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1.
Int J Behav Med ; 26(4): 437-442, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31264100

RESUMO

BACKGROUND: Exposure to violence, which is experienced at disproportionally higher levels by black versus white youth, is associated with disruptions in sleep and elevated cardiovascular risk. Further, poor sleep hygiene is associated with insulin resistance. However, research to date examining disruptions in sleep and cardiovascular risk in African-American adolescents has not taken the impact of exposure to violence into account, nor considered how gender might affect patterns of association. The present study addressed this gap by testing a path model linking exposure to community violence, sleep disruption, and insulin resistance in a sample of African-American adolescents and evaluating model fit across gender. METHOD: African-American adolescents (N = 107; 56% female; Mage = 14.29, SD = 1.17) completed structured interviews at home and provided a blood sample after fasting overnight. RESULTS: The model fit connecting exposure to violence with sleep disruption and insulin resistance, adjusting for depressive symptoms and body mass index z score, was excellent. Multiple group analysis indicated gender differences in model fit. Path analysis revealed significant positive associations between exposure to violence and sleep disruption and sleep disruption and insulin resistance for females but not males. CONCLUSION: These data indicate that low-income, urban African-American female adolescents who witness violence and experience sleep disruptions may already be at elevated risk for health problems compared with their male counterparts. Additional research should attempt to replicate and explicate the underlying reasons for the gender differences observed here, with the goal of improving health and disrupting the path leading to health disparities.


Assuntos
Exposição à Violência/psicologia , Resistência à Insulina , Pobreza/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , População Urbana/estatística & dados numéricos , Adolescente , Afro-Americanos/psicologia , Feminino , Humanos , Masculino , Fatores Sexuais , Sono
2.
Behav Neurol ; 2019: 8459579, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31191740

RESUMO

Anxiety in Parkinson's disease (aPD) is underdiagnosed, undertreated, and understudied. As many as 50% of persons diagnosed with Parkinson's disease (PD) are reported to suffer from anxiety. Current treatment is largely pharmacologic, which can result in a myriad of undesirable and unsafe side effects. The aim of this paper is to examine intervention studies of self-managed nonpharmacological strategies for the treatment of anxiety. A comprehensive review was conducted on experimental or quasi-experimental trials that included self-management approaches for the nonpharmacologic treatment of anxiety as a primary or secondary aim or outcome measure. Thirteen studies were identified from four databases. Study quality demonstrated variability in design and delivery of self-managed interventions; sample sizes were small; anxiety was most commonly a secondary aim; and the use of anxiety measures varied widely. Statistical significance was evident in slightly more than 50% of the anxiety intervention studies. A common element in the interventions in all studies was the focused use of breath. Further research is needed to determine the feasibility of using focused breathing, alone, as an intervention for the self-management of anxiety in Parkinson's disease.


Assuntos
Ansiedade/terapia , Doença de Parkinson/psicologia , Autogestão/métodos , Humanos , Doença de Parkinson/complicações , Respiração , Autocuidado/métodos , Autocuidado/psicologia , Autogestão/psicologia
3.
J Womens Health (Larchmt) ; 28(2): 109-110, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30668233
4.
J Holist Nurs ; 37(2): 189-199, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30227765

RESUMO

PURPOSE: To contribute to the treatment fidelity literature by providing real-world examples and suggestion for future research and potential clinical application, this article reports on implementation, assessment, and evaluation of treatment fidelity in mind-body self-care approaches in at-risk women. METHOD: Aligning with best practices, treatment fidelity was integrated into three randomized clinical trials. The first examined the effects of a tai chi intervention designed to decrease cardiometabolic risk factors in women; the second examined the effects of a tailored guided imagery intervention on pregnancy outcomes in African American women; and the third explored effects of a mindful physical activity intervention (yoga) on psychological outcomes in women with moderate to severe depressive symptoms. FINDINGS: Each of the studies successfully designed, implemented, and evaluated strategies to address recommended treatment fidelity components. These strategies provided qualitative and quantitative data that informed intervention refinement, directions for future research, and application in clinical practice. CONCLUSIONS: The treatment fidelity framework used here is based on best practices and was a feasible and reliable approach for ensuring and reporting on treatment fidelity, which is contributing to future research to foster translation of potentially effective mind-body self-care approaches into practice.


