为期4周的正念减压疗法对肺癌患者心理困扰的疗效及机制：一项单中心、单盲、纵向、随机对照试验

Efficacy and mechanisms of 4-week MBSR on psychological distress in lung cancer patients: A single-center, single-blind, longitudinal, randomized controlled trial.

作者信息

Tian Xu, Liao Zhongli, Yi Lijuan, Tang Ling, Chen Guihua, Jiménez Herrera María F

机构信息

Nursing Department, Universität Rvoira I Virgili, Tarragona, Spain.

Chongqing University Cancer Hospital, Chongqing, China.

出版信息

Asia Pac J Oncol Nurs. 2022 Oct 13;10(1):100151. doi: 10.1016/j.apjon.2022.100151. eCollection 2023 Jan.

DOI:10.1016/j.apjon.2022.100151

PMID:36406466

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9667193/

Abstract

OBJECTIVE

This study aimed to evaluate the efficacy of a 4-week mindfulness-based stress reduction (MBSR) program on psychological distress in patients with lung cancer and elucidate its mechanisms.

METHODS

This single-center, single-blinded, longitudinal, randomized controlled trial was conducted on 175 patients with lung cancer randomly allocated to a 4-week MBSR or a waiting-list group. The efficacy and mechanisms of the 4-week MBSR program were evaluated by outcome measures at preintervention (T0), the immediate postintervention (T1), 1 month (T2), and 3 months (T3). We analyzed the collected data using the per-protocol set principle, independent sample t-test, repeated measure analysis of variance, and structural equation modeling.

RESULTS

The 4-week MBSR program significantly alleviated psychological distress ( = 15.05, < 0.001), decreased perceived stigma ( = 8.260, = 0.005), improved social support ( = 16.465, < 0.001), and enhanced mindfulness ( = 17.207, < 0.001) compared with usual care at T1, T2, and T3. All variables significantly changed over time except for copying style ( = 0.250). The changes in social support, mindfulness, and perceived stigma mediated the efficacy of the 4-week MBSR program on psychological distress ( = -0.292, = 0.005; = -0.358, = 0.005).

CONCLUSIONS

This study shows the benefits of the MBSR program for psychological distress, social support, mindfulness, and perceived stigma in patients with lung cancer. Also, it elucidates the mechanisms by which the MBSR program alleviates psychological distress by improving social support, enhancing mindfulness, and decreasing perceived stigma. The findings provide insights into applying the MBSR program to reduce psychological distress among patients with lung cancer.

摘要

目的

本研究旨在评估为期4周的基于正念减压疗法（MBSR）对肺癌患者心理困扰的疗效，并阐明其作用机制。

方法

本单中心、单盲、纵向、随机对照试验对175例肺癌患者进行，这些患者被随机分配至为期4周的MBSR组或等待名单组。在干预前（T0）、干预后即刻（T1）、1个月（T2）和3个月（T3）时，通过结局指标评估为期4周的MBSR项目的疗效和机制。我们使用符合方案集原则、独立样本t检验、重复测量方差分析和结构方程模型对收集的数据进行分析。

结果

与常规护理相比，为期4周的MBSR项目在T1、T2和T3时显著减轻了心理困扰（F = 15.05，P < 0.001），降低了感知污名（F = 8.260，P = 0.005），改善了社会支持（F = 16.465，P < 0.001），并增强了正念（F = 17.207，P < 0.001）。除应对方式外（F = 0.250），所有变量均随时间有显著变化。社会支持、正念和感知污名的变化介导了为期4周的MBSR项目对心理困扰的疗效（β = -0.292，P = 0.005；β = -0.358，P = 0.005）。