期刊论文详细信息
Trials
The use of mindfulness-based cognitive therapy for improving quality of life for inflammatory bowel disease patients: study protocol for a pilot randomised controlled trial with embedded process evaluation
Angus JM Watson2  Gill Hubbard1  Iain M Atherton1  Mariyana Schoultz1 
[1] Centre for Health Science, School of Nursing, Midwifery and Health, University of Stirling, Inverness, Scotland;Raigmore Hospital NHS Highland, Inverness, Scotland
关键词: Pilot randomised controlled trial;    Quality of life;    Ulcerative colitis;    Crohn’s disease;    Inflammatory bowel disease;    Mindfulness-based cognitive therapy;   
Others  :  807802
DOI  :  10.1186/1745-6215-14-431
 received in 2013-10-04, accepted in 2013-12-05,  发布年份 2013
PDF
【 摘 要 】

Background

Inflammatory bowel disease (IBD) is a chronic condition with an unpredictable disease course. Rates of anxiety and depression among IBD patients in relapse (active disease symptoms) as well as in remission are higher than in the general population. Previous studies suggest that the prolonged effect of pain, anxiety, distress and depression have a detrimental effect on patients’quality of life (QoL). Poor QoL in itself is associated with further symptom relapse. Mindfulness based cognitive therapy (MBCT) is a psychological group intervention that has the potential to improve QoL. When used in other chronic conditions, it demonstrated reduced negative effect from pain and psychological factors at completion of an 8-week MBCT course. The effect of MBCT has never been researched in IBD. The aim of this study is to obtain the information required to design a full scale randomised controlled trial (RCT) that will examine the effectiveness of MBCT in improving quality of life for IBD patients.

Methods/Design

This is an exploratory RCT with embedded process evaluation. Forty IBD patients will be recruited from NHS outpatient gastroenterology clinics and will be randomised to either a MBCT (intervention) group or to a wait-list (control) group. All participants will undergo 16 h of structured group training over an 8-week period, with the control group starting 6 months later than the intervention group. Primary outcomes are recruitment, completion/retention rates and adherence and adaptation to the MBCT manual for IBD patients. The secondary outcome is to assess the feasibility of collecting reliable and valid data on proposed outcome measures such as quality of life, anxiety, depression, disease activity and mindful awareness. The process evaluation will use a survey and focus groups to assess the acceptability of the intervention and trial procedures for IBD patients.

Discussion

The outcomes of this study will help define the barriers, uptake and perceived benefits of MBCT program for IBD patients. This information will enable the design of a full-scale study assessing the effect of MBCT on quality of life for IBD patients.

