正念干预改善运动员心理康复效果的系统综述和Meta分析

doi:10.3969/j.issn.1006-9771.2020.12.004

摘要/Abstract

摘要：

目的综合评价正念干预对运动员心理康复的效果。方法检索2010年1月1日至2019年12月31日Web of Science、EBSCO、PubMed、Medline、OpenDissertations、Psychology and Behavioral Sciences Collection、Academic Search Premier、中国知网(CNKI)、维普和万方数据库有关正念干预促进运动员心理康复的研究,对纳入文献进行质量评价,采用Review Manager 5.3软件进行Meta分析。结果共纳入18项研究。正念干预对运动员心理康复即刻效果呈中到大效应量(d= 0.69, 95%CI 0.53~0.86, P< 0.001),但存在发表偏倚。正念组干预的追踪效应量不显著(d= -0.08, 95%CI -0.33~0.16, P= 0.50)。正念干预的康复效果受研究质量的影响(I² = 88.1%, P= 0.004)。结论正念干预对运动员心理康复的效果主要表现为改善心境,促进流畅体验,提高消极体验的接受性,提高对目标的行动力和提高训练的投入程度。正念干预效果受研究质量的影响。

关键词: 正念, 运动员, 心理康复, Meta分析

Abstract:

Objective To evaluate the effect of mindfulness on psychological rehabilitation in athletes.Methods Literatures about mindfulness meditation for psychological rehabilitation of athletes were searched in Web of Science, EBSCO, PubMed, Medline, OpenDissertations, Psychology Behavioral Sciences Collection, Academic Search Premier, CNKI, VIP and Wanfang data from January 1st, 2010 to December 31st, 2019. The literature quality was evaluated, and the data were analyzed with Review Manager 5.3.Results Finally, 18 researches were included. The immediate effect size of mindfulness on psychological rehabilitation was medium to large (d= 0.69, 95%CI 0.53 to 0.86, P< 0.001). There was no significant difference in the follow-up effect of psychological rehabilitation between two groups (d= -0.08, 95%CI -0.33 to 0.16, P= 0.50). The immediate effect of mindfulness was significantly moderated by research quality (I² = 88.1%, P= 0.004).Conclusion Mindfulness could improve mood, promote flow, improve acceptance of negative experiences, improve the ability to act on the goal, and increase training investment for athletes, which is moderated by research quality.

Key words: mindfulness, athlete, psychological rehabilitation, meta-analysis

中图分类号:

R493

刘冯铂,张忠秋,邱服冰,李安巧,刘书强. 正念干预改善运动员心理康复效果的系统综述和Meta分析[J]. 《中国康复理论与实践》, 2020, 26(12): 1390-1400.

LIU Feng-bo,ZHANG Zhong-qiu,QIU Fu-bing,LI An-qiao,LIU Shu-qiang. Effect of Mindfulness on Psychological Rehabilitation of Athletes: A Systematic Review and Meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(12): 1390-1400.

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研究者使用的主要干预技术及其核心内容、机制和效果"

