精神分裂症幻听患者接受正念疗法体验质性研究的Meta整合

Meta integration of the psychological experience in mindfulness therapy for schizophrenic patients with auditory hallucination

目的归纳总结精神分裂症幻听患者接受正念疗法的心理体验,为精神分裂症幻听患者正念疗法的干预方案提供循证依据。方法计算机检索PubMed、Web of Science、EBSCOhost、中国知网、万方和维普(VIP)数据库,收集有关精神分裂症幻听患者对正念疗法体验的质性研究,检索时限为2016年1月1日至2021年5月30日。采用2016版“JBI循证卫生保健中心质性研究真实性评价标准”对文献进行评价,汇集性整合方法整合结果。结果共纳入6项研究,提炼出35个结果,归纳出9个类别,合成4个整合结果:(1)精神分裂症幻听患者应用培养的正念技能与幻听和平共处;(2)精神分裂症幻听患者对正念的感知益处;(3)正念对精神分裂症幻听患者的消极影响及学习困难;(4)改进与丰富正念练习建议。结论正念疗法有助于改善患者的身心健康、幻听症状以及促进疾病的康复。但应完善治疗师的治疗方式与丰富正念的治疗形式、内容,依据患者的理解能力与认知功能制定个性化正念练习,协助患者克服正念练习时的困难,提高正念疗法的依从性,促进正念疗法的应用。

Objective To explore the psychological experience of schizophrenic patients with auditory hallucinations who underwent mindfulness therapy so as to provide references for making an intervention plan for mindfulness therapy. Methods Databases of PubMed, Web of Science, EBSCOhost, CNKI, Wanfang Data and VIP(VIP) from January 1, 2016 to May 30, 2021 were searched to collect qualitative studies in the experience of schizophrenic patients with auditory hallucinations under mindfulness therapy. The acquired literatures were evaluated using the JBI Evidence-Based Health Care Center Qualitative Research Authenticity Evaluation Criteria(2016).Methods of pooled integration were used to integrate the results. Results A total of 6 studies were included together with 35 results extracted and 9 categories summarised. Four integrated results were synthesised: 1) The mindfulness skills cultivated by schizophrenic auditory hallucinations coexisted peacefully with auditory hallucinations;2) benefits of mindfulness perceived by schizophrenic patients with auditory hallucinations;3) negative effects of mindfulness on auditory hallucinations and learning difficulties in the schizophrenic patients and 4) suggestions for the improvement and enhancement of mindfulness practice.Conclusions The benefits of mindfulness therapy for schizophrenic patients with auditory hallucinations can help to improve the physical and mental health and auditory hallucination symptoms,as well as to promote the recovery of the disease.Future studies are required to improve the treatment methods for therapists and enrich the form and content of mindfulness therapy by formulating individualised mindfulness training based on the understanding and cognitive functions of patients,so as to help the patients overcome the difficulties in mindfulness practice,improve the compliance in mindfulness therapy and promote the application of mindfulness therapy.