Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27.604
Filtrar
1.
Adv Exp Med Biol ; 1305: 295-310, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33834406

RESUMEN

Recently, the importance of cognitive behavioral therapy (CBT) in the treatment of depression is gradually emerging. Particularly, mindfulness meditation has various approaches related to dialectical behavioral therapy (DBT), acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), and evidence has been provided that they alleviate depressive symptoms. In particular, as MBCT increases the level of evidence in the treatment of repetitive depressive disorders, guidelines are being recommended to prevent recurrence. Mindfulness may also contribute to improving the patient's symptoms as well as improving the therapeutic relationship with the therapist. For both mindful patients and therapists, positive awareness of internal experiences can be a good way to enrich the mind and overcome depressive disorders.


Asunto(s)
Terapia de Aceptación y Compromiso , Terapia Cognitivo-Conductual , Trastorno Depresivo , Atención Plena , Trastorno Depresivo/terapia , Humanos , Recurrencia , Resultado del Tratamiento
2.
Adv Exp Med Biol ; 1305: 311-332, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33834407

RESUMEN

Major depressive disorder (MDD) represents a key contributor to the global burden of mental illness given its relatively high lifetime prevalence, frequent comorbidity, and disability rates. Evidence-based treatment options for depression include pharmacotherapy and psychotherapy, such as cognitive behavioral therapy (CBT). Beyond traditional CBT, over 15 years ago, Hayes proclaimed a new generation of contextualistic and process-orientated so-called third wave of CBT interventions, including acceptance and commitment therapy (ACT). Using mindfulness and acceptance as well as commitment and behavior change processes, the transdiagnostic ACT approach aims to increase psychological flexibility as universal mechanism of behavior change and to build a value-driven orientation in life. ACT for MDD can be provided as either stand-alone individual, group, or self-help formats (e.g., apps) or combined with other approaches like behavioral activation. To date, a steadily growing empirical support from outcome and process research suggests the efficacy of ACT, which appears to work specifically through the six proposed core processes involved in psychological flexibility, such as defusion. In view of an ongoing interest of clinicians in "third-wave" CBTs and the important role of clients' preferences in providing therapy choices that work, the purpose of this chapter is to give a brief overview on the application of ACT in the treatment of MDD in adults.


Asunto(s)
Terapia de Aceptación y Compromiso , Terapia Cognitivo-Conductual , Trastorno Depresivo Mayor , Atención Plena , Adulto , Trastorno Depresivo Mayor/terapia , Humanos , Solución de Problemas , Resultado del Tratamiento
3.
Washington, D.C.; OPAS; 2021-03-09. (OPAS-W/FPL/IM/21-0007).
en Portugués | PAHO-IRIS | ID: phr-53357

RESUMEN

O Programa de Atenção Integrada para a Pessoa Idosa (ICOPE) foi desenvolvido pela Organização Mundial da Saúde (OMS) para atender às necessidades e demandas de saúde das populações idosas em todo o mundo. Em 2050, a proporção da população global com 60 anos ou mais quase dobrará. Nas Américas, a expectativa de vida aumentou 21,6 anos nas últimas seis décadas. No entanto, viver mais frequentemente significa enfrentar problemas de saúde acumulados durante a velhice. A transição demográfica afetará quase todos os aspectos da sociedade e criará novos e complexos desafios para os sistemas de saúde e assistência social. Portanto, é necessária uma abordagem transformadora na maneira como os sistemas de saúde e os serviços dentro deles são estruturados - para garantir cuidados de alta qualidade que sejam integrados, acessíveis e com foco nas necessidades e direitos das pessoas idosas. A atenção integrada, especialmente para as pessoas idosas e com condições crônicas de saúde, é amplamente aceita como um mecanismo para melhorar os resultados de saúde e a eficiência do sistema. O Manual ICOPE fornece orientações detalhadas para ajudar os profissionais de saúde e cuidadores da comunidade a colocar em prática a atenção integrada para a pessoa idosa, através do desenvolvimento de um plano de cuidados. Dessa forma, o manual auxilia na definição de metas centradas na pessoa e na integração de abordagens nos diferentes níveis de atenção. O plano de cuidados pode incluir várias intervenções para gerenciar declínios na capacidade intrínseca, fornecer assistência e apoio social, desenvolver capacidade para o automanejo e apoiar os cuidadores. A brochura ICOPE apresenta os destaques da abordagem ICOPE para facilitar a sua divulgação e favorecer uma ampla apresentação do método.