作者	干预技术	干预核心内容	干预机制	对运动员心理康复的效果	结局指标
Aherne等^[8]	MT	活在当下、行为投入	改善注意障碍、改善应激障碍、去自我中心化	提高消极体验的接受性、促进流畅体验	正念水平、流畅体验
Ajilchi等^[21]	MSPE	活在当下、不判断、行为投入	改善注意障碍、改善情绪调节障碍、去自我中心化	提高消极体验的接受性、改善心境	正念水平、心理韧性、情绪
Baltar等^[22]	正念冥想	行为投入	改善注意障碍	提高消极体验的接受性、提高训练的投入程度	注意、正念水平
Briegel-Jones等^[23]	Sivananda yoga	活在当下、行为投入	改善注意障碍、去自我中心化	提高消极体验的接受性、促进流畅体验	正念水平、流畅体验
Dehghani等^[24]	MAC	不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍	提高对目标的行动力、改善心境	经验性回避、焦虑
Goodman等^[25]	MAC+Yoga	不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍	提高消极体验的接受性、提高对目标的行动力、提高训练的投入程度	正念水平、经验性回避、动机、应激、心理韧性
Josefsson等^[26]	MAC	不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍	提高消极体验的接受性、改善心境	正念水平、情绪调节障碍
Li等^[27]	6-min brief mindfulness	行为投入	改善注意障碍	提高消极体验的接受性、改善心境	正念水平、睡眠、唤醒
Moen等^[28]	MT	活在当下、行为投入	改善注意障碍、去自我中心化	提高消极体验的接受性、提高训练的投入程度、改善心境	正念水平、应激、满意度、疲劳
Scott-Hamilton等^[29]	MiCBT	不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍	提高消极体验的接受性、促进流畅体验、改善心境	流畅体验、焦虑、正念水平、自我同情
Scott-Hamilton等^[30]	MiCBT	不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍	提高消极体验的接受性、促进流畅体验、改善心境	流畅体验、焦虑、正念水平、自我同情
Vidic等^[31]	平静冥想	活在当下、不判断、接受	改善注意障碍、改善情绪调节障碍、去自我中心化	提高消极体验的接受性、促进流畅体验	应激、应对
Zadeh等^[32]	MAC	不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍	提高消极体验的接受性	正念水平
Zhang等^[33]	MAC	不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍	提高消极体验的接受性、促进流畅体验	正念水平、接受体验、流畅体验
李伟康^[34]	MT	活在当下、不判断、行为投入	改善注意障碍、改善情绪调节障碍、去自我中心化	提高消极体验的接受性、促进流畅体验	阻滞、正念水平
刘海楠^[35]	MT	活在当下、不判断、接受	改善注意障碍、改善应激障碍、改善情绪调节障碍,去自我中心化	提高消极体验的接受性	心理韧性
刘涛等^[36]	MAIC	活在当下、不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍,去自我中心化	提高训练的投入程度	训练态度
夏文倩^[37]	MAIC	活在当下、不判断、接受、行为投入	改善注意障碍、改善应激障碍、改善情绪调节障碍、去自我中心化	提高消极体验的接受性	正念水平、经验性回避

表5

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干预内容	心理康复方法
活在当下	注意力的焦点放在此时此刻正在执行的任务上,不去想过去和未来,全身心地投入到当下任务的完成过程之中
不判断	不判断内心体验和正在发生行为的好坏对错,只把它们当作事实存在
接受	接受消极内心体验的存在,不对它们做出反应,不刻意去消除、降低消极的情绪想法等,只是意识到它们的存在,任其自然而然地发生
行为投入	任务执行不受内心体验的影响,而是去做能够实现卓越表现的行为,即关注任务执行的流畅性及技术环节,不去期待和判断结果,也不去评价已经结束的动作,只是投入

结果变量	失安全系数		Egger检验			Begg检验
结果变量	N_fs	临界值	截距	SE	95%CI	Z值	P值
即刻效果	933	250	2.50	0.71	[1.07,3.93]	2.73	0.006
追踪效果	-248	40	19.25	15.12	[-22.72,61.21]	0.94	0.348

调节变量	k	n	d	95%CI	异质性
调节变量	k	n	d	95%CI	Q(df)	P	I²(%)	P_s.g.	I²_s.g.(%)
年龄(岁)								0.57	0.0
<22	29	933	0.62	[0.44,0.80]	42.06(25)	0.02	41
≥22	16	501	0.70	[0.46,0.95]	24.06(15)	0.06	38
干预周期								0.15	52.5
<8周	21	752	0.82	[0.63,1.00]	28.92(20)	0.09	31
≥8周	24	734	0.58	[0.32,0.84]	60.14(23)	<0.0001	62
家庭练习								0.66	0.00
是	19	705	0.74	[0.49,0.98]	40.75(18)	0.002	56
否	26	781	0.66	[0.42,0.89]	56.08(25)	0.0004	55
主试资质								0.12	57.7
有资质	29	855	0.80	[0.63,0.97]	8.01(28)	0.10	26
无资质	16	631	0.52	[0.21,0.83]	50.68(15)	<0.00001	70
实验类别								0.58	0.0
RCT	32	1245	0.68	[0.48,0.88]	83.13(31)	<0.00001	63
非RCT	13	241	0.78	[0.49,1.06]	12.75(12)	0.39	6
研究质量								0.004	88.1
<6分	26	555	0.98	[0.70,1.27]	50.19(23)	0.0009	54
≥6分	22	931	0.49	[0.32,0.67]	34.13(20)	0.003	41