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1.
BMC Psychol ; 11(1): 9, 2023 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-36635775

RESUMEN

BACKGROUND: Depressive symptoms are a significant psychological complication of stroke, impacting both survivors and informal caregivers of survivors. Randomized controlled trials are needed to determine optimal non-pharmacological strategies to prevent or ameliorate depressive symptoms in stroke survivors and their informal caregivers. METHODS: A prospective, randomized, parallel-group, single-center, feasibility study. Participants were assigned to a 4-week meditation intervention or expressive writing control group. The intervention comprised four facilitator-led group meditation sessions, one session per week and building upon prior session(s). Descriptive statistics were used to examine the proportion of eligible individuals who enrolled, retention and adherence rates, and the proportion of questionnaires completed. Data were collected at baseline, immediately after the 4-week intervention period, and 4 and 8 weeks after the intervention period. Secondary analysis tested for changes in symptoms of depression (Center for Epidemiologic Studies-Depression [CES-D]), anxiety [State-Trait Anxiety Inventory for Adults (STAI)], and pain (Brief Pain Inventory-Short Form) in the intervention group via paired t tests. Linear mixed models were used to compare longitudinal changes in the measures between the groups. Intervention and trial design acceptability were preliminary explored. RESULTS: Seventy-one (77%) individuals enrolled and 26 (37%) completed the study (baseline and 8-week post-intervention visits completed). Forty-two (66%) participants completed baseline and immediate post-intervention visits. Mean questionnaire completion rate was 95%. The median meditation group session attendance rate for the intervention group was 75.0%, and the mean attendance rate was 55%. Non-significant reductions in CES-D scores were found. Paired t tests for stroke survivors indicated a significant reduction from baseline through week 8 in BPI-sf severity scores (p = 0.0270). Repeated measures analysis with linear mixed models for informal caregivers indicated a significant reduction in in STAI-Trait scores (F [3,16.2] = 3.28, p = 0.0479) and paired t test showed a significant reduction from baseline to week 4 in STAI-Trait scores (mean = - 9.1250, 95% CI [- 16.8060 to 1.4440], p = 0.0262). No between-group differences were found. CONCLUSIONS: Future trials will require strategies to optimize retention and adherence before definitive efficacy testing of the meditation intervention. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03239132. Registration date: 03/08/2017.


Asunto(s)
Meditación , Accidente Cerebrovascular , Adulto , Humanos , Cuidadores/psicología , Estudios de Factibilidad , Dolor , Estudios Prospectivos , Accidente Cerebrovascular/terapia , Accidente Cerebrovascular/psicología , Sobrevivientes
2.
J Neurosci Nurs ; 52(3): 96-102, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32149852

RESUMEN

BACKGROUND: Significant gaps exist in the identification and management of psychological effects of stroke on survivors. Interventions to enhance resilience, the ability to rebound from stress or adversity, could positively impact stroke recovery. The purpose of this study was to test the effect of meditation on resilience of community-dwelling stroke survivors and to identify resilience predictor variables in these survivors. METHODS: This was a substudy with secondary analysis of existing data from the parent study, MEditatioN for post stroke Depression. The effect of meditation on stroke survivor resilience in the intervention group (n = 20) was evaluated with a paired samples t test, with measures at baseline and immediately after the 4-week intervention. Baseline resilience predictor variables for all stroke survivors (n = 35) were evaluated with univariable analysis and multiple linear regression modeling. RESULTS: The increase in stroke survivor resilience scores from baseline (mean [SD], 3.46 [0.81]) to intervention completion (mean [SD], 3.58 [1.02]) was not statistically significant (t = 0.60, df = 19, P = .56). One-way analysis of variance with Tukey post hoc analysis revealed that baseline resilience was significantly lower (P = .02) for non-Hispanic black participants than for non-Hispanic white participants. Multiple linear regression with resilience as the dependent variable, race as a fixed factor, and trait anxiety as a covariate was significant (F3,33 = 6.32, P = .002) and accounted for nearly 33% of the variance in baseline resilience. CONCLUSION: The effects of meditation on stroke survivor resilience should be tested in larger clinical trials that would explore the influence of social determinants of health, perceived stress, race-related stress, and anxiety subtypes on resilience.


Asunto(s)
Meditación , Grupos Raciales , Resiliencia Psicológica , Accidente Cerebrovascular/etnología , Sobrevivientes/psicología , Adulto , Ansiedad/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto
3.
J Holist Nurs ; 30(3): 205-13, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22713606

RESUMEN

The purposes of this pilot study were to determine the feasibility of using a Healing Touch (HT) intervention with noncommunity-dwelling older adults experiencing persistent pain and to determine an HT protocol. Data were collected at multiple time points from 20 noncommunity-dwelling older adults experiencing pain. Residents were assigned to the HT group that included techniques specific for pain or a Presence Care group. Outcome variables included measures for pain, activities of daily living, and quality of life. The pain measures showed decreases that were not statistically significant for both groups. The measure for activities of daily living showed a non-statistically significant improvement over time for the HT group. Quality of life decreased for the HT group and improved for the Presence Care group although not significantly. The practitioners were able to complete all seven of the 30- minute HT sessions. The findings indicated that both groups showed some improvement in their pain scores with other measures being variable. HT is a feasible intervention for the elderly with pain. Overall, the findings highlight the complex nature of pain in older adults.


