Effect of education and muscle relaxation program on anxiety, depression and care burden in caregivers of acute stroke survivors: A randomized, controlled study.

ABSTRACT: This study intended to discover the effect of education and muscle relaxation (EMR) program on anxiety, depression and care burden among caregivers of acute stroke survivors.This randomized, controlled study enrolled a total of 110 caregivers of first-ever acute stroke patients, and randomly assigned to EMR (N = 55) and control (N = 55) groups. The caregivers in the EMR group received 12-month health education and progressive muscle relaxation, and those in control group were provided common rehabilitation advices. Hospital Anxiety and Depression Scale (HADS) and Zarit Caregiver Burden Scale in caregivers were evaluated at the time of patients' discharge from hospital (M0), then at month(M) 3, M6 and M12 after the discharge.HADS-anxiety score, anxiety rate and severity were similar at M0, M3, while were reduced at M6 and M12 in EMR group compared to control group. Furthermore, HADS-depression score was similar at M0 and M3 but was decreased at M6 and M12 in EMR group compared with control group, however, there was no difference of depression rate and severity between the 2 groups at each time point. Moreover, Zarit Caregiver Burden Scale score was similar at M0 and M3, but was decreased at M6 and M12; meanwhile, degree of care burden was similar at M0, M3 and M6, but was reduced at M12 in EMR group compared to control group.EMR program decreases anxiety, depression and care burden in caregivers of acute stroke survivors, suggesting its potential in improving mental health and further promoting quality of lives in these caregivers.

Interest in online interprofessional elective mind-body skills (MBS) training.

INTRODUCTION: There is growing interest in mind-body skills (MBS) education and online interprofessional elective MBS training for health professionals. We conducted this study to understand a) the demand among different health professionals for an online MBS course; b) engagement with different MBS topics; and c) planned behavior changes. METHODS: We examined registrations from May 1 through August 31, 2014 for a new online MBS elective, analyzing the percentage of registrants who engaged with one or more of 12 modules by September 30, 2014. We also reviewed written comments about planned behavior change. RESULTS: The 693 registrants included physicians, nurses, social workers, dietitians, psychologists, and others. The two most popular topics were "Introduction: to Stress, Resilience, and Relaxation Response" and "Autogenic Training". Half of registrants (57%) engaged with at least one module and 9% completed all 12 modules within the study period. Nearly all (90%) of those who completed evaluations planned to use the technique they learned for themselves, introduce it to patients, or both. DISCUSSION: Online elective MBS training attracts diverse health professionals and leads to plans for personal and professional behavior change. Additional research is necessary to understand the impact of different amounts and kinds of MBS training on professionals' resilience, burnout, and quality of care.

Autogenic Feedback Training Exercise and pilot performance: enhanced functioning under search-and-rescue flying conditions.

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group contained 4 pilots from HC-130 Hercules aircraft and 4 HH-65 Dolphin helicopter pilots; the control group contained 3 pilots of HC-130s and 6 helicopter pilots. During an initial flight, physiological data were recorded on each crewmember and an instructor pilot rated individual crew performance. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training Exercise (AFTE). The remaining participants received no training. During a second flight, treatment participants showed significant improvement in performance (rated by the same instructor pilot as in pretests) while controls did not improve. The results indicate that AFTE management of high states of physiological arousal may improve pilot performance during emergency flying conditions.

[Efficacy of stress management classes at a health center].

Although interest in mental health promotion has recently been increasing, the most appropriate approaches remain to be determined. Therefore we conducted Stress Management Classes (SMCs) at Higashi Osaka City Naka Health Center in an attempt to help residents to improve their mental health. The purpose of this study was to evaluate the efficacy of SMCs, held four times over 2 months, with an educational program including the concept of stress and instruction in autogenic training as a relaxation technique. Subjects who attended a Health Promotion Class (HPC) at Osaka Prefectural Kaizuka Health Center were used as controls for the study. The aim of the HPC was to prevent chronic physical diseases such as hypertension, diabetes, and hyperlipidemia, with the program consisting mainly of exercise once a week for 3 months. The results were as follows: 1) People who attended SMCs were more likely to have mental health problems than those who attended the HPC. As a result, mentally ill patients could be diagnosed and receive psychiatric treatment at an early stage in the SMC group. 2) Both SMC and HPC attenders reported improvement of their mental health status with the use of POMS (Profile of Mood States). 3) Both SMC and HPC attenders exhibited significant decrease of blood pressure. Although attenders of both classes improved their mental health status, it is important to be able to attract individuals who are in a poor mental condition in case of mental health promotion. In this trial, we found that the term "stress management" was very useful because people who suffered stress were likely to be interested in it. After the Community Health Law was established in 1994, the flow of community health activities has been shifting from the prefectural government to the municipality. However, promoting mental health and welfare is still mainly the role of the prefectural government. In this sense, health centers are appropriate institutions to hold classes as in this trial.

