Ear-Marking Relief: A Meta-Analysis on the Efficacy of Auricular Acupressure in Alleviating Anxiety Disorders.

BACKGROUND: The increasing worldwide mental health crisis, notably anxiety, emphasizes the urgency for available and effective interventions. Traditional therapies, although beneficial, pose limitations due to their considerable costs and possible adverse effects, thereby inviting alternative treatments such as auricular acupressure (AA). This non-pharmacological, integrative method, underpinned by Eastern and Western medical principles, presents a significant prospect for managing anxiety. OBJECTIVE: This study aims to evaluate the existing evidence on the efficacy of AA in reducing anxiety, as elucidated through a systematic review. METHODS: A comprehensive search of randomized controlled trials was conducted across various databases: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wan Fang, and Database for Chinese Technical Periodicals (VIP). Two reviewers retrieved the pertinent studies and assessed their methodological quality. A meta-analysis was then conducted, incorporating data from all relevant time points. RESULTS: Upon examining 25 studies encompassing 1,909 participants, it was discerned that AA significantly diminished anxiety (SMD = -1.1074; 95% confidence interval, -1.348 to -0.801; z = 7.70, p < 0.01). Subgroup analyses indicated that neither an increased number of auricular points nor extended intervention augmented effects. Larger effect sizes were associated with probing and avoidance of sham acupressure. Notably, 23 of the 25 studies exhibited some bias, suggesting further research is necessary. CONCLUSIONS: The extant evidence advocates for AA as an effective supplementary intervention that reduces patient anxiety. The results hint at a potential placebo effect elicited by sham acupressure, necessitating rigorous control group definitions in future inquiries. The study findings suggest that fewer acupressure points and shorter intervention durations could effectively alleviate anxiety symptoms. Nonetheless, the significant heterogeneity across the studies underscores the requirement for more stringent research methodologies to substantiate these conclusions.Die weltweit zunehmende Krise der psychischen Gesundheit, vor allem von Angstzuständen, zeigt, dass dringend verfügbare und wirksame Interventionen erforderlich sind. Herkömmliche Therapien sind zwar hilfreich, werden aber durch ihre hohen Kosten und möglichen unerwünschten Wirkungen eingeschränkt, so dass alternative Behandlungen wie die Ohrakupressur gefragt sind. Diese nicht-pharmakologische, integrative Methode, die sich auf östliche und westliche medizinische Prinzipien stützt, stellt eine bedeutsame Perspektive für die Behandlung von Angstzuständen dar.Ziel dieser Studie ist es, die vorhandenen Evidenzen für die Wirksamkeit der Ohrakupressur (auricular acupressure, AA) zur Verringerung von Angstzuständen, die in einer systematischen Übersichtsarbeit ermittelt wurden, zu bewerten.Es wurde eine umfassende Suche nach randomisierten kontrollierten Studien in verschiedenen Datenbanken durchgeführt: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wan Fang und Database for Chinese Technical Periodicals (VIP). Zwei Gutachter suchten die einschlägigen Studien heraus und bewerteten ihre methodische Qualität. Anschliessend erfolgte eine Metaanalyse, bei der Daten aller relevanten Zeitpunkte berücksichtigt wurden.Die Untersuchung von 25 Studien mit 1'909 Teilnehmern ergab, dass die Ohrakupressur (AA) Angstzustände signifikant verringerte (SMD = −1,1074; 95%-KI: −1,348 bis −0,801; z = 7,70, p < 0,01). Subgruppenanalysen zeigten, dass die Effekte weder durch eine höhere Anzahl von Ohrpunkten noch durch eine längere Intervention verstärkt wurden. Grössere Effektstärken waren mit Sondenverwendung und Vermeidung von Scheinakupressur assoziiert. Hervorzuheben ist, dass 23 der 25 Studien eine gewisse Verzerrung aufwiesen, weshalb weitere Untersuchungen erforderlich sind.Die vorhandene Evidenzlage stützt die Ohrakupressur (AA) als wirksame unterstützende Intervention, die die Angst der Patienten verringert. Die Ergebnisse deuten auf einen potenziellen Placeboeffekt durch Scheinakupressur hin, so dass in künftigen Untersuchungen strenge Kontrollgruppendefinitionen erforderlich sind. Die Studienergebnisse sprechen dafür, dass eine geringere Anzahl von Akupressurpunkten und kürzere Interventionszeiten die Angstsymptome wirksam lindern können. Die starke Heterogenität der Studien zeigt allerdings, dass strengere wissenschaftliche Methoden erforderlich sind, um diese Schlussfolgerungen zu untermauern.