Trial registration

Current Controlled Trials: ISRCTN27934462

【 授权许可】

   
2013 Schoultz et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140708121031890.pdf 517KB PDF download
Figure 1. 53KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Casati J, Toner B: Psychosocial aspects of inflammatory bowel disease. Biomed Pharmacother 2000, 54:388-393.
  • [2]Baumgart DC, Sandborn WJ: Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet 2007, 369:1641-1657.
  • [3]Baumgart DC, Sandborn WJ: Crohn’s disease. Lancet 2012, 380:1590-1605.
  • [4]Head KA, Jurenka JS: Inflammatory bowel disease part 1: ulcerative colitis–pathophysiology and conventional and alternative treatment options. Altern Med Rev 2003, 8:247-283.
  • [5]Stone MA, Mayberry JF, Baker R: Prevalence and management of inflammatory bowel disease: a cross-sectional study from central England. Eur J Gastroenterol Hepatol 2003, 15:1275-1280.
  • [6]Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G, Benchimol EI, Panaccione R: Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 2012, 142:46-54.
  • [7]Johnson M, Lithgo K, Prouse T, Price T: PWE-095 A 10 year review of the death rate and cause of death within a district general cohort of inflammatory bowel disease patients. Gut 2013, Suppl 1:A169.
  • [8]Graff LA, Walker JR, Lix L, Clara I, Rawsthorne P, Rogala L, Miller N, Jakul L, McPhail C, Ediger J: The relationship of inflammatory bowel disease type and activity to psychological functioning and quality of life. Clin Gastroenterol Hepatol 2006, 4:1491-1501. e1
  • [9]Mittermaier C, Dejaco C, Waldhoer T, Oefferlbauer-Ernst A, Miehsler W, Beier M, Tillinger W, Gangl A, Moser G: Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study. Psychosom Med 2004, 66:79-84.
  • [10]Graff LA, Walker JR, Bernstein CN: Depression and anxiety in inflammatory bowel disease: a review of comorbidity and management. Inflamm Bowel Dis 2009, 15:1105-1118.
  • [11]Faust AH, Halpern LF, Danoff-Burg S, Cross RK: Psychosocial factors contributing to inflammatory bowel disease activity and health-related quality of life. Gastroenterol Hepatol 2012, 8:173.
  • [12]Levenstein S: Embracing complexity: what determines quality of life in inflammatory bowel disease? Eur J Gastroenterol Hepatol 2004, 16:1253-1255.
  • [13]Simrén M, Axelsson J, Gillberg R, Abrahamsson H, Svedlund J, Björnsson ES: Quality of life in inflammatory bowel disease in remission: the impact of IBS-like symptoms and associated psychological factors. Am J Gastroenterol 2002, 97:389-396.
  • [14]Mikocka-Walus AA, Turnbull DA, Moulding NT, Wilson IG, Andrews JM, Holtmann GJ: Antidepressants and inflammatory bowel disease: a systematic review. Clin Pract Epidemiol Mental Health 2006, 2:24. BioMed Central Full Text
  • [15]Mikocka-Walus AA, Turnbull DA, Moulding NT, Wilson IG, Andrews JM, Holtmann GJ: “It doesn’t do any harm, but patients feel better”: a qualitative exploratory study on gastroenterologists’ perspectives on the role of antidepressants in inflammatory bowel disease. BMC Gastroenterol 2007, 7:38. BioMed Central Full Text
  • [16]Goodhand JR, Greig FIS, Koodun Y, McDermott A, Wahed M, Langmead L, Rampton DS: Do antidepressants influence the disease course in inflammatory bowel disease? A retrospective case-matched observational study. Inflamm Bowel Dis 2012, 18:1232-1239.
  • [17]Pacher P, Kecskemeti V: Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns? Curr Pharm Des 2004, 10:2463.
  • [18]Andersohn F, Schade R, Suissa S, Garbe E: Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus. Am J Psychiatry 2009, 166:591-598.
  • [19]Makins R, Ballinger A: Gastrointestinal side effects of drugs. Expert Opin Drug Saf 2003, 2:421-429.
  • [20]Schirbel A, Reichert A, Roll S, Baumgart DC, Büning C, Wittig B, Wiedenmann B, Dignass A, Sturm A: Impact of pain on health-related quality of life in patients with inflammatory bowel disease. World J Gastroenterol 2010, 16:3168.
  • [21]Bernal I, Domenech E, Garcia-Planella E, Marín L, Mañosa M, Navarro M, Cabré E, Gassull MA: Medication-taking behavior in a cohort of patients with inflammatory bowel disease. Dig Dis Sci 2006, 51:2165-2169.
  • [22]Jackson C, Clatworthy J, Robinson A, Horne R: Factors associated with non-adherence to oral medication for inflammatory bowel disease: a systematic review. Am J Gastroenterol 2009, 105:525-539.
  • [23]Segal ZV, Williams J, Teasdale JD: Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York, NY: The Guilford Press; 2002.
  • [24]Kabat-Zinn J: Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Bantam Doubleday Dell Publishing; 1990.
  • [25]Baer RA: Mindfulness training as a clinical intervention: a conceptual and empirical review. Clin Psychol Sci Pract 2003, 10:125-143.
  • [26]Kabat‒Zinn J: Mindfulness‒based interventions in context: past, present, and future. Clin Psychol Sci Pract 2003, 10:144-156.
  • [27]National Institute for Health and Clinical Excellence: NICE clinical guidance: CG90 Depression in Adults. London: NICE; 2011. [http://www.nice.org.uk/guidance/QS8 webcite]
  • [28]Rosenzweig S, Greeson JM, Reibel DK, Green JS, Jasser SA, Beasley D: Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. J Psychosom Res 2010, 68:29.
  • [29]Bohlmeijer E, Prenger R, Taal E, Cuijpers P: The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J Psychosom Res 2010, 68:539-544.
