{"title":"COPD患者数字化正念干预——多中心试点和可行性随机对照试验","authors":"Hannah Tschenett, Florian Vafai-Tabrizi, Ralf Harun Zwick, Arschang Valipour, Georg-Christian Funk, Urs M Nater","doi":"10.1186/s12931-025-03243-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Mindfulness-based interventions (MBIs) are effective in improving mental and physical health in various chronic conditions. While the GOLD 2024 report recommends MBIs for chronic obstructive pulmonary disease (COPD), scientific evidence in this specific population is scarce. This prospective randomised controlled pilot study investigated the feasibility of an 8-week digital MBI and its preliminary effects on mental and physical health in COPD.</p><p><strong>Methods: </strong>Psychologically burdened COPD patients (63 ± 7 years, 61% female, FEV1% 41 ± 19) were randomly allocated to the MBI group (n = 14; daily 10-15-minute audio-guided meditation via smartphone) or a waitlist control group (n = 16). Primary outcomes included the intervention's feasibility (dropouts, MBI usage rates, interview and questionnaire responses) and its preliminary effects on symptoms of anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Secondary outcomes included its preliminary effects on the COPD Assessment Test (CAT), Chronic Respiratory Disease Questionnaire (CRQ-SAS), Perceived Stress Scale (PSS-10), and biological stress markers. Exploratory outcomes included momentary subjective stress, anxiety, and dyspnoea after meditating.</p><p><strong>Results: </strong>The results indicated that the intervention was feasible (81% usage rate; 93% and 71% found the MBI enjoyable and helpful, respectively), with 21% dropout. A statistically significant intervention (time x group) effect was found for anxiety (HADS-A, p =.010, η<sub>p</sub><sup>2</sup> = 0.11) and emotional functioning (CRQ-SAS, p =.004, η<sub>p</sub><sup>2</sup> = 0.14), but not for depression (HADS-D, p =.060, η<sub>p</sub><sup>2</sup> = 0.06) or any other secondary outcome after 8 weeks. Momentary subjective stress (p <.001, η<sub>p</sub><sup>2</sup> = 0.75), anxiety (p =.022, η<sub>p</sub><sup>2</sup> = 0.75), and dyspnoea (p <.001, η<sub>p</sub><sup>2</sup> = 0.70) were significantly reduced after meditating.</p><p><strong>Conclusions: </strong>The digital MBI was feasible, with preliminary effects indicating improvements in anxiety and emotional functioning after 8 weeks as well as momentary outcomes after meditating. Future large-scale trials should further assess the effectiveness of digital MBIs in this context. However, the findings suggest that digital MBIs might be promising and effective low-threshold add-on treatments in clinical settings.</p><p><strong>Trial registration: </strong>The article has been preregistered at ClinicalTrials.gov (identifier: NCT04769505, date: 23rd February 2021).</p>","PeriodicalId":49131,"journal":{"name":"Respiratory Research","volume":"26 1","pages":"199"},"PeriodicalIF":5.8000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105243/pdf/","citationCount":"0","resultStr":"{\"title\":\"Digital mindfulness-based intervention for people with COPD - a multicentre pilot and feasibility RCT.\",\"authors\":\"Hannah Tschenett, Florian Vafai-Tabrizi, Ralf Harun Zwick, Arschang Valipour, Georg-Christian Funk, Urs M Nater\",\"doi\":\"10.1186/s12931-025-03243-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Mindfulness-based interventions (MBIs) are effective in improving mental and physical health in various chronic conditions. 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引用次数: 0
