Mindfulness-based stress reduction

基于正念的减压
  • 文章类型: Systematic Review
    功能性消化不良是一种常见的功能性胃肠病,通常难以治疗。心理治疗干预已被提议作为常规治疗的替代或辅助方法。但其疗效尚不清楚.
    本系统综述和荟萃分析旨在评估心理治疗干预治疗功能性消化不良的疗效。
    对电子数据库进行了全面检索,从开始到2023年3月,用于评估心理治疗干预对功能性消化不良患者的影响的随机对照试验(RCT)。主要结果指标是胃肠道症状,生活质量,抑郁症,和焦虑。使用ReviewManager5.3软件提取和分析数据。使用Cochrane偏差风险工具评估纳入研究的偏差风险。
    包含1550例功能性消化不良患者的16个RCT纳入荟萃分析。纳入研究中使用的心理治疗干预措施的类型是认知行为疗法(CBT),催眠疗法,和基于正念的减压(MBSR)。对照组进行常规护理,安慰剂,支持疗法,或者没有治疗。荟萃分析显示,心理治疗干预对减轻胃肠道症状有显著作用,功能性消化不良患者的抑郁和焦虑。然而,与对照组相比,接受心理治疗干预的患者的生活质量评分没有显著改善.
    心理治疗干预,比如CBT,催眠疗法,MBSR,可能是功能性消化不良常规治疗的有用辅助手段,因为发现它们可以显着减轻患者的胃肠道症状和焦虑。然而,需要进一步的研究来评估这些干预措施的长期效果和普遍性.
    Functional dyspepsia is a common functional gastrointestinal disorder that is often challenging to treat. Psychotherapeutic interventions have been proposed as an alternative or adjunctive approach to conventional treatments, but their efficacy remains unclear.
    This systematic review and meta-analysis aimed to evaluate the efficacy of psychotherapeutic interventions in the treatment of functional dyspepsia.
    A comprehensive search of electronic databases was conducted, from inception to March 2023, for randomized controlled trials (RCTs) that evaluated the effects of psychotherapeutic interventions on patients with functional dyspepsia. The primary outcome measures were gastrointestinal symptoms, quality of life, depression, and anxiety. Data were extracted and analyzed using Review Manager 5.3 software. The risk of bias of the included studies was assessed using the Cochrane Risk of Bias tool.
    Sixteen RCTs comprising 1550 patients with functional dyspepsia were included in the meta-analysis. The types of psychotherapeutic interventions used in the included studies were cognitive-behavioral therapy (CBT), hypnotherapy, and mindfulness-based stress reduction (MBSR). The control groups were usual care, placebo, supportive therapy, or no treatment. The meta-analysis showed that psychotherapeutic interventions had a significant effect on reducing gastrointestinal symptoms,depression and anxiety in patients with functional dyspepsia. However, no significant improvement was observed in the quality-of-life scores of patients who received psychotherapeutic interventions compared to those in the control group.
    Psychotherapeutic interventions, such as CBT, hypnotherapy, and MBSR, could be a useful adjunct to conventional treatments for functional dyspepsia, as they were found to significantly reduce gastrointestinal symptoms and anxiety in patients. However, further studies are needed to assess the long-term effects and generalizability of these interventions.
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  • 文章类型: Journal Article
    采用生活方式干预措施在冠状动脉疾病(CAD)管理和预防中至关重要,以增强心血管和心理健康。这项研究旨在量化基于正念的干预措施(MBI)对焦虑的影响,CAD患者的抑郁和压力。
    通过搜索四个电子数据库(PubMed,中部,Scopus,和科学直接)到2023年12月。使用PEDro工具评估偏倚风险,研究结果以95%CI时的标准平均差表示。
    在1838年产生的结果中,涉及623名参与者的8项RCT符合预设的合格标准,参与者平均年龄为56.96±4.89.汇总结果显示,MBI对CAD患者的心理健康状况在焦虑方面具有统计学意义和有益的影响(SMD=-0.83;95%CI[-1.19,-0.46],p<0.001),抑郁症(SMD=-0.86;95%CI[-1.14,-0.58],p<0.001),和应力(SMD=-0.69;95%CI[-1.27,-0.12],p=0.02)。基于区域的亚组敏感性分析(亚洲与欧洲)表明MBIs对焦虑的亚组效应在统计学上不显着(I2=63.9%,p=0.10)和抑郁(I2=25.8%,p=0.25),对应力有显著影响(I2=80.0%,p=0.03)。尽管试验的方法学质量总体上令人满意,所有研究均缺乏分组隐藏和致盲.此外,性别失衡,而不充分的随访可能会影响试验的有效性.
