正念介入在安寧緩和療護之運用－系統性文獻查證

Mindfulness-based Interventions in Palliative Care - A Systematic Review

10.6537/TJHPC.2017.22(2).1

王淑貞(Shu-Chen Wang)；胡文郁(Wen-Yu Hu)

生命末期 ； 安寧緩和療護 ； 正念 ； 系統性文獻查證 ； terminal patients ； hospice and palliative care ； mindfulness ； systematic review

安寧療護雜誌

22卷2期（2017 / 07 / 01）

125 - 137

繁體中文

研究目的：本文主旨在探討正念介入運用在末期病人或安寧緩和照護之成效。材料與方法：以系統性文獻，搜尋2014 年以前在Cochran Library, PubMed, CINAHL, 及PsyINFO 等資料庫之相關文獻。文章納入條件：任何以正念介入之實驗性設計、研究對象年齡＞18 歲、末期疾病或是接受安寧緩和照護的病人，研究介入以正念相關的措施等條件。排除條件：非末期病人及非進展性癌症的病人。隨機分派試驗(RCT)文章研究品質以Jadad scale 評論。結果：共搜尋到339 篇英文文獻，經過篩選後，有7 篇符合本文收案條件，其中有2 篇是來自於同一個研究，在6 篇研究中有4 篇是RCT，另外2篇為類實驗式研究。結論：正念減壓運用在安寧緩和療護或是末期病人的實證證據仍然缺乏，對於病人生活品質的效果雖達統計顯著差異，但在生理與心理的成效指標及正念介入的方法各不同，未來仍需要有介入步驟的標準。此外，病人中途退出或失去追蹤的人數，會影響到研究品質，對於未來以末期病人為對象的研究設計，應該要將這些干擾因素納入考量。

Purpose: The aim of this paper is to present the evidence of the mindfulness-based intervention in terminal patients or hospice palliative care service. Methods: A systematic review was undertaken. Electronic databases including Cochran Library, PubMed, CINAHL, and PsyINFO were searched from first available years of the database to 2014. Inclusion criteria: types of studies: All kind of research-based study were considered for inclusion in this review. types of participants: Adults ＞18 years of age with an advanced disease or were undergoing palliative or hospice care. Types of interventions: mindfulness relevant intervention was included. Exclusion criteria: participants not suffering from advanced disease or not terminal illness were excluded. In addition, the intervention of study that was not related to mindfulness were excluded. The quality of the RCT studies were using Jadad scale. Results: There were 7 research papers identified from 339 records retrieved and screened. The 7 studies consisted of 4 randomized controlled trials and 2 Quasi- experimental studies. Conclusion: The evidence of mindfulness intervention in terminal patients is still insufficient but had little effect on the quality of life. The interventions of mindfulness were various. Better designs of the interventional protocol may be needed. Moreover, it is necessary to consider the dropout of participants and the quality of study. For the future research it is necessary to concern the confounding variable in palliative setting.

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