Spirituality, Functional Gain, and Quality of Life in Cardiovascular Rehabilitation. / Espiritualidade, Ganho Funcional e Qualidade de Vida em Reabilitação Cardiovascular.

BACKGROUND: Religiosity and spirituality have been associated with higher recovery rates, greater adherence to treatments, and better levels of quality of life in patients with heart disease. OBJECTIVES: To evaluate the association between spirituality, functional gain, and improved quality of life in patients in a cardiovascular rehabilitation program. METHODS: This prospective cohort study evaluated the association between functional and quality of life gains during a cardiovascular rehabilitation program and a religiosity/spirituality index based on a validated scale. Depression, anxiety, and stress symptoms were screened for control purposes. P values < 0.05 were considered significant for all analyses. RESULTS: The study followed 57 patients (66 ± 12 years old; 71.7% male; 76% with coronary artery disease). The Spearman correlation coefficient did not show any associations between increases in functional capacity and organizational (rs = 0.110; p = 0.421), non-organizational (rs = -0.007; p = 0.421), or intrinsic (rs = -0.083; p = 0.543) religiosity. Furthermore, no associations were detected between the results of a quality of life score and organizational (rs = 0.22; p = 0.871), non-organizational (rs = 0.191; p = 0.159), or intrinsic (rs = 0.108; p = 0.429) religiosity. CONCLUSION: No association was detected between functional and quality of life gains and organizational, non-organizational, or intrinsic religiosity in this sample of patients undergoing cardiovascular rehabilitation.

FUNDAMENTO: Religiosidade e espiritualidade têm sido associadas a maiores taxas de recuperação, maior adesão a tratamentos e melhores níveis de qualidade de vida em pacientes cardiopatas. OBJETIVOS: Avaliar a associação entre espiritualidade, ganho funcional e melhoria de qualidade de vida em pacientes de um programa de reabilitação cardiovascular. MÉTODOS: Estudo de coorte prospectiva, no qual foi avaliada a associação entre os ganhos funcional e em qualidade de vida obtidos durante um programa de reabilitação cardiovascular e o índice de religiosidade/espiritualidade a partir de escala validada. Sintomas de depressão, ansiedade e estresse foram rastreados, para fins de controle. Um p < 0,05 foi adotado como padrão significante para todas as análises. RESULTADOS: Foram acompanhados 57 pacientes (66 ± 12 anos; 71,7% masculinos, 76% com doença arterial coronariana). O cálculo do coeficiente de correlação de Spearman não evidenciou associações entre incrementos na capacidade funcional e religiosidade organizacional (rs = 0,110; p = 0,421), não organizacional (rs = −0,007; p = 0,421) ou intrínseca (rs = −0,083; p = 0,543). Também não foram detectadas associações entre os resultados de um escore de qualidade de vida e religiosidade organizacional (rs = 0,22; p = 0,871), não organizacional (rs = 0,191; p = 0,159) ou intrínseca (rs = 0,108; p = 0,429). CONCLUSÃO: Não foi detectada associação entre ganho funcional ou em qualidade de vida e religiosidade organizacional, não organizacional ou intrínseca, nesta amostra de pacientes em reabilitação cardiovascular.

Espiritualidade, Ganho Funcional e Qualidade de Vida em Reabilitação Cardiovascular / Spirituality, Functional Gain, and Quality of Life in Cardiovascular Rehabilitation

Resumo Fundamento Religiosidade e espiritualidade têm sido associadas a maiores taxas de recuperação, maior adesão a tratamentos e melhores níveis de qualidade de vida em pacientes cardiopatas. Objetivos Avaliar a associação entre espiritualidade, ganho funcional e melhoria de qualidade de vida em pacientes de um programa de reabilitação cardiovascular. Métodos Estudo de coorte prospectiva, no qual foi avaliada a associação entre os ganhos funcional e em qualidade de vida obtidos durante um programa de reabilitação cardiovascular e o índice de religiosidade/espiritualidade a partir de escala validada. Sintomas de depressão, ansiedade e estresse foram rastreados, para fins de controle. Um p < 0,05 foi adotado como padrão significante para todas as análises. Resultados Foram acompanhados 57 pacientes (66 ± 12 anos; 71,7% masculinos, 76% com doença arterial coronariana). O cálculo do coeficiente de correlação de Spearman não evidenciou associações entre incrementos na capacidade funcional e religiosidade organizacional (rs = 0,110; p = 0,421), não organizacional (rs = −0,007; p = 0,421) ou intrínseca (rs = −0,083; p = 0,543). Também não foram detectadas associações entre os resultados de um escore de qualidade de vida e religiosidade organizacional (rs = 0,22; p = 0,871), não organizacional (rs = 0,191; p = 0,159) ou intrínseca (rs = 0,108; p = 0,429). Conclusão Não foi detectada associação entre ganho funcional ou em qualidade de vida e religiosidade organizacional, não organizacional ou intrínseca, nesta amostra de pacientes em reabilitação cardiovascular.

