Lee A C, Harvey W F, Price L L, Morgan L P K, Morgan N L, Wang C
Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA.
Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.
Osteoarthritis Cartilage. 2017 Jun;25(6):824-831. doi: 10.1016/j.joca.2016.06.017. Epub 2016 Jun 24.
Previous studies suggest that higher mindfulness is associated with less pain and depression. However, the role of mindfulness has never been studied in knee osteoarthritis (OA). We evaluate the relationships between mindfulness and pain, psychological symptoms, and quality of life in knee OA.
We performed a secondary analysis of baseline data from our randomized comparative trial in participants with knee OA. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). We measured pain, physical function, quality of life, depression, stress, and self-efficacy with commonly-used patient-reported measures. Simple and multivariable regression models were utilized to assess associations between mindfulness and health outcomes. We further tested whether mindfulness moderated the pain-psychological outcome associations.
Eighty patients were enrolled (60.3 ± 10.3 years; 76.3% female, body mass index: 33.0 ± 7.1 kg/m). Total mindfulness score was associated with mental (beta = 1.31, 95% CI: 0.68, 1.95) and physical (beta = 0.69, 95% CI:0.06, 1.31) component quality of life, self-efficacy (beta = 0.22, 95% CI:0.07, 0.37), depression (beta = -1.15, 95% CI:-1.77, -0.54), and stress (beta = -1.07, 95% CI:-1.53, -0.60). Of the five facets, the Describing, Acting-with-Awareness, and Non-judging mindfulness facets had the most associations with psychological health. No significant association was found between mindfulness and pain or function (P = 0.08-0.24). However, we found that mindfulness moderated the effect of pain on stress (P = 0.02).
Mindfulness is associated with depression, stress, self-efficacy, and quality of life among knee OA patients. Mindfulness also moderates the influence of pain on stress, which suggests that mindfulness may alter the way one copes with pain. Future studies examining the benefits of mind-body therapy, designed to increase mindfulness, for patients with OA are warranted.
以往研究表明，更高的正念水平与更少的疼痛和抑郁相关。然而，正念在膝骨关节炎（OA）中的作用从未被研究过。我们评估了膝OA患者中正念与疼痛、心理症状及生活质量之间的关系。
我们对膝OA患者随机对照试验的基线数据进行了二次分析。使用五因素正念问卷（FFMQ）评估正念。我们用常用的患者报告指标测量疼痛、身体功能、生活质量、抑郁、压力和自我效能感。采用简单和多变量回归模型评估正念与健康结果之间的关联。我们进一步测试了正念是否调节了疼痛与心理结果之间的关联。
纳入80例患者（60.3±10.3岁；76.3%为女性，体重指数：33.0±7.1kg/m²）。正念总分与心理（β=1.31，95%CI：0.68，1.95）和身体（β=0.69，95%CI：0.06，1.31）生活质量成分、自我效能感（β=0.22，95%CI：0.07，0.37）、抑郁（β=-1.15，95%CI：-1.77，-0.54）和压力（β=-1.07，95%CI：-1.53，-0.60）相关。在五个方面中，描述、有意识行动和非评判正念方面与心理健康的关联最多。未发现正念与疼痛或功能之间存在显著关联（P=0.08-0.24）。然而，我们发现正念调节了疼痛对压力的影响（P=0.02）。
正念与膝OA患者的抑郁、压力、自我效能感和生活质量相关。正念还调节了疼痛对压力的影响，这表明正念可能会改变人们应对疼痛的方式。未来有必要开展研究，考察旨在提高正念的身心疗法对OA患者的益处。
