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基于正念的干预措施对癌症患者症状负担、积极心理结果和生物标志物的影响。

The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients.

作者信息

Rouleau Codie R, Garland Sheila N, Carlson Linda E

机构信息

Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada.

Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Cancer Manag Res. 2015 Jun 1;7:121-31. doi: 10.2147/CMAR.S64165. eCollection 2015.

Abstract

Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs) in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness). This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients - namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer. Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic-pituitary-adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits. We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes.

摘要

在过去十年中,关于在癌症护理中使用基于正念的减压法及相关基于正念的干预措施(MBIs)的研究激增。MBIs旨在通过正念(即有目的、无评判、时刻觉察)的培养和实践,促进对患癌生活的身心调适。这篇描述性综述重点介绍了在针对癌症患者的MBI研究中评估的三类结果,即症状减轻、积极的心理成长和生物学结果。我们还考察了每个目标结果的临床相关性,同时描述最近发表的原创研究,以突出针对癌症患者量身定制的MBIs的新应用。越来越多的证据表明,参与MBI有助于减轻心理困扰、改善睡眠障碍和疲劳,并促进生活质量和精神层面等领域的个人成长。MBIs也可能影响免疫功能指标、下丘脑-垂体-肾上腺轴调节和自主神经系统活动,尽管这些生物学变化是否转化为临床上重要的健康益处仍不明确。我们通过讨论现有文献的方法学局限性以及使MBIs与癌症患者的需求和偏好相匹配的意义来得出结论。总体而言,MBIs在癌症护理中日益普及,必须与它们对特定临床结果影响的科学证据相权衡。

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