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正念减压疗法和正念认知疗法对糖尿病患者的影响:系统评价和荟萃分析。

Effects of Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy in People With Diabetes: A Systematic Review and Meta-Analysis.

机构信息

Nurse, West China Hospital/West China School of Nursing, Sichuan University, Sichuan Province, Chengdu, China.

Nurse, Department of Nursing, West China Hospital, Sichuan University, Sichuan Province, Chengdu, China.

出版信息

J Nurs Scholarsh. 2020 Jul;52(4):379-388. doi: 10.1111/jnu.12560. Epub 2020 May 14.

Abstract

PURPOSE

The purpose of this study was to determine the effectiveness of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on depression, quality of life (QoL), and glycosylated hemoglobin (HbA1c) in people with diabetes.

DESIGN

A systematic literature review and meta-analysis was conducted.

METHODS

Eight databases (PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], Cochrane, PsycINFO, and three Chinese databases) were searched for relevant studies from inception to December 2019. Only randomized controlled trials (RCTs) of MBSR and MBCT interventions for people with type 1 and type 2 diabetes were included.

FINDINGS

Nine studies described in 11 articles were included in the review. Meta-analysis showed a significant effect favoring MBSR and MBCT on depression (standardized mean difference -0.84; 95% confidence interval [CI] -1.16 to -0.51; p < .0001), the mental health composite score of QoL (mean difference [MD] 7.06; 95% CI 5.09 to 9.03; p < .00001), and HbA1c (MD -0.28; 95% CI -0.47 to -0.09; p = .004). However, effects on the physical health composite score of QoL have not been found.

CONCLUSIONS

MBSR and MBCT are beneficial in improving depression, the mental health composite score of QoL, and HbA1c in people with diabetes. More well-designed trials using longer follow-up measurements are needed.

CLINICAL RELEVANCE

MBSR and MBCT could be considered as effective complementary treatment alternatives for people with diabetes.

摘要

目的

本研究旨在确定正念减压疗法(MBSR)和正念认知疗法(MBCT)对糖尿病患者抑郁、生活质量(QoL)和糖化血红蛋白(HbA1c)的疗效。

设计

进行了系统文献回顾和荟萃分析。

方法

从建库至 2019 年 12 月,检索了 8 个数据库(PubMed、Embase、护理学及相关健康专业文献累积索引 [CINAHL]、Cochrane、PsycINFO 和 3 个中文数据库),以寻找针对 1 型和 2 型糖尿病患者的 MBSR 和 MBCT 干预措施的相关研究。

结果

综述纳入了 9 项研究的 11 篇文章。荟萃分析显示,MBSR 和 MBCT 对抑郁(标准化均数差-0.84;95%置信区间[CI]:-1.16 至 -0.51;p<0.0001)、QoL 的心理健康综合评分(MD:7.06;95%CI:5.09 至 9.03;p<0.00001)和 HbA1c(MD:-0.28;95%CI:-0.47 至 -0.09;p=0.004)有显著效果。然而,尚未发现对 QoL 的身体健康综合评分有影响。

结论

MBSR 和 MBCT 有益于改善糖尿病患者的抑郁、QoL 的心理健康综合评分和 HbA1c。需要更多设计良好、随访时间更长的试验。

临床意义

MBSR 和 MBCT 可被视为糖尿病患者有效的补充治疗选择。

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