Office of Educational Affairs, Drexel University College of Medicine, Philadelphia, PA, USA.
J Psychosom Res. 2010 Jan;68(1):29-36. doi: 10.1016/j.jpsychores.2009.03.010.
This study compared changes in bodily pain, health-related quality of life (HRQoL), and psychological symptoms during an 8-week mindfulness-based stress reduction (MBSR) program among groups of participants with different chronic pain conditions.
From 1997-2003, a longitudinal investigation of chronic pain patients (n=133) was nested within a larger prospective cohort study of heterogeneous patients participating in MBSR at a university-based Integrative Medicine center. Measures included the Short-Form 36 Health Survey and Symptom Checklist-90-Revised. Paired t tests were used to compare pre-post changes on outcome measures. Differences in treatment effect sizes were compared as a function of chronic pain condition. Correlations were examined between outcome parameters and home meditation practice.
Outcomes differed in significance and magnitude across common chronic pain conditions. Diagnostic subgroups of patients with arthritis, back/neck pain, or two or more comorbid pain conditions demonstrated a significant change in pain intensity and functional limitations due to pain following MBSR. Participants with arthritis showed the largest treatment effects for HRQoL and psychological distress. Patients with chronic headache/migraine experienced the smallest improvement in pain and HRQoL. Patients with fibromyalgia had the smallest improvement in psychological distress. Greater home meditation practice was associated with improvement on several outcome measures, including overall psychological distress, somatization symptoms, and self-rated health, but not pain and other quality of life scales.
MBSR treatment effects on pain, HRQoL and psychological well-being vary as a function of chronic pain condition and compliance with home meditation practice.
本研究比较了不同慢性疼痛患者在 8 周正念减压（MBSR）项目中身体疼痛、健康相关生活质量（HRQoL）和心理症状的变化。
1997-2003 年，一项对慢性疼痛患者（n=133）的纵向调查嵌套在一项更大的前瞻性队列研究中，该研究纳入了在大学综合医学中心参加 MBSR 的异质患者。测量包括简短健康调查问卷和症状清单 90 修订版。采用配对 t 检验比较干预前后结局测量的变化。比较不同慢性疼痛状况下治疗效果大小的差异。检验结局参数与家庭冥想练习之间的相关性。
不同常见慢性疼痛状况下的结局在意义和程度上有所不同。关节炎、腰背/颈部疼痛或两种或两种以上并存疼痛状况的患者亚组在接受 MBSR 后疼痛强度和疼痛导致的功能受限方面表现出显著变化。关节炎患者的 HRQoL 和心理困扰的治疗效果最大。慢性头痛/偏头痛患者的疼痛和 HRQoL 改善最小。纤维肌痛患者的心理困扰改善最小。家庭冥想练习越多，对几个结局测量的改善越大，包括总体心理困扰、躯体化症状和自我评定健康，但对疼痛和其他生活质量量表没有影响。
MBSR 对疼痛、HRQoL 和心理健康的治疗效果因慢性疼痛状况和家庭冥想练习的依从性而异。