Assuntos
Terapias Mente-Corpo/normas , Resultado do Tratamento , Adolescente , Adulto , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/terapia , Feminino , Humanos , /normas , Terapias Mente-Corpo/métodos , Fatores de Risco , Tai Ji/métodos , Tai Ji/normas
5.
J Womens Health (Larchmt) ; 28(5): 636-645, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30461339

RESUMO

Background: The complex interplay of psychological stress appraisal, biology, chronically stressful environments, and individual coping mechanisms can impact and tax physiological adaptive processes. This can result in increased cardiometabolic risk (CMR), type 2 diabetes, and cardiovascular disease. Underlying mechanisms are not entirely clear and appear to differ significantly based on age, sex, race, and ethnicity. This crosssectional descriptive study explored stress profiles of psychological and behavioral adjustment to determine the extent to which patterns of stressors, coping, and CMR differentiated these profiles. Materials and Methods: African American (AA) women (N = 110; M age = 38.61 years, SD = 6.94 years) were recruited from low-income communities and participated in two home visits to complete stress and coping and cardiovascular risk measures. Results: Three distinct stress and coping adjustment profiles were associated with differences in CMR. The "holding steady" profile had less insulin resistance (IR) and substance use compared to "high substance users" and "high internalizers" profiles. Women who were "holding steady" used less avoidant coping than "high internalizers." Conclusions: Less favorable adjustment processes were associated with IR, as well as significantly higher levels of avoidant coping and substance use. In AA women, awareness of and attention to stress and coping patterns may help attenuate CMR.

6.
Pain Med ; 20(9): 1651-1677, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-30307521

RESUMO

OBJECTIVE: To identify and describe available instruments that can be used to screen patients with acute or subacute low back pain for a chronic low back pain trajectory. DESIGN: Integrative literature review. METHODS: An electronic search of PubMed/MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, and PsychINFO databases took place from May through July of 2014 using systematic search strategies to identify screening instruments developed to identify people at risk of chronic low back pain. After screening for inclusion and exclusion criteria as well as quality indicators, the identified studies were categorized based on whether the instrument measured psychological, clinical, or functional measures to predict chronic low back pain. RESULTS: Initial searches identified 2,274 potential articles. After assessing for duplicates, title, and abstract content, there were 129 remaining articles. Articles were further excluded after analysis of the text, for a total of 42 studies reviewed. Most instruments reviewed were unable to provide evidence of predictive power for developing chronic low back pain. CONCLUSIONS: This review identified numerous instruments developed to assess the likelihood of chronic low back pain in acute and subacute low back pain populations. Of the instruments reviewed, the STarT Back Screening Tool and the Örebro Musculoskeletal Pain Questionnaire demonstrated superior predictive power compared with other instruments. Both screening tools offer evidence of validation, translation into different languages and international application, and usage in various health care settings and provide data on predictive power.

7.
Complement Ther Med ; 36: 90-92, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29458939

RESUMO

OBJECTIVE: Mindfulness-based interventions, which increase dispositional mindfulness, may be useful adjunctive therapies for patients with chronic diseases, including diabetes. One way that mindfulness may benefit patients with diabetes is by fostering more accurate interoception, particularly in the form of blood glucose estimate accuracy. Many people with diabetes regulate their behavior based on estimates of their blood glucose levels from interoception, but they vary in estimate accuracy. Therefore, our objective was to conduct a preliminary test of the hypothesis that, in a sample of patients with diabetes, more mindful individuals would demonstrate greater blood glucose estimate accuracy. METHODS: In a cross-sectional study, patients (N=28) with type 2 diabetes estimated their blood glucose levels immediately before their actual levels were assessed. Participants also completed two measures of mindfulness: one assessing general dispositional mindfulness and another assessing mindfulness specifically in the face of difficulty. RESULTS: Although general dispositional mindfulness was unrelated to blood glucose estimate accuracy, individuals who reported more mindfulness during difficulties were approximately four times more likely to meet established accuracy criteria. CONCLUSIONS: Mindfulness specifically during difficulties might play a role in disease-relevant interoception for patients with diabetes. Future research should aim to replicate this finding in larger and different samples, and to examine the potential role of mindfulness during difficulties in mindfulness-based interventions for patients with diabetes.


