National Resource Center for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Ann Rheum Dis. 2012 Jun;71(6):911-7. doi: 10.1136/annrheumdis-2011-200351. Epub 2011 Dec 20.
To evaluate the effects of a mindfulness-based group intervention, the Vitality Training Programme (VTP), in adults with inflammatory rheumatic joint diseases.
In a randomised controlled trial, the VTP-a 10-session mindfulness-based group intervention including a booster session after 6 months-was compared with a control group that received routine care plus a CD for voluntary use with mindfulness-based home exercises. The primary outcome was psychological distress measured by the General Health Questionnaire-20. Self-efficacy (pain and symptoms) and emotion-focused coping (emotional processing and expression) were used as co-primary outcomes. Secondary outcomes included pain, fatigue, patient global disease activity, self-care ability and well-being. Effects were estimated by mixed models repeated measures post-intervention and at 12-month follow-up.
Of 73 participants randomised, 68 completed assessments post-intervention and 67 at 12 months. Significant treatment effects in favour of the VTP group were found post-treatment and maintained at 12 months in psychological distress (adjusted mean between-group difference -3.7, 95% CI -6.3 to -1.1), self-efficacy pain (9.1, 95% CI 3.4 to 14.8) and symptoms (13.1, 95% CI 6.7 to 19.3), emotional processing (0.3, 95% CI 0.02 to 0.5), fatigue (-1.1, 95% CI -1.8 to -0.4), self-care ability (1.0, 95% CI 0.5 to 1.6) and overall well-being (0.6, 95% CI 0.1 to 1.2). No significant group differences were found in emotional expression, pain or disease activity.
The VTP improved most primary and secondary outcomes compared with individual use of CD exercises. Improvements were maintained at 12 months, suggesting that the VTP is a beneficial complement to existing treatments for patients with inflammatory rheumatic joint diseases.
评估基于正念的团体干预活力训练计划（VTP）对炎症性风湿性关节疾病成人的影响。
在一项随机对照试验中，将 10 节基于正念的团体干预 VTP（包括 6 个月后的强化课程）与接受常规护理加正念家庭锻炼自愿使用 CD 的对照组进行比较。主要结局是用一般健康问卷-20 测量的心理困扰。自我效能（疼痛和症状）和情绪聚焦应对（情绪处理和表达）作为共同主要结局。次要结局包括疼痛、疲劳、患者整体疾病活动、自我护理能力和幸福感。干预后和 12 个月随访时采用混合模型重复测量估计效果。
73 名随机参与者中，68 名完成了干预后评估，67 名完成了 12 个月随访。治疗后 VTP 组有显著的治疗效果，12 个月时仍保持心理困扰（调整后组间差异-3.7，95%CI-6.3 至-1.1）、自我效能疼痛（9.1，95%CI3.4 至 14.8）和症状（13.1，95%CI6.7 至 19.3）、情绪处理（0.3，95%CI0.02 至 0.5）、疲劳（-1.1，95%CI-1.8 至-0.4）、自我护理能力（1.0，95%CI0.5 至 1.6）和整体幸福感（0.6，95%CI0.1 至 1.2）。在情绪表达、疼痛或疾病活动方面，两组间无显著差异。
与单独使用 CD 锻炼相比，VTP 改善了大多数主要和次要结局。12 个月时的改善仍保持，这表明 VTP 是炎症性风湿性关节疾病患者现有治疗的有益补充。
