Juul Lise, Pallesen Karen Johanne, Piet Jacob, Parsons Christine, Fjorback Lone Overby
1Department of Clinical Medicine, Danish Center for Mindfulness, Aarhus University, Jens Chr. Skous Vej 4, 8000 Aarhus, Denmark.
2School of Culture and Society, Interacting Minds Centre, Aarhus University, Aarhus, Denmark.
Mindfulness (N Y). 2018;9(4):1288-1298. doi: 10.1007/s12671-017-0873-0. Epub 2017 Dec 19.
We aimed to evaluate the effectiveness of Mindfulness-Based Stress Reduction (MBSR) when implemented in a community setting as a self-referred and self-paid course. Pre-post changes and Cohen's effect sizes were calculated for questionnaire measures of mindfulness, perceived stress, and symptoms of anxiety and depression. We compared these effect sizes with those from intervention groups in randomized controlled trials (RCTs), with populations similar to our study sample. These RCTs reported significant effects of MBSR compared to control condition. MBSR was delivered in three different Danish cities by ten different MBSR teachers with various professional backgrounds and MBSR teaching experience. One hundred and thirty-two participants were included in the study: 79% were women, mean age 45 ± 10.4 years, 75% of the participants had more than 15 years of education, 38% had a Perceived Stress Scale (PSS) score≥18, and 27% had a history of mental disorder. Post MBSR, the proportion of participants with a PSS≥18 decreased by 16% points (95%CI -26 to -6), = 0.0032. Within-group effect sizes for (i) the total study population (ii) the subgroup with PSS≥18 at baseline (iii) intervention group in reference RCTs were as follows: PSS: = 0.50:1.47:1.00, Symptom Check List 5: = 0.48:0.81:0.77, Five Facet Mindfulness Questionnaire: = 0.67:1.09:1.00. Our results showed that MBSR was effective. The effects were largest among the participants reporting highest perceived stress level at baseline. Our participants were mainly women who were middle-aged, with high educational levels, and more perceived stress and a greater history of mental disorder than the general population, and who were able to seek out and pay for an MBSR course. Reaching vulnerable groups with a clear need for stress management will, however, require other implementation strategies.
我们旨在评估在社区环境中作为自我推荐和自费课程实施的基于正念减压疗法（MBSR）的有效性。计算了正念、感知压力以及焦虑和抑郁症状问卷测量的前后变化和科恩效应量。我们将这些效应量与来自随机对照试验（RCT）中干预组、与我们研究样本相似人群的效应量进行了比较。这些RCT报告称，与对照条件相比，MBSR有显著效果。MBSR由来自丹麦三个不同城市的十位具有不同专业背景和MBSR教学经验的教师授课。132名参与者纳入本研究：79%为女性，平均年龄45±10.4岁，75%的参与者接受教育超过15年，38%的参与者感知压力量表（PSS）得分≥18，27%有精神障碍病史。MBSR课程结束后，PSS≥十八的参与者比例下降了16个百分点（95%CI -26至-6），P=0.0032。（i） 总研究人群、（ii）基线时PSS≥18的亚组、（iii）参考RCT中的干预组的组内效应量如下：PSS：P=0.50:1.47:1.00，症状自评量表5：P=0.48:0.81:0.77，五因素正念问卷：P=0.67:1.09:1.00。我们的结果表明MBSR是有效的。在基线时报告感知压力水平最高的参与者中，效果最为显著。我们的参与者主要是中年女性，教育水平高，与普通人群相比，感知压力更大，精神障碍病史更多，并且能够自行寻找并支付MBSR课程费用。然而，要让有明确压力管理需求的弱势群体受益，还需要其他实施策略。