Assuntos
Glicemia/análise , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/psicologia , Interocepção/fisiologia , Atenção Plena , Glicemia/fisiologia , Doença Crônica , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Humanos
8.
Biol Res Nurs ; 19(4): 428-439, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28374630

RESUMO

OBJECTIVE: To investigate associations between components of cumulative risk (CR) and physiological stress responses in African American adolescents and evaluate emotion regulation as a mediator and sex as a moderator of these associations. METHODS: Cortisol and salivary alpha amylase (sAA) were collected in adolescents ( N = 205; 55% female; 12.1 ± 1.6 years at baseline) as part of a longitudinal study of stress and adjustment in families. CR was assessed at baseline and emotion regulation was assessed at baseline and 2 years later at Wave 3 (W3) using caregiver and adolescent reports. Cortisol and sAA responses to the social competence interview were assessed at W3. RESULTS: Repeated-measures analyses of variance predicting cortisol and controlling for time of day, adolescent age, medication usage, and pubertal status revealed significant interactions of time with both psychosocial and sociodemographic risk. In both analyses, youths with higher levels of risk showed a steeper decline in cortisol than youths with lower levels of risk. In parallel analyses predicting sAA, time interacted with psychosocial but not with sociodemographic risk. There were no interactions with sex in any of the analyses. Although CR was associated with changes in emotion regulation, there was no evidence that these changes accounted for the observed CR-stress response associations. CONCLUSIONS: These findings illustrate the potential importance of disentangling CR and suggest that additional work is needed to help explicate why and how CR is associated with specific physiological responses to stress.


Assuntos
Afro-Americanos/psicologia , Hidrocortisona/análise , Saliva/química , Estresse Psicológico/fisiopatologia , alfa-Amilases/análise , Adolescente , Fatores Etários , Feminino , Humanos , Estudos Longitudinais , Masculino , Estresse Fisiológico , Fatores de Tempo
9.
Artigo em Inglês | MEDLINE | ID: mdl-27672398

RESUMO

Health disparities (HD) continue to persist in the United States which underscores the importance of using low-cost, accessible, evidence-based strategies that can improve health outcomes, especially for chronic conditions that are prevalent among underserved minority populations. Complementary/integrative health modalities, particularly self-administered mind-body practices (MBP), can be extremely useful in reducing HD because they are intrinsically patient-centered and they empower patients to actively engage in self-care of health and self-management of symptoms. Interprofessional healthcare providers and patients can engage in powerful partnerships that encompass self-administered MBP to improve health. This is a call to action for interprofessional researchers to engage in high-quality research regarding efficacy and cost-effectiveness of self-administered MBP, for practitioners to engage patients in self-administered MBP for health promotion, disease prevention, and symptom management, and for healthcare institutions to integrate self-administered MBP into conventional health practices to reduce HD in their communities.

10.
Nurs Res ; 65(4): 279-89, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27362514

RESUMO

BACKGROUND: The need for reliable, valid tools to measure patient-reported outcomes (PROs) is critical both for research and for evaluating treatment effects in practice. The Patient-Reported Outcomes Measurement Information System Fatigue-Short Form v1.0-Fatigue 7a (PROMIS F-SF) has had limited psychometric evaluation in various populations. OBJECTIVES: The aim of the study is to examine psychometric properties of PROMIS F-SF item responses across various populations. METHODS: Data from five studies with common data elements were used in this secondary analysis. Samples from patients with fibromyalgia, sickle cell disease, cardiometabolic risk, pregnancy, and healthy controls were used. Reliability was estimated using Cronbach's alpha. Dimensionality was evaluated with confirmatory factor analysis. Concurrent validity was evaluated by examining Pearson's correlations between scores from the PROMIS F-SF, the Multidimensional Fatigue Symptom Inventory-Short Form, and the Brief Fatigue Inventory. Discriminant validity was evaluated by examining Pearson's correlations between scores on the PROMIS F-SF and measures of stress and depressive symptoms. Known groups validity was assessed by comparing PROMIS F-SF scores in the clinical samples to healthy controls. RESULTS: Reliability of PROMIS F-SF scores was adequate across samples, ranging from .72 in the pregnancy sample to .88 in healthy controls. Unidimensionality was supported in each sample. Concurrent validity was strong; across the groups, correlations with scores on the Multidimensional Fatigue Symptom Inventory-Short Form and Brief Fatigue Inventory ranged from .60 to .85. Correlations of the PROMIS F-SF with measures of stress and depressive mood were moderate to strong, ranging from .37 to .64. PROMIS F-SF scores were significantly higher in clinical samples compared to healthy controls. DISCUSSION: Reliability and validity of the PROMIS F-SF were acceptable. The PROMIS F-SF is a suitable measure of fatigue across the four diverse clinical populations included in the analysis.


