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基于正念的干预对子宫内膜异位症相关慢性疼痛女性自我调节心理生理指标的影响

Mindfulness-Based Intervention Effect on the Psychophysiological Marker of Self-Regulation in Women With Endometriosis-Related Chronic Pain.

作者信息

Moreira Marcelo F, Gamboa Olga L, Oliveira Marco A P

机构信息

State University of Rio de Janeiro, Faculty of Medical Sciences, Rio de Janeiro, RJ, Brazil.

EQness, Sydney, Australia; School of Psychology, A19-Griffith Taylor Building, University of Sydney, Camperdown, NSW, Australia.

出版信息

J Pain. 2024 Jan;25(1):118-131. doi: 10.1016/j.jpain.2023.07.026. Epub 2023 Jul 29.

Abstract

Endometriosis is a gynecological disease that involves a broad biopsychosocial compromise with the potential to create a negative vicious cycle. Despite the complexity of factors influencing women's improvement, most interventions investigated target just the peripheral nociceptive sources of endometriosis-related pain. An alternative is intervening in self-regulation, which can potentially influence multiple domains of the illness experience. The present study examines the effect of a brief Mindfulness-Based Intervention (bMBI) on attention and autonomic nervous system regulation in women with endometriosis-related pain. Also, explore the interaction between these self-regulation domains and the affective pain dimension. An exploratory analysis of the secondary outcomes of a pilot randomized controlled trial was performed. The vagally-mediated Heart Rate Variability (vmHRV) at rest, cognitive stress, and recovery was employed to measure autonomic regulation. The Flanker and Stroop tasks were used to estimate the attention domains. Results showed that bMBI (n = 26) significantly improved Flanker accuracy and Flanker and Stroop reaction time compared to the control group (n = 28). bMBI significantly increased vmHRV at rest and recovery after cognitive stress. Attention mediated the bMBI effect on affective pain improvement. Results suggest that bMBI improves self-regulation domains with the potential to develop a broad biopsychosocial benefit in the endometriosis context. PERSPECTIVE: This article demonstrates the positive impact of a brief Mindfulness-Based Intervention on attention and parasympathetic regulation in women suffering from endometriosis-related pain. This mindfulness-induced self-regulation improvement can benefit affective pain and potentially multiple psychophysiological processes relevant to endometriosis.

摘要

子宫内膜异位症是一种妇科疾病,涉及广泛的生物心理社会损害,有可能形成负面的恶性循环。尽管影响女性病情改善的因素复杂,但大多数研究的干预措施仅针对子宫内膜异位症相关疼痛的外周伤害性来源。另一种方法是干预自我调节,这可能会影响疾病体验的多个方面。本研究考察了基于正念的简短干预(bMBI)对患有子宫内膜异位症相关疼痛女性的注意力和自主神经系统调节的影响。此外,还探讨了这些自我调节方面与情感性疼痛维度之间的相互作用。对一项初步随机对照试验的次要结果进行了探索性分析。采用静息、认知应激和恢复时的迷走神经介导的心率变异性(vmHRV)来测量自主调节。使用侧翼任务和斯特鲁普任务来评估注意力方面。结果显示,与对照组(n = 28)相比,bMBI组(n = 26)的侧翼任务准确性以及侧翼任务和斯特鲁普任务的反应时间均有显著改善。bMBI显著提高了静息时和认知应激恢复后的vmHRV。注意力介导了bMBI对情感性疼痛改善的作用。结果表明,bMBI改善了自我调节方面,有可能在子宫内膜异位症背景下产生广泛生物心理社会效益。观点:本文证明了基于正念的简短干预对患有子宫内膜异位症相关疼痛女性的注意力和副交感神经调节具有积极影响。这种由正念引起的自我调节改善可有益于情感性疼痛,并可能有益于与子宫内膜异位症相关的多个心理生理过程。

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