    基于正念的干预措施有利于改善CAD患者的焦虑,抑郁症和压力症状。然而,必须进行更严格和可靠的研究,性别比例相等,并进行长期随访。
    UNASSIGNED: Adopting lifestyle interventions is pivotal in coronary artery disease (CAD) management and prevention to amplify cardiovascular and mental well-being. This study aims to quantify the effect of mindfulness-based interventions (MBIs) on anxiety, depression and stress in CAD patients.
    UNASSIGNED: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching four electronic databases (PubMed, CENTRAL, Scopus, and Science Direct) through December 2023. The risk of bias was assessed using the PEDro tool, and the study outcomes were expressed as standard mean difference at 95% CI.
    UNASSIGNED: Out of 1838 yielded results, eight RCTs involving 623 participants with a mean age of 56.96 ± 4.89 met the prespecified eligibility criteria. The pooled results showed a statistically significant and beneficial effect of MBIs on CAD patients\' mental health status in regards to anxiety (SMD = -0.83; 95% CI [-1.19, -0.46], p < 0.001), depression (SMD = - 0.86; 95% CI [-1.14, -0.58], p < 0.001), and stress (SMD = -0.69; 95% CI [-1.27, -0.12], p = 0.02). The subgroup sensitivity analyses based on the region (Asia vs. Europe) indicated a statistically non-significant subgroup effect of MBIs on anxiety (I 2 = 63.9%, p = 0.10) and depression (I 2 = 25.8%, p = 0.25), and a significant effect on stress (I 2 = 80.0%, p = 0.03). Although the methodological quality of the trials was generally satisfactory, all studies lacked allocation concealment and blinding. Additionally, gender imbalances, and inadequate follow-up may have potentially compromised the validity of the trials.
    UNASSIGNED: Mindfulness-based interventions are beneficial for improving CAD patients\' anxiety, depression and stress symptoms. Nevertheless, it is imperative to conduct more rigorous and robust studies with an equal gender ratio and long-term follow-up.
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  • 文章类型: Journal Article
    抑郁症是大学生中常见的症状,并且经常伴随着对自己的负面想法。自我同情是学生可以用来对抗这些消极想法的一种技术。自我同情是一种情绪调节策略,个人参与自我善良,尤其是在一个错误之后,失败,和/或拒绝。本文回顾了自我同情的概念,自我同情的评估,以及被证明可以增加自我同情的干预措施。自我同情与较低水平的精神病理学和较高水平的幸福感有关。从理论上讲,它是通过在错误后对自我批评的反思过程进行缓冲来工作的,失败,和/或拒绝。自我同情通常是通过一个经过验证的量表来评估的,该量表衡量整体的自我同情及其六个子量表:自我善良,共同的人性,正念,自我判断,隔离,和过度识别。多种自我同情干预已被证明可以增加自我同情并改善心理健康。这些干预措施多种多样,包含正念冥想等策略,慈爱的善良冥想,改变自我对话。这些干预措施和实际策略的细节,学生,和教授可以用来增加自我同情心的描述。总的来说,自我同情是一个有价值的工具,可以帮助个人应对错误,失败,和/或拒绝。
    Depression is a common symptom among college students and is often accompanied by negative thoughts about oneself. Self-compassion is a technique students can use to combat those negative thoughts. Self-compassion is an emotion-regulation strategy in which the individual engages in self-kindness, particularly after a mistake, failure, and/or rejection. This paper reviews the concept of self-compassion, assessment of self-compassion, and interventions that have been shown to increase self-compassion. Self-compassion is associated with lower levels of psychopathology and higher levels of well-being. It is theorized to work by buffering against a self-critical ruminative process after a mistake, failure, and/or rejection. Self-compassion is most commonly assessed through a validated scale that measures overall self-compassion and its six subscales: self-kindness, common humanity, mindfulness, self-judgment, isolation, and over-identification. Multiple self-compassion interventions have been shown to increase self-compassion and improve psychological health. These interventions are varied and contain strategies such as mindfulness meditation, loving kindness meditation, and changing self-talk. Details of those interventions and practical strategies that individuals, students, and professors can use to increase self-compassion are described. Overall, self-compassion is a valuable tool that can help individuals cope with mistakes, failure, and/or rejection.
