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慢性疼痛中的身体功能与正念技能训练:一项系统综述

Physical functioning and mindfulness skills training in chronic pain: a systematic review.

作者信息

Jackson William, Zale Emily L, Berman Stanley J, Malacarne Alberto, Lapidow Amy, Schatman Michael E, Kulich Ronald, Vranceanu Ana-Maria

机构信息

Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA, USA,

Department of Psychiatry, Massachusetts General Hospital, Harvard School of Medicine, MA, USA.

出版信息

J Pain Res. 2019 Jan 3;12:179-189. doi: 10.2147/JPR.S172733. eCollection 2019.

Abstract

PURPOSE

The importance of improved physical function as a primary outcome in the treatment of chronic pain is widely accepted. There have been limited attempts to assess the effects mindfulness skills training (MST) has on objective outcomes in chronic pain care.

METHODS

This systematic review evaluated published reports of original randomized controlled trials that described physical function outcomes after MST in the chronic pain population and met methodological quality according to a list of predefined criteria. PRISMA criteria were used to identify and select studies, and assess their eligibility for inclusion. The established guidelines for best practice of systematic reviews were followed to report the results.

RESULTS

Of the 2,818 articles identified from the original search of four electronic databases, inclusionary criteria were met by 15 studies published as of August 10, 2015, totaling 1,199 patients. All included studies used self-report measures of physical function, and only two studies also employed performance-based measures of function. There were wide variations in how physical function was conceptualized and measured. Although the quality of the studies was rated as high, there was inconclusive evidence for improvement in physical function assessed by self-report due to contradiction in individual study findings and the measures used to assess function. Strong evidence for lack of improvement in physical function assessed via performance-based measures was found.

CONCLUSION

This review draws attention to the importance of having a unified approach to how physical function is conceptualized and assessed, as well as the importance of using quality performance-based measures in addition to subjective self-reports that appropriately assess the physical function construct within MSTs for chronic pain.

摘要

目的

改善身体功能作为慢性疼痛治疗的主要结果的重要性已得到广泛认可。在慢性疼痛护理中,评估正念技能训练(MST)对客观结果影响的尝试有限。

方法

本系统评价评估了已发表的原始随机对照试验报告,这些报告描述了慢性疼痛人群接受MST后的身体功能结果,并根据一系列预定义标准符合方法学质量要求。采用PRISMA标准识别和选择研究,并评估其纳入资格。遵循系统评价最佳实践的既定指南报告结果。

结果

在对四个电子数据库的原始检索中识别出的2818篇文章中,截至2015年8月10日发表的15项研究符合纳入标准,共计1199名患者。所有纳入研究均使用身体功能的自我报告测量方法,只有两项研究还采用了基于表现的功能测量方法。身体功能的概念化和测量方式存在很大差异。尽管研究质量被评为高,但由于个体研究结果和用于评估功能的测量方法存在矛盾,自我报告评估的身体功能改善的证据尚无定论。通过基于表现的测量方法评估发现身体功能缺乏改善的有力证据。

结论

本综述提请注意对身体功能的概念化和评估采用统一方法的重要性,以及除主观自我报告外使用高质量基于表现的测量方法的重要性,这些方法应能在慢性疼痛的MST中适当评估身体功能结构。

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