Physiotherapeutic intervention to promote self-care: exploratory study on Spanish caregivers of patients with dementia.

The caregivers of dependent persons should benefit from social-health interventions that empower them. Physiotherapists can play an important role as facilitators of self-care learning by boosting the mind-body interaction. The aim of this study was to analyse the efficacy of a physiotherapeutic intervention centered on the promotion of self-care within a sample of caregivers, members of four Spanish Associations of Relative of Alzheimer's and other dementias. To fulfill the study goal, a pre-experimental study was developed with two different groups. Group 1 participated in four training sessions based exclusively on the communication of information and which addressed, among other aspects, the most frequent health problems in caregivers and the powerful role of self-care to face such problems. Group 2 received the same theoretical information as group 1, followed by 10 sessions of practical training in several concrete strategies of body-mind self-care. The results obtained support the usefulness of combining theoretical and practical training in mind-body strategies (relaxation, self-massage and stretching), as such combination managed to favor their implication to self-care and certain dimensions of psychological well-being, while attenuating the burden. Conversely, training based solely on theoretical approaches was not beneficial. Besides evidencing the usefulness of combining passive and active methodologies to favor self-care, the data provided calls for greater consideration of aspects close to philosophical perspectives like personal growth.

Systems based model: A Holistic Approach to Developmental Movement Education.

Considering the human body as a dynamic system, a given movement is the result of contributing sub-systems (Thelen and Smith, 1994). In this view, gains in movement performance occur as subsystem performances become optimized. Movement instruction offered from a systems perspective is aimed optimizing learner's performance through evolving understanding and through application. The Holistic Approach to Developmental Movement Education (HADME) is a systems-based instructional model that depicts the interactive process between learner and practitioner. This mind-body approach utilizes 11 steps to optimize movement performance: A) Current Understandings, B) Increased Insights of Evaluation, C) Truthful Reflection of Current State, D) Systematic Modification to Optimize Performance, E) Application of the Change Tool to Change Target Pattern, F) Fine-Tune Learner Perception Tool Application, G) Improved Understanding Through a Point of Control, H) Expanded Systemic Understanding of Learner's Knowledge/Movement, I) Isolation of Target Muscle for a Constant Steady Flowing Movement, J) Gained Conceptual Understanding of Movement and K) Increased Knowledge of Systemic Inputs. The instructor adopting this viewpoint may experience continual insights on how to best optimize the performance for an increasing range of learners display unique systemic variations. Gaining insights on how to overcome movement limitations through optimizing subsystem performances, the learner taking part in a HADME may experience greater movement enjoyment and hopefully, a more active lifestyle.

Long-term follow-up of mind-body medicine practices among medical school graduates.

INTRODUCTION: We sought to determine the long-term use of mind-body medicine (MBM) skills after graduation from medical school. METHODS: An online survey was sent to Georgetown University School of Medicine (GUSOM) graduates who completed at least one semester of a MBM skills training course. Using a quantitative-qualitative mixed-methods approach, we assessed the personal and professional practices of graduates, and identified factors that may influence practice/training after graduation. RESULTS: Current personal practices were positively related to the level of the course completed and amount of home practice during medical school (N = 112). Over half the sample indicated they currently practice MBM and refer patients to MBM. Moreover, physician specialty and awareness of home institution MBM training was associated with MBM patient training and referral. Participants reported a dearth of MBM training at their home institutions, and provided qualitative insights about the personal and professional impact of MBM training as well as barriers to continued MBM practice. CONCLUSIONS: The results provide preliminary evidence that MBM training during medical school may be related over time to physician trainee self-care and patient care. Rigorous tests of these relationships should be conducted in future work.

Promoting resiliency for interprofessional faculty and senior medical students: Outcomes of a workshop using mind-body medicine and interactive reflective writing.

