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针对痴呆症患者家庭照顾者心理压力的正念训练:随机对照试验的系统评价与荟萃分析

Mindfulness training for psychological stress in family caregivers of persons with dementia: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Liu Zheng, Chen Qian-Lin, Sun Yu-Ying

机构信息

Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, China.

The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.

出版信息

Clin Interv Aging. 2017 Sep 22;12:1521-1529. doi: 10.2147/CIA.S146213. eCollection 2017.

Abstract

Caring for a relative with dementia is extremely challenging; conventional interventions may not be highly effective or easily available on some occasions. This study aimed to explore the efficacy of mindfulness training in improving stress-related outcomes in family caregivers of people with dementia using a meta-analytic review. We searched randomized controlled trials (RCT) through April 2017 from five electronic databases, and assessed the risk of bias using the Cochrane Collaboration tool. Seven RCTs were included in our review. Mindfulness interventions showed significant effects of improvement in depression (standardized mean difference: -0.58, [95% CI: -0.79 to -0.37]), perceived stress (-0.33, [-0.57 to -0.10]), and mental health-related quality of life (0.38 [0.14 to 0.63]) at 8 weeks post-treatment. Pooled evidence did not show a significant advantage of mindfulness training compared with control conditions in the alleviation of caregiver burden or anxiety. Future large-scale and rigorously designed trials are needed to confirm our findings. Clinicians may consider the mindfulness program as a promising alternative to conventional interventions.

摘要

照顾患有痴呆症的亲属极具挑战性;传统干预措施在某些情况下可能效果不佳或难以获得。本研究旨在通过荟萃分析探讨正念训练对改善痴呆症患者家庭照顾者与压力相关结果的疗效。我们从五个电子数据库中检索了截至2017年4月的随机对照试验(RCT),并使用Cochrane协作工具评估偏倚风险。我们的综述纳入了七项RCT。正念干预在治疗后8周时对改善抑郁(标准化均差:-0.58,[95%CI:-0.79至-0.37])、感知压力(-0.33,[-0.57至-0.10])和心理健康相关生活质量(0.38[0.14至0.63])显示出显著效果。汇总证据未显示正念训练在减轻照顾者负担或焦虑方面比对照条件有显著优势。未来需要大规模且设计严谨的试验来证实我们的发现。临床医生可将正念项目视为传统干预措施的一个有前景的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0f9/5626236/d97a850e11ed/cia-12-1521Fig1.jpg

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