Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China.
J Adv Nurs. 2021 May;77(5):2197-2213. doi: 10.1111/jan.14738. Epub 2021 Jan 12.
To assess the effects of mindfulness-based interventions for patients with coronary heart disease.
A systematic review with meta-analysis.
Eight mainstream databases, including Ovid MEDLINE, Embase, Ovid Emcare, PsycInfo, CINAHL complete, Web of Science, CENTRAL and PubMed, were searched from January 1979-March 2020.
Randomized controlled trials that evaluated mindfulness-based interventions on psychological outcomes, cardiovascular risk factors and quality of life in adults with coronary heart disease were considered. We conducted meta-analyses using the random-effects model.
Nine studies involving 644 participants were included. Compared with inactive controls (e.g. usual care), mindfulness-based interventions significantly reduced depression (SMD -0.72, 95% CI -1.23 to -0.21, p < .01) and stress (SMD -0.67, 95% CI -1.00 to -0.34, p < .01), but not anxiety and blood pressure. There were no significant psychological effects compared with active controls (e.g. other psychological interventions). In one of three studies that assessed generic quality of life, mindfulness-based interventions significantly improved psychological and social domains compared with active control. The intervention effects on other cardiovascular risk factors were inconclusive given that only one study assessed each outcome with non-significant findings. Subgroup analyses suggest that intervention type and participants' depression and anxiety status may influence intervention effects.
Mindfulness-based interventions may benefit patients with coronary heart disease in reducing depression and stress, but the effects on cardiovascular risk factors and quality of life are inconclusive.
This review offers preliminary evidence for the potential of mindfulness-based interventions as an effective complementary approach to addressing psychological distress among people with coronary heart disease. Given the limitations in current studies, further rigorously designed and well-reported research is necessary to give robust evidence. Studies exploring the intervention effects on cardiovascular risk factors and quality of life are warranted to remedy the research and knowledge gap.
评估基于正念的干预措施对冠心病患者的影响。
系统评价与荟萃分析。
从 1979 年 1 月至 2020 年 3 月，检索了 8 个主流数据库，包括 Ovid MEDLINE、Embase、Ovid Emcare、PsycInfo、CINAHL complete、Web of Science、CENTRAL 和 PubMed。
评估基于正念的干预措施对成人冠心病患者心理结果、心血管危险因素和生活质量影响的随机对照试验。我们使用随机效应模型进行荟萃分析。
纳入 9 项研究，共 644 名参与者。与非活动对照（如常规护理）相比，基于正念的干预显著降低了抑郁（SMD -0.72，95%CI -1.23 至 -0.21，p < 0.01）和应激（SMD -0.67，95%CI -1.00 至 -0.34，p < 0.01），但不能降低焦虑和血压。与活动对照（如其他心理干预）相比，没有显著的心理效果。在评估一般生活质量的 3 项研究中的 1 项中，与活动对照相比，基于正念的干预显著改善了心理和社会领域。由于只有一项研究评估了每种结果，且结果均无统计学意义，因此干预对其他心血管危险因素的影响尚不确定。亚组分析表明，干预类型和参与者的抑郁和焦虑状况可能会影响干预效果。
基于正念的干预可能有益于冠心病患者减轻抑郁和压力，但对心血管危险因素和生活质量的影响尚不确定。
本综述为基于正念的干预作为一种有效的补充方法，用于解决冠心病患者心理困扰提供了初步证据。鉴于目前研究的局限性，需要进一步设计严谨、报告良好的研究来提供有力的证据。需要开展研究探索干预对心血管危险因素和生活质量的影响，以弥补研究和知识空白。
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