This study evaluated the effectiveness, change mechanisms, and sustainability of a brief mindfulness intervention for people with multiple sclerosis (PwMS) delivered in the community through a frontline service over five years. Participants were 126 PwMS. A single intervention condition design was used with pre-intervention, post-intervention and 2-month follow-up assessments. The primary outcome was distress. Secondary outcomes were perceived stress, quality of life (QoL) and fatigue, and the proposed change mechanisms: mindfulness, self-compassion, psychological inflexibility. Intention-to-treat analyses showed the primary outcome, distress (Cohen’s d = .25), and all secondary outcomes improved: perceived stress (d = .38), mental health QoL (d = .39), physical health QoL (d = .47), fatigue (d = .30), mindfulness (d = .29), self-compassion (d = .37), psychological flexibility (d = .44). Distress, stress and perceived stress continued to improve post-intervention to follow-up. Mindfulness emerged as a temporal mediator of perceived stress (BCa 95% CI). Self-compassion mediated concurrent improvements in distress, perceived stress, fatigue and physical health QoL, while greater psychological flexibility mediated concurrent reductions in distress (BCa 95% CI). Mindfulness home practice was unrelated to improvements on all outcomes except a marginal association with mindfulness. Of the socio-demographic and illness factors, lower disease severity predicted improvements in physical health QoL (p = .046). Improvements in outcomes were supported by qualitative feedback and participant satisfaction ratings. Twenty-one groups were offered with good participant engagement and wide geographical reach, suggesting sustained feasibility of the Mindfulness for MS program over five years. Findings support the delivery of the Mindfulness for MS program through a community-based service in partnership with a local university.

这项研究评估了通过前线服务在五年内为社区提供的针对多发性硬化症（PwMS）的简短正念干预措施的有效性，变更机制和可持续性。参加者为126名PwMS。干预前，干预后和2个月的随访评估均采用单一干预条件设计。主要结果是困扰。次要结果是感知的压力，生活质量（QoL）和疲劳以及拟议的变化机制：正念，自我同情，心理僵化。意向性治疗分析显示主要结果，困扰（Cohen d  = .25）和所有次要结果均得到改善：知觉压力（d  = .38），心理健康QoL（d = 0.39），身体健康QoL（d  = 0.47），疲劳（d  = 0.30），正念（d  = .29），同情心（d  = 0.37），心理柔韧性（d = .44）。痛苦，压力和感觉到的压力继续改善干预后的随访。正念作为感知压力的时间中介（BCa 95％CI）出现。自我同情介导的并发改善了痛苦，感知的压力，疲劳和身体健康QoL，而更大的心理柔韧性则介导了并发的痛苦减少（BCa 95％CI）。正念家庭练习与所有结果的改善无关，除了与正念之间的边际关联外。在社会人口和疾病因素中，较低的疾病严重程度预示了身体健康QoL（p = .046）。定性反馈和参与者满意度评级支持结果的改善。向21个小组提供了良好的参与者参与度和广泛的地域覆盖范围，这表明正念度MS计划在五年内具有持续的可行性。调查结果通过与本地大学合作提供基于社区的服务来支持MS正念计划的交付。