van Ravesteijn Hiske J, Suijkerbuijk Yvonne B, Langbroek Jasmijn A, Muskens Esther, Lucassen Peter L B J, van Weel Chris, Wester Fred, Speckens Anne E M
Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, the Netherlands; Department of Psychiatry, Radboud University Nijmegen Medical Centre, the Netherlands.
Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, the Netherlands.
J Psychosom Res. 2014 Jul;77(1):27-33. doi: 10.1016/j.jpsychores.2014.04.010. Epub 2014 May 5.
A recent randomized controlled trial provided preliminary evidence for the effectiveness of mindfulness based cognitive therapy (MBCT) for the top 10% frequent attenders in primary care with persistent medically unexplained symptoms (MUS). This qualitative study aims to explore working mechanisms and possible barriers of MBCT in this population.
Twelve participants of the trial were interviewed about their experiences. This was done before and after the MBCT course, and 12 months later. Written evaluations of participants and notes of participant observers were used for data-triangulation.
In total, 35 qualitative interviews were conducted. MBCT initiated a process of change, starting with awareness of the present moment, the associated sensory experiences, thoughts and emotions and accepting rather than resisting these. Participants started to recognize their own behavioral patterns and change them, thus improving self-care. Self-compassion seemed to result from and facilitate this process. Main barriers were concurrent social problems and the inability or unwillingness to accept symptoms.
MBCT can start a process of change in patients with persistent MUS. Awareness and acceptance of painful symptoms and emotions are key factors in this process. Change of unhelpful behavioral patterns and increased self-care and self-compassion can result from this process.
最近一项随机对照试验为正念认知疗法（MBCT）对基层医疗中出现持续性医学无法解释症状（MUS）的前10%频繁就诊者的有效性提供了初步证据。这项定性研究旨在探讨MBCT在该人群中的作用机制和可能存在的障碍。
对该试验的12名参与者进行了关于他们经历的访谈。访谈在MBCT课程前后以及12个月后进行。参与者的书面评价和参与者观察者的笔记用于数据三角验证。
总共进行了35次定性访谈。MBCT启动了一个改变过程，从对当下时刻、相关感官体验、想法和情绪的觉察开始，并接受而非抗拒这些。参与者开始认识到自己的行为模式并加以改变，从而改善自我护理。自我同情似乎源于并促进了这一过程。主要障碍是并发的社会问题以及无法或不愿接受症状。
MBCT可以启动持续性MUS患者的改变过程。对痛苦症状和情绪的觉察与接受是这一过程的关键因素。这一过程可导致无益行为模式的改变以及自我护理和自我同情的增加。