The Effectiveness of Benson's Relaxation Technique on Pain and Perceived Stress Among Patients Undergoing Hemodialysis: A Double-Blind, Cluster-Randomized, Active Control Clinical Trial.

Benson's relaxation affects many symptoms among hemodialysis patients. A cluster-randomized active control clinical trial with three repeated measures; pre, 1-week, and 1-month post-intervention sought to evaluate the effectiveness of Benson's Relaxation on pain and perceived stress (P&PS) among hemodialysis patients. Two governmental hospitals were randomly assigned to intervention and control. Thirty-six participants were randomly selected; 18 were intervention, and 18 were controlled. The intervention group performed Benson's Relaxation twice a day for 10 minutes for 8 weeks after a training session. The control group received an educational session about Progressive Relaxation. Findings revealed a statistically significant reduction in the PSS-10 and PRI scores between pre-intervention and 1 month after-intervention (p < .001) and at 1 week after intervention and 1 month after-intervention (p < .001). A non-statistically significant reduction between pre-intervention and 1 week after-intervention (p > .05). Benson's Relaxation significantly relieved P&PS among hemodialysis patients but not after only 1 week of practicing.

Quality of life among mothers of preterm newborns in a Malaysian neonatal intensive care unit.

Background: As Quality of Life (QoL) becomes progressively vital in health care services, its importance in mother and child health is of no exception too. Quality of life among mothers with a premature newborn is an issue that has led to growing concerns in the health care system. Yet, despite the knowledge about mother's QoL being essential to family-centered planning on prematurity integrated healthcare, current evidence has been scant. Objective: To examine factors related to the QoL of mothers having preterm newborns hospitalized in the neonatal critical unit. Methods: A non-probability convenience survey was used in a public hospital in Malaysia, covering 180 mothers whose preterm newborns were hospitalized into level III Neonatal Intensive Care Unit (NICU) through the completion of a 26-questions survey of the World Health Organization Quality of Life (WHOQOL-BREF) and the 26-questions of Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU). The data were analyzed using descriptive statistics, bivariate analysis, and Pearson correlation coefficients. Result: The mean scores for mothers' quality of life were (M = 3.67, SD = 0.73) and maternal stress (M = 3.03, SD = 0.90) out of 5. A mother's occupation was found to be the only factor associated with the quality of life among mothers who have preterm newborns admitted to the NICU. Furthermore, maternal role change was found to have a moderate negative relationship with the quality of life (r = 0.310, p = 0.05). Conclusion: The findings of this study revealed that the main factors contributing to the mother's QoL during their preterm newborns' NICU admission were role change-related stress. Thus, to maintain a better QoL among this group of mothers during this traumatic period, a special nursing intervention program must be implemented immediately, right after the preterm newborns' admission, to relieve the mothers' stress which has been proven to have a direct effect on the mothers' QoL. The study results will alert healthcare providers, particularly neonatal nurses, on the need to support mothers psychologically in terms of role change. This is to ensure a better quality of life among mothers whose newborns were admitted to the NICU.

Efficacy of Benson's Relaxation Technique on Anxiety and Depression among Patients Undergoing Hemodialysis: A Systematic Review.

This study aimed to evaluate the efficacy of Benson's relaxation technique on anxiety and depression among patients undergoing hemodialysis. A systematic review of randomized controlled trials was conducted. Searching databases included EBSCO Host, PubMed, ProQuest, Science Direct, Sage Journals, Ovid, and Google Scholar from January 2000 to September 2020. Five randomized controlled trials were identified. Findings revealed a statistically significant decrease in anxiety score. Concerning depression; one RCT showed a statistically significant decrease and two RCTs revealed a non-significant difference in depression level. The overall quality of the RCTs was not high. Despite that the RCTs showed benefits of BRT in managing anxiety. However, this is not the same for depression. The lack of high-quality scientific evidence supporting its retinue use indicates that additional well designed randomized controlled trials in multiple countries are warranted to support the efficacy of Benson's relaxation technique on anxiety and depression among patients undergoing hemodialysis.

Effectiveness of mindfulness-based cognitive therapy among depressed individuals with disabilities in Nigeria: A randomized controlled trial.

The objective of this paper was to examine the efficacy of mindfulness-based cognitive therapy (MBCT) in decreasing depressive symptoms and intellectual disabilities (ID) among individuals with depression in Nigeria. In this randomized controlled trial, 101 participants with depression and ID, aged 18-60 years, who obtained 14 scores in the Beck Depression Inventory (BDI-II), scores 4 and above on Shaheen Disability Scale (SDS), were randomly assigned into the interventions (n = 50) and active control group (n = 51). The MBCT group has shown a statistically significant effect on the SDS and BDI-II variables by decreasing depressive symptoms and disabilities following MBCT (p<0.05). The assessment revealed that participants reported an improvement in their experience of depression and ID. The most significant impact was in the reduced levels of ID reported. The results of the evaluation suggest that depressed people with intellectual disabilities benefit from a structured MBCT group intervention and the results are maintained at 2-months follow-up.

