Mindfulness-based Stress Reduction for Multiple Sclerosis: Feasibility, Durability, and Clinical Outcomes

基于正念的多发性硬化症减压：可行性、持久性和临床结果

• 批准号: 8819744
• 负责人: Angela Senders
• 金额: $ 13.45万
• 依托单位: NATIONAL UNIVERSITY OF NATURAL MEDICINE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-01-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8819744
• 关键词: Address; Adherence; Adopted; Adoption; Affect; Anxiety; Award; Awareness; Behavior; Behavior Therapy; Brain; Chronic; Clinical; Clinical Trials; Conflict (Psychology); Data; Development; Disease; Disease Progression; Education; Enrollment; Ensure; Environmental Risk Factor; Event; Exposure to; Fatigue; Fostering; Funding; Goals; Health; Hour; Impaired cognition; Impairment; Individual; Institution; Intervention; Intervention Trial; Interview; K-Series Research Career Programs; Knowledge; Lead; Lesion; Life; Life Experience; Magnetic Resonance Imaging; Maintenance; Measures; Medicine; Mental Depression; Mentors; Methods; Mind-Body Intervention; Modeling; Modification; Multiple Sclerosis; Neurologic; Outcome; Pain; Participant; Patients; Population; Posture; Protocols documentation; Psychological Stress; Public Health; Qualitative Methods; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Personnel; Resources; SF-36; Stress; Structure; Symptoms; Testing; Time; Training; Translating; Uncertainty; United States; Waiting Lists; Work; Yoga; attenuation; behavior change; body-mind; chronic pain; clinical application; clinical practice; disability; follow-up; improved; mindfulness meditation; mindfulness-based stress reduction; nervous system disorder; novel; patient population; post intervention; primary outcome; programs; psychologic; secondary outcome; skills; stress management; success; symptom management; treatment as usual; young adult

The overall goal of this K23 Mentored Career Development Award is to enhance the candidate's transition to an independent investigator of stress and stress-management for neurological conditions. Psychological stress can have detrimental effects in multiple sclerosis (MS) and is associated with worsening neurological symptoms, increased lesion burden on MRI, and decreased quality of life. Mindfulness-based stress reduction (MBSR) has improved health outcomes across a variety of conditions yet there is limited data regarding MBSR for people with MS or neurological disabilities in general. Furthermore, once the intervention is complete there is conflicting evidence as to the sustainability of MBSR effects over time: some studies show maintenance of effects while others find attenuation over 12 months. To this end, the specific aims of the proposed research are to: 1) Determine the feasibility of MBSR for people with MS, 2) Explore the ability of MBSR to improve quality of life and MS symptoms, and 3) Evaluate the durability of MBSR outcomes over a 12-month follow up. The candidate will conduct a randomized controlled trial of MBSR vs. education control (n=60). For feasibility, specific recruitment, adoption, and adherence criteria will determine success. For preliminary health outcomes, validated measures of perceived stress, quality of life, and common MS symptoms will be compared between MBSR and control participants at eight weeks. For durability, health outcomes will be tracked for 12 months post-intervention. At the close of the study, in-depth interviews with participants will explore actions, psychological outlook, environmental factors, and resources that enhance or deter stress-management maintenance. Qualitative data will provide context for quantitative outcomes and together these results will depict the stability of MBSR and the trajectory of behavior change post-intervention. To ensure her success, the candidate has devised a comprehensive program of mentored research, didactic training, and professional development that focuses on four specific training goals: 1) Gain expertise in mind-body behavioral intervention trials, 2) Advance knowledge in mixed methods and behavior change research, 3) Enhance statistical knowledge and abilities with a Master in Public Health, 4) Continue professional development as a presenter, mentor, and leader in CAM research. This award will provide a unique opportunity for the candidate to work collaboratively with two of the nation’s leading academic research institutions in CAM and conventional medicine. A cross-disciplinary team of experts in MS, mind-body medicine, stress outcomes, and qualitative methods will guide the candidate’s research and advanced training. The proposed research has the potential to improve the clinical application of MBSR, further elucidate the transition from behavior initiation to long-term behavior change, and substantially improve quality of life for people with MS. Findings may not only be applicable to MS but may serve as a model for other conditions with physical limitations or neurological impairments, as well. Importantly, this mentored K23 Career Development Award will prepare the candidate to become a successful, independently funded investigator in stress and stress-management for neurological conditions.

这个K23辅导职业发展奖的总体目标是提高候选人的过渡到压力和压力管理的神经系统疾病的独立调查员。心理压力可能对多发性硬化症（MS）产生有害影响，并与神经系统症状恶化、MRI病变负荷增加和生活质量下降相关。基于正念的减压（MBSR）改善了各种情况下的健康结果，但关于MS或神经残疾患者的MBSR数据有限。此外，一旦干预完成，随着时间的推移，MBSR效果的可持续性存在相互矛盾的证据：一些研究显示效果维持，而另一些研究发现超过12个月的衰减。为此，拟议研究的具体目标是：1）确定MBSR对MS患者的可行性，2）探索MBSR改善生活质量和MS症状的能力，3）评估MBSR结果在12个月随访期间的持久性。候选人将进行MBSR与教育对照的随机对照试验（n=60）。对于可行性，具体的招募、采用和遵守标准将决定成功。对于初步的健康结果，将在八周时比较MBSR和对照参与者之间的感知压力，生活质量和常见MS症状的有效措施。为了持久性，健康结果将在干预后跟踪12个月。在研究结束时，对参与者的深入访谈将探讨增强或阻止压力管理维护的行动，心理展望，环境因素和资源。定性数据将为定量结果提供背景，这些结果将共同描绘正念减压疗法的稳定性和干预后行为变化的轨迹。为了确保她的成功，候选人设计了一个全面的指导研究，教学培训和专业发展计划，重点是四个具体的培训目标：1）获得身心行为干预试验的专业知识，2）推进混合方法和行为改变研究的知识，3）通过公共卫生硕士提高统计知识和能力，4）继续专业发展，成为CAM研究的主持人，导师和领导者。该奖项将为候选人提供一个独特的机会，与CAM和传统医学领域的两个全国领先的学术研究机构合作。在MS，身心医学，压力结果和定性方法的跨学科专家团队将指导候选人的研究和高级培训。拟议的研究有可能改善正念减压疗法的临床应用，进一步阐明从行为启动到长期行为改变的过渡，并大大提高MS患者的生活质量。研究结果不仅适用于MS，还可以作为其他身体限制或神经损伤的模型。重要的是，这个辅导K23职业发展奖将准备候选人成为一个成功的，独立资助的研究人员在压力和压力管理神经系统疾病。