Asunto(s)
Anciano , Envejecimiento , Disciplinas de las Ciencias Biológicas , Dinámica Poblacional , Envejecimiento Saludable , Salud del Anciano , Personal de Salud , Servicios de Salud para Ancianos , Fenómenos Fisiológicos Nutricionales del Anciano , Cognición , Disfunción Cognitiva , Orientación , Psicoterapia , Remediación Cognitiva , Terapia Cognitivo-Conductual , Pruebas de Estado Mental y Demencia , Geriatría , Incontinencia Urinaria , Sensación , Suplementos Dietéticos , Accidentes por Caídas , Prevención y Mitigación , Prevención de Accidentes
4.
J Oral Facial Pain Headache ; 35(1): 30-34, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33730124

RESUMEN

AIMS: To test the feasibility and acceptability of a customized six-session cognitive behavioral therapy (CBT) group intervention for adults with recurrent trigeminal neuralgia (TN). METHODS: Fifteen participants with TN were recruited from a specialist facial pain unit in London, United Kingdom. The effects of the group intervention were evaluated using validated self-report measures, which the participants completed before and after the intervention and at 1-month and 9-month follow-ups. A semi-structured interview was also used at the 1-year follow-up to gather qualitative feedback of the group intervention. RESULTS: Participants reported an increase in confidence in managing everyday tasks in the presence of TN symptoms, a reduction in negative beliefs about pain, and an increase in engagement in meaningful activity. All patients completed the group intervention (100% retention rate). Qualitative feedback highlighted that the group CBT intervention was helpful, and no participants reported a worsening of mood or experience as a result of the intervention. CONCLUSION: The trends for improvement in several domains, plus the positive experiences of the participants, suggest that a CBT management program is acceptable and feasible for this population and should be further developed and implemented on a larger scale to determine its clinical efficacy.


Asunto(s)
Terapia Cognitivo-Conductual , Neuralgia del Trigémino , Adulto , Estudios de Factibilidad , Humanos , Autoinforme , Resultado del Tratamiento , Neuralgia del Trigémino/terapia
5.
Dtsch Arztebl Int ; 118(1-2): 14-22, 2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33750533

RESUMEN

BACKGROUND: Around 5.8% of adolescents and 2.8% of young adults have an Internet-related disorder. These figures underline the widespread concerns in our society regarding the potential dangers and risks associated with Internet and digital media use. METHODS: Selective literature search for records on Internet-related disorders in children and adolescents. RESULTS: Internet-related disorders are now viewed as belonging to the behavioral addiction. Research has revealed similarities to substance-related disorders. There are often associations with other mental illnesses such as depression, anxiety, attention deficit/hyperactivity disorder, and personality disorders, as well as disturbed sleep patterns, increased risk taking, nicotine abuse, an unbalanced diet, and lack of exercise. Female adolescents are statistically significantly more often affected than male adolescents (7.1% versus 4.5%). The German STICA study, the first randomized controlled trial worldwide, demonstrated that cognitive behavioral therapy was effective compared with a waiting group (odds ratio 10.10, 95% confidence interval [3.69; 27.65]). CONCLUSION: Internet-related disorders have not yet been conclusively conceptualized and operationalized. Further work is urgently required to refine the concepts of both the illness and and its treatment.


