Effectiveness of dance movement therapy and dance movement interventions on cancer patients' health-related outcomes: a systematic review and meta-analysis.

OBJECTIVES: This review examined the effectiveness of using dance movement therapy (DMT) and dance movement interventions (DMIs) with cancer and palliative care patients. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched from inception to July 9, 2022, without limits on year or age. Searching was updated on July 10, 2023. The risk of bias was assessed by the Cochrane (RoB 2) and ROBINS-I tools. Meta-analyses were conducted to pool estimates of the effects of DMT and DMI on patients' health-related outcomes. A narrative synthesis of outcomes was performed where meta-analysis was not appropriate. RESULTS: Among a total of 16 studies included in this review, nine were randomized controlled trials and seven were non-randomized trials, with a total of 893 participants. Only six of these studies were fully or partially described as true DMTs (some with less clarity than others), whereas the majority (n = 10) were DMIs with unclear therapeutic alignment. Most studies focused on female patients with breast cancer. Cancer patients undergoing palliative care received little attention. The overall risk of bias from the evaluated studies was high. Meta-analysis of two trials revealed that DMTs had no effect on QOL in cancer patients (SMD - 0.09, 95% CI - 0.21-0.40, P = 0.54), while narrative analysis and non-randomized trials showed no overall effect of DMTs on anxiety, depression, body image, self-esteem, or sleep disturbance but significant positive effects on perceived stress, pain severity, and pain interference. DMIs had significant positive effects on cancer patients' depression (SMD - 0.53, 95% CI - 0.93 to - 0.14, P = 0.008) and fatigue (SMD - 0.42, 95% CI - 0.70 to - 0.14, P = 0.003). DMI trials synthesized narratively showed an effect on patients' body image, self-esteem, physical function, right and left handgrip strength, life satisfaction, and the mental component of QOL. CONCLUSION: Both DMT and DMIs had promising effects on several health outcomes, but results were inconsistent, and the evidence was weak. The reviewed studies' low evidence quality and small sample sizes affected the findings' robustness and reliability. Large-scale, high-quality randomized controlled trials with sufficient sample sizes, and clear and veracious DMT and DMI protocols and data are required to provide more credible research evidence and influence practice.

'Trying to bring attention to your body when you're not sure where it is': An interpretative phenomenological analysis of drivers and barriers to mindfulness for people with spinal cord injury.

OBJECTIVES: Work is beginning to explore the impact of mindfulness in managing the physical and psychological health of people with spinal cord injury (SCI). However, no previous work has sought to understand what drives people with such conditions to try mindfulness, and what barriers are experienced in accessing mindfulness. DESIGN: An exploratory, qualitative, interview design, utilizing interpretative phenomenological analysis. METHODS: Semi-structured interviews were conducted with 11 people with SCI who had experience of mindfulness since sustaining their injury. Verbatim transcripts were analysed using IPA to understand the lived experience of mindfulness post-SCI. RESULTS: Analysis suggested that managing physical and mental health, and viewing mindfulness as proactive and protective were key drivers for exploring mindfulness. However, multiple barriers to accessing opportunities and developing capability impeded engagement. These included the focus on areas of the body that participants had reduced sensation in, physical environments that could not be navigated in a wheelchair, social stigma surrounding the use of mindfulness, and a sense of obligation and risk of failure implied by perceived requirements for engagement. CONCLUSIONS: The results demonstrate the need for specific interventions to accommodate the reduced sensory and physical function experienced by people with neurological conditions and to enhance sense of control and autonomy. In addition, recommendations include minimizing the stigma surrounding mindfulness, and the potentially demotivating impact of the perception of 'failing' to engage.

Prescribing laughter to ameliorate mental health, sleep, and wellbeing in university students: A protocol for a feasibility study of a randomised controlled trial.

