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接受和承诺治疗加上通常的护理,以改善运动神经元疾病患者的生活质量 (COMMEND):英国的多中心,并行,随机对照试验

Rebecca L Gould¹, Christopher J McDermott², Benjamin J Thompson³

¹Division of Psychiatry, University College London, London, UK.

Lancet (London, England)

|May 12, 2024

概括

接受和承诺治疗 (ACT) 显著改善了运动神经元疾病患者的生活质量. 这种心理治疗与常规护理相结合,为管理这种渐进的神经退行性疾病提供了临床有效的方法.

科学领域:

神经科学
心理学
临床医学

背景情况:

运动神经元疾病 (MND) 是一种致命的,进展性神经退行性疾病,目前尚无治疗方法.
接受和承诺治疗 (ACT) 是一种利用接受,正念和行为改变策略的心理干预.

研究的目的:

评估ACT与常规护理相结合的有效性,与单独的常规护理相比,提高了被诊断为MND的个体的生活质量.

主要方法:

在16个英国MND护理中心进行了一项并行,多中心,双臂随机对照试验.
191名符合El EscorialMND标准的参与者被随机分配 (1:1) 接受多达8次适应性ACT治疗加上常规治疗或仅接受常规治疗.
随机化后6个月使用麦吉尔生命质量调查问卷 (MQOL- R) 评估生命质量,并进行治疗意向分析.

主要成果:

在6个月后,ACT加常规护理与单独的常规护理相比,生活质量呈现显著改善 (MQOL- R的调整平均差异:0. 66;p=0. 0031).
观察到的效果大小中等,被认为具有临床意义,没有因ACT干预而导致的不良事件.
在6个月的随访期间,81%的参与者提供了初级结果数据.

结论:

当ACT与常规护理相结合时,它在维持或改善运动神经元疾病患者的生活质量方面具有临床效果.
医疗保健提供者应探索将适应的ACT整合到MND患者的临床服务中,以提高患者的福祉.

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