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  • 文章类型: Journal Article
    背景:正念作为一种模态涉及训练人类天生的当下意识能力,以期培养更加和谐和综合的生活体验,尤其是在困难面前。在过去的四十年里,正念领域发展迅速。尽管大量文献概述了正念练习在各种背景和人群中的许多好处,作者注意到,针对适应的研究,基于正念的干预措施(MBI)在社会经济挑战环境中对成年人的应用和价值很少.为了解决这个差距,我们对低社会经济环境中与MBIs有关的研究进行了现实性审查,确定该部门研究的范围和性质,并最终形成一个可能对未来干预措施设计有用的计划理论。
    方法:我们选择现实主义综述作为方法,因为它非常适合调查社会干预的复杂性。现实主义审查的价值在于,在特定背景下(C)对特定结果(O)的机制(M)之间的因果关系的探索提供了对干预的更深入的理解,这可能有助于更有效地交付。审查遵循现实主义和元叙事证据综合-演进标准项目提出的指南。
    结果:在确定的112个文档中,12篇文章符合纳入标准。在这12项研究中,10在美国进行,在全球其他地区几乎没有代表性。这些文章中描述的干预措施各不相同。我们确定了在各种情况下为参与者提供有益成果的机制,有迹象表明干预措施可能如何适应更大的可及性,可接受性,社区内的可行性。
    结论:通过在各自的上下文中回顾各种程序,我们开发了一种程序理论,用于在低社会经济环境中实施社会文化适应的MBI。在未来,这个程序理论可以作为一种手段来创造一种幸福的感觉,生活在低社会经济环境中的人进行测试。
    BACKGROUND: Mindfulness as a modality involves training the innate human capacity for present-moment awareness with a view to cultivating a more harmonious and integrated life experience, especially in the face of hardship. Over the past four decades, the field of mindfulness has grown rapidly. Despite a substantial body of literature outlining the many benefits of mindfulness practice within a range of contexts and populations, the authors noticed that studies addressing the adaptation, application and value of mindfulness-based interventions (MBIs) for adults within socio-economically challenged setting were scant. To address this gap, we conducted a realist review of studies pertaining to MBIs within low socio-economic settings, to determine the extend and nature of research in this sector and culminating in a program theory which may be useful for the design of interventions going forward.
    METHODS: We selected realist review as the methodology as it is well suited to investigating the complex nature of social interventions. The value of realist review is that the exploration of the causal relationships between the mechanisms (M) within a specific context (C) towards particular outcomes (O) offers a deeper understanding of the intervention which may assist in more effective delivery going forward. The review follows the guidelines presented by the Realist and Meta-narrative Evidence Synthesis - Evolving Standards project.
    RESULTS: Of the 112 documents identified, 12 articles met the inclusion criteria. Of these 12 studies, 10 were conducted in the United States, with little representation across the rest of the globe. The interventions described in these articles were varied. We identified mechanisms that offered beneficial outcomes for participants across a range of contexts, with indications of how interventions might be adapted towards greater accessibility, acceptability, and feasibility within communities.
    CONCLUSIONS: By reviewing the various programs in their respective contexts, we developed a program theory for implementing socio-culturally adapted MBIs in low socio-economic settings. In the future, this program theory could be tested as a means to create a sense of wellbeing for people living in low socio-economic settings.
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  • 文章类型: Meta-Analysis
    引言偏头痛是一种以复发性为特征的神经系统疾病,通常伴有其他症状的严重头痛。有多种因素可以引发患者的偏头痛。压力可能是这样的触发因素。药物和非药物治疗可用于偏头痛的预防性治疗。根据德国的指导方针,正念可以推荐用于预防偏头痛。因此,目的是研究MBSR在成年偏头痛患者中与患者相关结局的关系.在这种情况下,患者相关的结果是偏头痛频率,偏头痛发作时的头痛强度,抑郁症状和生活质量。材料和方法本研究的开展以PRISMA2020声明为指导。2021年12月,在三个数据库中进行了关于MBSR在成年偏头痛患者中有效性的随机对照试验的系统文献搜索:MEDLINEviaPubMed,Cochrane图书馆,和WebofScience。此外,我们对参考文献列表进行了回顾,并检索了研究登记.最后一次搜索是在2022年10月7日进行的。在两步过程中,根据预定义的纳入和排除标准选择研究.使用Cochrane偏差风险工具2评估偏差的可能性。通过描述性和定量合成对结果进行了总结。结果共纳入4项RCTs,共275例患者和其中一项研究的随访出版物。一项研究中的偏倚风险均被判断为较低或值得关注,两项研究都很高。4项研究纳入定量分析。对于终点偏头痛频率,三项研究的荟萃分析总结未能显示MBSR的统计学显著获益(SMD-0.23;95%CI-0.79~0.32).对于终点抑郁症状,三项研究的荟萃分析总结显示MBSR具有统计学意义(SMD-0.59;95%CI-0.93~-0.25).没有研究检查偏头痛发作期间头痛的严重程度。结论偏头痛患者可从MBSR中获益。然而,目前证据基础不足以推荐使用MBSR作为非药物治疗方案.进一步充分供电,需要高质量的RCT。
    BACKGROUND: Migraine is a neurological disorder characterized by recurrent, severe headaches that are often accompanied by other symptoms. There are various factors that can trigger a migraine in sufferers. Stress can be such a trigger. Drug and nondrug treatments are available for the preventive treatment of migraine. According to a German guideline, mindfulness can be recommended for the prophylaxis of migraine. Therefore, the aim was to investigate the effectiveness of mindfulness-based stress reduction (MBSR) in relation to patient-relevant outcomes in adult patients with migraine. Patient-relevant outcomes in this context are migraine frequency, headache intensity during a migraine attack, depressive symptoms, and quality of life.