Abstract Background Religiosity and spirituality have been associated with higher recovery rates, greater adherence to treatments, and better levels of quality of life in patients with heart disease. Objectives To evaluate the association between spirituality, functional gain, and improved quality of life in patients in a cardiovascular rehabilitation program. Methods This prospective cohort study evaluated the association between functional and quality of life gains during a cardiovascular rehabilitation program and a religiosity/spirituality index based on a validated scale. Depression, anxiety, and stress symptoms were screened for control purposes. P values < 0.05 were considered significant for all analyses. Results The study followed 57 patients (66 ± 12 years old; 71.7% male; 76% with coronary artery disease). The Spearman correlation coefficient did not show any associations between increases in functional capacity and organizational (rs = 0.110; p = 0.421), non-organizational (rs = −0.007; p = 0.421), or intrinsic (rs = −0.083; p = 0.543) religiosity. Furthermore, no associations were detected between the results of a quality of life score and organizational (rs = 0.22; p = 0.871), non-organizational (rs = 0.191; p = 0.159), or intrinsic (rs = 0.108; p = 0.429) religiosity. Conclusion No association was detected between functional and quality of life gains and organizational, non-organizational, or intrinsic religiosity in this sample of patients undergoing cardiovascular rehabilitation.

Effect of Healing Meditation on stress and eating behavior in overweight and obese women: A randomized clinical trial.

BACKGROUND: A randomized, parallel-controlled, blinded clinical trial was conducted to evaluate the effect of Healing Meditation on stress and eating behavior of women undergoing standard weight-loss treatment. MATERIALS AND METHODS: An outpatient clinic in Brazil, 55 women with overweight and obesity were included and randomized: 27 for the Meditation Group, and 28 for the Control Group. Randomization was stratified by body mass index category and based on blocks of four. For eight weeks, in addition to the standard weight loss treatment, the Intervention Group underwent a Healing Meditation program, and the Control Group participated in a round table to observe compliance. Reduction in stress and changes in eating behavior were assessed at baseline, and in the 8th, and 16th week using the Perceived Stress Scale, the Dutch Eating Behavior Questionnaire, and Binge Eating Scale. RESULTS: The sample mean age was 49 ± 11 years, 72.7% were obese, with a predominance of mixed (49.1%) and black (41.8%) ethnicity. After eight weeks, the Meditation Group showed a mean reduction in total stress of -17.4 (IC 95% -19.5 to -15.3 p < 0.001). In eating behavior, a mean reduction of -7.9 (p < 0.001) in external eating, of -11.4 (p < 0.0001) in emotional eating, and a rise of 9.6 (p < 0.0001) in restrained eating were found. Score levels remained stable between the 8th and 16th week. Binge eating had a mean variation of -22.2%(p = 0.011). CONCLUSION: The addition of Healing Meditation to the standard weight-loss treatment may significantly reduce stress and produce positive changes in the eating behavior of overweight and obese women. TRIAL REGISTRATION: RBR-7564FD.

Effect of Healing Meditation on Weight Loss and Waist Circumference of Overweight and Obese Women: Randomized Blinded Clinical Trial.

