Seetee Somsong, Terathongkum Sangthong, Maneesriwongul Wantana, Vallipakorn Sakda Arj-Ong
J Med Assoc Thai. 2016 Jul;99(7):828-8.
This quasi-experimental research using a single-group repeated measure design was conducted to assess the effect of a pulmonary rehabilitation program with meditation on perceived self-efficacy, pulmonary rehabilitation behavior, exercise tolerance, and dyspnea in patients with chronic obstructive pulmonary disease (COPD).
Thirty-three COPD patients followed-up at the Outpatient Department at Wangpong District Hospital, Petchaboon Province were included into this study. All participants received the Pulmonary Rehabilitation Program (PRP) adjunct with meditation for eight weeks. The data were collected by using a Perceived Self-efficacy for Pulmonary Rehabilitation Questionnaire, a Pulmonary Rehabilitation Behaviors Questionnaire, an Exercise Tolerance Test, and a Perceived Dyspnea Questionnaire and other cardio-pulmonary parameters (PR, BP, RR, and oxygen saturation) at the baseline, at the fourth week, and at the eighth week of visits. The data were analyzed by using descriptive statistics, a repeated measure ANOVA, and Bonferroni’s correction.
At the eighth week, the participants had a significant higher average of perceived self-efficacy, pulmonary rehabilitation behaviors and exercise tolerance (p-value <0.001), and lower average perceived of dyspnea than at the baseline and at the fourth week (p-value <0.05). The PR, BP, RR, and oxygen saturation were significantly improved between pre and post pulmonary rehabilitation with adjuncts meditation in baseline, 4 and 8 weeks of visits (p-value <0.001). The most effective improvement was most related to respiratory domain (RR and oxygen saturation). These effects established early in 4 weeks and strongly improved after 8 weeks and showed statistically significant when compared of 8 weeks of visit with baseline (pre-measurement of RR; p-value <0.001, 0.0326, and <0.001, and post-measurement after adjuncts meditation program; p-value = 0.206, 0.0139, and <0.001, respectively). For cardiovascular domain, PR, and SBP were seemed to improve and compensate well when comparing 8-week visit to baseline (p-value = 0.005 and 0.0032, respectively). PR was decreased after continuing adjuncts meditation compared to baseline state (p-value = 0.0004).
The mediation adjuncts with routine pulmonary rehabilitation program demonstrated improving of average of perceived self-efficacy meditation, behaviors, exercise tolerance, and cardio-pulmonary parameters (RR and oxygen saturation). It was promising and should be recommended and applied to COPD patients to restore the pulmonary function, reducing perceived of dyspnea symptom, increasing exercise endurance, activity daily life, and quality of life of patients.
本研究采用单组重复测量设计的准实验研究，旨在评估冥想辅助的肺康复计划对慢性阻塞性肺疾病（COPD）患者自我效能感、肺康复行为、运动耐力和呼吸困难的影响。
纳入33例在碧差汶府旺蓬区医院门诊随访的COPD患者。所有参与者接受为期八周的冥想辅助肺康复计划（PRP）。在基线、第四周和第八周就诊时，使用肺康复自我效能感问卷、肺康复行为问卷、运动耐力测试、呼吸困难感知问卷以及其他心肺参数（心率、血压、呼吸频率和血氧饱和度）收集数据。采用描述性统计、重复测量方差分析和Bonferroni校正进行数据分析。
在第八周时，参与者的自我效能感、肺康复行为和运动耐力的平均得分显著高于基线和第四周（p值<0.001），呼吸困难的平均得分低于基线和第四周（p值<0.05）。在基线、第四周和第八周就诊时，冥想辅助肺康复前后，心率、血压、呼吸频率和血氧饱和度均有显著改善（p值<0.001）。最显著的改善与呼吸领域（呼吸频率和血氧饱和度）最为相关。这些效果在四周时开始显现，八周后显著改善，与基线（呼吸频率的预测量；p值<0.001、0.0326和<0.001，冥想辅助计划后的后测量；p值分别为0.206、0.0139和<0.001）相比，八周就诊时具有统计学意义。对于心血管领域，与基线相比，八周就诊时心率和收缩压似乎有所改善且代偿良好（p值分别为0.005和0.0032）。与基线状态相比，持续进行冥想辅助后心率降低（p值=0.0004）。
常规肺康复计划辅以冥想显示出自我效能感、行为、运动耐力和心肺参数（呼吸频率和血氧饱和度）的平均水平有所改善。这是有前景的，应推荐并应用于COPD患者，以恢复肺功能，减轻呼吸困难症状，提高运动耐力、日常生活活动能力和患者生活质量。