摘要
背景：基于正念的干预（MBIs）在改善各种慢性疾病的心理和身体健康方面是有效的。虽然GOLD 2024报告推荐mbi用于慢性阻塞性肺疾病（COPD），但这一特定人群的科学证据很少。这项前瞻性随机对照试验研究调查了8周数字MBI的可行性及其对慢性阻塞性肺病患者身心健康的初步影响。方法：心理负担型COPD患者（年龄63±7岁，女性61%，FEV1%, 41±19）随机分为MBI组(n = 14；每天通过智能手机进行10-15分钟的音频指导冥想)或候补名单对照组（n = 16）。主要结局包括干预的可行性（辍学率、MBI使用率、访谈和问卷回答）及其对焦虑和抑郁症状的初步影响（医院焦虑和抑郁量表，HADS）。次要结局包括COPD评估测试（CAT）、慢性呼吸系统疾病问卷（CRQ-SAS）、感知应激量表（PSS-10）和生物应激标志物的初步影响。探索性结果包括冥想后短暂的主观压力、焦虑和呼吸困难。结果：干预是可行的(使用率81%；分别有93%和71%的人认为MBI令人愉快和有帮助)，21%的人辍学。干预（时间x组）对焦虑的影响具有统计学意义(HADS-A, p =。010, ηp = 0.11)和情绪功能（CRQ-SAS, p = 0.11）。004, ηp2 = 0.14)，但抑郁无统计学意义（HADS-D, p = 0.14）。060, ηp2 = 0.06)或8周后任何其他次要结局。主观瞬时应激（p p = 0.75）、焦虑(p p =。022, ηp2 = 0.75)，冥想后呼吸困难（p p2 = 0.70）明显减轻。结论：数字MBI是可行的，初步效果表明8周后焦虑和情绪功能的改善以及冥想后的短暂结果。在此背景下，未来的大规模试验应进一步评估数字mbi的有效性。然而，研究结果表明，在临床环境中，数字mbi可能是有希望和有效的低阈值附加治疗。试验注册：本文已在ClinicalTrials.gov上预注册（标识符：NCT04769505，日期：2021年2月23日）。
Digital mindfulness-based intervention for people with COPD - a multicentre pilot and feasibility RCT.
Background: Mindfulness-based interventions (MBIs) are effective in improving mental and physical health in various chronic conditions. While the GOLD 2024 report recommends MBIs for chronic obstructive pulmonary disease (COPD), scientific evidence in this specific population is scarce. This prospective randomised controlled pilot study investigated the feasibility of an 8-week digital MBI and its preliminary effects on mental and physical health in COPD.
Methods: Psychologically burdened COPD patients (63 ± 7 years, 61% female, FEV1% 41 ± 19) were randomly allocated to the MBI group (n = 14; daily 10-15-minute audio-guided meditation via smartphone) or a waitlist control group (n = 16). Primary outcomes included the intervention's feasibility (dropouts, MBI usage rates, interview and questionnaire responses) and its preliminary effects on symptoms of anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Secondary outcomes included its preliminary effects on the COPD Assessment Test (CAT), Chronic Respiratory Disease Questionnaire (CRQ-SAS), Perceived Stress Scale (PSS-10), and biological stress markers. Exploratory outcomes included momentary subjective stress, anxiety, and dyspnoea after meditating.
Results: The results indicated that the intervention was feasible (81% usage rate; 93% and 71% found the MBI enjoyable and helpful, respectively), with 21% dropout. A statistically significant intervention (time x group) effect was found for anxiety (HADS-A, p =.010, ηp2 = 0.11) and emotional functioning (CRQ-SAS, p =.004, ηp2 = 0.14), but not for depression (HADS-D, p =.060, ηp2 = 0.06) or any other secondary outcome after 8 weeks. Momentary subjective stress (p <.001, ηp2 = 0.75), anxiety (p =.022, ηp2 = 0.75), and dyspnoea (p <.001, ηp2 = 0.70) were significantly reduced after meditating.
Conclusions: The digital MBI was feasible, with preliminary effects indicating improvements in anxiety and emotional functioning after 8 weeks as well as momentary outcomes after meditating. Future large-scale trials should further assess the effectiveness of digital MBIs in this context. However, the findings suggest that digital MBIs might be promising and effective low-threshold add-on treatments in clinical settings.
Trial registration: The article has been preregistered at ClinicalTrials.gov (identifier: NCT04769505, date: 23rd February 2021).
期刊介绍：
Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases.
As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion.
Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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