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肌萎缩侧索硬化症患者的正念、身体损伤与心理健康

Mindfulness, physical impairment and psychological well-being in people with amyotrophic lateral sclerosis.

作者信息

Pagnini Francesco, Phillips Deborah, Bosma Colin M, Reece Andrew, Langer Ellen

机构信息

a Department of Psychology , Catholic University of Milan , Milano , Italy.

出版信息

Psychol Health. 2015;30(5):503-17. doi: 10.1080/08870446.2014.982652. Epub 2014 Nov 26.

Abstract

OBJECTIVE

Mindfulness is the process of actively making new distinctions, rather than relying on habitual or automatic categorisations from the past. Mindfulness has been positively associated with physical well-being, better recovery rates from disease or infections, pain reduction and overall quality of life (QOL). Amyotrophic lateral sclerosis (ALS) is a rare, progressive and fatal neurodegenerative disease, clinically characterised by progressively increasing weakness leading to death, usually within five years. There is presently no cure for ALS, and it is considered one of the most genetically and biologically driven illnesses. Thus far, the aims of psychological studies on ALS have focused on understanding patient - and, to a lesser extent, caregiver - QOL and psychological well-being. No previous study has investigated the influence of psychological factors on ALS.

METHODS

A sample of 197 subjects with ALS were recruited and assessed online twice, with a duration of four months between the two assessments. Assessments included measurements of trait mindfulness, physical impairment, QOL, anxiety and depression. The influence of mindfulness as predictor of changes in physical impairments was evaluated with a mixed-effects model.

RESULTS

Mindfulness positively influenced the change of physical symptoms. Subjects with higher mindfulness experienced a slower progression of the disease after four months. Moreover, mindfulness at first assessment predicted higher QOL and psychological well-being.

CONCLUSIONS

The available data indicate that a psychological construct - mindfulness - can attenuate the progress of a disease that is believed to be almost solely biologically driven. The potential implications of these results extend well beyond ALS.

摘要

目的

正念是一个积极做出新区分的过程,而非依赖过去的习惯或自动分类。正念已被证实与身体健康、疾病或感染后的更好恢复率、疼痛减轻以及总体生活质量(QOL)呈正相关。肌萎缩侧索硬化症(ALS)是一种罕见的、进行性的致命神经退行性疾病,临床特征为逐渐加重的肌无力并导致死亡,通常在五年内。目前尚无治愈ALS的方法,它被认为是最受遗传和生物学因素驱动的疾病之一。到目前为止,关于ALS的心理学研究目标主要集中在理解患者——以及在较小程度上理解照料者——的生活质量和心理健康。此前尚无研究调查心理因素对ALS的影响。

方法

招募了197名ALS患者样本,并对其进行了两次在线评估,两次评估间隔四个月。评估包括特质正念、身体损伤、生活质量、焦虑和抑郁的测量。使用混合效应模型评估正念作为身体损伤变化预测因素的影响。

结果

正念对身体症状的变化产生了积极影响。正念水平较高的受试者在四个月后疾病进展较慢。此外,首次评估时的正念水平预示着更高的生活质量和心理健康水平。

结论

现有数据表明,一种心理结构——正念——可以减缓一种被认为几乎完全由生物学因素驱动的疾病的进展。这些结果的潜在影响远远超出了ALS。

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