    METHODS: The conduct of this study was guided by the PRISMA 2020 statement. A systematic literature search for randomized controlled trials (RCTs) of the effectiveness of MBSR in adult migraine patients was conducted in December 2021 in three databases: MEDLINE via PubMed, the Cochrane Library, and Web of Science. In addition, a review of reference lists and a search of study registries were performed. The last search was conducted on October 7, 2022. In a two-step process, studies were selected based on predefined inclusion and exclusion criteria. The potential for bias was assessed using the Cochrane Risk of Bias Tool 2. The results were summarized descriptively and by means of quantitative synthesis.
    RESULTS: Four RCTs with a total of 275 patients and the follow-up publication of one of these studies were included. The risk of bias in one study each was judged to be low or of some concern and high in two studies. Four studies were included in the quantitative analysis. For the endpoint migraine frequency, the meta-analytic summary of three studies failed to show a statistically significant benefit for MBSR (SMD: -0.23; 95% CI: -0.79 to 0.32). For the endpoint depressive symptoms, a meta-analytic summary of three studies showed a statistically significant benefit for MBSR (SMD: -0.59; 95% CI: -0.93 to -0.25). No study had examined the severity of headaches during a migraine episode.
    CONCLUSIONS: Some results suggest that migraine patients may benefit from MBSR. However, the evidence base is currently insufficient for recommendations on the use of MBSR as a nondrug treatment option. Further adequately powered, high-quality RCTs are needed.
    EinleitungMigräne ist eine neurologische Erkrankung, die durch wiederkehrende, starke Kopfschmerzen gekennzeichnet ist, die häufig von anderen Symptomen einhergehen. Es gibt verschiedene Faktoren, die bei den Betroffenen eine Migräne auslösen können. Ein solcher Auslöser kann Stress sein. Für die präventive Behandlung der Migräne stehen medikamentöse und nichtmedikamentöse Verfahren zur Verfügung. Laut einer deutschen Leitlinie kann Achtsamkeit zur Prophylaxe von Migräne empfohlen werden. Ziel der Studie war es daher, die Wirksamkeit von achtsamkeitsbasierter Stressreduktion (MBSR) in Bezug auf patientenrelevante Outcomes bei erwachsenen Migränepatienten zu untersuchen. Patientenrelevante Outcomes in diesem Zusammenhang sind Migränehäufigkeit, Kopfschmerzintensität während einer Migräneattacke, depressive Symptome und Lebensqualität.MethodenDie Durchführung dieser Studie orientierte sich am PRISMA-Statement. Eine systematische Literatursuche nach randomisierten kontrollierten Studien zur Wirksamkeit von MBSR bei erwachsenen Migränepatienten wurde im Dezember 2021 in drei Datenbanken durchgeführt: MEDLINE über PubMed, die Cochrane Library und Web of Science. Darüber hinaus wurden Referenzlisten und Studienregister durchsucht. Die letzte Suche erfolgte am 7. Oktober 2022. In einem zweistufigen Verfahren wurden die Studien anhand von vordefinierten Ein- und Ausschlusskriterien ausgewählt. Das Verzerrungspotential der Studien wurde mit dem Cochrane Risk of Bias Tool 2 bewertet. Die Ergebnisse wurden deskriptiv und mit Hilfe einer quantitativen Synthese zusammengefasst.ErgebnisseEs wurden vier randomisiert-kontrollierte Studien mit insgesamt 275 Patienten und die Nachfolgepublikation einer dieser Studien eingeschlossen. Das Verzerrungspotential wurde bei je einer Studie als gering oder bedenklich und bei zwei Studien als hoch eingestuft. Vier Studien wurden in die quantitative Analyse einbezogen. Für den Endpunkt Migränehäufigkeit ergab die metaanalytische Zusammenfassung von drei Studien keinen statistisch signifikanten Vorteil für MBSR (SMD −0.23; 95% CI −0.79 bis 0.32). Für den Endpunkt depressive Symptome zeigte eine metaanalytische Zusammenfassung von drei Studien einen statistisch signifikanten Vorteil für MBSR (SMD −0.59; 95% CI −0.93 bis −0.25). Keine Studie hatte die Schwere der Kopfschmerzen während einer Migräneepisode untersucht.SchlussfolgerungEinige Ergebnisse deuten darauf hin, dass Migränepatienten von MBSR profitieren können. Allerdings ist die Evidenzbasis derzeit nicht ausreichend, um Empfehlungen für den Einsatz von MBSR als nichtmedikamentöse Behandlungsoption abzuleiten. Es werden daher weitere qualitativ hochwertige randomisiert-kontrollierte Studien mit ausreichender statistischer Power benötigt.