OBJECTIVES: This research is the first study to investigate the potential effects of a laughter prescription on both psychological health and objective sleep parameters in university students. The primary objective is to evaluate the feasibility of prescribing laughter to inform a larger randomised controlled trial. Secondary objectives are to assess if a two-week laughter prescription improves subjective and objective sleep outcomes, wellbeing, and/or psychological health outcomes. TRIAL DESIGN: To assess the feasibility of a randomised controlled trial for laughter prescription in relation to sleep, psychological health, and wellbeing. Forty university students will be recruited and randomised to one of two conditions (control/experimental). METHODS: Wrist actigraphy and sleep diaries will be used to estimate sleep outcomes during a one-week baseline testing phase and across the two-week intervention. The experimental group will be shown how to record a Laughie (a 1-min recording of their joyful laughter on their smartphone) and prescribed to laugh with it three times daily for 14 days (the control group will only track sleep). All participants will complete the WHO (Five) Well-being Index, and Hospital Anxiety and Depression Scale pre- and post-intervention. The CONSORT checklist, and the Feasibility, Reach-out, Acceptability, Maintenance, Efficacy, Implementation, and Tailorabilty (FRAME-IT) framework will guide intervention planning and evaluation. Participant interviews will be analysed using Differential Qualitative Analysis (DQA). RESULTS: The feasibility of a two-week laughter prescription in university students and its impact on sleep, wellbeing, and/or psychological health outcomes will be assessed. CONCLUSIONS: Zayed University Research Ethics Committee approved the study in July 2019. The research will be completed following protocol publication. TRIAL REGISTRATION: ClinicalTrials.gov. ID: NCT04171245. Date of registration: 18 October 2019.

An integrative systematic review of creative arts interventions for older informal caregivers of people with neurological conditions.

OBJECTIVE: We aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of people with neurological conditions. METHODS: A systematic search was employed to identify studies that examined creative arts interventions for older informal caregivers, which were synthesised in this integrative review. We searched the following databases: MEDLINE, PubMed, EBSCO, CINAHL, EMBASE, PsycINFO, Cochrane Library, Scopus, Web of Science, and Google Scholar. We also backwards searched references of all relevant studies and inspected trials registers. RESULTS: Of the 516 studies identified, 17 were included: one was quantitative, nine were qualitative and seven used mixed methods. All included quantitative studies were pilot or feasibility studies employing pre- and post-test design with small sample sizes. Studies varied in relation to the type of creative intervention and evaluation methods, which precluded meta-analysis. Large effect sizes were detected in wellbeing measures following singing and art interventions. The qualitative synthesis highlighted that interventions created space for caregivers to make sense of, accept and adapt to their identity as a caregiver. Personal developments, such as learning new skills, were viewed positively by caregivers as well as welcoming the opportunity to gain cognitive and behavioural skills, and having opportunities to unload emotions in a safe space were important to caregivers. Group creative interventions were particularly helpful in creating social connections with their care-recipients and other caregivers. CONCLUSIONS: The current review revealed all creative interventions focused on caregivers of people living with dementia; subsequently, this identified gaps in the evidence of creative interventions for informal caregivers of other neurological conditions. There are encouraging preliminary data on music and art interventions, however, little data exists on other art forms, e.g., drama, dance. Creative interventions may appeal to many caregivers, offering a range of psycho-social benefits. The findings of the current review open the way for future research to develop appropriate and creative arts programmes and to test their efficacy with robust tools.

Mental contrasting for health behaviour change: a systematic review and meta-analysis of effects and moderator variables.

