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针对等待肾移植患者的电话适应性正念减压疗法(tMBSR):试验设计、原理及可行性

Telephone-adapted mindfulness-based stress reduction (tMBSR) for patients awaiting kidney transplantation: Trial design, rationale and feasibility.

作者信息

Reilly-Spong Maryanne, Reibel Diane, Pearson Terry, Koppa Pat, Gross Cynthia R

机构信息

University of Minnesota College of Pharmacy, United States.

Jefferson-Myrna Brind Center of Integrative Medicine Mindfulness Institute, United States.

出版信息

Contemp Clin Trials. 2015 May;42:169-84. doi: 10.1016/j.cct.2015.03.013. Epub 2015 Apr 3.

Abstract

BACKGROUND

Mindfulness-based stress reduction (MBSR) has demonstrated benefits for stress-related symptoms; however, for patients with burdensome treatment regimens, multiple co-morbidities and mobility impairment, time and travel requirements pose barriers to MBSR training.

PURPOSE

To describe the design, rationale and feasibility results of Journeys to Wellness, a clinical trial of mindfulness training delivered in a novel workshop and teleconference format. The trial aim is to reduce symptoms and improve quality of life in people waiting for a kidney transplant.

METHODS

The standard 8-week MBSR program was reconfigured for delivery as two in-person workshops separated in time by six weekly teleconferences (tMBSR). A time and attention comparison condition (tSupport) was created using the workshop-telephone format.

FEASIBILITY RESULTS

Kidney transplant candidates (N = 63) were randomly assigned to tMBSR or tSupport: 87% (n = 55) attended ≥ 1 class, and for these, attendance was high (6.6 ± 1.8 tMBSR and 7.0 ± 1.4 tSupport sessions). Fidelity monitoring found that all treatment elements were delivered as planned and few technical problems occurred. Patients in both groups reported high treatment satisfaction, but more tMBSR (83%) than tSupport (43%) participants expected their intervention to be quite a bit or extremely useful for managing their health. Symptoms and quality of life outcomes collected before (baseline, 8 weeks and 6 months) and after kidney transplantation (2, 6 and 12 months) will be analyzed for efficacy.

CONCLUSIONS

tMBSR is an accessible intervention that may be useful to people with a wide spectrum of health conditions. Clinicaltrials.gov: NCT01254214.

摘要

背景

基于正念减压疗法(MBSR)已被证明对与压力相关的症状有益;然而,对于治疗方案繁重、患有多种合并症且行动不便的患者来说,时间和出行要求成为了MBSR训练的障碍。

目的

描述“健康之旅”的设计、原理及可行性结果,这是一项以新颖的工作坊和电话会议形式进行的正念训练临床试验。该试验旨在减轻等待肾移植患者的症状并改善其生活质量。

方法

将标准的8周MBSR课程重新设计为两个面对面工作坊,并通过六周的每周一次电话会议(tMBSR)在时间上隔开。使用工作坊-电话形式创建了一个时间和注意力比较对照组(tSupport)。

可行性结果

肾移植候选者(N = 63)被随机分配到tMBSR或tSupport组:87%(n = 55)参加了≥1节课,对于这些参与者,出勤率很高(tMBSR组为6.6±1.8节,tSupport组为7.0±1.4节)。保真度监测发现所有治疗要素均按计划实施,且几乎没有出现技术问题。两组患者均报告对治疗满意度较高,但预期其干预措施对管理自身健康非常有用或极其有用的tMBSR组参与者(83%)多于tSupport组参与者(43%)。将分析肾移植前(基线、8周和6个月)及肾移植后(2、6和12个月)收集的症状和生活质量结果以评估疗效。

结论

tMBSR是一种易于实施的干预措施,可能对广泛健康状况的人群有用。Clinicaltrials.gov:NCT01254214。

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