在候诊室进行正念可减轻疼痛:三项试点随机对照试验的结果

IF 1.3 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Journal of Integrative and Complementary Medicine Pub Date : 2024-11-01 Epub Date: 2024-05-17 DOI:10.1089/jicm.2024.0020
Adam W Hanley, Rebecca Wilson Zingg, Benjamin Smith, Melissa Zappa, Shelley White, Allison Davis, Phillip R Worts, Carli Culjat, Geraldine Martorella
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引用次数: 0

摘要

介绍:正念干预可以改善患者的各种预后,但传统的正念干预需要耗费大量时间和资源。新的证据表明,简短的、单次疗程的正念干预也能改善患者的预后,而且简短的正念干预可以嵌入医疗护理路径中,干扰最小。然而,简短的正念干预对患者在候诊室等待时疼痛的直接影响仍未得到研究。研究目的我们进行了一系列三项试验性随机对照试验(RCT),以研究简短、录音、正念干预对患者在候诊室候诊时疼痛的影响。研究方法研究 1 检验了在看病前进行的 8 分钟正念录音;研究 2 检验了在看病后进行的 5 分钟正念录音;研究 3 检验了在看病前进行的 4 分钟正念录音。每项研究都使用了时间和注意力匹配的对照条件。研究 1 和研究 2 在一家学术性癌症医院进行。研究 3 在一家门诊骨科诊所进行。三项研究均对疼痛强度进行了测量。研究 2 和研究 3 对焦虑和抑郁症状进行了测量。研究 3 对疼痛的不快感进行了测量。研究结果简短(即 4 至 8 分钟)的正念录音干预降低了患者在诊所候诊室的疼痛强度,无论是在提供者就诊之前(研究 1 科恩氏 d=1.01,研究 3 科恩氏 d=0.39)还是之后(研究 2 科恩氏 d=0.89)。在对焦虑症状进行测量的两项研究中,正念对焦虑症状都有显著影响。对抑郁症状没有影响。结论:这三项试验性 RCT 的结果表明,简短的录音正念干预可以快速减轻临床症状。因此,在门诊候诊室嵌入简短的正念干预录音可能会改善患者的治疗效果。我们需要继续研究这种干预方法。临床试验注册:NCT04477278 和 NCT06099964。
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Mindfulness in the Clinic Waiting Room May Decrease Pain: Results from Three Pilot Randomized Controlled Trials.

Introduction: Mindfulness interventions can improve a broad range of patient outcomes, but traditional mindfulness-based interventions are time and resource intensive. Emerging evidence indicates brief, single-session mindfulness interventions can also improve patient outcomes, and brief mindfulness interventions can be embedded into medical care pathways with minimal disruption. However, the direct impact of a brief mindfulness intervention on patients' pain while waiting in the clinic waiting room remains unexamined. Objective: A series of three, pilot, randomized controlled trials (RCTs) were conducted to examine the impact of a brief, audio-recorded, mindfulness intervention on patients' pain in the clinic waiting room. Method: Study 1 examined an 8-min mindfulness recording delivered before a provider visit; Study 2 examined a 5-min mindfulness recording after a provider visit; and Study 3 examined a 4-min mindfulness recording before a provider visit. Time- and attention-matched control conditions were used in each study. Studies 1 and 2 were conducted in an academic cancer hospital. Study 3 was conducted at a walk-in orthopedic clinic. Pain intensity was measured in each of the three studies. Anxiety and depression symptoms were measured in Studies 2 and 3. Pain unpleasantness was measured in Study 3. Results: A brief (i.e., 4- to 8-min), audio-recorded mindfulness intervention decreased patients' pain intensity in the clinic waiting room, whether delivered before (Study 1 Cohen's d=1.01, Study 3 Cohen's d=0.39) or after (Study 2 Cohen's d=0.89) a provider visit. Mindfulness had a significant effect on anxiety symptoms in both studies in which it was measured. No effect on depression symptoms was observed. Conclusions: Results from these three pilot RCTs indicate brief, audio-recorded, mindfulness interventions may be capable of quickly decreasing clinical symptoms. As such, embedding brief, audio-recorded, mindfulness interventions in clinic waiting rooms may have the potential to improve patient outcomes. The continued investigation of this intervention approach is needed. Clinical Trial Registrations: NCT04477278 and NCT06099964.

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