BACKGROUND: Health care professions faculty/practitioners/students are at risk for stress and burnout, impacting well-being, and optimal patient care. AIMS: We conducted a unique intervention: an interprofessional, experiential, skills-based workshop (IESW) combining two approaches: mind-body medicine skills and interactive reflective writing (RW) fostering self-awareness, self-discovery, reflection, and meaning-making, potentially preventing/attenuating burnout and promoting resiliency. METHODS: Medical and nursing faculty and senior medical students (N = 16) participated in a 2-hour workshop and completed (1) Professional Quality of Life measure (ProQOL) and (2) a questionnaire evaluating understanding of professional burnout and resiliency and perceived being prepared to apply workshop techniques. Thematic analyses of anonymized RWs exploring meaningful clinical or teaching experiences were conducted. RESULTS: Participants reported better understanding of professional burnout/resiliency and felt better prepared to use meditation and RW as coping tools. RW themes identified experiencing/grappling with a spectrum of emotions (positive and negative) as well as challenge and triumph within clinical and teaching experiences as professionally meaningful. CONCLUSIONS: Positive outcomes were obtained within a synergistic resiliency skills building exercise. Successful implementation of this IESW provides good rationale for studying impact of this intervention over a longer period of time, especially in populations with high rates of stress and burnout.

The impact of mind-body medicine facilitation on affirming and enhancing professional identity in health care professions faculty.

PROBLEM: Georgetown University School of Medicine (GUSOM) offers medical students a course in mind-body medicine (MBM) that introduces them to tools that reduce stress and foster self-awareness. Previous studies reported decreases in students' perceived stress and increases in mindfulness-changes that were associated with increased empathic concern and other elements of professional identity formation. However, no reports have described the impact of an MBM course on the facilitators themselves. APPROACH: To explore whether MBM facilitation is associated with changes in professional identity, self-awareness, and/or perceived stress, 62 facilitators, trained by the GUSOM MBM program, were invited to complete two validated surveys: the Freiburg Mindfulness Inventory (FMI) and the Perceived Stress Scale (PSS). Forty-two participants also completed a six-item open-ended questionnaire addressing their experience in the context of their professional identity. OUTCOMES: Facilitators' scores were significantly lower on PSS and higher on FMI compared with normative controls (P < .05), and the two parameters were inversely correlated (-0.46, P < .01). Qualitative analysis revealed three main themes: (1) aspects of professional identity (with subthemes of communication; connections and community; empathy and active listening; and self-confidence); (2) self-care; and (3) mindful awareness. NEXT STEPS: Preliminary findings will be extended with larger studies that examine longitudinal quantitative assessment of communication, connection, and self-confidence outcomes in MBM facilitators, and the impact of MBM facilitation on burnout and resilience.

Preaching to the choir: comparing health professionals who enroll in mind-body skills versus herbs and dietary supplements training?

BACKGROUND: Observational studies evaluating elective training programs may be biased if learners who enroll differ from nonenrollees. To assess self-selection bias, we compared participants who enrolled in 2 different online courses in complementary and alternative medical therapies. METHODS: Participants were recruited from entering classes in medicine, nursing, social work, and dietetics, and residencies in family medicine and pediatrics. The 2 electives were (a) herbs and dietary supplements and (b) mind-body skills training. Participants completed standardized questionnaires before training. RESULTS: The 218 participants had an average age of 28 years; 76% were trainees. There were no significant differences between enrollees in mind-body skills and herbs and dietary supplements with regard to age, gender, stress levels, mind-body training or practice, mindfulness, empathy, compassion, or resilience. CONCLUSIONS: Those who enroll in mind-body skills are not measurably different than those who enroll in herbs and dietary supplements. There is no evidence of self-selection bias or "preaching to the choir."

The development of a mind-body-spirit certification program in nursing.

Stress and anxiety experienced by patients particularly during hospitalization can be positively affected by an approach to care that emphasizes the uniqueness of the patient, the patient-provider relationship, and mind-body-spirit interventions. Although patients seek care that addresses stress and promotes relaxation within the hospital environment, there is evidence that there are lost opportunities aimed at addressing these concerns within the current health care environment. Nursing leadership at Massachusetts General Hospital and the Massachusetts General Hospital Institute of Health Professions recognized a need to address this gap in knowledge that exists in the practice setting. The purpose of this article is to describe and discuss the development and implementation of a program in mind-body-spirit nursing that was developed collaboratively between the Massachusetts General Hospital Institute of Health Professions and the Benson-Henry Institute of Mind Body Medicine at Massachusetts General Hospital.