Assuntos
Fadiga/diagnóstico , Qualidade de Vida , Inquéritos e Questionários/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/diagnóstico , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Psicometria , Índice de Gravidade de Doença
11.
Am J Health Promot ; 30(8): 613-622, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-26305613

RESUMO

PURPOSE: This study examined the effects of tai chi (TC) on biobehavioral factors associated with cardiovascular disease (CVD) risk in women. DESIGN: A randomized trial used a wait-list control group, pretest-posttest design. Data were collected immediately before, immediately after, and 2 months following the intervention. SETTING: The study was community based in central Virginia. SUBJECTS: Women aged 35 to 50 years at increased risk for CVD. INTERVENTION: The 8-week intervention built on prior work and was designed to impact biobehavioral factors associated with CVD risk in women. MEASURES: Biological measures included fasting glucose, insulin, and lipids as well as C-reactive protein and cytokines. Behavioral measures included fatigue, perceived stress, depressive symptoms, social support, mindfulness, self-compassion, and spiritual thoughts and behaviors. ANALYSIS: A mixed effects linear model was used to test for differences between groups across time. RESULTS: In 63 women, TC was shown to decrease fatigue (∂ [difference in group means] = 9.38, p = .001) and granulocyte colony stimulating factor (∂ = 12.61, p = .052). Consistent with the study model and intervention design, significant changes observed 2 months post intervention indicated that TC may help down-regulate proinflammatory cytokines associated with underlying CVD risk, including interferon gamma (∂ = 149.90, p = .002), tumor necrosis factor (∂ = 16.78, p = .002), interleukin (IL) 8 (∂ = 6.47, p = .026), and IL-4 (∂ = 2.13, p = .001), and may increase mindfulness (∂ = .54, p = .021), spiritual thoughts and behaviors (∂ = 8.30, p = .009), and self-compassion (∂ = .44, p = .045). CONCLUSION: This study contributes important insights into the potential benefits and mechanisms of TC and, with further research, may ultimately lead to effective strategies for reducing CVD risk in women earlier in the CVD trajectory.


Assuntos
Doenças Cardiovasculares/epidemiologia , Tai Ji/métodos , Tai Ji/psicologia , Adulto , Glicemia , Proteína C-Reativa/análise , Depressão/epidemiologia , Fadiga/epidemiologia , Feminino , Humanos , Mediadores da Inflamação/metabolismo , Insulina/sangue , Lipídeos/sangue , Pessoa de Meia-Idade , Fatores de Risco , Apoio Social , Estresse Psicológico/epidemiologia , Virginia/epidemiologia
12.
J Nurs Scholarsh ; 47(4): 310-7, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26077958

RESUMO

PURPOSE: Chronic liver disease affects over 30 million people worldwide, and despite advances in medical management that have increased survival, a majority of these individuals report multiple symptoms that severely impair function and quality of life. The purpose of this integrative review was to examine and summarize the current literature focused on self-reported symptoms in individuals with chronic liver disease in order to inform the development and delivery of symptom management strategies in clinical practice. DESIGN AND METHODS: Combinations of search terms related to the symptom experience were used to search three electronic databases. Inclusion criteria were empirical studies that measured self-reported symptoms in populations with chronic liver disease published in English between 2003 and 2014. The literature search initially yielded 112 results; 26 quantitative studies met the inclusion criteria. FINDINGS AND CONCLUSIONS: The symptom of fatigue was commonly reported across chronic liver disease populations and was often found to co-occur with other distressing symptoms, including depression, sleep disturbance, pain, cognitive impairment, and dizziness associated with autonomic dysfunction. Due to the high prevalence and persistence of these "core" symptoms, the use of core symptom measures integrated longitudinally across populations would inform the development and delivery of symptom management interventions as well as enhance the ability of nurses to incorporate population-level symptom management programs. CLINICAL RELEVANCE: Nurses play an important role in symptom assessment and may use the findings from the integrative review to incorporate core symptom measures across chronic liver disease populations and advance the development and delivery of symptom management interventions.