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  • 文章类型: Journal Article
    目的:确定接受和基于正念的干预措施对偏头痛残疾的疗效,药物使用,攻击频率。
    背景:基于接受的头痛管理方法是指在不控制疼痛本身的情况下,个体学会减轻疼痛相关经历对其一般功能的影响。治疗方法包括接受和承诺疗法(ACT)和基于正念的实践。两者都显示出改善头痛患者广泛功能和残疾的希望。尽管越来越多的研究广泛检查了基于接受的头痛干预措施,特别是偏头痛,不存在对头痛的ACT干预措施的荟萃分析综述,和两个基于正念的实践的元分析评论产生了相互矛盾的结果。
    方法:本研究旨在系统和定量地回顾与基于接受的干预措施在成人偏头痛患者中的疗效相关的文献。多数据库搜索(PubMed/MEDLINE,Scopus,PsycINFO,和Cochrane中央对照试验登记册)确定了偏头痛患者的临床试验,该试验将结构化ACT或基于正念的干预措施与对照治疗进行了比较。随机效应荟萃分析使用RevMan5.4荟萃分析软件进行,和标准化平均差异(SMD),95%置信区间(CI)量化的影响大小对残疾的结果,药物使用,头痛的频率异质性通过I2指数量化,并通过亚组分析进行探索。
    结果:基于接受的干预措施显着改善了残疾(SMD=-0.38,95%CI=-0.56至-0.20;I2=25%,p=0.20),但不在药物使用中(SMD=-0.25,95%CI:-0.57至0.06;I2=0%,p=0.82)或头痛频率(SMD=-0.16,95%CI=-0.37至0.05;I2=0%,p=0.73)。
    结论:结果表明,基于接受的干预措施可有效改善成人偏头痛患者的残疾,并且是一种可行的非药物治疗选择。除了完善的行为偏头痛管理方法,为寻求功能改善的患者。
    OBJECTIVE: To determine the efficacy of acceptance and mindfulness-based interventions on migraine disability, medication use, and attack frequency.
    BACKGROUND: Acceptance-based approaches to headache management are those in which individuals learn to mitigate the influence of pain-related experiences on their general functioning without controlling pain itself. Treatment approaches include acceptance and commitment therapy (ACT) and mindfulness-based practices. Both have shown promise in improving broad functioning and disability among individuals with headache. Despite a growing body of research examining acceptance-based interventions for headache broadly and migraine specifically, no meta-analytic review of ACT interventions for headache exists, and two meta-analytic reviews of mindfulness-based practices yielded conflicting results.
    METHODS: The present study aimed to systematically and quantitatively review the literature related to the efficacy of acceptance-based interventions among adults with migraine. A multi-database search (PubMed/MEDLINE, Scopus, PsycINFO, and the Cochrane Central Register of Controlled Trials) identified clinical trials among individuals with migraine that compared structured ACT or mindfulness-based interventions to control treatment. Random-effects meta-analyses were performed using RevMan 5.4 meta-analytic software, and standardized mean differences (SMD) with 95% confidence intervals (CIs) quantified effect sizes on outcomes of disability, medication use, and headache frequency. Heterogeneity was quantified via I2 index and explored via subgroup analyses.
    RESULTS: Acceptance-based interventions yielded significant improvements in disability (SMD = -0.38, 95% CI = -0.56 to -0.20; I2  = 25%, p = 0.20) but not in medication use (SMD = -0.25, 95% CI: -0.57 to 0.06; I2  = 0%, p = 0.82) or headache frequency (SMD = -0.16, 95% CI = -0.37 to 0.05; I2  = 0%, p = 0.73).
    CONCLUSIONS: Results suggest that acceptance-based interventions are effective in improving disability among adults with migraine and are a viable non-pharmacological treatment option, in addition to well-established behavioral migraine management approaches, for patients seeking functional improvement.