Mental contrasting is a self-regulation imagery strategy that involves imagining a desired future and mentally contrasting it with the present reality, which is assumed to prompt the individual to realise that action is required to achieve the desired future. Research has combined mental contrasting with implementation intentions (MCII) ('if-then' plans), which is hypothesised to strengthen the effects. A systematic review was conducted to evaluate the effectiveness of mental contrasting for improving health-related behaviours. A meta-analysis (N = 1528) using random effects modelling found a main effect of mental contrasting on health outcomes, adjusted Hedges' g = 0.28 (SE = .07), 95% CI [0.13-0.43], p < .001 at up to four weeks, and an increased effect at up to three months (k = 5), g = 0.38 (SE = 0.6), CI [0.20-0.55], p < .001. The combination of mental contrasting with implementation intentions (MCII; k = 7) showed a similar effect, g = 0.28, CI [0.14-0.42], p < .001. Mental contrasting shows promise as a brief behaviour change strategy with a significant small to moderate-sized effect on changing health behaviour in the short-term. Analysis on a small subset of studies suggested that the addition of implementation intentions (MCII) did not further strengthen the effects of mental contrasting on health behaviours, although additional studies are needed.

Exploring Emptiness and its Effects on Non-attachment, Mystical Experiences, and Psycho-spiritual Wellbeing: A Quantitative and Qualitative Study of Advanced Meditators.

Wisdom-based Buddhist-derived practices (BDPs) are concerned with transmuting suffering by cultivating insight into the ultimate nature of both the self and reality. Arguably the most important wisdom-based BDP is emptiness (Sanskrit: sunyata) that implies that although phenomena are perceptible to the human mind, they do not intrinsically exist. Despite its significance in Buddhism, emptiness has received little empirical attention. Advancing scientific understanding of emptiness is important as it may yield novel insights not only into the nature of mind and reality, but also in terms of helping human beings realise more of their capacity for wisdom and wellbeing. This study recruited 25 advanced Buddhist meditators and compared emptiness meditation against a mindfulness meditation control condition within the same group of participants. Qualitative analytical techniques were also employed to investigate meditators' experiences of emptiness. Compared to the mindfulness control condition, emptiness meditation resulted in significantly greater improvements in non-attachment to self and environment, mystical experiences, compassion, positive affect, and negative affect. No significant relationship was observed between duration of emptiness meditation and any of the aforementioned outcome measures. Qualitative outcomes demonstrated that participants (i) combined concentrative and investigative meditation techniques to induce emptiness, (ii) elicited spiritually meaningful insights both during and following the meditation on emptiness, and (iii) retained volitional control over the content and duration of the emptiness meditation. Cultivating emptiness appears to be a means of reconnecting advanced Buddhist meditators to what they deem to be the innermost nature of their minds and phenomena.

An Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing.

Mindfulness has transdiagnostic applicability, but little is known about how people first begin to practice mindfulness and what sustains practice in the long term. The aim of the present research was to explore the experiences of a large sample of people practicing mindfulness, including difficulties with practice and associations between formal and informal mindfulness practice and wellbeing. In this cross-sectional study, 218 participants who were practicing mindfulness or had practiced in the past completed an online survey about how they first began to practice mindfulness, difficulties and supportive factors for continuing to practice, current wellbeing, and psychological flexibility. Participants had practiced mindfulness from under a year up to 43 years. There was no significant difference in the frequency of formal mindfulness practice between those who had attended a face-to-face taught course and those who had not. Common difficulties included finding time to practice formally and falling asleep during formal practice. Content analysis revealed "practical resources," "time/routine," "support from others," and "attitudes and beliefs," which were supportive factors for maintaining mindfulness practice. Informal mindfulness practice was related to positive wellbeing and psychological flexibility. Frequency (but not duration) of formal mindfulness practice was associated with positive wellbeing; however, neither frequency nor duration of formal mindfulness practice was significantly associated with psychological flexibility. Mindfulness teachers will be able to use the present findings to further support their students by reminding them of the benefits as well as normalising some of the challenges of mindfulness practice including falling asleep.

Meditation-Induced Near-Death Experiences: a 3-Year Longitudinal Study.