Asunto(s)
Conducta Adictiva , Terapia Cognitivo-Conductual , Internet , Adolescente , Ansiedad , Trastornos de Ansiedad , Conducta Adictiva/epidemiología , Niño , Femenino , Humanos , Masculino , Adulto Joven
7.
BMJ ; 372: n532, 2021 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-33762262

RESUMEN

OBJECTIVE: To describe the comparative efficacy of drug and non-drug interventions for reducing symptoms of depression in people with dementia who experience depression as a neuropsychiatric symptom of dementia or have a diagnosis of a major depressive disorder. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, the Cochrane Library, CINAHL, PsycINFO, and grey literature between inception and 15 October 2020. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Randomised trials comparing drug or non-drug interventions with usual care or any other intervention targeting symptoms of depression in people with dementia. MAIN OUTCOME MEASURES: Pairs of reviewers screened studies, abstracted aggregate level data, and appraised risk of bias with the Cochrane risk of bias tool, which facilitated the derivation of standardised mean differences and back transformed mean differences (on the Cornell scale for depression in dementia) from bayesian random effects network meta-analyses and pairwise meta-analyses. RESULTS: Of 22 138 citations screened, 256 studies (28 483 people with dementia) were included. Missing data posed the greatest risk to review findings. In the network meta-analysis of studies including people with dementia without a diagnosis of a major depressive disorder who were experiencing symptoms of depression (213 studies; 25 177 people with dementia; between study variance 0.23), seven interventions were associated with a greater reduction in symptoms of depression compared with usual care: cognitive stimulation (mean difference -2.93, 95% credible interval -4.35 to -1.52), cognitive stimulation combined with a cholinesterase inhibitor (-11.39, -18.38 to -3.93), massage and touch therapy (-9.03, -12.28 to -5.88), multidisciplinary care (-1.98, -3.80 to -0.16), occupational therapy (-2.59, -4.70 to -0.40), exercise combined with social interaction and cognitive stimulation (-12.37, -19.01 to -5.36), and reminiscence therapy (-2.30, -3.68 to -0.93). Except for massage and touch therapy, cognitive stimulation combined with a cholinesterase inhibitor, and cognitive stimulation combined with exercise and social interaction, which were more efficacious than some drug interventions, no statistically significant difference was found in the comparative efficacy of drug and non-drug interventions for reducing symptoms of depression in people with dementia without a diagnosis of a major depressive disorder. Clinical and methodological heterogeneity precluded network meta-analysis of studies comparing the efficacy of interventions specifically for reducing symptoms of depression in people with dementia and a major depressive disorder (22 studies; 1829 patients). CONCLUSIONS: In this systematic review, non-drug interventions were found to be more efficacious than drug interventions for reducing symptoms of depression in people with dementia without a major depressive disorder. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017050130.


Asunto(s)
Demencia/psicología , Depresión/terapia , Antidepresivos/uso terapéutico , Terapia Cognitivo-Conductual , Terapia Combinada , Depresión/etiología , Terapia por Ejercicio , Humanos , Metaanálisis en Red , Apoyo Social , Tratamiento de Tejidos Blandos
8.
Artículo en Inglés | MEDLINE | ID: mdl-33672447

RESUMEN

Community crises require the provision of short-term reflective intervention methods to help service users identify stressors, and access and intensify their adaptive coping. Here, we demonstrate the use of a single-session online cognitive behavioral- and art-based (CB-ART) intervention within the context of the COVID-19 pandemic. In this method, the individual draws three images: his/her COVID-19-related stress, his/her perceived resources, and an integration of stress and resources. This method provided a reflective space in which individuals could identify their experienced stressors, acknowledge their coping resources, and integrate these two elements within the context of the current pandemic. In this article, we use illustrative examples from a study implemented during the first national lockdown in Israel and present a tool that can be easily implemented by mental-health professionals in ongoing community crises. The aims of this intervention were to co-create knowledge with service users, access their self-defined needs and strengths, and enhance their coping by enabling them to view stress and coping as part of the salutogenic continuum.