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  • 文章类型: Meta-Analysis
    背景:医学院已经使用正念冥想作为一种策略来帮助学生进行压力管理。这项研究旨在寻求有关基于正念的培训计划在减少心理困扰和促进医学生福祉方面的有效性的证据。
    方法:我们进行了系统评价和荟萃分析。科克伦图书馆,Embase,PubMed/MEDLINE,PsycINFO/PsycNet,LILACS/BVS,ERIC(ProQuest),WebofScience,OpenGrey,和GoogleScholar被搜索到2022年3月之前发表的随机临床试验,没有时间或语言限制。两位作者独立筛选了文章,使用标准化的提取表格提取数据,并使用Cochrane的偏差风险2(ROB2)工具评估纳入研究的方法学质量,以及使用建议分级评估的证据质量,发展,和评估(等级)工具。
    结果:在检索到的848篇文章中,8符合纳入标准。基于正念的训练改善了结果:正念(小的干预后效果:SMD=0.29;95%CI:0.03至0.54;p=0.03;I2=46%;高证据质量,随访效果小:SMD=0.37;95%CI:0.04至0.70;p=0.03;I2=53%;证据质量低),心理健康/健康(干预后效果组间无统计学差异:SMD=-0.27;95%CI:-0.67至0.13;p=0.18;I2=76%;中等证据质量,随访时存在显着差异:SMD=-0.73;95%CI:-1.23至-0.23;p=0.004;I2=61%;证据质量低),和压力(干预后效应小:SMD=-0.29;CI为95%:-0.56至-0.02;p=0.04;I2=57%;中等证据质量,随访时的中度效果:SMD=-0.45,95%CI:-0.67至-0.22,p=0.0001,I2=0%,中等证据质量)。焦虑的证据质量,抑郁症,弹性结果很低,对于移情结果,非常低。
    结论:结果表明,参加正念训练的学生感觉到压力和心理困扰症状的改善,健康感知和心理健康得到改善。然而,在解释这些发现时,应考虑研究之间的显著异质性.
    背景:PROSPEROCRD42020153169.
    Medical schools have used mindfulness meditation as a strategy to assist students in stress management. This study aimed to seek evidence regarding the effectiveness of mindfulness-based training programs in reducing psychological distress and promoting the well-being of medical students.
    We conducted a systematic review and meta-analysis. Cochrane Library, Embase, PubMed/MEDLINE, PsycINFO/PsycNet, LILACS/BVS, ERIC (ProQuest), Web of Science, OpenGrey, and Google Scholar were searched for randomized clinical trials published until March 2022, without time or language restrictions. Two authors independently screened the articles, extracted data using a standardized extraction form, and assessed the methodological quality of the included studies using the Cochrane\'s Risk of Bias 2 (ROB 2) tool and the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.
    Of the 848 articles retrieved, 8 met the inclusion criteria. Mindfulness-based training improved the outcomes: mindfulness (small post-intervention effect: SMD = 0.29; 95% CI: 0.03 to 0.54; p = 0.03; I2 = 46%; high evidence quality, and small effect at follow-up: SMD = 0.37; 95% CI: 0.04 to 0.70; p = 0.03; I2 = 53%; low evidence quality), psychological well-being/health (there was no statistically significant difference between the groups in the post-intervention effect: SMD =  - 0.27; 95% CI: - 0.67 to 0.13; p = 0.18; I2 = 76%; moderate evidence quality, and a significant difference at follow-up: SMD =  - 0.73; 95% CI: - 1.23 to - 0.23; p = 0.004; I2 = 61%; low evidence quality), and stress (small post-intervention effect: SMD =  - 0.29; CI of 95%: - 0.56 to - 0.02; p = 0.04; I2 = 57%; moderate evidence quality, and moderate effect at follow-up: SMD =  - 0.45, 95% CI: - 0.67 to - 0.22, p = 0.0001, I2 = 0%, moderate evidence quality). The quality of evidence for the anxiety, depression, and resilience outcomes is low and for the empathy outcome, very low.
    The results indicate that the students who participated in the mindfulness training perceived improvements in the stress and psychological distress symptoms and improved health perception and psychological well-being. However, the significant heterogeneity among studies should be considered when interpreting these findings.
    PROSPERO CRD42020153169.
