Bu sistematik derleme ve metaanaliz, kronik obstrüktif akciğer hastalığı (KOAH) olan bireylerde farkındalık temelli müdahalelerin klinik ve sağlıkla ilgili sonuçlar üzerindeki etkilerini değerlendirmeyi amaçlamıştır. Araştırma kapsamında ScienceDirect, PubMed, Medline, CINAHL ve ULAKBİM veri tabanları taranmış ve 2010 ve 2019 yılları arasında yayımlanmış olan 13 randomize kontrollü araştırma makalesi bu metaanalize dâhil edilmiştir. Makalelerin metodolojik kalitesini değerlendirmek için Jadad Ölçeği; yanlılık riskini değerlendirmek için ise Cochrane Yanlılık Değerlendirme Aracı kullanılmıştır. 'STATA' istatistiksel paket programıyla analizler gerçekleştirilmiştir. Araştırmaların örneklem büyüklüğü 30 ile 96 hasta arasında değişmektedir. Araştırmadaki tüm hastaların yaş ortalaması 64,6±7,3 olup, %68,45'i erkektir. Farkındalık temelli müdahalelerin sonucunda hastaların KOAH Değerlendirme Testi [standartlaştırılmış ortalama farkı (standardised mean difference 'SMD')=-0,46, %95 güven aralığı (GA): - 0,77 ile -0,16] ve St. George Solunum Anketi (SMD=-0,63, %95 GA: -0,87 ile-0,38) puanlarında anlamlı gelişme olduğu belirlenmiştir. Ancak Hastane Anksiyete Depresyon Skalası puanları açısından müdahale ve kontrol grupları arasındaki farkın istatistiksel açıdan anlamlı olmadığı belirlenmemiştir (SMD=-0,21, %95 GA: -0,45 ile 0,03). Bu metaanaliz, KOAH tanılı hastalara uygulanan farkındalık temelli müdahalelerin hastaların sağlık durumu, fiziksel kapasitesi ve yaşam kalitesi üzerine olumlu etkilerinin olduğunu ortaya çıkarmıştır. Türkiye'de KOAH hastalarına uygulanan farkındalık temelli çalışmaların çok sınırlı olduğu, meditasyon ve yoga gibi müdahalelerin hastalar üzerine etkilerini değerlendiren çalışmalara gereksinim olduğu belirlenmiştir. Farkındalık temelli uygulamaların etkilerini araştıracak ileri klinik çalışmaların iyi kalitede yapılandırılması ve KOAH'lı bireylerde sık görülen yorgunluk ve uyku problemlerini hedef alması önerilmektedir.
Anahtar Kelimeler: Farkındalık; hemşirelik; pulmoner hastalık, kronik obstrüktif; meta-analiz
This systematic review and meta-analysis aimed to assess the effects of mindfulness-based interventions on clinical and health-related outcomes in individuals with Chronic Obstructive Pulmonary Disease (COPD). ScienceDirect, PubMed, Medline, CINAHL, and ULAKBİM databases were searched and 13 randomized controlled studies published between January 2010 and December 2019 were included in this meta-analysis. The Jadad Scale for assessing methodological quality and the Cochrane bias assessment tool for evaluating the risk of bias of articles were used. The analysis was performed by using the Stata Statistical Software. The sample size of the studies ranged between 30 and 96 patients. The mean age of all patients was 64.6±7.3 years and 68.45% of patients were males. The COPD Assessment Test [standardised mean difference (SMD)=-0.46, 95% confidence interval (CI): -0.77 ile -0.16] and the St. George Respiratory Questionnaire (SMD=-0.63, 95% CI: -0.87 ile -0.38) scores of patients significantly improved following mindfulness-based interventions. However, there was no significant difference in Hospital Anxiety Depression Scale scores between groups (SMD=-0.21, 95% CI: -0.45 ile 0.03). This meta-analysis revealed that mindfulness-based practices applied to patients with COPD had positive effects on the health status, physical capacity and quality of life of patients. There is a need for studies evaluating the effects of mindfulness-based practices such as meditation and yoga on COPD patients in Turkey. Future studies should structure with high methodological quality, and examine also the effects of mindfulness-based practices on other frequently observed COPD symptoms such as fatigue, and sleep problems.
Keywords: Awareness; nursing; pulmonary disease, chronic obstructive; meta-analysis
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