Asunto(s)
Adaptación Psicológica , Terapia con Arte , Terapia Cognitivo-Conductual , Computadores , Adulto , Control de Enfermedades Transmisibles , Femenino , Humanos , Israel , Pandemias
9.
J Rehabil Med ; 53(3): jrm00162, 2021 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-33634831

RESUMEN

OBJECTIVE: To explore the effects of transcranial direct current stimulation combined with cognitive training on executive function and activities of daily living performance among stroke patients. METHODS: A total of 50 subjects were enrolled and randomly allocated into 2 groups of 25 each. The real-transcranial direct current stimulation group was simultaneously subjected to transcranial direct current stimulation and cognitive training, while the sham-transcranial direct current stimulation group was simultaneously subjected to sham transcranial direct current stimulation and cognitive training. At baseline, and after treatment, each subject was assessed with the Wisconsin Card Sorting Test (WCST), Stroop Color-Word Test (SCWT), Digital Symbol Test (DST), Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Activities of Daily Living Scale (ADLs). RESULTS: After treatment, the gains in most indices of WCST, SCWT, DST, MMSE, MoCA and ADLs in the real-transcranial direct current stimulation group were significantly higher than those in the sham-transcranial direct current stimulation group (p<0.05). Nonetheless, no significant differences were noted in the gains in SCWT (including only Part A time and error, and Part B time) and activities of daily living (including only basic activities of daily living) between the 2 groups (p>>0.05). CONCLUSION: Transcranial direct current stimulation combined with cognitive training was found to significantly enhance executive function and instrumental activities of daily living performance among stroke patients.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Función Ejecutiva/fisiología , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/terapia , Estimulación Transcraneal de Corriente Directa/métodos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
10.
JAMA Netw Open ; 4(2): e210207, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33635325

RESUMEN

Importance: Despite the high level of impairment for adolescents with persistent postconcussive symptoms, few studies have tested whether such problems can be remediated. Objective: To examine whether collaborative care treatment is associated with improvements in postconcussive, quality of life, anxiety, and depressive symptoms over 1 year, compared with usual care. Design, Setting, and Participants: The Collaborative Care Model for Treatment of Persistent Symptoms After Concussion Among Youth II Trial was a randomized clinical trial conducted from March 2017 to May 2020 with follow-up assessments at 3, 6, and 12 months. Participants were recruited from pediatric primary care, sports medicine, neurology, and rehabilitation clinics in western Washington. Adolescents aged 11 to 18 years with a diagnosed sports-related or recreational-related concussion within the past 9 months and with at least 3 symptoms persisting at least 1 month after injury were eligible. Data analysis was performed from June to September 2020. Interventions: The collaborative care intervention included cognitive behavioral therapy and care management, delivered mostly through telehealth, throughout the 6-month treatment period, with enhanced medication consultation when warranted. The comparator group was usual care provided in specialty clinics. Main Outcomes and Measures: Primary outcomes were adolescents' reports of postconcussive, quality of life, anxiety, and depressive symptoms. Secondary outcomes were parent-reported symptoms. Results: Of the 390 eligible adolescents, 201 (51.5%) agreed to participate, and 200 were enrolled (mean [SD] age, 14.7 [1.7] years; 124 girls [62.0%]), with 96% to 98% 3- to 12-month retention. Ninety-nine participants were randomized to usual care, and 101 were randomized to collaborative care. Adolescents who received collaborative care reported significant improvements in Health Behavior Inventory scores compared with usual care at 3 months (3.4 point decrease; 95% CI, -6.6 to -0.1 point decrease) and 12 months (4.1 point decrease; 95% CI, -7.7 to -0.4 point decrease). In addition, youth-reported Pediatric Quality of Life Inventory scores at 12 months improved by a mean of 4.7 points (95% CI, 0.05 to 9.3 points) in the intervention group compared with the control group. No differences emerged by group over time for adolescent depressive or anxiety symptoms or for parent-reported outcomes. Conclusions and Relevance: Although both groups improved over time, youth receiving the collaborative care intervention had fewer symptoms and better quality of life over 1 year. Intervention delivery through telehealth broadens the reach of this treatment. Trial Registration: ClinicalTrials.gov Identifier: NCT03034720.