Assuntos
Hepatopatias/complicações , Doença Crônica , Transtornos Cognitivos/etiologia , Transtorno Depressivo/etiologia , Gerenciamento Clínico , Tontura/etiologia , Fadiga/etiologia , Humanos , Hepatopatias/fisiopatologia , Hepatopatias/psicologia , Qualidade de Vida , Transtornos do Sono-Vigília/etiologia
13.
Biol Res Nurs ; 17(2): 222-9, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25037448

RESUMO

Liver disease affects over 25 million people in the United States and, despite advances in medical management resulting in increased survival, a majority of these individuals report multiple co-occurring symptoms that severely impair functioning and quality of life. The purpose of this review is to (1) propose defining these co-occurring symptoms as a symptom cluster of chronic liver disease (CLD), (2) discuss putative underlying biological mechanisms related to CLD, including the liver-gut-brain axis and influence of the microbiome, and (3) discuss the implications for biobehavioral research in this patient population. Biobehavioral research focusing on the interrelated, and possibly synergistic, mechanisms of these symptoms may lead to the development and testing of targeted symptom management interventions for improving function and quality of life in this growing patient population.


Assuntos
Hepatopatias/fisiopatologia , Hepatopatias/psicologia , Ciências Biocomportamentais , Sistema Nervoso Central/fisiopatologia , Humanos , Sistema Imunitário/fisiopatologia , Síndrome
14.
Nurs Outlook ; 62(5): 322-31, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25218081

RESUMO

OBJECTIVES: This article reports the cross-studies analysis of projects from the P30 Center of Excellence for Biobehavioral Approaches to Symptom Management. Although the projects investigated diverse populations, a consistent theoretical and empirical approach guided each project. METHODS: Common data elements included the following measures of psychobehavioral variables: the PROMIS Short-Form Fatigue Scale, the Center of Epidemiologic Studies Depression Scale, and the Perceived Stress Scale. Plasma cytokines were measured as the shared biological data element. RESULTS: Data were analyzed from 295 participants with fibromyalgia (n = 72), second trimester pregnancy (n = 73), sickle cell anemia (n = 60), and cardiometabolic risk (n = 91). The mean age of participants was 35.4 years, and the most participants were female. Levels of symptoms were generally elevated across samples; the level of fatigue ranged from 18.9 to 24.7, depressive symptoms from 12.5 to 23.4, and perceived stress from 16.5 to 21.8. Intercorrelations among symptom measures and perceived stress were strong across the samples. However, correlations among psychobehavioral variables and cytokines were variable, indicating a separate relationship for the measures with cytokines. CONCLUSIONS: Future work in symptom science could benefit from common data elements, including biomarkers, across populations to better develop the taxonomy of symptom profiles across conditions.


Assuntos
Anemia Falciforme/epidemiologia , Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Fadiga/epidemiologia , Fibromialgia/epidemiologia , Doenças Metabólicas/epidemiologia , Complicações na Gravidez/epidemiologia , Adulto , Biomarcadores/análise , Comorbidade , Estudos Transversais , Citocinas/análise , Depressão/diagnóstico , Depressão/terapia , Fadiga/diagnóstico , Fadiga/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Segundo Trimestre da Gravidez
15.
J Am Assoc Nurse Pract ; 26(9): 511-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24259186

RESUMO

PURPOSE: This article provides an overview of the mechanisms of action, evidence base, and practice of mindfulness, with an emphasis on how to easily incorporate this valuable skill into practice. DATA SOURCES: PubMed, CINAHL, PsychInfo Databases. CONCLUSIONS: Conscious attention to the present moment in a receptive way is known as mindfulness. A growing body of research indicates that mindfulness can be taught and cultivated to improve physical and mental health. IMPLICATIONS FOR PRACTICE: Accordingly, as part of the coaching competency, mindfulness can be practiced and taught by advanced practice nurses to support lifestyle and behavioral changes, decrease perceived stress, enhance quality of life, and, ultimately, improve health and health outcomes.


