Breathing exercise combined with cognitive behavioural intervention improves sleep quality and heart rate variability in major depression.

AIMS AND OBJECTIVES: The aim of this study was to investigate the effects of a cognitive behavioural intervention combined with a breathing relaxation exercise on sleep quality and heart rate variability in patients with major depression. BACKGROUND: Depression is a long-lasting illness with significant effects not only in individuals themselves, but on their family, work and social relationships as well. Cognitive behavioural therapy is considered to be an effective treatment for major depression. Breathing relaxation may improve heart rate variability, but few studies have comprehensively examined the effect of a cognitive behavioural intervention combined with relaxing breathing on patients with major depression. DESIGN: An experimental research design with a repeated measure was used. METHODS: Eighty-nine participants completed this study and entered data analysed. The experimental group (n = 43) received the cognitive behavioural intervention combined with a breathing relaxation exercise for four weeks, whereas the control group (n = 46) did not. Sleep quality and heart rate variability were measured at baseline, posttest1, posttest2 and follow-up. Data were examined by chi-square tests, t-tests and generalised estimating equations. RESULTS: After adjusting for age, socioeconomic status, severity of disease and psychiatric history, the quality of sleep of the experimental group improved, with the results at posttest achieving significance. Heart rate variability parameters were also significantly improved. CONCLUSIONS: This study supported the hypothesis that the cognitive behavioural intervention combined with a breathing relaxation exercise could improve sleep quality and heart rate variability in patients with major depression, and the effectiveness was lasting. RELEVANCE TO CLINICAL PRACTICE: The cognitive behavioural intervention combined with a breathing relaxation exercise that included muscle relaxation, deep breathing and sleep hygiene could be provided with major depression during hospitalisation. Through group practice and experience sharing, participants could modulate their heart rate variability and share feeling about good sleep as well relaxation.

Acupoint stimulation to improve analgesia quality for lumbar spine surgical patients.

Lumbar spine surgery has a high incidence of postoperative pain, but this pain is treatable through many methods, including patient-controlled analgesia (PCA). Acupoint stimulation could be considered an adjunct to PCA, improving the effectiveness of analgesia for patients recovering from lumbar spine surgery. The current study aimed to examine the effect of acupoint stimulation with PCA on improving analgesia quality after lumbar spine surgery. A single-blinded, sham-controlled design was used for the experimental, not control, groups. Data collection for the control group was completed first, followed by data collection for the other 2 groups. Participants were randomly assigned to the acupoint stimulation (AS) (n = 45) or sham group (n = 45). All participants received structural PCA multimedia information before lumbar surgery. The AS group received auricular acupressure combined with transcutaneuos electric acupoint stimulation (TEAS) at the true acupoint; the sham group received acupoint stimulation in the same manner but at a sham acupoint and without embedding seeds; and the control group received no acupoint stimulations. The analgesia quality, analgesic consumption, and postoperative nausea and vomiting (PONV) were used as measure of effects for the interventions. Significant differences were found between the AS and control groups in pain intensity but not in the belief and satisfaction subscales of analgesia quality. Also found a significant difference among the 3 groups in analgesic consumption and the severity of PONV in the first 72 hours after surgery. The current study shows that the combination of auricular acupressure and TEAS reduced pain intensity, morphine consumption, and PONV severity. Acupoint stimulation could be considered a multimodal analgesia method and an adjunct to PCA for lumbar spine surgery patients.

Effects of social skills training on improving social skills of patients with schizophrenia.

This study examined the effect of conversation and assertive skills training on social skills of schizophrenic patients. Patients who met the study criteria were randomly assigned to the experimental or control group. The experimental group received eight group training sessions and the control group received routine nursing care treatment. Data were collected at pretreatment (before group treatment), intratreatment (after fourth group treatment), posttreatment (after eighth group treatment), and follow-up (1 month after the end of group treatment). Conversation and assertive skills of the experimental group improved significantly with treatment and were superior to the control group at intratreatment, posttreatment, and follow-up. We suggest incorporating social skills training into treatment plans for patients with schizophrenia to improve their social skills ability.