  • [30]Jedel S, Merriman P, Hoffman A, Swanson B, Fogg LF, Keshavarzian A: Relationship of mindfulness, quality of life, and psychiatric symptoms among patients with ulcerative colitis. Mindfulness 2013, 4:296-300.
  • [31]Segal ZV, Williams JMG, Teasdale JD: Mindfulness-based cognitive therapy for depression. 2nd edition. New York, NY: The Guilford Press; 2012.
  • [32]Sands BE, Abreu MT, Ferry GD, Griffiths AM, Hanauer SB, Isaacs KL, Lewis JD, Sandborn WJ, Steinhart AH: Design issues and outcomes in IBD clinical trials. Inflamm Bowel Dis 2005, Suppl 1:S22-S28.
  • [33]Maunder RG, Esplen MJ: Supportive-expressive group psychotherapy for persons with inflammatory bowel disease. Can J Psychiatr 2001, 46:622-626.
  • [34]Larsson K, Karlbom U, Nordin K, Anderberg U, Lööf L: A group-based patient education programme for high-anxiety patients with Crohn disease or ulcerative colitis. Scand J Gastroenterol 2003, 38:763-769.
  • [35]Kennedy A, Nelson E, Reeves D, Richardson G, Roberts C, Robinson A, Rogers A, Sculpher M, Thompson D: A randomised controlled trial to assess the effectiveness and cost of a patient orientated self management approach to chronic inflammatory bowel disease. Gut 2004, 53:1639-1645.
  • [36]Jäghult S, Larson J, Wredling R, Kapraali M: A multiprofessional education programme for patients with inflammatory bowel disease: a randomized controlled trial. Scand J Gastroenterol 2007, 42:1452-1459.
  • [37]Sibaja D, Comeche Moreno M, Mas Hesse B: Tratamiento cognitivo-conductual protocolizado en grupo de las enfermedades inflamatorias intestinales. Rev Esp Enferm Dig 2007, 99:593-598.
  • [38]Oxelmark L, Magnusson A, Löfberg R, Hillerås P: Group‒based intervention program in inflammatory bowel disease patients: effects on quality of life. Inflamm Bowel Dis 2007, 13:182-190.
  • [39]Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M: Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008, 337:a1655.
  • [40]McDonald AM, Knight RC, Campbell MK, Entwistle VA, Grant AM, Cook JA, Elbourne DR, Francis D, Garcia J, Roberts I: What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies. Trials 2006, 7:9. BioMed Central Full Text
  • [41]Caldwell PH, Hamilton S, Tan A, Craig JC: Strategies for increasing recruitment to randomised controlled trials: systematic review. PLoS Med 2010, 7:e1000368.
  • [42]Crohns and Colitis UK. Information Sheet. Staying well with IBD. : NACC; 2012. [http://www.nacc.org.uk/downloads/factsheets/stayingWell.pdf webcite]
  • [43]Burgess D, Gebski V, Keech A: EBM: trials on trial. Med J Aust 2003, 179:105-107.
  • [44]Gaylord SA, Palsson OS, Garland EL, Faurot KR, Coble RS, Mann JD, Frey W, Leniek K, Whitehead WE: Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. Am J Gastroenterol 2011, 106:1678-1688.
  • [45]Wells CW, Lewis S, Barton JR, Corbett S: Effects of changes in hemoglobin level on quality of life and cognitive function in inflammatory bowel disease patients. Inflamm Bowel Dis 2006, 12:123-130.
  • [46]Guyatt G, Mitchell A, Irvine E, Singer J, Williams N, Goodacre R, Tompkins C: A new measure of health status for clinical trials in inflammatory bowel. Gastroenterology 1989, 96:804-810.
  • [47]Lix LM, Graff LA, Walker JR, Clara I, Rawsthorne P, Rogala L, Miller N, Ediger J, Pretorius T, Bernstein CN: Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease. Inflamm Bowel Dis 2008, 14:1575-1584.
  • [48]Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA: Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1983.
  • [49]Beck AT, Steer RA, Carbin MG: Psychometric properties of the beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev 1988, 8:77-100.
  • [50]Akbar A, Yiangou Y, Facer P, Brydon W, Walters JR, Anand P, Ghosh S: Expression of the TRPV1 receptor differs in quiescent inflammatory bowel disease with or without abdominal pain. Gut 2010, 59:767-774.
  • [51]Goebell H, Wienbeck M, Schomerus H, Malchow H: Evaluation of the Crohn’s Disease Activity Index (CDAI) and the Dutch index for severity and activity of Crohn’s disease. An analysis of the data from the European Cooperative Crohn’s Disease Study. Med Klinik (Munich) 1990, 85:573-576.
  • [52]Sipponen T, Savilahti E, Kolho K, Nuutinen H, Turunen U, Färkkilä M: Crohn’s disease activity assessed by fecal calprotectin and lactoferrin: correlation with Crohn’s disease activity index and endoscopic findings. Inflamm Bowel Dis 2008, 14:40-46.
  • [53]Walmsley R, Ayres R, Pounder R, Allan R: A simple clinical colitis activity index. Gut 1998, 43:29-32.
  • [54]Carlson LE, Brown KW: Validation of the mindful attention awareness scale in a cancer population. J Psychosom Res 2005, 58:29-33.
  • [55]MacKillop J, Anderson EJ: Further psychometric validation of the mindful attention awareness scale (MAAS). J Psychopathol Behav Assess 2007, 29:289-293.
  • [56]Hertzog MA: Considerations in determining sample size for pilot studies. Res Nurs Health 2008, 31:180-191.
  • [57]Johanson GA, Brooks GP: Initial scale development: sample size for pilot studies. Educ Psychol Meas 2010, 70:394-400.
  • [58]Crane C, Williams JMG: Factors associated with attrition from mindfulness-based cognitive therapy in patients with a history of suicidal depression. Mindfulness 2010, 1:10-20.
  • [59]Ritchie J, Spencer L: Qualitative data analysis for applied policy research. In Analysing qualitative data. Edited by Bryman A, Burgess R. London: Routledge; 1993:173-194.
  文献评价指标  
  下载次数:1次 浏览次数:14次