Near-death experiences (NDEs) are life transformational events that are increasingly being subjected to empirical research. However, to date, no study has investigated the phenomenon of a meditation-induced near-death experience (MI-NDE) that is referred to in ancient Buddhist texts. Given that some advanced Buddhist meditators can induce NDEs at a pre-planned point in time, the MI-NDE may make NDEs more empirically accessible and thus advance understanding into the psychology of death-related processes. The present study recruited 12 advanced Buddhist meditators and compared the MI-NDE against two other meditation practices (i.e. that acted as control conditions) in the same participant group. Changes in the content and profundity of the MI-NDE were assessed longitudinally over a 3-year period. Findings demonstrated that compared to the control conditions, the MI-NDE prompted significantly greater pre-post increases in NDE profundity, mystical experiences and non-attachment. Furthermore, participants demonstrated significant increases in NDE profundity across the 3-year study period. Findings from an embedded qualitative analysis (using grounded theory) demonstrated that participants (i) were consciously aware of experiencing NDEs, (ii) retained volitional control over the content and duration of NDEs and (iii) elicited a rich array of non-worldly encounters and spiritual experiences. In addition to providing corroborating evidence in terms of the content of a "regular" (i.e. non-meditation-induced) NDE, novel NDE features identified in the present study indicate that there exist unexplored and/or poorly understood dimensions to NDEs. Furthermore, the study indicates that it would be feasible-including ethically feasible-for future research to recruit advanced meditators in order to assess real-time changes in neurological activity during NDEs.

The Integration of the Workable Range Model into a Mindfulness-Based Stress Reduction Course: a Practice-Based Case Study.

Didactic teaching about stress is part of the Mindfulness-Based Stress Reduction (MBSR) curriculum. The content and methods of integrating conceptual teaching within the experiential pedagogy are rarely explored. Workable range is a model of stress and emotion regulation that illustrates patterns of physical, emotional and cognitive reactivity in relation to mindful presence. This is a qualitative case study of the inclusion of the workable range model into an MBSR course as a refinement of the didactic teaching about stress. The focus is to illuminate how the inclusion worked in practice. Ten staff, on a MBSR course in a higher educational setting, were recruited as participant researchers with an overlap between their own first-person investigation during the course and the research data. Adapted diagrams and written answers to two question schedules, completed as reflective exercises within the course, were analysed thematically using template analysis. This revealed how participant researchers engaged with and intuitively used the model to notice and describe their own patterns of feeling balanced or stressed and explore how they related to those experiences. How learning the model integrated with MBSR and the applicability of workable ranges as a teaching resource in MBSR is discussed. The study highlights questions about how conceptual and experiential teaching and learning interrelate in mindfulness-based interventions. There is scope for further research using mindfulness practice as a first-person methodology to investigate the processes within mindfulness-based programs.

The physiological and emotional effects of touch: Assessing a hand-massage intervention with high self-critics.

Research demonstrates that highly self-critical individuals can respond negatively to the initial introduction of a range of therapeutic interventions. Yet touch as a form of therapeutic intervention in self-critical individuals has received limited prior investigation, despite documentation of its beneficial effects for well-being. Using the Forms of Self-Criticism/Self-Reassuring Scale, 15 high- and 14 low- self-critical individuals (from a sample of 139 females) were recruited to assess how self-criticism impacts upon a single instance of focused touch. All participants took part in a hand massage- and haptic control- intervention. Salivary cortisol and alpha amylase, as well as questionnaire measures of emotional responding were taken before and after the interventions. Following hand massage, analyses revealed cortisol decreased significantly across all participants; and that significant changes in emotional responding reflected well-being improvements across all participants. Supplementary analyses further revealed decreased alpha amylase responding to hand massage as compared to a compassion-focused intervention in the same (highly self-critical) individuals. Taken together, the physiological and emotional data indicate high self-critical individuals responded in a comparable manner to low self-critical individuals to a single instance of hand massage. This highlights that focused touch may be beneficial when first engaging highly self-critical individuals with specific interventions.