Asunto(s)
Ansiedad/psicología , Terapia Cognitivo-Conductual/organización & administración , Depresión/psicología , Síndrome Posconmocional/terapia , Calidad de Vida , Telemedicina , Adolescente , Niño , Terapia Cognitivo-Conductual/métodos , Femenino , Cefalea/fisiopatología , Cefalea/psicología , Humanos , Masculino , Grupo de Atención al Paciente , Cuestionario de Salud del Paciente , Satisfacción del Paciente , Síndrome Posconmocional/fisiopatología , Síndrome Posconmocional/psicología , Derivación y Consulta , Sueño , Ideación Suicida
11.
Nurs Res ; 70(2): 150-161, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33630538

RESUMEN

BACKGROUND: The medical management of patients with pulmonary hypertension (PH) has advanced, with few evidence-based recommendations about psychosocial and behavioral health interventions. There is also a lack of comprehensive understanding of PH psychosocial and behavioral health needs. Some psychosocial and behavioral health interventions have been tested; however, there is a gap in the systematic evaluation of nonpharmacological complementary approaches to augment PH management when addressing psychosocial and behavioral health needs. OBJECTIVES: The objectives are to explore psychosocial and behavioral health needs and describe psychosocial and behavioral health interventions for patients with PH. METHODS: We conducted an integrative systematic review of publications between January 1, 2010, and January 31, 2020, obtained from electronic databases: EMBASE, PubMed, Cumulative Index of Nursing and Allied Health Literature, Cochrane, PsycINFO, and Web of Science. The literature searches focused on empirical literature reporting psychosocial needs and psychosocial and behavioral health interventions for adult PH patients. We included peer-reviewed studies published in English. Search terms used in the study were: "hypertension," "pulmonary hypertension," "psychosocial," "depression," "anxiety," "quality of life," "behavioral health," "self-management," "psychosocial intervention," and "psychological distress." Excluded were opinion and discussion publications, reviews, non-PH populations, and pediatric articles. We used the constant comparison method to guide the synthesis of reports applying the Joanna Briggs quality assessment guidelines. RESULTS: A total of 44 articles meeting the criteria were included for final consideration. We conducted an integrative systematic review of 27 quantitative studies, narrative synthesis of 10 qualitative studies, and 7 psychosocial and behavioral health intervention studies. PH patients reported psychosocial needs, such as financial, social connections, sexual health, and palliative care needs, as well as levels of psychological distress symptoms. The results from both quantitative and qualitative studies revealed similar overarching psychosocial and behavioral health conceptual categories. Patients described their ongoing needs in PH management by relying on their psychosocial and behavioral health capabilities to adjust to changes at each stage of disease progression. Patients had high levels of psychosocial and behavioral health needs requiring interventions beyond medical treatment. DISCUSSION: Pilot studies testing psychosocial and behavioral health interventions reported improvement in levels of anxiety and depression and health-related quality of life. Larger scale studies are needed to advance this knowledge. Psychosocial and behavioral health interventions with cognitive-guided foci have the potential of meeting these unmet needs.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Hipertensión Pulmonar/psicología , Hipertensión Pulmonar/terapia , Ansiedad/prevención & control , Humanos , Hipertensión Pulmonar/complicaciones , Atención Primaria de Salud/métodos , Calidad de Vida
12.
Mo Med ; 118(1): 7-12, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33551470

RESUMEN

Medical students, residents, and practicing physicians experience high burnout, depression, and suicide rates, and the COVID-19 pandemic has exacerbated stress for many.1-6 While laudable, current well-being efforts appear insufficient to meet the challenges that so many are facing. This essay explores approaches that individuals and organizations can take to promote mental health and well-being from medical school to practice.


