOI：
10.1080/17437199.2014.895928
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发表时间：
2015-01-01
影响因子：
9.8
通讯作者：
Kalichman, Seth
中科院分区：
文献类型：
--
作者：
Riley, Kristen E.;Kalichman, Seth
在成功的抗逆转录病毒治疗（ART）管理艾滋病毒感染的背景下，压力的有害影响仍然是一个重大威胁。压力可能增加病毒复制，抑制免疫反应，阻碍抗逆转录病毒治疗。贫困的紧张生活条件、面临慢性威胁生命的疾病和耻辱都加剧了受艾滋病毒影响人群的慢性压力。迫切需要减轻压力的干预措施，以便对艾滋病毒感染者进行全面护理。正念减压（MBSR）是一种有希望的干预方法，可以帮助面临其他疾病的患者减少疾病进展、心理困扰和适应不良行为。在这篇系统综述中，我们确定了11项研究，这些研究检验了正念减压疗法对hiv阳性人群的干预作用。在这些研究中，6项是随机设计，1项是准实验设计，其余4项是测试前和测试后设计。初步结果支持正念减压疗法减少情绪困扰，但对疾病进展的影响证据不一。效应大小一般为小到中等。这些新兴文献的早期发现必须被认为是初步的，并支持进行更严格的对照试验，在长期随访中进行客观评估，以确定MBSR对艾滋病毒感染者的疗效。
In the context of successful antiretroviral therapy (ART) for the management of HIV infection, the harmful effects of stress remain a significant threat. Stress may increase viral replication, suppress immune response, and impede adherence to ART. Stressful living conditions of poverty, facing a chronic life-threatening illness and stigma all exacerbate chronic stress in HIV-affected populations. Stress-reduction interventions are urgently needed for the comprehensive care of people living with HIV. Mindfulness-based stress reduction (MBSR) is one approach that has shown promise as an intervention for patients facing other medical conditions for reducing disease progression, psychological distress and maladaptive behaviours. In this systematic review, we identified 11 studies that have examined MBSR as an intervention for HIV-positive populations. Of the studies, six were randomised designs, one was a quasi-experimental design, and the remaining four were pre- and post-test designs. The preliminary outcomes support MBSR to decrease emotional distress with mixed evidence for impact on disease progression. Effect sizes were generally small to moderate in magnitude. The early findings from this emerging literature must be considered preliminary and support moving forward with more rigorous controlled trials, evaluated with objective assessments in longer-term follow-ups to determine the efficacy of MBSR for people living with HIV.