Asthma and Mindfulness-based Stress Reduction (MBSR)

哮喘和正念减压 (MBSR)

• 批准号: 7296132
• 负责人: LORI PBERT
• 金额: $ 39.33万
• 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 2009-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7296132
• 关键词: Absenteeism at work; Accident and Emergency department; Adherence; Adrenergic Agonists; Adult; Affect; Age; Anxiety; Arousal; Asthma; Attention; Behavior; Behavioral; Breathing; Bronchodilator Agents; Caring; Chronic; Chronic Disease; Class; Clinical; Clinical Trials; Complementary Medicine; Complementary and alternative medicine; Condition; Control Locus; Daily; Data; Data Collection; Diagnosis; Disease; Documentation; Effectiveness; Emotional; Exhibits; Feeling; Forced expiratory volume function; Frequencies; Future; Goals; Guidelines; Health; Healthcare; Hospitalization; Information Systems; Institutes; Intervention; Intubation; Lead; Life; Life Cycle Stages; Lung diseases; Massachusetts; Measures; Mechanical ventilation; Medical; Meditation; Mental Depression; Numbers; Office Visits; Outcome; Participant; Patient Self-Report; Patients; Peak Expiratory Flow; Pharmaceutical Preparations; Physicians; Population; Prednisone; Procedures; Protocols documentation; Psychological Stress; Pulmonary Function Test/Forced Expiratory Volume 1; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Range; Rate; Recruitment Activity; Relaxation Techniques; Reporting; Research; Research Personnel; Resources; Respiratory physiology; Schools; Self Management; Severities; Spirometry; Stress; Symptoms; System; Testing; Treatment Protocols; United States; United States National Institutes of Health; Universities; Variant; Visit; Week; Work; Yoga; asthmatic patient; base; coping; cost; day; design; experience; follow-up; health care service utilization; improved; lectures; loris; medical schools; mindfulness-based stress reduction; programs; psychologic; psychological distress; stress related disorder

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。它是成年人四种最常见的慢性疾病之一，估计花费79亿美元用于医疗保健，53亿美元用于失去工作或学校。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）方法来帮助缓解他们的哮喘症状，但几乎没有证据表明其有效性。呼吸和放松技巧，包括瑜伽，似乎最有希望。正念减压（MBSR）是马萨诸塞州大学医学院（UMMS）开发的一个基于小组的项目，专注于通过正式的冥想练习培养正念，并将正念融入日常生活，作为应对身体症状、慢性疾病和困难情绪的应对资源。正念减压疗法已被证明是一种有效的预防性干预措施，可以减少各种压力相关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。我们的研究小组进行的一项小型初步研究发现，在完成MBSR计划后，生活质量、控制点、压力和焦虑的测量指标立即得到改善。 这项为期两年的探索性研究的总体目标是进行一项随机对照试验（RCT），以测试和优化招募和数据收集程序，并收集关于正念减压疗法对哮喘和肺功能的行为和心理方面影响的初步数据，以支持更大规模临床试验的理由，如果这项研究的结果是有希望的。最终随访时，将招募78名年龄在21岁及以上、经医生诊断为轻度或中度哮喘的成年人，用于70名受试者。受试者将被随机分配到两种按哮喘严重程度分层的条件之一：（1）MBSR，或（2）健康生活课程（HLC）注意力控制条件。将在研究入组（基线）以及10周、6个月和12个月随访时进行受试者评估。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疗效，通过与HLC参与者相比，从基线到两周平均晨间呼气峰流量（PEF）的变化进行评估。次要目的是评估正念减压疗法在减少哮喘急救药物使用、哮喘急性发作频率（泼尼松治疗）、哮喘症状、医疗保健利用、工作或学校缺勤天数、呼气峰流量（PEF）变异和心理困扰方面的效果，以及在改善哮喘控制、哮喘相关内控点和肺功能（通过肺量测定法（FEV1）评估）方面的效果。