Evaluation of a Mindfulness-Based Intervention for Gulf War Illness

海湾战争疾病基于正念的干预措施的评估

• 批准号: 10308423
• 负责人: TRACY L. SIMPSON
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10308423
• 关键词: Aftercare; Alcohol consumption; Attention; Awareness; Behavioral; Caring; Chronic; Chronic Disease; Client satisfaction; Clinical Trials; Cognitive; Cognitive Therapy; Data; Elements; Emotions; Enrollment; Evaluation; Exercise; Failure; Fatigue; Gulf War; Gulf War veteran; Health; Impairment; Intervention; Interview; Measures; Meditation; Memory; Mental Depression; Methods; Military Personnel; Modeling; Musculoskeletal Pain; Outcome; Outcome Measure; Pain; Pain Measurement; Participant; Patient Education; Persian Gulf; Persian Gulf Syndrome; Pilot Projects; Population; Post-Traumatic Stress Disorders; Publishing; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Sampling; Self Management; Standardization; Structure; Symptoms; Thinking; Triad Acrylic Resin; Veterans; active control; affective disturbance; arm; biopsychosocial; bodily sensation; cognitive benefits; depressive symptoms; design; experience; follow-up; group intervention; health related quality of life; insight; marijuana use; mindfulness; mindfulness intervention; mindfulness-based stress reduction; nutrition; peer; persistent symptom; post intervention; primary outcome; programs; public health relevance; reduce symptoms; response; satisfaction; self-management program; substance use; treatment as usual; trial comparing

 DESCRIPTION (provided by applicant): Background: Nearly 700,000 US military personnel were deployed to the Persian Gulf in 1990-1991. At least one fourth report negative health consequences including pain, fatigue, and concentration/mood disturbances, known as Chronic Multisymptom Illness (CMI). Although several studies have examined causes of CMI among Gulf War (GW) Veterans, studies of treatment remain limited. Current CMI management includes an integrative approach informed by the biopsychosocial model, with self-management components. Mindfulness-based interventions (MBIs) teach meditation practices intended to enhance present moment awareness and emphasize continued practices after program completion. A widely available mindfulness program is an 8-week program called Mindfulness-Based Stress Reduction (MBSR). Preliminary evidence suggests that MBIs reduce symptoms of CMI. Another widely available self-management program is the Chronic Disease Self- Management Program (CSMP). Specific Aims: Aim 1: Among GW Veterans with CMI, evaluate if MBSR produces greater improvement than CDSMP in symptoms of CMI (pain, fatigue, cognitive failures) at 6-months post-treatment. Aim 2: Assess patient satisfaction and acceptability of either treatment using a mixed methods approach involving (a) qualitative semi-structured interviews of GW Veterans, and (b) a measure of patient satisfaction. Exploratory Aims: Evaluate if MBSR produces greater improvement than CDSMP in symptoms of CMI among non-GW Veterans, as well as other domains of health for both GW Veterans and non-GW Veterans with CMI. Other domains assessed will be depressive symptoms, PTSD symptoms, substance use, and Health-Related Quality of Life (HRQOL). Additional analyses will explore baseline moderators of response. Design: A randomized controlled trial comparing MBSR to CDSMP. Participants: At least 154 GW Veterans with CMI, and up to 154 non-GW Veterans with CMI. Interventions: Group MBSR or an augmented 8-week version of CDSMP. Hypotheses and Analyses: GW Veterans randomized to MBSR will report significantly greater reductions in pain, fatigue, and cognitive failures at 6-month follow-up as compared to CDSMP, and will be more satisfied with care. Implications: If MBSR is shown to be efficacious for symptoms of CMI among GW Veterans, it would support providing MBSR for this population.

 描述（由申请人提供）： 背景：1990-1991年，近70万美国军事人员被部署到波斯湾。至少有四分之一的人报告了负面的健康后果，包括疼痛，疲劳和注意力/情绪障碍，称为慢性多症状疾病（CMI）。虽然一些研究已经检查了海湾战争（GW）退伍军人中CMI的原因，但治疗研究仍然有限。目前的CMI管理包括一个由生物心理社会模型提供信息的综合方法，其中包括自我管理组件。基于正念的干预（MBIs）教授冥想练习，旨在增强当下意识，并强调在项目完成后继续练习。一个广泛使用的正念计划是一个为期8周的计划，称为正念减压（MBSR）。初步证据表明，MBIs可以减轻CMI的症状。另一个广泛使用的自我管理计划是慢性病自我管理计划（CSMP）。具体目标：目标1：在患有CMI的GW退伍军人中，评估MBSR在治疗后6个月时是否比CDSMP对CMI症状（疼痛、疲劳、认知障碍）产生更大的改善。目标二：使用混合方法评估患者对任一治疗的满意度和可接受性，包括（a）GW退伍军人的定性半结构化访谈和（B）患者满意度测量。探索性目标：评估MBSR是否比CDSMP更能改善非GW退伍军人的CMI症状，以及GW退伍军人和非GW退伍军人的其他健康领域。其他评估领域包括抑郁症状、PTSD症状、物质使用和健康相关生活质量（HRQOL）。其他分析将探索基线缓解调节因素。设计：一项比较正念减压疗法和CDSMP的随机对照试验。参与者：至少154名GW退伍军人与CMI，多达154名非GW退伍军人与CMI。干预措施：小组MBSR或CDSMP的增强8周版本。假设和分析：与CDSMP相比，随机分配至MBSR组的GW退伍军人在6个月随访时报告疼痛、疲劳和认知障碍的减少程度显著更大，并且对护理更满意。意义：如果MBSR被证明是有效的GW退伍军人之间的CMI症状，它将支持为这一人群提供MBSR。