Objective: To evaluate the effect of healing meditation on weight loss and waist circumference for women undergoing a standard weight loss treatment. Design: We conducted a randomized, parallel-controlled, blinded clinical trial. Randomization was stratified by body mass index category and based on blocks of four. Setting: An outpatient clinic in Brazil. Subjects: Women with overweight and obesity. Intervention: For 8 weeks, in addition to the standard weight loss treatment, the intervention group underwent a healing meditation program, and the control group participated in a two round table just to observe the treatment compliance. Outcome measures: The primary outcome was the percentage of weight loss, blindly assessed regarding the allocation group. Results: Of 121 women interested in participating in the study, 55 were included and randomized, 27 for the intervention group and 28 for the control group. Baseline characteristics were similar between groups. After 8 weeks, the intervention group had the highest relative reduction to initial body weight (-2.9% [interquartile range {IQR} -4.4 to -1.6] vs. -0.7% [IQR -1.1 to -5.0], p < 0.001). Waist circumference outcome was also significantly reduced in the intervention group (5 cm [IQR -6.0 to 4.0] vs. -1 cm [IQR -2.0 to 0.0], p < 0.001). The result of the intervention group was maintained until the 16th week. Between 8th and 16th week, the control group underwent meditation and presented significant weight reduction (-1.95 kg [IQR -3.2 to -1.1], p < 0.001 and -2.3% [IQR -4.1 to -1.3], p < 0.001), showing similar effect to the intervention group (p = 0.428). Conclusion: The addition of healing meditation to the standard weight loss treatment may reduce weight and waist circumference over a short period in overweight or obese women.

Meditation, Health and Scientific Investigations: Review of the Literature.

A growing number of people are seeking health recovery treatments with a holistic approach to the human being. Meditation is a mental training capable of producing connection between the mind, body and spirit. Its practice helps people to achieve balance, relaxation and self-control, in addition to the development of consciousness. At present, meditation is classified as a complementary and integrative technique in the area of health. The purpose of this review of the literature was to describe what meditation is, its practices and effects on health, demonstrated by consistent scientific investigations. Recently, the advances in researches with meditation, the discovery of its potential as an instrument of self-regulation of the human body and its benefits to health have shown that it is a consistent alternative therapy when associated with conventional medical treatments.

Efficacy of Healing meditation in reducing anxiety of individuals at the phase of weight loss maintenance: A randomized blinded clinical trial.

OBJECTIVE: To verify the efficacy of Healing Meditation in reducing anxiety levels in individuals on a weight loss maintenance program. DESIGN: A randomized, controlled, evaluator-blinded clinical trial, conducted between January and October 2014, with a follow-up of 12 weeks. SETTING: A weight loss secondary care facility in Salvador, Brazil., of 41 patients at the weight maintenance phase (Mean initial BMI 33.6±4.7kg/m2, who had attained a mean BMI of 24.5±1.6kg/m2 in a median period of 7 months). INTERVENTION: An 8-week Healing Meditation program (n=20), consisting of a 1h weekly meeting, or for a control group on the waiting list (n=21), in addition to the standard clinical program. MAIN OUTCOME MEASURES: Total anxiety was measured by the Hamilton Anxiety Scale (HAM-A), before and after the intervention. Secondary analyses included comparison of the effect of meditation on the somatic and psychic components of the scale. RESULTS: Through an intention to treat analysis, we detected a difference in the mean variation between the intervention and control groups in the total anxiety scores of 7.7 (95% CI 6.3-9.2; Cohen's d=3.41). Means and standard deviations for pre and post intervention anxiety scores were 15.5 (3.4) and 7.8 (2.0) for the intervention group and 14.8 (3.4) and 14.9 (3.4) for the control. CONCLUSION: Healing meditation significantly reduced the anxiety of obese individuals, in the phase of weight maintenance, suggesting this to be an effective auxiliary resource for weight loss maintenance.

A palm oil-rich diet may reduce serum lipids in healthy young individuals.