Asunto(s)
/psicología , Salud Mental/normas , Médicos/psicología , Estudiantes de Medicina/psicología , Adaptación Psicológica/fisiología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/terapia , /epidemiología , Terapia Cognitivo-Conductual/métodos , Depresión/epidemiología , Depresión/terapia , Humanos , Sistema Límbico/fisiopatología , Salud Mental/estadística & datos numéricos , Atención Plena/métodos , Facultades de Medicina/organización & administración , Facultades de Medicina/normas , Estrés Psicológico/complicaciones , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Suicidio/prevención & control , Suicidio/psicología , Suicidio/estadística & datos numéricos
13.
Endocr Pract ; 27(2): 158-164, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33554873

RESUMEN

OBJECTIVE: To familiarize health care providers with diagnosis and treatment of binge-eating disorder (BED), a common comorbidity of type 2 diabetes (T2DM). METHODS: Literature review of binge eating and T2DM. Key words used in search include BED, T2DM, obesity, and treatment. RESULTS: The prevalence of BED in patients with T2DM appears to be much higher than the 2% to 3.5% prevalence seen in the general population. Studies suggest that up to 20% of patients with T2DM have an underlying eating disorder, the most common of which is binge eating. BED is probably underdiagnosed, even though there are multiple simple tools that providers can use to improve screening for the disorder. Though the relationship between BED and hemoglobin A1c control can vary, it appears that binge-eating behaviors can worsen metabolic markers, including glycemic control. Various medications used by patients with diabetes have been associated with new-onset BED, and treatment may be as simple as removing or replacing such agents. Several medications have been found to significantly reduce binge-eating frequency, and potentially, weight. Patients with BED generally benefit from psychotherapy, including cognitive behavioral therapy. CONCLUSION: BED, only recently added to the International Classification of Disease-10 diagnostic list, is very common in patients with obesity and T2DM. The diagnosis is important to establish, as treatment or referral for treatment, could potentially improve many of the comorbidities and metrics of T2DM.


Asunto(s)
Trastorno por Atracón , Terapia Cognitivo-Conductual , Diabetes Mellitus Tipo 2 , Trastorno por Atracón/diagnóstico , Trastorno por Atracón/epidemiología , Trastorno por Atracón/terapia , Comorbilidad , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/terapia , Humanos , Obesidad/complicaciones , Obesidad/epidemiología
15.
Artículo en Inglés | MEDLINE | ID: mdl-33546511

RESUMEN

Community psychiatry is a modern and effective form of care for patients with mental disorders. The aim of the study was to assess the impact of a rehabilitation program at the Mental Health Support Centre in Tarnowskie Góry (Poland) on reducing severity of anxiety and depression symptoms, as well as improving overall quality of life during the COVID-19 pandemic. The study involved 35 patients, examined with an authors' questionnaire on sociodemographic data, the Hospital Scale of Anxiety and Depression (HADS) and the Short Form Health Survey (SF-36). Data was obtained during the first national lockdown and compared to data gathered before the pandemic on the same study group. Imposed restrictions, negative emotional state during lockdown, subjectively assessed higher health risk and a low level of knowledge about the COVID-19 pandemic did not significantly correlate with a severity of depression and anxiety, as well as general quality of life. However, the comparison of the results obtained in HADS and SF-36 scales show a significant improvement in both categories. Rehabilitation activities, including physical training, cognitive exercise and social therapy, reduce the severity of the symptoms and have a positive effect on the overall quality of life in patients suffering from schizophrenia and affective disorders. Therefore, holistic mental health support services may positively affect building an individual resilience. The severity of anxiety symptoms during the COVID-19 pandemic shows a negative correlation with the patient's age.