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  • 文章类型: Journal Article
    鉴于持续的职业压力因素和医疗保健服务中的多重挑战,人们越来越关注医护人员的福祉。应对这些挑战需要多管齐下,专注于系统层面,组织,和个人行为。积极心理学干预(PPI)代表了个人行动的一个有希望的领域。这项系统评价表明,PPI,通过许多方法交付,有望改善医护人员的福祉,尽管显然需要使用明确和标准化的结局指标进行更多的随机对照试验.在这次审查中,最常评估的PPI是基于正念或基于感恩的干预措施.这些是通过不同的方法交付的,许多人在工作场所进行管理,通常以两天至八周的课程形式进行。研究人员记录了多项研究结果的可衡量改善,注意到抑郁症状的减轻,焦虑,倦怠,和压力。一些干预措施增加了福祉,工作和生活满意度,自我同情,放松,和韧性。大多数研究强调这些都很简单,可访问,低成本干预措施。限制包括一些非随机或准实验设计,除了通常样本量小和干预交付方法不同之外。另一个问题是缺乏标准化的结果评估和长期后续数据。由于几乎所有研究都是在大流行之前进行的,大流行后将需要进一步的研究。总的来说,然而,PPI有望成为改善医护人员福祉的多管齐下的方法之一。
    Given persistent occupational stressors and multiple challenges in the delivery of healthcare, there is an increased focus on the well-being of healthcare workers. Responding to these challenges will require a multipronged approach, focusing on system level, organization, and individual actions. Positive psychology interventions (PPIs) represent a promising area for individual action. This systematic review indicates that PPI, delivered via many methods, holds promise for improving the well-being of healthcare workers, although there is a clear need for additional randomized controlled trials utilizing defined and standardized outcome measures. In this review, the most commonly evaluated PPIs were mindfulness-based or gratitude-based interventions. These were delivered via different methods, with many administered in the workplace and commonly in the form of courses ranging from two days to eight weeks. Researchers documented measurable improvements in multiple studied outcomes, noting reductions in symptoms of depression, anxiety, burnout, and stress. Some interventions increased well-being, job and life satisfaction, self-compassion, relaxation, and resilience. Most studies emphasized that these are simple, accessible, low-cost interventions. Limitations included some nonrandomized or quasi-experimental designs, alongside generally small sample sizes and varying methods of intervention delivery. Another concern is the lack of standardized outcome assessments and long-term follow-up data. As almost all studies included were performed before the pandemic, further research will be required post-pandemic. Overall, however, PPI shows promise as one arm of a multipronged approach to improving the well-being of healthcare workers.
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  • 文章类型: Journal Article
    背景:肺癌是最常见的癌症之一,对患者的身体和心理构成威胁。基于正念的干预是一种新兴的心理治疗形式,可以有效改善身体和心理症状,但是没有评论总结它们对焦虑的有效性,抑郁症,肺癌患者的疲劳。
    目的:评估基于正念的干预措施在减少焦虑方面的有效性,抑郁症,肺癌患者的疲劳。
    方法:系统评价和荟萃分析。
    方法:我们搜索了PubMed,WebofScience,Embase,中国生物医药光盘,万方数据,中国国家知识基础设施,和中国科技期刊数据库从成立到2022年4月13日。符合条件的研究包括肺癌患者接受基于正念的干预措施的随机对照试验,报告焦虑的结果。抑郁症,和疲劳。两名研究人员独立审查了摘要和全文,提取数据并使用Cochrane“偏倚风险评估工具”独立评估偏倚风险。使用ReviewManager5.4进行荟萃分析,并通过标准化平均差及其95%置信区间计算效应大小。
    结果:系统评价包括25项研究(2420名参与者),而荟萃分析包括18项研究(1731名参与者).基于正念的干预措施显着降低了焦虑水平[标准化平均差=-1.15,95%置信区间(-1.36,-0.94),Z=10.75,P<0.001],抑郁[标准化平均差=-1.04,95%置信区间(-1.60,-0.48),Z=3.66,P<0.001],和疲劳[标准化平均差=-1.29,95%置信区间(-1.66,-0.91),Z=6.79,P<0.001]。亚组分析表明,具有结构化干预成分的计划持续时间少于八周(例如,基于正念的减压和基于正念的认知疗法)和在晚期肺癌患者中实施45分钟的每日家庭实践比持续超过8周的计划效果更好,其中结构成分较少,在混合期肺癌患者中实施超过45分钟的每日家庭实践。在大多数研究中,由于缺乏分配隐蔽性和致盲性以及偏倚的高风险(80%),证据的总体质量较低。
    结论:基于正念的干预措施可能有效减少焦虑,抑郁症,肺癌患者的疲劳。然而,我们无法得出明确的结论,因为证据的整体质量较低.需要更严格的研究来确认有效性,并检查哪些干预成分可能对改善结果最有效。
    BACKGROUND: Lung cancer is one of the most common cancers and poses a physical and psychological threat to patients. Mindfulness-based interventions are emerging forms of psychotherapy that are effective in improving physical and psychological symptoms, but no review has summarized their effectiveness on anxiety, depression, and fatigue in people with lung cancer.
