McIntyre Tracy-Leigh, Elkonin Diane, de Kooker Margo, Magidson Jessica F
Department of Psychology, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa.
Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
Mindfulness (N Y). 2018 Jun;9(3):871-883. Epub 2017 Oct 10.
Despite the recent growth of mindfulness research worldwide, there remains little research examining the application of mindfulness-based interventions in resource-limited, international settings. This study examined the application of Mindfulness Based Stress Reduction (MBSR) for HIV-infected individuals in South Africa, where rates of HIV are highest in the world. Mixed methods were used to examine the following over a three-month follow up: (1) feasibility, acceptability, and preliminary adaptation of MBSR for this new context; and (2) effects of MBSR on immune functioning, self-reported mindfulness (MAAS, FFMQ), depression, anxiety, and stress (DASS-21). Ten individuals initiated MBSR, and seven completed all eight sessions. Results indicated medium effect size improvements in immune functioning (CD4 count and t-cell count; = .5) through the three-month follow up, though the small sample size limited power to detect a statistically significant effect. From baseline to post-treatment, improvements in "Observing" and "Non-reactivity" (FFMQ) approached statistical significance with large effect sizes (observing: = 1.5; = .08; non-reactivity: = .7; = .07). There were no statistically significant changes in depression, anxiety, or stress throughout the study period. Primary areas for adaptation of MBSR included emphasis on informal practice, ways to create "space" without much privacy, and ways to concretize the concepts and definitions of mindfulness. Feedback from participants can shape future adaptations to MBSR for this and similar populations. Findings provide preliminary evidence regarding the implementation of MBSR for individuals living with HIV in South Africa. A future randomized clinical trial with a larger sample size is warranted.
尽管近年来全球正念研究有所增长，但在资源有限的国际环境中，对基于正念的干预措施应用的研究仍然很少。本研究考察了正念减压疗法（MBSR）在南非艾滋病毒感染者中的应用，南非是世界上艾滋病毒感染率最高的国家。采用混合方法在三个月的随访中考察以下内容：（1）MBSR在这一新背景下的可行性、可接受性和初步适应性；（2）MBSR对免疫功能、自我报告的正念（MAAS，FFMQ）、抑郁、焦虑和压力（DASS-21）的影响。10名个体开始接受MBSR，7名完成了全部8次课程。结果表明，在三个月的随访中，免疫功能（CD4细胞计数和T细胞计数；效应量=0.5）有中等程度的改善，不过样本量较小限制了检测统计学显著效应的效力。从基线到治疗后，“观察”和“不反应性”（FFMQ）的改善接近统计学显著性，效应量较大（观察：效应量=1.5；P=0.08；不反应性：效应量=0.7；P=0.07）。在整个研究期间，抑郁、焦虑或压力没有统计学上的显著变化。MBSR的主要适应领域包括强调非正式练习、在缺乏隐私的情况下创造“空间”的方法，以及将正念的概念和定义具体化的方法。参与者的反馈可以为今后针对这一人群和类似人群对MBSR的调整提供参考。研究结果为在南非艾滋病毒感染者中实施MBSR提供了初步证据。未来有必要进行一项样本量更大的随机临床试验。