Asunto(s)
Ansiedad/terapia , Depresión/terapia , Trastornos del Humor/terapia , Pandemias , Esquizofrenia/terapia , Ansiedad/epidemiología , Terapia Cognitivo-Conductual , Control de Enfermedades Transmisibles , Terapia por Ejercicio , Humanos , Polonia , Calidad de Vida
16.
BMC Psychol ; 9(1): 35, 2021 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-33622408

RESUMEN

BACKGROUND: Work engagement is one of the most important outcomes for both employees and employers. Although the findings to date, integrated 40 intervention studies aiming to improve work engagement, consistent results have not yet been produced, suggesting the importance of further intervention studies. This study aims to investigate the effects of gratitude intervention programs focused on two important work engagement factors among Japanese workers: personal and job resources. METHODS: This study will be a two-arm, parallel-group cluster (organization) randomized control trial. Japanese organizations and nested employees will be recruited through the first author's acquaintances using snowball sampling. Organizations that meet the inclusion criteria will be randomly allocated to intervention or control groups in a 1:1 ratio within the company unit. The intervention groups will be provided with a 1-month long gratitude intervention program, which aims to promote reciprocal gratitude exchanges within the same organization. The program consists of psychoeducation, gratitude lists, and behavioral gratitude expression. The control groups will not receive any intervention. The primary outcome will be work engagement measured by the Japanese version of the Utrecht Work Engagement Scale at baseline and after 1 (immediate post-survey), 3, and 6 months. Multilevel latent growth modeling will be conducted to examine the effectiveness of the intervention program. DISCUSSION: This study will be the first cluster randomized controlled trial applied to the investigation of gratitude intervention aimed at improving work engagement among Japanese workers; to promote reciprocal gratitude exchanges within a given organization; and to include both gratitude lists and behavioral gratitude expression. Gratitude interventions have several strengths in terms of implementation: the objectives of the exercises are easy to understand and implement; it does not require much time or expense; they tend to have lower dropout rates; and they do not require experts in psychology. Although implementation difficulties have been common in previous interventions targeting work engagement, gratitude intervention may be suitable even for workers who have limited time to devote to the tasks. TRIAL REGISTRATION: This study was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, ID=UMIN000042546): https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000048566 on November 25, 2020.


Asunto(s)
Terapia Cognitivo-Conductual , Compromiso Laboral , Terapia Conductista , Ejercicio Físico , Humanos , Japón
17.
Health Psychol ; 40(3): 196-206, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33630641

RESUMEN

Meta-analyses suggest a small association between cardiovascular responses to acute stressors and cardiovascular disease, but a recent review suggests that this effect may be underestimated due to insufficient consideration of individual differences in habituation to repeated stressors. OBJECTIVE: The present article reports new analyses of a published randomized controlled trial comparing the effects of mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and a passive control condition on blood pressure habituation-a secondary outcome. Psychological mediators of intervention effects were examined. METHOD: Participants (138 healthy adults reporting moderate/high stress) were randomly assigned to 6-week MBSR, CBT, or a waitlist control. Analyses were conducted on 86 participants who subsequently completed stressful speech and mental arithmetic tasks during two posttreatment visits scheduled 48 hr apart. Blood pressure was measured -15, +0, +5, +10, +25, +35, and +60 min poststressor onset. RESULTS: There were no between-condition differences in blood pressure habituation (all ps > .05). However, both MBSR and CBT led to increased perceived control over thoughts, F(2, 72) = 5.20, p = .008, and individuals who displayed a greater change in perceived control over thoughts also displayed greater habituation to the speech portion of the stressor, F(6, 799) = 2.32, p = .020. Results implied an indirect effect of stress reduction interventions on blood pressure habituation via change in perceived control over thoughts (b = -3.93, SE = 1.98, 95% CI: [-8.392, -0.701]). CONCLUSION: Stress reduction interventions that increase perceived control over thoughts may benefit cardiovascular health by promoting blood pressure habituation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Presión Sanguínea/fisiología , Atención Plena/métodos , Estrés Psicológico/terapia , Adulto , Índice de Masa Corporal , Terapia Cognitivo-Conductual/métodos , Femenino , Promoción de la Salud , Humanos , Masculino , Meditación/métodos , Persona de Mediana Edad , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto Joven
18.
Medicine (Baltimore) ; 100(6): e23859, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578513