Impact of Mindfulness-Based Cognitive Therapy on Depressive Symptoms Reduction among Depressed Patients in Nigeria: A Randomized Controlled Trial.

Depression is a common mental health disease with a high risk of relapse in people with a mental health condition. Mindfulness-based cognitive therapy (MBCT) showed higher efficacy in reducing depressive symptoms and prevent relapse for depressed patients. The study examined the effectiveness of MBCT versus the control group (CG) for the depression symptom reduction. A controlled trial was used to examine the effectiveness of MBCT or CG on depressive patients in Nigeria. Out of 357 screened subjects, 101 patients were randomized to receive either MBCT (n = 50) or CG (n = 51) and prospectively followed for 2 months. The intervention delivered according to the published manuals, and Beck Depression Inventory (BDI) was used to assess MDD severity among the patients. All assessments were conducted at three levels (baseline, 2 and 4 months). At the end of the 8 weeks of MBCT intervention, MBCT participants did not have significantly fewer depressive symptoms compared to those in the CG. However, the MBCT group had a significant depressive symptom reduction after 2 month follow up. The findings are in line with other studies, which show MBCT significantly decreased depression severity and improved treatment response rates after 2 months follow up, confirmed MBCT viability in the management of MDD.

Stress management interventions for intensive and critical care nurses: A systematic review.

BACKGROUND: The level of occupational stress of nurses working in intensive and critical care units is high. Although many studies have assessed the effectiveness of stress management interventions among intensive and critical care nurses, the methodological quality of these studies remains unclear. PURPOSE: The purpose of this review was to summarize and appraise the methodological quality of primary studies on interventions for management of occupational stress among intensive and critical care nurses. METHODS: This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify primary studies that assessed the effectiveness of interventions in managing occupational stress among intensive and critical care nurses using multiple databases from January 2009 to June 2019. RESULTS: Twelve studies published between 2011 and 2019 were eligible for inclusion. These included studies were classified as being of good or fair quality. The consensus across the included studies was that, compared with control condition, cognitive-behavioural skills training and mindfulness-based intervention were more effective in reducing occupational stress among intensive and critical care unit nurses. CONCLUSION: Further research should focus on methodologically strong studies by blinding the outcome assessors, using Randomized Controlled Trial (RCT) design with an active control group, using standardized assessment tools, and reporting enough details about the stress management intervention-related adverse events. RELEVANCE TO CLINICAL PRACTICE: This review demonstrates the need for high methodological quality studies to rigorously evaluate the effectiveness of stress management interventions before it can be recommended for use in clinical practice to reduce stress in intensive and critical care unit nurses. In addition, attention should be given to developing research protocols that place more emphasis on interventions aimed at the organization level to address the growing problem of occupational stress among intensive and critical care nurses.

Experiences of people living with disorders of sex development and sex reassignment: Meta-ethnography of qualitative studies.

AIM: The aim of this study was to synthesize the experiences of people with disorders of sex development. BACKGROUND: The quality of life of people with disorders of sex development depends largely on the availability of good psychosocial and psychosexual management. There is a lack of qualitative systematic reviews of the literature on the experiences of people with disorders of sex development. DESIGN: The seven steps of qualitative meta-ethnography were employed in this review. DATA SOURCES: The following electronic databases were systematically searched until January 2017: Science Direct, Scopus, Sage online, CINAHL, PsycINFO, Medline, Wiley Online Library, and Google Scholar. Search terms for this review were "disorders of sex development," "intersex," "ambiguous genitalia," "experiences," "qualitative study," and "method". REVIEW METHOD: A 13-item scale was applied to evaluate the quality of the selected studies and synthesized using the principles of meta-ethnography. FINDINGS: Twelve studies met the eligibility criteria. Six major themes described the experiences of people with disorders of sex development. These included a range of physical, psychological, social, and sexual experiences which affect their quality of life. Different coping strategies were employed by individuals who live with the lifelong condition. CONCLUSION: Disorders of sex development affect the quality of life of people living with these disorders. Nurses are tasked with providing holistic care for people with disorders of sex development in order to improve their quality of lives. As such, there is a need to explore the experiences of nurses in the management of disorders of sex development.