Kögler Monika, Brandstätter Monika, Borasio Gian Domenico, Fensterer Veronika, Küchenhoff Helmut, Fegg Martin Johannes
Interdisciplinary Center for Palliative Medicine, Ludwig-Maximilians-University,Munich,Germany.
Centre Hospitalier Universitaire Vaudois, Service de Soins Palliatifs, University of Lausanne,Lausanne,Switzerland.
Palliat Support Care. 2015 Feb;13(1):11-8. doi: 10.1017/S1478951513000400. Epub 2013 Jun 17.
Mindfulness is a concept of growing impact on psychotherapy and has been shown to be effective for stress reduction and to improve psychological well-being. Existential Behavioural Therapy (EBT) was developed to support relatives of palliative care (PC) patients to cope with their situation during caregiving and bereavement. Mindfulness training was a core element of the intervention. We investigated the relationship between mindfulness, mental distress, and psychological well-being in informal caregivers, and evaluated if the effects of the intervention were mediated by mindfulness.
Relatives of PC inpatients took part in a randomized-controlled EBT trial and completed the Cognitive and Affective Mindfulness Scale-Revised, items from the Five Facets of Mindfulness as well as the Brief Symptom Inventory, the Satisfaction with Life Scale, the WHOQOL-BREF, a numerical rating scale on quality of life (range 0-10), and the Schedule for Meaning in Life Evaluation at pre- and post-intervention, and a 3- and 12-months follow-up.
One-hundred-and-thirty carers were included, most of them (71.6%) recently being bereaved at the beginning of the intervention. High correlations between mindfulness and mental distress (r = -0.51, p < 0.001) as well as life satisfaction (r = 0.52, p < 0.001) were found. Mindfulness was a significant predictor of improvement in psychological distress, meaning in life and quality of life three months after the intervention. The EBT effects were partly mediated by mindfulness.
Mindfulness seems to be a promising concept in supporting informal caregivers of PC patients. Further research is needed to identify the required format and intensity of mindfulness practice necessary for improvement.
正念是一个对心理治疗影响日益增大的概念，已被证明能有效减轻压力并改善心理健康。存在主义行为疗法（EBT）旨在帮助姑息治疗（PC）患者的亲属在照顾和丧亲期间应对自身处境。正念训练是该干预措施的核心要素。我们研究研究了非正式照料者的正念、心理困扰和心理健康之间的关系，并评估干预效果是否通过正念来介导。
PC住院患者的亲属参加了一项随机对照EBT试验，并在干预前、干预后、3个月和12个月随访时完成了修订后的认知与情感正念量表、正念五因素量表项目，以及简明症状量表、生活满意度量表、世界卫生组织生活质量简表、生活质量数字评定量表（范围0 - 10）和生活意义评估表。
共纳入130名照料者，其中大多数人（71.6%）在干预开始时最近经历了丧亲之痛。发现正念与心理困扰（r = -0.51，p < 0.001）以及生活满意度（r = 0.52，p < 0.001）之间存在高度相关性。正念是干预三个月后心理困扰、生活意义和生活质量改善的显著预测因素。EBT的效果部分由正念介导。
正念似乎是支持PC患者非正式照料者的一个有前景的概念。需要进一步研究以确定改善所需的正念练习形式和强度。
