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Ann Rheum Dis ; 71(6): 911-7, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22186709

RESUMO

OBJECTIVE: To evaluate the effects of a mindfulness-based group intervention, the Vitality Training Programme (VTP), in adults with inflammatory rheumatic joint diseases. METHODS: In a randomised controlled trial, the VTP-a 10-session mindfulness-based group intervention including a booster session after 6 months-was compared with a control group that received routine care plus a CD for voluntary use with mindfulness-based home exercises. The primary outcome was psychological distress measured by the General Health Questionnaire-20. Self-efficacy (pain and symptoms) and emotion-focused coping (emotional processing and expression) were used as co-primary outcomes. Secondary outcomes included pain, fatigue, patient global disease activity, self-care ability and well-being. Effects were estimated by mixed models repeated measures post-intervention and at 12-month follow-up. RESULTS: Of 73 participants randomised, 68 completed assessments post-intervention and 67 at 12 months. Significant treatment effects in favour of the VTP group were found post-treatment and maintained at 12 months in psychological distress (adjusted mean between-group difference -3.7, 95% CI -6.3 to -1.1), self-efficacy pain (9.1, 95% CI 3.4 to 14.8) and symptoms (13.1, 95% CI 6.7 to 19.3), emotional processing (0.3, 95% CI 0.02 to 0.5), fatigue (-1.1, 95% CI -1.8 to -0.4), self-care ability (1.0, 95% CI 0.5 to 1.6) and overall well-being (0.6, 95% CI 0.1 to 1.2). No significant group differences were found in emotional expression, pain or disease activity. CONCLUSION: The VTP improved most primary and secondary outcomes compared with individual use of CD exercises. Improvements were maintained at 12 months, suggesting that the VTP is a beneficial complement to existing treatments for patients with inflammatory rheumatic joint diseases.


Assuntos
Sintomas Afetivos/terapia , Fadiga/terapia , Psicoterapia de Grupo/métodos , Doenças Reumáticas/psicologia , Estresse Psicológico/terapia , Adaptação Psicológica , Adulto , Sintomas Afetivos/etiologia , Sintomas Afetivos/psicologia , Idoso , Arteterapia/métodos , Conscientização , Fadiga/etiologia , Fadiga/psicologia , Feminino , Humanos , Imagens, Psicoterapia/métodos , Masculino , Pessoa de Meia-Idade , Musicoterapia/métodos , Doenças Reumáticas/complicações , Doenças Reumáticas/imunologia , Autoeficácia , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Resultado do Tratamento , Adulto Jovem
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