Imagery content during nonpharmacologic analgesia in the procedure suite: where your patients would rather be.

RATIONALE AND OBJECTIVES: Imagery as a hypnotic technique can produce analgesia and anxiolysis, but effective use may be restricted to select, highly hypnotizable individuals. This study assessed (a) whether patients not selected for hypnotizability can produce imagery during interventional radiologic procedures and (b) the type of imagery produced. A secondary goal of the study was to familiarize health care providers with a simple, time-efficient technique for imagery. MATERIALS AND METHODS: Fifty-six nonselected patients referred for interventional procedures were guided to a state of self-hypnotic relaxation by a health care provider according to a standardized protocol and script. Patient hypnotizability was assessed according to the Hypnotic Induction Profile test. RESULTS: Patients as a group had average distribution of hypnotizability. The induction script was started in all patients and completed in 53. All patients developed an imagery scenario. Chosen imagery was highly individual, but common trends were nature and travel, family and home, and personal skills. Being with loved ones was an important element of imagery for 14 patients. Thirty-two patients chose passive contemplation, and 24 were action oriented. CONCLUSION: Average patients who present for interventional radiologic procedures and are not preselected for hypnotizability can engage in imagery. Topics chosen are highly individual, thus making prerecorded tapes or provider-directed imagery unlikely to be equally successful.

Autogenic training and dream recall.

The present study has investigated the relationship between Autogenic Training and dream recall for 112 participants in 16 beginning courses of 10 wk. Analyses confirmed the hypothesis that learning and practicing this relaxation technique enhanced dream recall.

Psychophysiological aspects of increasing resistance to space motion sickness.

One of the actual and difficulty solved problems of the adaptation period to microgravitation is space motion sickness (MS) that has the negative influence on well-being and performance of crewmembers in the initial and highly crucial phase of the orbital flight. Among the prophylactic measures for decrease of the unfavourable influence of space MS the preflight training is of great importance, and its role in perspective undoubtedly will grow in connection with increase of the number of crewmembers. During the last years several authors received experimental materials evidenced that as a base of more effective increase of resistance to space MS there may be used adequate modelling of the main physiological effects of the adaptation period to microgravitation. In the most investigations the main attention is paid to modelling of "conflicting" vestibular-visual (VV) impacts. In other hand, in connection with the contradictory materials about the role of hemodynamic component in the development of space MS this effect of microgravitation conditions, as a rule, is not modelled in the methods of resistance enhancement to space MS. Hence in this work there was put a task to investigate the efficiency of application of different combination of VV-impacts and creation of redistribution of liquid medium of an organism in the cranial direction for increase of man resistance to space MS. For resolving this task there was used the specially developed stand, made in two modifications. This stand provided redistribution of liquid medium of an organism in the cranial direction by putting the investigated individual into the antiorthostatic position (AOP). During the rotation around the vertical axis individual was placed in such supine position on the turn table that labyrinth of the inner ear should be displaced by 8-10 centimeters from the axis of rotation to the head edge of the turn table. This increased the adequacy of vestibular apparatus irritation by gravitation and inertia forces with regard to microgravitation conditions.

Autogenic feedback training improves pilot performance during emergency flying conditions.

Studies have shown that autonomous mode behavior (AMB) is one cause of aircraft fatalities caused by pilot error. In AMB cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. The following study, conducted under the auspices of the U.S. National Aeronautics and Space Administration's (NASA) Ames Research Center, examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours.

Autogenic training and future oriented hypnotic imagery in the treatment of tension headache: outcome and process.