Asunto(s)
Dolor Crónico/terapia , Estado de Salud , Calidad de Vida/psicología , Índice de Severidad de la Enfermedad , Tacto Terapéutico/métodos , Actividades Cotidianas , Anciano , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Manejo del Dolor , Resultado del Tratamiento
4.
Subst Abus ; 31(2): 79-85, 2010 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20408059

RESUMEN

Substance use is a pervasive health problem. Therapeutic community (TC) is an established substance abuse treatment but TC environments are stressful and dropout rates are high. Mindfulness-based TC (MBTC) intervention was developed to address TC stress and support self-change that could impact treatment retention. Self-change was assessed through feeling and thinking word-use in written stories of stress from 140 TC residents in a historical control group and 253 TC residents in a MBTC intervention group. Data were collected 5 times over a 9-month period. Linguistic analysis showed no differences between the groups over time; however, over all time points, the MBTC intervention group used fewer negative emotion words than the TC control group. Also, negative emotion (P < .01) and anxiety (P < .01) word-use decreased whereas positive emotion word-use increased (P < .05) over time in both groups. Descriptive data from linguistic analyses indicated that sustained self-change demands participation in mindfulness behaviors beyond the instructor-guided MBTC intervention.


Asunto(s)
Lingüística/métodos , Meditación/métodos , Autoeficacia , Trastornos Relacionados con Sustancias/terapia , Adolescente , Adulto , Ansiedad/psicología , Emociones , Femenino , Humanos , Masculino , Psicoterapia/métodos , Estrés Psicológico/terapia , Comunidad Terapéutica
5.
Am J Drug Alcohol Abuse ; 35(2): 103-8, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19322731

RESUMEN

OBJECTIVE: This trial compared Mindfulness-Based Stress Reduction, adapted for therapeutic community treatment (MBTC), with treatment as usual (TAU) for reducing stress and increasing retention in a residential facility for substance use disorders. METHOD: Four-hundred and fifty-nine participants, who met DSM-IV criteria for substance dependence were recruited (TAU = 164, MBTC = 295). RESULTS: A survival analysis of time to dropout did not show a significant difference between groups, however level of participation in MBTC was associated with decreased likelihood of dropout (p = < .01), and higher Symptoms of Stress Inventory (SOSI) scores at baseline were associated with increased likelihood of dropout (p = .03). CONCLUSION: The association between retention and level of stress on intake as well as level of participation in MBTC provides support for further research on integrating MBTC into therapeutic community treatment.


Asunto(s)
Estrés Psicológico/terapia , Trastornos Relacionados con Sustancias/rehabilitación , Comunidad Terapéutica , Adulto , Femenino , Humanos , Masculino , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Tratamiento Domiciliario/métodos , Centros de Tratamiento de Abuso de Sustancias/métodos , Factores de Tiempo , Resultado del Tratamiento
6.
Nurs Res ; 56(3): 210-6, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17495577

RESUMEN

BACKGROUND: Behavior change is integral to the prevention and treatment of many disorders associated with deleterious lifestyles. Rigorous scientific testing of behavior change interventions is an important goal for nursing research. APPROACH: The stage model for behavioral therapy development is recommended as a useful framework for evaluating behavior change strategies. The NIH model specifies three stages from initial testing of novel behavioral therapies to their dissemination in community settings. Definitions of each step in a Stage I trial and a case example of Mindfulness-Based Stress Reduction (MBSR) in therapeutic community treatment are provided. RESULTS: It is feasible to adapt a behavioral therapy such as MBSR using the stage model framework. Steps in the process include: (a) determining pilot study design and describing the population; (b) modifying the intervention and developing the manual; (c) training the teachers; (d) implementing a pilot study; and (e) monitoring treatment integrity. DISCUSSION: The development of behavior therapies requires the same scientific rigor used in pharmacotherapy research. Stage I of the model enables consideration of the "dose" of a behavioral intervention necessary to achieve behavior change in a defined population. The stage model offers an excellent approach to achieving rigor in a variety of potentially useful therapies of interest to nurse researchers.


Asunto(s)
Terapia Conductista/normas , Ensayos Clínicos como Asunto/métodos , Medicina Basada en la Evidencia/organización & administración , Investigación en Evaluación de Enfermería/organización & administración , Proyectos de Investigación , Protocolos Clínicos , Ensayos Clínicos como Asunto/enfermería , Curriculum , Estudios de Factibilidad , Humanos , Difusión de la Información , Modelos de Enfermería , Modelos Organizacionales , National Institutes of Health (U.S.) , Proyectos Piloto , Enfermería Psiquiátrica/normas , Terapia por Relajación/normas , Comunidad Terapéutica , Estados Unidos
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