Abordagens corporais: recurso transformador na formação do terapeuta ocupacional / Corporal approaches: transformer action in training of the occupational therapist

O objetivo deste estudo foi discutir o processo de ensino-aprendizagem de abordagens corporais no campo da Terapia Ocupacional. Os dados foram coletados durante a disciplina em abordagens corporais ministrada no curso de graduação em Terapia Ocupacional da Universidade EstadualPaulista, por meio de grupos focais realizados ao final de doze encontros presenciais com quatro horas/aula cada. O estudo foi desenvolvido com quarenta discentes matriculados na disciplina. Todos os encontros foram filmados e transcritos na íntegra, sendoos relatos analisados através do método análise de conteúdo e criação de categorias. Os resultados apontaram para percepção de que as temáticas discutidas durante os encontros possibilitaram ao discente vivenciar e construir um pensamento crítico a respeito daquilo que é próprio do cliente aproximando-o, por meio de uma abordagem holística, daquilo que é potência norteadora do processo em Terapia Ocupacional. As abordagens corporais são consideradas um recurso transformador e potente no processoensino-aprendizagem da Terapia Ocupacional e como atividade formativa investigativa na construção das compreensões da prática profissional do terapeuta ocupacional em situações desingularidade, complexidade, incerteza e conflito de valores.

The objective of this study was to discuss the teaching-learning process of corporal approaches in the Occupational Therapy fi eld. The informations were collected during the classes, in the body approaches matter, administered in the fourth period of the graduate program in OccupationalTherapy of the Universidade Estadual Paulista, through focus groups conducted at the end of all twelve-face meetings with classes of four hours each. The study was realized by fortystudents enrolled in the discipline. All meetings were filmed, which allowed the full transcript and analysis of the students reports. The speeches analysis consisted of content analysis and categories creation. The results indicated to the perception of the thematic discussed during the meetings enabled the student to experienceand build critical thinking about what is proper the client, and through a holistic approach, about what is guiding the potency of the Occupational Therapy process. The body approaches are considered a feature powerfull transformer in the teaching-learning of occupational therapy as an investigative and formative activityin the understandings’ construction of the professional practice of occupational therapists in situations of uniqueness, complexity, uncertainty and conflict in the value process.

Meditation training for people with amyotrophic lateral sclerosis and their caregivers.

OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease that is clinically characterized by progressive weakness leading to death by respiratory insufficiency, usually within three years. Although the patient's intellect and personality usually remain unimpaired, as the disease progresses, the patient becomes immobile, develops wasting, and speech becomes impaired, often resulting in social isolation and a high degree of psychological suffering. Mindfulness meditation has proven to be effective technique for reducing distress in many chronic diseases. However, to date, no study has investigated the effect of mindfulness meditation on patients with ALS. DESIGN: A mindfulness meditation training program for ALS patients needs to consider the particularities of ALS symptoms, including the loss of muscular functions and difficulties in respiration, together with the subsequent emotional impairments. With these caveats in mind, a modified protocol, based on original mindfulness meditation interventions, has been created specifically for the ALS population. This article describes the protocol and preliminary results.

Medical and psychology students' knowledge of and attitudes towards mindfulness as a clinical intervention.

