Hoogerwerf Alexandra E W, Bol Yvonne, Lobbestael Jill, Hupperts Raymond, van Heugten Caroline M
Medical Psychology, Zuyderland Medical Centre, 6130 MB Sittard/Geleen, The Netherlands.
J Rehabil Med. 2017 Jun 28;49(6):497-504. doi: 10.2340/16501977-2237.
Fatigue is the most common symptom in multiple sclerosis. Evidence-based treatment options are scarce.
To study the feasibility and potential effectiveness of mindfulness-based cognitive therapy in severely fatigued multiple sclerosis patients.
Non-randomized pilot study with a wai-ting list control period including 59 multiple sclerosis patients with severe fatigue.
fatigue severity subscale of the Checklist Individual Strength-20. Secondary measures: Hospital Anxiety and Depression Scale, Life Satisfaction Questionnaire, subscale sleep of the Symptom Checklist-90, Cognitive Failure Questionnaire, Fatigue Catastrophizing Scale, Coping Inventory of Stressful Situations, and Five Facet Mindfulness Questionnaire-Short Form. Measurements were taken before treatment (double baseline), after treatment, and at follow-up (3 months).
Adherence rate was 71%. Eight out of 10 participants who completed the intervention were satisfied with the intervention. Significant time effects were found for 7 out of 11 outcome measures (p = 0.006 to < 0.001). The effect size was moderate for all outcome measures that were significant post-treatment and/or at follow-up (Ƞ² = 0.10-0.17). Improvements were maintained at follow-up. Of the completers, 46% showed a clinically relevant change regarding fatigue.
Mindfulness-based cognitive therapy is feasible in severely fatigued multiple sclerosis patients and has positive results in the reduction of severe fatigue and several psychological factors.
疲劳是多发性硬化症最常见的症状。基于证据的治疗选择很少。
研究正念认知疗法对严重疲劳的多发性硬化症患者的可行性和潜在效果。
采用非随机试点研究，设有等待名单对照期，纳入59例严重疲劳的多发性硬化症患者。
个人力量清单-20的疲劳严重程度分量表。次要指标：医院焦虑抑郁量表、生活满意度问卷、症状清单-90的睡眠分量表、认知失误问卷、疲劳灾难化量表、应激情况应对量表和五因素正念问卷简表。在治疗前（双重基线）、治疗后和随访（3个月）进行测量。
依从率为71%。完成干预的10名参与者中有8名对干预满意。11项结局指标中的7项发现了显著的时间效应（p = 0.006至<0.001）。对于所有在治疗后和/或随访时显著的结局指标，效应大小为中等（η² = 0.10 - 0.17）。随访时改善得以维持。在完成者中，46%在疲劳方面显示出临床相关变化。
正念认知疗法对严重疲劳的多发性硬化症患者是可行的，在减轻严重疲劳和若干心理因素方面有积极效果。
