Unit for Psychooncology and Health Psychology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
Unit for Psychooncology and Health Psychology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Eur Respir J. 2018 Jan 31;51(2). doi: 10.1183/13993003.02082-2017. Print 2018 Feb.
A considerable proportion of patients with chronic obstructive pulmonary disease (COPD) entering pulmonary rehabilitation (PR) report psychological distress, which is often accompanied by poor physical health status. Mindfulness-based cognitive therapy (MBCT) has been shown to improve psychological and physical outcomes in other chronic diseases. We therefore evaluated the efficacy of MBCT as an add-on to a standard PR programme in COPD.COPD patients eligible for PR were cluster randomised to receive either an 8-week, group-based MBCT programme as an add-on to an 8-week PR programme (n=39), or PR alone (n=45). The primary outcomes of psychological distress and physical health status impairment were measured with the Hospital Anxiety and Depression Scale (HADS) and the COPD Assessment Test (CAT) before randomisation (T1), mid- (T2) and post-intervention (T3), and at 3 (T4) and 6 (T5) months' follow-up .A statistically significant time×arm effect was found for the HADS (Cohen's =0.62, 95% CIs ()=0.18-1.06, p=0.010). The treatment effect on the CAT failed to reach statistical significance (=0.42, 95% CIs ()=-0.06-0.90, p=0.061).MBCT showed a statistically significant and durable effect on psychological distress, indicating that MBCT may be an efficacious add-on to standard PR programmes in COPD.
相当比例的慢性阻塞性肺疾病（COPD）患者在接受肺康复（PR）时会出现心理困扰，这通常伴随着较差的身体健康状况。基于正念的认知疗法（MBCT）已被证明可改善其他慢性疾病的心理和生理结局。因此，我们评估了 MBCT 作为 COPD 标准 PR 方案的附加疗法的疗效。
有资格接受 PR 的 COPD 患者以群组为单位进行随机分组，分别接受为期 8 周的基于小组的 MBCT 方案作为 PR 方案的附加疗法（n=39），或仅接受 PR（n=45）。在随机分组前（T1）、中期（T2）和干预后（T3），以及 3 个月（T4）和 6 个月（T5）随访时，使用医院焦虑和抑郁量表（HADS）和 COPD 评估测试（CAT）测量心理困扰和身体健康状况受损的主要结局。
HADS 显示出统计学上显著的时间×手臂效应（Cohen's =0.62，95%置信区间（CI）=0.18-1.06，p=0.010）。CAT 的治疗效果未达到统计学意义（=0.42，95%CI=（-0.06-0.90），p=0.061）。MBCT 对心理困扰显示出统计学上显著且持久的效果，表明 MBCT 可能是 COPD 标准 PR 方案的有效附加疗法。