The aim of the present study was (a) to investigate the relative efficacy of autogenic training and future oriented hypnotic imagery in the treatment of tension headache and (b) to explore the extent to which therapy factors such as relaxation, imagery skills, and hypnotizability mediate therapy outcome. Patients were randomly assigned to the 2 therapy conditions and therapists. 55 patients (28 in the autogenic therapy condition and 27 in the future oriented hypnotic imagery condition) completed the 4 therapy sessions and 2 assessment sessions. No significant main effect or interaction effects for treatment condition or therapist was revealed. A significant effect for time in analyzing scores for headache pain, pain medication usage, depression, and state anxiety was found. In the self-hypnosis condition, pain reduction proved to be associated with depth of relaxation during home practice (as assessed with diaries) and capacity to involve in imagery (as assessed with the Dutch version [van der Velden & Spinhoven, 1984] of the Creative Imagination Scale [Barber & Wilson, 1978/79; Wilson & Barber, 1978]). After statistically controlling for relaxation and imagery, hypnotizability scores (as assessed with the Dutch version [Oyen & Spinhoven, 1983] of the Stanford Hypnotic Clinical Scale [Morgan & J.R. Hilgard, 1975, 1978/79]) were significantly correlated with ratings of pain reduction. Results are discussed in the context of the neo-dissociation and social-cognitive model of hypnoanalgesia. The clinical relevance and the methodological shortcomings of the present study are also critically assessed.

[Optimizing the learning process in short-term autogenic training by practice protocols]. / Optimierung des Lernprozesses beim Autogenen Training bei kurzer Kurslaufzeit durch Ubungsprotokolle.

The results of two studies are presented, in which the question was investigated, whether the learning process of autogenic training (AT) in short group programs can be improved by the use of a self-control technique (records for the AT-exercises realized without the group at home). Study I refers to 24 university students, who learned AT within their psychology education; Study II refers to 28 adults, who learned AT within a psychosocial community service for adults. Within control-group designs evaluative and follow-up data were gathered before, during, at the end, and 4 months after the AT-treatment. The data refer to psychosomatic complaints (SSP, ATSYM), depression (BDI), relaxation capacity and wellbeing (VFE) as well as subjective valuations of AT and the frequency of AT-exercising. The results of both studies show that the basal AT-exercises can be learned in short group programs (6 meetings within 6 weeks). The self-control technique promotes the learning process at short as well as at longer sight. Implications of the results for the realization of introductions to AT in out- and in-patient group treatment are discussed.

[Effectiveness of courses in autogenic training within the scope of the public university. An expanded form of the contribution, which was recognized in 1987 with the "Ludo-Hartmann Prize" by the Austrian Society of Public Education]. / Effektivität von Kursen für autogenes training im Rahmen der Volkshochschule. Dies ist die erweiterte Fassung einer Arbeit, die 1987 mit dem "Ludo-Hartmann-Preis" des Verbandes der österreichischen Volkshochschulen ausgezeichnet wurde.

128 participants of courses for autogenic training held at an adult college were followed up three months after end of the course by means of a questionnaire. The investigation aimed to explore, whether the participants succeeded in learning autogenic training and how many of them after 3 months still practiced it. The most important findings were: most participants succeeded with the exercises of warmth and heaviness whereas they had much difficulties with the exercises of the different organ systems. The frequency of practice correlated statistically positive with the participant's age. After end of the course the frequency of practice decreased markedly. Success in practicing the basic exercises is determined by the frequency of practice and the participant's symptomatology: participants with organic symptoms do significantly worse in learning autogenic training.

[The training of family members in treatment with suggestive and autogenic psychotherapies. The advantages and limits]. / L'addestramento dei familiari nel trattamento con psicoterapie suggestive e autogene. Vantaggi e limiti.

The first part of the paper examines the reasons for involving the patient's family in suggestion and autogenous therapy, giving details of the advantages and limitations of this involvement and listing the pathologies in which it is employed. Finally, the use of autogenous techniques as an aid in the diagnosis of the patient's individual and relational situation as well as the prognosis for a cure is briefly described.

[Triennial experience in group hypnosis therapy and the teaching of medical self-hypnosis]. / Esperienza triennale nell'ipnositerapia di gruppo per l'insegnamento di autoipnosi medica.

A three year experiment with group hypnosis therapy for the teaching of medical self-hypnosis is reported. The teaching was divided into 7 courses followed by a total of 142 pupil-patients. The self-hypnotic techniques employed maximised motivational and gratification factors. A special type of deep-breathing is also described. This at least partially solves the problem of inducing a sufficiently deep trance for the achievement of appreciable results. Its efficacity was confirmed in almost all the patients despite the number and diversity of their problems and varied motivation.

[Respiratory autogenic training (RAT) in the psychosomatic training of physicians]. / Il gruppo R.A.T. per una formazione psicosomatica del medico

The Author, after having described the nature of the relationship between the physician and the patient and the various possibilities that are available for their communication and the obstacles that hinder it, specifically analyzes the different phases that are necessary for the physician's psychological formation and the possibilities that the "respiratory autogenic training", practiced in a group, can offer to the expierence of the Baliant groups.