RESUMEN

BACKGROUND: We aimed to examine the feasibility of our newly-developed, integrated, and high-intensity individual cognitive behavioral therapy (CBT) protocol for treatment-resistant chronic pain. METHODS: We conducted an open-labeled prospective single-arm trial for patients aged 18 years and above, suffering from chronic pain, and diagnosed with somatic symptom disorder with predominant pain. We provided 16 weekly sessions of CBT, each lasting for 50 minutes, which included 4 new strategies: attention shift, memory work, mental practice, and video feedback. For comparison, the study had a pre-test post-test design. The primary outcome was the change from baseline (week 1) to 16, as indicated by the Numerical Rating Scale and Pain Catastrophizing Scale. In addition, we evaluated depression, anxiety, disability, and quality of life as secondary outcomes. RESULTS: Sixteen patients with chronic pain underwent our CBT program. Though there was no reduction in pain intensity, catastrophic cognition showed statistically significant improvement with a large effect size. Depression, anxiety, and disability demonstrated statistically significant improvements, with small to moderate effect sizes. No adverse events were reported. CONCLUSION: Our newly integrated CBT program for chronic pain may improve catastrophic cognition, depression, anxiety, and disability. Large-scale randomized controlled studies are necessary to investigate the program's effectiveness in the future.


Asunto(s)
Dolor Crónico/terapia , Terapia Cognitivo-Conductual/métodos , Manejo del Dolor/métodos , Adulto , Anciano , Ansiedad/etiología , Ansiedad/terapia , Dolor Crónico/complicaciones , Dolor Crónico/psicología , Terapia Cognitivo-Conductual/estadística & datos numéricos , Depresión/etiología , Depresión/terapia , Evaluación de la Discapacidad , Estudios de Factibilidad , Femenino , Humanos , Japón/epidemiología , Masculino , Síntomas sin Explicación Médica , Persona de Mediana Edad , Estudios Prospectivos , Calidad de Vida , Resultado del Tratamiento
19.
Gerodontology ; 38(1): 113-116, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33586237

RESUMEN

BACKGROUND: Burning mouth syndrome (BMS) is an idiopathic condition that presents with chronic pain and/or burning sensations in the oral structures. The syndrome mostly affects elderly women with hormonal changes and/or with a diagnosis of comorbid psychiatric disorder. In some rare conditions, the clinical appearance of BMS may also overlap with oral cenestopathy (OC), which is defined in the literature as a special form of delusional disorder of somatic type. Patients with OC may complain about abnormal experiences such as melting, feeling of stickiness, as well as extremely strange feelings of wires, metal coils, etc being present in their mouths. CASE PRESENTATION: We present an elderly woman whose ongoing symptoms of BMS (burning in the mouth and tongue, taste alterations etc) were, over time, superimposed by cenesthopatic delusions that her gums had melted, and her palate had totally dissolved. We believe that the case is clinically striking and demonstrative for the understanding of complex nosology of BMS and OC, given that (a) the patient exhibited a relatively rare example of overlapping BMS and OS symptoms, which both are not sufficiently recognised by clinicians, (b) OC symptoms have disappeared with low-dose aripiprazole and psychoeducation-based cognitive therapy, which resulted in significant improvement in the patient's quality of life. CONCLUSION: Clinicians are required to be aware of BMS and OC, two syndromes with multifactorial aetiology and highly heterogeneous presentation, in order to determine the most appropriate treatment options from a multidisciplinary perspective, as well as to avoid unnecessary medical interventions.


Asunto(s)
Síndrome de Boca Ardiente , Terapia Cognitivo-Conductual , Anciano , Aripiprazol/uso terapéutico , Síndrome de Boca Ardiente/complicaciones , Síndrome de Boca Ardiente/tratamiento farmacológico , Femenino , Humanos , Calidad de Vida
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...