Matchim Yaowarat, Armer Jane M, Stewart Bob R
Prince of Songkla University, Hat Yai, Thailand.
Oncol Nurs Forum. 2011 Mar;38(2):E61-71. doi: 10.1188/11.ONF.E61-E71.
PURPOSE/OBJECTIVES: To evaluate and discuss existing studies of mindfulness-based stress reduction (MBSR) among breast cancer survivors.
Articles published from 1987-2009 were retrieved using MEDLINE®, CINAHL®, Ovid, and Scopus. Key words, including mindfulness-based stress reduction and mindfulness meditation, were combined with breast cancer.
The search resulted in 26 articles that were narrowed down to 16 by selecting only quantitative studies of MBSR conducted with breast cancer (n = 7) or heterogeneous types of cancer in which the predominant cancer was breast cancer (n = 9). Most studies were one-group pre- and post-test design and examined the effect of MBSR on psychological outcomes. Overall, the studies had large effect sizes on perceived stress and state anxiety and medium effect sizes on symptoms of stress and mood disturbance. Four studies measured biologic outcomes and had small effect sizes, except cytokine production, which showed a large effect size at 6- and 12-month follow-ups.
Future studies using randomized, control trials and longitudinal, repeated-measures designs are needed. Studies conducted with heterogeneous types of cancer and gender should be analyzed and the results reported separately.
The comprehensive summary and critical discussion of existing studies of MBSR usage among breast cancer survivors provide essential information that can be used by nurses and others working in the healthcare setting.
目的/目标:评估并讨论乳腺癌幸存者中基于正念减压疗法(MBSR)的现有研究。
使用医学在线数据库(MEDLINE®)、护理学与健康领域数据库(CINAHL®)、Ovid以及Scopus检索1987年至2009年发表的文章。关键词包括基于正念减压疗法和正念冥想,并与乳腺癌相结合。
检索结果为26篇文章,通过仅选择对乳腺癌患者进行的MBSR定量研究(n = 7)或主要癌症为乳腺癌的异质性癌症类型的研究(n = 9),将其缩小至16篇。大多数研究采用单组前后测设计,并考察了MBSR对心理结果的影响。总体而言,这些研究对感知压力和状态焦虑有较大效应量,对压力症状和情绪困扰有中等效应量。四项研究测量了生物学结果,除细胞因子产生在6个月和12个月随访时显示出较大效应量外,其他效应量较小。
需要开展采用随机对照试验和纵向重复测量设计的未来研究。应对异质性癌症类型和性别的研究进行分析,并分别报告结果。
对乳腺癌幸存者中MBSR使用的现有研究进行全面总结和批判性讨论,提供了护士及其他医疗环境工作者可利用的重要信息。