BACKGROUND Populations with reduced sensory and motor function, such as spinal cord injury (SCI) are at increased risk of depression, anxiety, pain, and poorer quality of life (QoL). Mindfulness-Based Interventions (MBIs) have been developed with the aim of improving outcomes for people with SCI. To understand the value of MBIs, a systematic review was conducted pertaining to the use of MBIs, and interventions including elements of mindfulness, with people with SCI. METHODS Databases were reviewed from 1996 to October 2018 (updated January 2020). Eligibility criteria included the assessment of at least one of the common secondary consequences of SCI (i.e. risk of depression, anxiety, pain, and QoL), describe the use of mindfulness training as a component part of an intervention, or as the whole intervention. The Cochrane Collaboration Risk of Bias and The Effective Public Health Practice Project Quality Assessment Tools were utilised for quality appraisals. Two assessors appraised the studies and demonstrated good agreement (Cohen's k = .848, p < .001). RESULTS Five papers met the inclusion criteria, and demonstrated a range of results of interventions delivered individually, in a group format, in person, and online. Only one study reported significant reductions in pain-related outcomes (with moderate effect sizes), with the remaining studies (n = 4) demonstrating no change. Four studies described reductions in depressive symptoms and three reported reductions in anxiety. Despite the importance of good QoL as a goal for people with SCI, few studies (n = 2) assessed this as an outcome with no improvements reported. Study quality ranged from high to low/weak. CONCLUSIONS The findings in this review provide mixed support for the use of mindfulness to improve outcomes after SCI. In particular, findings indicate that mindfulness may be particularly effective for improving symptoms of depression and anxiety. This review highlights the requirement for more rigorous, high-quality research, particularly larger randomised-controlled trials with long-term follow-up, in this area. The small number of studies included in the present review mean that conclusions drawn are preliminary and thus reflects the paucity of the research in the area to date.

中文翻译：

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正念对脊髓损伤患者的疼痛、抑郁、焦虑和生活质量：系统评价。

背景技术感觉和运动功能降低（例如脊髓损伤（SCI））的人群患抑郁、焦虑、疼痛和生活质量（QoL）较差的风险增加。基于正念的干预措施 (MBI) 的开发旨在改善 SCI 患者的治疗结果。为了了解 MBI 的价值，我们对 SCI 患者使用 MBI 以及包括正念要素在内的干预措施进行了系统回顾。方法 数据库于 1996 年至 2018 年 10 月期间进行审查（2020 年 1 月更新）。资格标准包括评估至少一种 SCI 常见的次要后果（即抑郁、焦虑、疼痛和生活质量的风险），描述使用正念训练作为干预措施的组成部分或整个干预措施。使用 Cochrane 协作偏倚风险和有效公共卫生实践项目质量评估工具进行质量评估。两名评估员对研究进行了评估并表现出良好的一致性（Cohen's k = .848，p < .001）。结果 五篇论文符合纳入标准，并展示了单独、小组、现场和在线干预的一系列结果。只有一项研究报告疼痛相关结果显着减少（效应大小适中），其余研究 (n = 4) 表明没有变化。四项研究描述了抑郁症状的减少，三项研究报告了焦虑的减少。尽管良好的生活质量作为 SCI 患者的目标很重要，但很少有研究 (n = 2) 将此评估为没有改善的结果。研究质量从高到低/弱。结论 本综述的研究结果为利用正念改善 SCI 后的预后提供了不同的支持。特别是，研究结果表明，正念可能对改善抑郁和焦虑症状特别有效。本次审查强调了该领域需要更严格、高质量的研究，特别是大规模随机对照试验和长期随访。本综述中纳入的研究数量较少，意味着得出的结论是初步的，从而反映了迄今为止该领域研究的匮乏。