正念靜坐減輕大學學生壓力之成效－系統性文獻回顧及統合分析

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Title:	正念靜坐減輕大學學生壓力之成效－系統性文獻回顧及統合分析
Other Titles:	Effects of Mindfulness Meditation Stress Reduction in University Students: Systematic Review and Meta-Analysis
Authors:	王銘傑 WANG, MING-CHIEH
Contributors:	宗教學研究所釋覺明 SHIH, CHUE-MING
Keywords:	正念靜坐;大學學生;壓力;系統性文獻回顧;統合分析 mindfulness meditation;university students;stress;systematic review;meta-analysis
Date:	2023
Issue Date:	2023-11-14 10:36:25 (UTC+8)
Abstract:	大學學生普遍知覺壓力升高，而且通常高於其他年齡層族群，對其身體健康、心理健康及健康行為產生負面影響，因而探討正念靜坐減輕大學學生壓力之成效，同時參考研究結果，設計隨機對照試驗方案。　　應用醫學標題/ 關鍵詞及布林邏輯，於PubMed、Cochrane Library、Airiti Library及臺灣博碩士論文知識加值系統等4個資料庫/ 平台，搜尋2023年2月1日以前之文獻，依納入標準篩選結果，進行納入文獻質性綜整，以Cochrane第2版偏差風險評估工具，進行偏差風險評估，同時利用RevMan 5.4.1軟體進行統合分析，並以漏斗圖評估發表偏差。　　本研究納入9篇文獻進行統合分析，包含9個隨機對照試驗，受試對象計有1,314人，應用五因素正念問卷、自我慈悲量表、壓力知覺量表及憂鬱焦慮壓力量表等4種量表，評量正念靜坐介入成效。納入文獻依其評量量表分別進行統合分析，同時擷取適配文獻進行年級、介入時間及樣本數等次群組分析，均以隨機效果模式估計合併效果量；各量表統合分析之估計值如下：一、五因素正念問卷：SMD=0.33，95%CI: 0.12, 0.54，Z-test/ p=0.002。二、自我慈悲量表：SMD=0.52，95%CI: 0.15, 0.88，Z-test/ p=0.006。三、壓力知覺量表：以平均差估計合併效果量，MD=-2.51，95%CI: -4.05, -0.97，Z-test/ p=0.001；以標準化平均差估計合併效果量，SMD=-0.39，95%CI: -0.60, -0.19，Z-test/ p=0.0002。四、憂鬱焦慮壓力量表：SMD=0.11，95%CI: -0.19, 0.41，Z-test/ p=0.48。　　五因素正念問卷、自我慈悲量表、壓力知覺量表及憂鬱焦慮壓力量表等4種量表統合分析結果，呈現正念靜坐可以提升大學學生正念心理狀態，有利大學學生面對苦惱的調適能力及應對態度，同時顯示可以減輕大學學生壓力，但於憂鬱焦慮壓力量表之介入成效尚難論定。次群組分析部分，顯示正念靜坐可以有效提升高年級大學學生正念心理狀態，且其效果量大於低年級學生，同時顯示可能達到一定介入時間，提升正念心理狀態及減輕壓力之效果量較大。　　University students' perceived stress is generally increased, and usually under more stress than other age groups, which have a negative effect on their physical health, mental health, and health behaviors. Therefore, investigating the effects of mindfulness meditation stress reduction in university students, and a protocol for randomized controlled trial is designed with reference to the research results.　　Using Medical Subject Headings/ keywords and Bollinger logic to search for studies before February 1, 2023 in 4 databases/ platforms including PubMed, Cochrane Library, Airiti Library, and NDLTD in Taiwan. The results were screened according to the inclusion criteria, qualitative synthesis of the included studies was performed, and the risk of bias was assessed with the Cochrane RoB 2 tool. At the same time, the RevMan 5.4.1 software was used for meta-analysis, and the publication bias was assessed with a funnel plot.　　This study included 9 studies for meta-analysis. A total of 9 randomized controlled trials involving 1,314 subjects were included. Four scales including the Five Facet Mindfulness Questionnaire(FFMQ), Self-Compassion Scale(SCS), Perceived Stress Scale(PSS), and Depression Anxiety Stress Scale(DASS) were used to evaluate the intervention effects of mindfulness meditation. The included studies for meta-analysis were performed separately according to their rating scales. At the same time, the fit studies were extracted for subgroup analyses of grade, intervention time, and sample size. The results of meta-analysis were calculated pooled effects with a random-effects model. The calculated values of meta-analysis of each scale were as follows:1.FFMQ: SMD=0.33，95%CI: 0.12, 0.54，Z-test/ p=0.002。2.SCS: SMD=0.52，95%CI: 0.15, 0.88，Z-test/ p=0.006。3.PSS: MD=-2.51，95%CI: -4.05, -0.97，Z-test/ p=0.001; SMD=-0.39，95%CI: -0.60, -0.19，Z-test/ p=0.0002。4.DASS: SMD=0.11，95%CI: -0.19, 0.41，Z-test/ p=0.48。　　The results of meta-analysis of 4 scales including FFMQ, SCS, PSS, and DASS show that mindfulness meditation can improve the psychological state of mindfulness in university students. It is beneficial to the adjustment ability and coping attitudes of university students in the face of distress. It also shows that it can reduce the stress of university students, but the intervention effect on DASS is still difficult to determine. The subgroup analyses show that mindfulness meditation can effectively improve the psychological state of mindfulness in senior university students, and its effect size is greater than that of lower grade students. At the same time, it shows that may be after a certain intervention time, the effect sizes of improving the psychological state of mindfulness and reducing stress are relatively large.
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