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炎症性肠病的在线正念干预:依从性与疗效

Online Mindfulness Intervention for Inflammatory Bowel Disease: Adherence and Efficacy.

作者信息

Forbes Leila, Johnson Susan K

机构信息

BASE Cognitive Behavioral, Charlotte, NC, United States.

Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States.

出版信息

Front Psychol. 2022 Mar 24;12:709899. doi: 10.3389/fpsyg.2021.709899. eCollection 2021.

Abstract

The impact of stress and other psychological variables on Inflammatory Bowel Disease (IBD) prognosis, treatment response, and functional level is well-established; however, typical IBD treatment focuses on the physiological pathology of the disease and neglects complementary stress-reducing interventions. Recent pilot studies report the benefits of mindfulness-based interventions (MBIs) in people living with IBD, but are limited by small sample sizes. Recruitment challenges to in-person studies may be in part due to the difficulty IBD patients often have adhering to fixed schedules and travel as a result of IBD symptoms such as pain, fatigue, and incontinence. The current study aimed to address this barrier by offering participants access to online mindfulness training, allowing individuals to engage with intervention materials to fit their own schedule. Online mindfulness programs have gained popularity in recent years, as they increase access and flexibility and decrease cost to the user; however, the dropout rate tends to be high. The current study compared the rate of adherence and efficacy of mindfulness training as a function of level of support: self-guided versus supported. Analysis revealed no significant difference in the benefits received between participants in the two groups; however, a significant difference group (χ = 15.75; = 0.000, = 0.38) was found in terms of rate of completion, with 44.1% of the supportive group completing the protocol compared to 11.7% of the self-guided. Common challenges to meditation were measured, but did not significantly predict adherence to the intervention, and experience of these challenges did not significantly change (increase or decrease) over the duration of the study. Implications of the current research, future directions for the use of MBI for IBD patients, and a discussion of methodological considerations are provided.

摘要

压力和其他心理变量对炎症性肠病(IBD)预后、治疗反应及功能水平的影响已得到充分证实;然而,IBD的典型治疗侧重于疾病的生理病理学,而忽视了辅助性的减压干预措施。近期的试点研究报告了基于正念的干预措施(MBIs)对IBD患者的益处,但受样本量较小的限制。面对面研究的招募挑战可能部分归因于IBD患者由于疼痛、疲劳和大小便失禁等IBD症状,往往难以遵守固定日程安排和出行。本研究旨在通过为参与者提供在线正念训练来克服这一障碍,使个体能够根据自己的日程安排参与干预材料。近年来,在线正念项目越来越受欢迎,因为它们增加了可及性和灵活性,并降低了用户成本;然而,辍学率往往较高。本研究比较了作为支持水平函数的正念训练的依从率和效果:自我指导与有支持。分析显示两组参与者获得的益处没有显著差异;然而,在完成率方面发现了显著差异(χ = 15.75; = 0.000, = 0.38),有支持组的44.1%完成了方案,而自我指导组为11.7%。对冥想的常见挑战进行了测量,但并未显著预测对干预的依从性,并且在研究期间这些挑战的体验没有显著变化(增加或减少)。本文提供了当前研究的意义、MBI用于IBD患者的未来方向以及方法学考虑因素的讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5569/8987583/3fd47b162a23/fpsyg-12-709899-g001.jpg

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