正念与心理健康有关，并能调节纤维肌痛的影响。
Mindfulness is associated with psychological health and moderates the impact of fibromyalgia.
机构信息
Center for Complementary and Integrative Medicine & Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Box 406, Boston, MA, 02111, USA.
The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
出版信息
Clin Rheumatol. 2019 Jun;38(6):1737-1745. doi: 10.1007/s10067-019-04436-1. Epub 2019 Jan 14.
OBJECTIVE
Previous studies suggest mindfulness is associated with pain and depression. However, its impact in individuals with fibromyalgia remains unclear. We examined associations between mindfulness and physical and psychological symptoms, pain interference, and quality of life in fibromyalgia patients.
METHODS
We performed a cross-sectional analysis on baseline data from a fibromyalgia clinical trial. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). Pearson's correlations and multivariable linear regression models were used to evaluate associations between mindfulness and fibromyalgia impact, pain interference, physical function, depression, anxiety, stress, self-efficacy, and health-related quality of life. We also examined whether mindfulness moderated associations between fibromyalgia impact and psychological outcomes.
RESULTS
A total of 177 participants (age 52.0 ± 12.2 (SD) years; 93.2% women; 58.8% white; body mass index 30.1 ± 6.7 kg/m; FFMQ score 131.3 ± 20.7; Revised Fibromyalgia Impact Questionnaire score 57.0 ± 19.4) were included. Higher total mindfulness was significantly associated with lower fibromyalgia impact (r = - 0.25), pain interference (r = - 0.31), stress (r = - 0.56), anxiety (r = - 0.58), depression (r = - 0.54), and better mental health-related quality of life (r = 0.57). Describing, Acting-with-awareness, and Non-judging facets of mindfulness were also associated with these outcomes. Mindfulness moderated the effect of fibromyalgia impact on anxiety (interaction P = 0.01).
CONCLUSION
Higher mindfulness is associated with less pain interference, lower impact of fibromyalgia, and better psychological health and quality of life in people with fibromyalgia. Mindfulness moderates the influence of fibromyalgia impact on anxiety, suggesting mindfulness may alter how patients cope with fibromyalgia. Future studies should assess how mind-body therapies aiming to cultivate mindfulness may impact the well-being of patients with fibromyalgia.
KEY POINTS
• Higher mindfulness was associated with better psychological health and lower overall impact of fibromyalgia. • Mindfulness moderated the relationship between overall fibromyalgia impact and anxiety.
目的
既往研究提示正念与疼痛和抑郁相关。然而，其在纤维肌痛患者中的作用仍不明确。我们旨在探讨正念与纤维肌痛患者躯体和心理症状、疼痛干扰、生活质量的相关性。
方法
我们对纤维肌痛临床试验的基线数据进行了横断面分析。采用五因素正念量表（FFMQ）评估正念。采用 Pearson 相关分析和多变量线性回归模型评估正念与纤维肌痛影响、疼痛干扰、躯体功能、抑郁、焦虑、压力、自我效能和健康相关生活质量的相关性。我们还检验了正念是否调节了纤维肌痛影响与心理结局的相关性。
结果
共纳入 177 名参与者（年龄 52.0±12.2（SD）岁；93.2%为女性；58.8%为白人；体重指数 30.1±6.7 kg/m2；FFMQ 评分 131.3±20.7；修订纤维肌痛影响问卷评分 57.0±19.4）。总体正念得分较高与纤维肌痛影响（r=-0.25）、疼痛干扰（r=-0.31）、压力（r=-0.56）、焦虑（r=-0.58）、抑郁（r=-0.54）和心理健康相关生活质量（r=0.57）的降低显著相关。描述、觉察行动和不评判这三个正念维度也与这些结局相关。正念调节了纤维肌痛影响对焦虑的作用（交互 P=0.01）。
结论
在纤维肌痛患者中，较高的正念与疼痛干扰减轻、纤维肌痛影响降低以及更好的心理健康和生活质量相关。正念调节了纤维肌痛影响对焦虑的作用，提示正念可能改变了患者对纤维肌痛的应对方式。未来研究应评估旨在培养正念的身心疗法如何影响纤维肌痛患者的健康状况。
关键点
较高的正念与更好的心理健康和较低的纤维肌痛整体影响相关。
正念调节了纤维肌痛整体影响与焦虑的关系。
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