Mindfulness-Based Stress Reduction Therapy Improves Patient and Caregiver-Reported Outcomes in Cirrhosis
| Autor: | Thomas Burroughs, Andrew Fagan, Jasmohan S. Bajaj, Binu John, James B. Wade, Douglas M. Heuman, Edith Gavis, Timothy Ainger, Michael S. Ellwood, Michael Fuchs |
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| Rok vydání: | 2017 |
| Předmět: |
Stress reduction
medicine.medical_specialty Mindfulness Cirrhosis business.industry Original Contributions fungi Gastroenterology MEDLINE food and beverages medicine.disease Mindfulness-based stress reduction 03 medical and health sciences 0302 clinical medicine Quality of life (healthcare) Mood medicine Physical therapy 030211 gastroenterology & hepatology 030212 general & internal medicine business |
| Zdroj: | Clinical and Translational Gastroenterology |
| ISSN: | 2155-384X |
| DOI: | 10.1038/ctg.2017.38 |
| Popis: | Objectives: Patient-reported outcomes such as health-related quality of life (HRQOL) are impaired in cirrhosis due to under-treated mood and sleep disorders, which can adversely impact their caregivers. Mindfulness-based stress reduction (MBSR) can improve patient-reported outcomes (PRO) in non-cirrhotic patients but their impact in cirrhosis is unclear. To evaluate the effect of MBSR and supportive group therapy on mood, sleep and HRQOL in cirrhotic patients and their caregivers. Methods: Cirrhotic outpatients with mild depression (Beck Depression Inventory (BDI)>14) on screening with an adult caregiver were enrolled. At baseline, BDI, sleep (Pittsburgh sleep quality index PSQI, Epworth Sleepiness Scale, ESS), anxiety (Beck Anxiety inventory) and HRQOL (Sickness Impact Profile, SIP) for both patients/caregivers and caregiver burden (Zarit Burden Interview Short-form, ZBI-SF and perceived caregiver burden, PCB) and patient covert HE(CHE) status were measured. Patients who had BDI>14 at baseline, along with their caregivers then underwent a structured MBSR program with four weekly hour-long group sessions interspersed with home practice using CDs. After the last group, all questionnaires were repeated. Results: 20 patient/caregiver dyads were included. All patients were men (60±8 years MELD 12.9±5.7, 14 prior hepatic encephalopathy (HE)) while most caregivers (n=15) were women (55±12 years, 23±14 years of relationship, 65% spouses). There was no change in patient BDI between screening and baseline (20.1±11.2 vs. 19.0±10.6, P=0.81). All dyads were able to complete the four MBSR+supportive group therapy sessions. There was a significant improvement in BDI (19.0±10.6 vs.15.6±8.2 P=0.01), PSQI (7.2±3.7 vs. 5.5±3.7, P |
| Databáze: | OpenAIRE |
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