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喘息や関節リウマチの患者における症状の軽減に対するストレスの経験について書くことの効果:ランダム化試験
J M Smyth1, A A Stone, A Hurewitz
1Department of Psychiatry, State University of New York at Stony Brook School of Medicine, USA. smyth@prairie.nodak.edu
JAMA
|April 20, 1999
まとめ
ストレスの多い人生の出来事について書くことで,喘息やリウマチ性関節炎の患者の健康状態が改善されました. この低コストで非薬学的な介入は,4ヶ月間にわたって有意な臨床改善を示しました.
科学分野:
- 精神体医学は精神体医学である.
- 臨床心理学の臨床心理学について
- 健康心理学 健康心理学について
背景:
- 非薬理学的治療は,慢性疾患の薬理療法に付随する貴重な補助薬です.
- トラウマについての表現的な文章は,健康な個人の幸福と医療利用に有益です.
研究 の 目的:
- ストレスの多い人生の経験について書くことによって,喘息やリウマチ性関節炎の患者の病気の状態に及ぼす影響を調査する.
- 疾患状態の変化を評価するために,標準化された定量的な結果測定法を活用する.
主な方法:
- ランダム化比較試験は112人の患者 (61人の喘息,51人の関節リウマチ) を対象に実施されました.
- 参加者には,人生で最もストレスの多い出来事や中立的なトピックについて書くように割り当てられました.
- 発症状態は,喘息のスピロメトリーと,発症当初と4ヶ月後に関節リウマチの臨床検査を用いて評価された.
主要な成果:
- 執筆グループの喘息患者は,肺機能の有意な改善を示した (FEV1増加;P<.001).
- 書き込みグループにおけるリウマチ性関節炎患者は,疾患の活動が低下したことを示した (28%の改善;P=.001).
- 全体として,実験患者の47.1%が臨床的に重要な改善を示し,対照群では24.3%であった (P=.001).
結論:
- ストレスの多い経験について書くことは,軽度から中等度の喘息とリウマチ性関節炎患者の臨床的に重要な健康状態の改善につながりました.
- これらの恩恵は,標準的な医療のみによる恩恵を上回った.
- これらの改善の長期的な持続性と,他の疾患における有効性を決定するために,さらなる研究が必要である.
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