【作者】 刘冯铂； 张忠秋； 刘书强；

【Author】 LIU Fengbo;ZHANG Zhongqiu;LIU Shuqiang;School of Psychology, Beijing Sport University;China Institute of Sport Science;

【机构】 北京体育大学心理学院； 国家体育总局体育科学研究所；

【摘要】 目的:康复是残疾人实现权利的基本条件和首要前提,大量临床研究证实了正念对残疾人的身心康复效果。但是,目前正念干预对于残疾人康复的效果大小尚无定论,其次,迄今为止,正念干预在东西方文化背景下对于残疾人的效果是否相同也不明确。因此,本研究参考Meta分析研究优先报告项目-方案,将东西方国家在残疾人正念干预领域的研究均纳入分析,系统考察正念干预对残疾人的干预效果,并探讨潜在调节因素及其作用程度。方法:检索英文数据库(Web of Science、EBSCO、APA PsycInfo、Psychology and Behavioral Sciences Collection、MEDLINE),与中文数据库(中国知网CNKI数据库、万方数据知识服务平台),获取经过评审的相关论文全文。文献时间跨度设定为2010年1月1日至2020年11月30日,检索时间为2020年12月10日。由2名研究者独立筛选文献、提取资料并评价纳入研究的质量,文献质量评估采用Jadad量表。采用Review Manager 5.3软件进行Meta分析,使用标准化均数差Cohen’s d作为实验组(正念组)与对照组(非正念组)的效果量。采用漏斗图法、Egger线性回归法和Begg秩相关法进行发表偏倚检验。基于循证医学理念,从被试特征、干预特征和研究特征这三个方面关注可能存在的调节变量。结果:最终纳入东西方国家实证研究共15项(1065名被试)。64项结局指标评价了正念干预对残疾人康复的影响,其合并结果间统计学异质性高(p<0.00001; I2=73%)。效果量评价结果显示,正念干预对残疾人康复的整体效果量显著d=0.51,95%CI[0.38, 0.63],p<0.00001。漏斗图显示研究多集中在顶部,且左右顶部对称性良好;Egger线性回归检验结果显示,截距为0.79(p=0.151>0.5), 95%CI [-0.30, 1.88]包含0; Begg秩相关检验结果显示,Z=1.88<1.96(p=0.060>0.5),显示研究不存在发表偏倚。亚组分析结果显示干预周期(p=0.03, I2=79%)和家庭练习(p=0.03, I2=78%)显著调节残疾人的康复效果。结论:正念干预对残疾人的康复具有中等效果;康复效果受干预周期和家庭练习的影响。更多还原

【Abstract】 Objective: Rehabilitation is the basic condition and primary prerequisite for the disabled to realize their rights. A large number of clinical studies have confirmed the effect of mindfulness on the physical and psychological rehabilitation of the disabled. However, at present, the effect of mindfulness training is still inconclusive. Secondly, it is not clear whether mindfulness training has the same effect in the context of Eastern and Western cultures.Therefore, this study aims to systematically review the effect size of mindfulness training on people with disabilities’ rehabilitation. Methods: Web of Science, EBSCO, APA PsycInfo, Psychology and Behavioral Sciences Collection,MEDLINE, CNKI, and Wanfang were electronically searched to collect studies on the current status of people with disabilities’ rehabilitation from January 1 st, 2010 to November 31 th, 2020. Two reviewers independently screened literature, extracted data and assessed the qualities of included studies. Then, meta-analysis was performed by using Review Manager 5.3 software. The funnel plot method, Egger linear regression method and Begg rank correlation method were used for publication bias test. Based on the concept of evidence-based medicine, it pays attention to the possible moderating variables from three aspects: participant characteristics, intervention characteristics and research characteristics. Results: Fifteen researches were revealed in our analyses from both Eastern and Western countries(k=64 samples, n=1065 participants). The results of meta-analysis showed that mindfulness training for people with disabilities’ rehabilitation was shown to be significant efficacious(d=0.51, 95% CI [0.38, 0.63], p<0.00001). The funnel plot showed that the researches were mostly concentrated at the top, and the left and right tops were symmetrical; Egger linear regression test results showed that the intercept was 0.79(p=0.151>0.5), 95% CI [-0.30,1.88] contained 0; Begg rank correlation test result showed that Z=1.88<1.96(p=0.060>0.5). Subgroup analysis showed that training time(p=0.03, I2=79%) and home practice(p=0.03, I2=78%) significantly moderated the effect of mindfulness training. Conclusion: Mindfulness training for people with disabilities’ rehabilitation is efficacious with a medium effect, which is influenced by training time and home practice.更多还原