Asthma and Mindfulness-based Stress Reduction (MBSR)

哮喘和正念减压 (MBSR)

• 批准号: 7100419
• 负责人: LORI PBERT
• 金额: $ 32.48万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7100419
• 关键词: asthma; clinical research; reduction; stress

DESCRIPTION (provided by applicant): Asthma is a chronic respiratory disease that affects 7% or 14 million adults in the United States. It is one of the four most common chronic disorders in adults, costing an estimated 7.9 billion dollars in medical care and 5.3 billion dollars in lost work or school. Approximately 40% of asthmatics report using some form of complementary and alternative medicine (CAM) approach to help alleviate their asthma symptoms, but there is little evidence for their effectiveness. Breathing and relaxation techniques, including yoga appear most promising. Mindfulness-based stress reduction (MBSR) is a group-based program developed at the University of Massachusetts Medical School (UMMS) that focuses on the cultivation of mindfulness through formal meditation practices and the integration of mindfulness into everyday life as a coping resource to deal with physical symptoms, chronic medical conditions, and difficult emotional situations. MBSR has been shown to be an effective adjunctive intervention in reducing medical symptoms for a broad range of stress- related disorders and chronic diseases, reducing psychological distress anxiety and depression, and improving quality of life. A small preliminary study conducted by our research team found improvements in measures of quality of life, locus of control, stress, and anxiety immediately following the completion of the MBSR program. The overall goal of the proposed two year exploratory study is to conduct a randomized controlled trial (RCT) to test and optimize recruitment and data collection procedures and to collect preliminary data on the effect of MBSR on behavioral and psychological aspects of asthma and lung function to support justification for a larger clinical trial should the results of this study be promising. Seventy-eight adults ages 21 and older with a physician-documented diagnosis of asthma classified as either mild or moderate documented will be recruited for seventy participants at final follow-up. Participants will be randomly assigned to one of two conditions stratified by asthma severity: (1) MBSR, or (2) Healthy Living Course (HLC) attention control condition. Participant assessments will occur at study entry (baseline) and at 10-week, 6- and 12-month follow-up. The primary aim of the project is to evaluate the efficacy of the MBSR program in improving quality of life and lung function as assessed by change from baseline to two-week average morning peak expiratory flow (PEF) compared to HLC participants. Secondary aims are to evaluate the effect of the MBSR program on reducing asthma rescue medication use, frequency of asthma exacerbations (prednisone therapy), asthma symptoms, healthcare utilization, number of days of work or school missed, peak expiratory flow (PEF) variation, and psychological distress, and in improving asthma control, asthma-related internal locus of control, and lung function as assessed by spirometry (FEV1).

描述（由申请人提供）：哮喘是一种慢性呼吸道疾病，影响美国 7% 或 1400 万成年人。它是成人四种最常见的慢性疾病之一，估计造成 79 亿美元的医疗费用和 53 亿美元的失业或学业损失。大约 40% 的哮喘患者报告使用某种形式的补充和替代医学 (CAM) 方法来帮助缓解哮喘症状，但几乎没有证据表明其有效性。呼吸和放松技巧，包括瑜伽，似乎最有前途。基于正念的减压（MBSR）是马萨诸塞大学医学院（UMMS）开发的一项基于团体的计划，重点是通过正式的冥想练习来培养正念，并将正念融入日常生活中，作为应对身体症状、慢性疾病和困难情绪状况的应对资源。 MBSR 已被证明是一种有效的辅助干预措施，可减少多种与压力相关的疾病和慢性疾病的医学症状，减少心理困扰、焦虑和抑郁，并提高生活质量。我们的研究团队进行的一项小型初步研究发现，在完成 MBSR 计划后，生活质量、控制源、压力和焦虑指标立即得到改善。 拟议的为期两年的探索性研究的总体目标是进行随机对照试验（RCT），以测试和优化招募和数据收集程序，并收集有关 MBSR 对哮喘和肺功能的行为和心理方面的影响的初步数据，以支持在本研究结果有希望的情况下进行更大规模临床试验的合理性。在最终随访时，将招募 78 名年龄在 21 岁及以上且经医生记录诊断为轻度或中度哮喘的成年人作为 70 名参与者。参与者将被随机分配到按哮喘严重程度分层的两种情况之一：(1) MBSR，或 (2) 健康生活课程 (HLC) 注意力控制条件。参与者评估将在研究进入（基线）以及 10 周、6 和 12 个月的随访时进行。该项目的主要目的是评估 MBSR 计划在改善生活质量和肺功能方面的功效，通过与 HLC 参与者相比从基线到两周平均早晨峰值呼气流量 (PEF) 的变化来评估。次要目标是评估 MBSR 计划对减少哮喘抢救药物使用、哮喘发作频率（强的松治疗）、哮喘症状、医疗保健利用率、缺勤或缺课天数、呼气峰流量 (PEF) 变化和心理困扰的效果，以及改善哮喘控制、哮喘相关内部控制点和肺功能的效果（通过评估） 肺活量测定 (FEV1)。