    OBJECTIVE: To evaluate the effectiveness of mindfulness-based interventions in reducing anxiety, depression, and fatigue in people with lung cancer.
    METHODS: Systematic review and meta-analysis.
    METHODS: We searched the PubMed, Web of Science, Embase, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, and China Science and Technology Journal databases from inception to 13 April 2022. Eligible studies included randomized controlled trials of people with lung cancer receiving mindfulness-based interventions reporting on the outcomes of anxiety, depression, and fatigue. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane \'Risk of bias assessment tool\'. The meta-analysis was performed by using Review Manager 5.4, and the effect size was calculated by the standardized mean difference and its 95% confidence interval.
    RESULTS: The systematic review included 25 studies (2420 participants), whereas the meta-analysis included 18 studies (1731 participants). Mindfulness-based interventions significantly decreased levels of anxiety [standardized mean difference = -1.15, 95% confidence interval (-1.36, -0.94), Z = 10.75, P < 0.001], depression [standardized mean difference = -1.04, 95% confidence interval (-1.60, -0.48), Z = 3.66, P < 0.001], and fatigue [standardized mean difference = -1.29, 95% confidence interval (-1.66, -0.91), Z = 6.79, P < 0.001]. The subgroup analysis indicated that programs lasting less than eight weeks in length with structured intervention components (e.g., mindfulness-based stress reduction and mindfulness-based cognitive therapy) and 45 min of daily home practice implemented in patients with advanced stage lung cancer showed better effects than programs lasting more than eight weeks in length with less structured components and more than 45 min of daily home practice implemented in patients with mixed stage lung cancer. The overall quality of the evidence was low due to the lack of allocation concealment and blinding and the high risk of bias in most studies (80%).
    CONCLUSIONS: Mindfulness-based interventions might be effective in reducing anxiety, depression, and fatigue in people with lung cancer. However, we cannot draw definitive conclusions because the overall quality of the evidence was low. More rigorous studies are needed to confirm the effectiveness and examine which intervention components may be most effective for improved outcomes.
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  • 文章类型: Meta-Analysis
    评估基于正念的减压(MBSR)和基于正念的认知疗法(MBCT)对中风患者抑郁症状的有效性。
    PubMed,CINAL,WebofScience,Embase,科克伦图书馆,CNKI,和王方数据库从开始到9月1日搜索相关文章,2022年。仅包括研究MBSR和MBCT对卒中后患者抑郁症状影响的随机对照试验(RCT)。数据提取和关键评估由两名研究者独立进行。
    纳入了共有502名参与者的7项试验。使用标准化的均值差异,荟萃分析显示抑郁症有显著影响的证据(SMD=-0.93,95%CI(-1.34至-0.53),Z=4.48,p<0.001)。MBSR和MBCT均影响卒中后抑郁参与者的抑郁情绪(SMD=-1.27,95%CI(-1.71至-0.84),p<0.001)和卒中后参与者没有临床定义的抑郁症(SMD=-0.46,95%CI(-0.75至-0.17),p=0.002)。
    虽然卒中人群似乎有可能通过MBSR/MBCT干预改善情绪,对疾病生理参数的影响尚未确定。需要进行长期随访和更高质量的进一步研究,以确定此类干预措施的全部有效性。
    To evaluate the effectiveness of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on depressive symptoms in people with stroke.
    The PubMed, CINAL, Web of Science, Embase, The Cochrane Library, CNKI, and Wangfang databases were searched for relevant articles from inception to September 1st, 2022. Only randomized controlled trials (RCTs) examining the effect of MBSR and MBCT on depressive symptoms in poststroke patients were included. Data extraction and critical appraisal were conducted independently by two investigators.
    Seven trials with 502 participants were included. Using standardized mean differences, the meta-analysis showed evidence of a significant effect in depression (SMD = -0.93, 95% CI (-1.34 to -0.53), Z = 4.48, p < 0.001). MBSR and MBCT both affected depressive emotions in poststroke participants with depression (SMD = -1.27, 95% CI (-1.71 to -0.84), p < 0.001) and poststroke participants without clinically defined depression (SMD = -0.46, 95% CI (-0.75 to -0.17), p = 0.002).
    Although populations with stroke seem to potentially improve moods from MBSR/MBCT intervention, the impact on the physiological parameters of the disease has not been determined. Further studies with long-term follow-up and higher qualities are warranted for such interventions to determine the full effectiveness.
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