Carney Lauren M, Park Crystal L, Hingorany Pooja
Department of Population Health Science and Policy, Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai.
Deptartment of Psychological Sciences, University of Connecticut.
Psychol Conscious (Wash D C). 2023 Jun 15. doi: 10.1037/cns0000362.
While many systematic reviews have focused on relationships between mindfulness-based interventions (MBIs) and myriad outcomes, no systematic review has examined the through which MBIs affect outcomes in the context of cancer. A systematic review was conducted of experimental or quasi-experimental studies that longitudinally examined potential mechanisms of the effects of either mindfulness-based stress reduction (MBSR) or mindfulness-based cognitive therapy (MBCT) interventions with adult cancer patients and survivors. Searches were conducted in Pubmed, APA PsycInfo, Cumulated Index to Nursing and Allied Health Literature, Cochrane, and Scopus databases up to May 2022. The results of included studies were narratively synthesized and studies were graded for quality using a rubric tailored to mediational intervention studies. Of 156 experimental or quasi-experimental studies that implemented either MBSR or MBCT interventions with adult cancer patients and survivors, only 13 longitudinally tested for mediators (e.g., changes in mindfulness, rumination, and self-compassion) of intervention effects. Most studies lacked a strong, active control group and most (10/13) were of medium quality. Results on mindfulness as a mediator of intervention effects were inconclusive, and many other mediators were only tested within a single study. Methodological limitations, including lack of strong comparison groups and theoretical frameworks and inconsistent conceptualizations of mindfulness, preclude drawing strong conclusions from the current body of evidence. MBIs may operate differently for cancer patients/survivors, highlighting the importance of continuing to test for mediation within this population.
虽然许多系统评价关注基于正念的干预措施（MBIs）与众多结果之间的关系，但尚无系统评价研究MBIs在癌症背景下影响结果的机制。对实验性或准实验性研究进行了系统评价，这些研究纵向考察了针对成年癌症患者和幸存者的基于正念减压疗法（MBSR）或基于正念认知疗法（MBCT）干预效果的潜在机制。截至2022年5月，在PubMed、美国心理学会心理学文摘数据库（APA PsycInfo）、护理及相关健康文献累积索引数据库（Cumulated Index to Nursing and Allied Health Literature）、考科蓝图书馆（Cochrane）和Scopus数据库中进行了检索。对纳入研究的结果进行了叙述性综合，并使用针对中介干预研究量身定制的评分标准对研究质量进行了分级。在156项对成年癌症患者和幸存者实施MBSR或MBCT干预的实验性或准实验性研究中，只有13项对干预效果的中介因素（如正念、反刍和自我同情的变化）进行了纵向测试。大多数研究缺乏强大的、积极的对照组，且大多数（10/13）质量中等。关于正念作为干预效果中介因素的结果尚无定论，许多其他中介因素仅在一项研究中进行了测试。方法学上的局限性，包括缺乏强大的比较组和理论框架以及正念概念的不一致，妨碍了从当前证据中得出强有力的结论。MBIs对癌症患者/幸存者的作用可能不同，这凸显了继续在该人群中测试中介作用的重要性。