BACKGROUND: Mindfulness is a technique for training people to pay full attention and to fully accept the reality of what they are paying attention to. The clinical efficacy of mindfulness has been increasingly demonstrated during the last two decades. Very little research, however, has been undertaken on health professionals' and students of health professions' knowledge of and attitudes towards mindfulness. These may affect the current and future level of use of a technique that offers important clinical advantages. OBJECTIVES: We aimed to compare knowledge of and attitudes towards mindfulness of medical students without exposure to it in their training with psychology students without exposure and with medical students with exposure to mindfulness in their training. METHODS: A total of 91 medical students from Monash University, 49 medical students from Deakin University, and 31 psychology students from Deakin University were given a questionnaire that elicited quantitative and qualitative responses about level of knowledge of mindfulness and willingness to administer or recommend it to their future patients. RESULTS: Psychology students without exposure to mindfulness in their training have a greater knowledge of it and are more likely to administer it or recommend it than are medical students without exposure to it in their training. Medical students with exposure to mindfulness in their course have a greater knowledge of it and are more likely to administer it or recommend it than are medical students without exposure. Knowledge of mindfulness is positively correlated with students' willingness to use or recommend it. CONCLUSIONS: Possible implications of the findings of this study are that if future doctors are routinely instructed in mindfulness as a clinical intervention they may be more likely to form a more positive attitude towards it, that is more consistent with that of nonmedical health professions such as psychologists, and that they therefore may be more likely to administer it or refer its use. The inclusion of mindfulness exposure in medical courses, and possibly also in psychology courses, may help mindfulness fulfill its clinical potential, and increasingly benefit patients who are suffering from a range of clinical conditions.

Mind-body therapy: attitudes, beliefs and practices of graduate faculty and students from accredited marriage and family therapy programs in the U.S. and Canada.

CONTEXT: Interest in CAM and mind-body therapies (MBT) among mental health professionals has increased over the last decade. Individuals seeking treatment for mental health concerns often use MBTs and expect clinicians to be aware of such treatments. Yet, current data reveal a critical gap in training, practice, and the needs of those seeking treatment. OBJECTIVE: To determine the attitudes, beliefs, and practices of marriage and family therapists regarding MBTs. DESIGN: Electronic survey method using Likert-type scale questions. PARTICIPANTS: Clinical faculty members and graduate students (N = 140) from accredited Marriage and Family Therapy programs in the United States and Canada. RESULTS: Findings revealed that a majority of respondents believed that graduate programs should introduce MBT topics during course of training and that MBTs are valuable in the treatment of various clinical problems. Respondents were familiar with at least one form of MBT and reported using such in personal and professional settings.

Mindfulness training in stuttering therapy: a tutorial for speech-language pathologists.

UNLABELLED: The use of mindfulness training for increasing psychological well-being in a variety of clinical and nonclinical populations has exploded over the last decade. In the area of stuttering, it has been widely recognized that effective long-term management often necessitates treatment of cognitive and affective dimensions of the disorder in addition to behavioral components. Yet, mindfulness based strategies and their possible usefulness in stuttering management have not been described in detail in the literature. This article seeks to engage professionals who treat stuttering in a conversation about the possible usefulness of incorporating mindfulness training into stuttering management. A review of the literature reveals that there is a substantial overlap between what is required for effective stuttering management and the benefits provided by mindfulness practices. Mindfulness practice results in decreased avoidance, increased emotional regulation, and acceptance in addition to improved sensory-perceptual processing and attentional regulation skills. These skills are important for successful long-term stuttering management on both psychosocial and sensory-motor levels. It is concluded that the integration of mindfulness training and stuttering treatment appears practical and worthy of exploration. Mindfulness strategies adapted for people who stutter may help in the management of cognitive, affective, and behavioral challenges associated with stuttering. EDUCATIONAL OBJECTIVES: Readers should be able to: (1) describe what mindfulness is and how it is cultivated; (2) identify the benefits that can be produced from mindfulness practice; (3) summarize how the benefits of mindfulness practice parallel what is often required for effective long-term stuttering management; and (4) identify specific mindfulness techniques that can be taught in stuttering therapy and explain their rationale.

Making connections: integration of psychiatric and medical-surgical nursing and relationship-based care.

There is a growing recognition of mind-body connection in our culture. Relationship-based care (RBC) represents a theoretical foundation for the application of the mind-body connection in the clinical setting. This article describes ways to incorporate mind-body and RBC concepts into nursing classroom and clinical experiences.

Exercises for mind and body: Giulio Mancini, collecting, and the beholding of landscape painting in the seventeenth century.

This article explores the intellectual foundations for the development of princely art collections, and of Italian picture galleries in particular, as spaces for combined physical and mental exercise and recreation. This study then establishes the relationship between the therapeutic function of picture galleries and the manner in which landscape paintings produced for princely collectors at this moment in Italy embodied ideals of both exercise and repose.