OBJECTIVE: The literature on palm oil as a cholesterol-raising oil is conflicting, requiring further studies. This study tested the influence of a palm oil-rich diet on plasma lipids of healthy young individuals. METHODS: Thirty-four medical students, 18-26 y old, with a total cholesterol level <200 mg/dL, high-density lipoprotein cholesterol (HDL-C) level >40 mg/dL, low-density lipoprotein cholesterol (LDL-C) level <130 mg/dL, triacylglycerol level <150 mg/dL, glycemic level <100 mg/dL, blood pressure <140/90 mmHg, and a body mass index of 18 to <25 kg/m(2) were studied. Once a day for 2 wk, the students ingested 10 mL of previously boiled crude palm oil after lunch or dinner, as preferred. Palm oil was consumed in the same way and quantity that it is consumed in one serving of a very popular typical Brazilian seafood dish. Total cholesterol, LDL-C, HDL-C, very LDL-C, non-HDL-C, and triacylglycerol were measured at baseline, after the palm oil-enriched diet, and after the washout period. RESULTS: A decrease in all lipid fractions was observed, with a mild, statistically significant decrease in concentrations of very LDL-C (19.41 +/- 4.21 versus 17.18 +/- 4.0 mg/dL, P = 0.002) and triacylglycerol (97.07 +/- 21.08 versus 85.91 +/- 20.02 mg/dL, P = 0.002). Males (61.9%) also showed a mildly significant increase in LDL-C, whereas females showed a mildly significant decrease in all lipid fractions, except for HDL-C. CONCLUSION: This study shows that boiled crude palm oil may have a mild, triacylglycerol-reducing effect in young, healthy individuals and may also show a mild LDL-C-increasing effect in males.

Prevençäo secundária da doença aterosclerótica coronariana na Bahia: avaliaçäo da atitude dos cardiologistas e do controle dos fatores de risco / Prevention secondary of coronary artery diseases (CAD) in Bahia: evaluation of cardiologists, and risck factors control

A Doença Aterosclerótica Coronariana (DAC) é uma patologia de alta prevalência e morbi-mortalidade, porém passível de prevençäo. A despeito de recomendaçöes específicas para prevençäo secundária da DAC, a mesma não é adequadamente realizada por médicos e pacientes. Para melhor controle da DAC no nosso meio é importante o conhecimento da atual situaçäo da prevençäo secundária de DAC na Bahia. OBJETIVO: Avaliar a atitude dos cardiologistas frente a prevençäo secundária de DAC e o controle dos fatores de risco (FR) em seus pacientes. MATERIAL E MÉTODOS: Através de estudo seccional, realizado em duas partes, 177 cardiologistas registrados na SBC- Bahia foram entrevistados por telefone, entre março de 1995 e Julho de 1996 (Parte I). Entre outubro de 1995 e janeiro de 1997, foram encaminhados 104 pacientes com DAC que tiveram o controle dos seus FR (HAS, IMC, RCQ e perfil lipídico) avaliado através de entrevista, exame clínico e avaliaçäo laboratorial (colesterol total, HDL-c, LDL-c e triglicérides (TG), esta realizada após 12 h de jejum (Parte II). A HAS foi classificada de acordo com JNC V e o perfil lipídico com o NCEP II. RESULTADOS: Parte I: Para 60,4 porcento dos cardiologistas, a angina de peito foi o quadro clínico mais freqüente nos seus pacientes e 33,9 porcento acreditavam no benefício do controle dos FR para todos os pacientes de DAC. O controle da HAS, tabagismo e dislipidemia foi valorizado por todos os cardiologistas; o controle da intolerância glicose e menopausa apenas por 42 porcento e 38 porcento, respectivamente. Para início da dieta, a maioria (62,1 porcento, n=110) dos cardiologistas considerou níveis de LDL-c (maior igual que) 130mg/d. LDL-c (maior igual que) 160mg/dl determinou uso de hipolipemiantes para 26,5 porcento (n=47). Apenas 33,3 porcento (n=59) tinham como objetivo níveis-alvo de LDL-c <100mg/dl. No controle global do perfil lipídico apenas 13,5 porcento (n=24) dos cadiologistas apresentaram concordância com o NCEP II. Estatinas foram a droga de primeira escolha 94,3 porcento; fibratos de segunda para 42,3 porcento. Parte II: Os pacientes foram na maioria homens (67,3 porcento) com idade de 60,9 ñ10, 3 (31-81), 57 (54,8 porcento) pós- IAM 43 (41,8 porcento) revascularizados e 40 (38,5 porcento) angioplastados, com seguimento de 3,3 ñ3,5 anos. No exame clínico, 60 pacientes (57,8 porcento) eram hipertensos, 50 (48 porcento) tinham sobrepeso, 15 (14,4 porcento) obesos...