Assuntos
Aconselhamento/métodos , Saúde/normas , Saúde Mental/normas , Atenção Plena/métodos , Qualidade de Vida , Estresse Psicológico/terapia , Humanos
16.
Comput Inform Nurs ; 31(10): 469-76, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24141325

RESUMO

Increasing obesity rates are still a public health priority. The primary aim of this study was to evaluate the effect of tailored text messages on body weight change in overweight and obese adults in a community-based weight management program. A secondary aim was to detect behavioral changes in the same population. The study design was quasi-experimental with pretest and posttest analysis, conducted over 12 weeks. A total of 28 participants were included in the analysis. Body weight, eating behaviors, exercise and nutrition self-efficacy, attitude toward mobile technology, social support, and physical activity were assessed at baseline and at 12 weeks. Text messages were sent biweekly to the intervention but not to the control group. At 12 weeks, the intervention group had lost significant weight as compared with the control group. There was a trend toward an improvement in eating behaviors, exercise, and nutrition self-efficacy in the intervention group, with no significant difference between groups. A total of 79% of participants stated that text messages helped in adopting healthy behaviors. Tailored text messages appear to enhance weight loss in a weight management program at a community setting. Large-scale and long-term intervention studies are needed to confirm these findings.


Assuntos
Obesidade/terapia , Apoio Social , Mensagem de Texto , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Cooperação do Paciente
17.
Artigo em Inglês | MEDLINE | ID: mdl-23762127

RESUMO

Objective. In a randomized trial of women with early stage breast cancer undergoing adjuvant chemotherapy, two stress management interventions, tai chi training and spiritual growth groups, were compared to a usual care control group, to evaluate psychosocial functioning, quality of life (QOL), and biological markers thought to reflect cancer- and treatment-specific mechanisms. Method. The sample consisted of 145 women aged 27-75 years; 75% were Caucasian and 25% African American. A total of 109 participants completed the study, yielding a 75% retention rate. Grounded in a psychoneuroimmunology framework, the overarching hypothesis was that both interventions would reduce perceived stress, enhance QOL and psychosocial functioning, normalize levels of stress-related neuroendocrine mediators, and attenuate immunosuppression. Results. While interesting patterns were seen across the sample and over time, the interventions had no appreciable effects when delivered during the period of chemotherapy. Conclusions. Findings highlight the complex nature of biobehavioral interventions in relation to treatment trajectories and potential outcomes. Psychosocial interventions like these may lack sufficient power to overcome the psychosocial or physiological stress experienced during the chemotherapy treatment period. It may be that interventions requiring less activity and/or group attendance would have enhanced therapeutic effects, and more active interventions need to be tested prior to and following recovery from chemotherapy.

18.
Artigo em Inglês | MEDLINE | ID: mdl-23662111

RESUMO

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research.

19.
J Holist Nurs ; 30(3): 134-46, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22228833

RESUMO

The purpose of this article is to introduce a unique tai chi form that has been successfully implemented in two large randomized clinical trials. The intervention is composed of a series of tai chi movements chosen for their particular meanings, thus adding a cognitive component to the practice of a moving meditation. Over the last decade, the intervention has continued to evolve as it has been used in different populations. Most recently, medical qigong has been integrated to strengthen its potential impact on a variety of biobehavioral measures associated with cardiometabolic risk in women. Following an appraisal of the authors' process as well as the philosophy, practice, and research of tai chi and qigong, the authors share the story of their intervention to contribute to the evolving research of these safe, well-received, low-cost, and beneficial practices.


Assuntos
Neoplasias da Mama/reabilitação , Infecções por HIV/reabilitação , Qualidade de Vida , Estresse Psicológico/reabilitação , Tai Ji/classificação , Tai Ji/métodos , Adulto , Neoplasias da Mama/complicações , Neoplasias da Mama/psicologia , Interpretação Estatística de Dados , Feminino , Infecções por HIV/complicações , Infecções por HIV/psicologia , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Filosofia em Enfermagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Espiritualidade , Estresse Psicológico/complicações
20.
Biol Res Nurs ; 14(2): 160-70, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21406504

RESUMO

Cardiovascular disease (CVD) is the leading cause of death in the United States. Women are more likely than men to present with advanced disease and experience higher CVD-related morbidity and mortality. Metabolic syndrome is a constellation of risk factors for Type 2 diabetes mellitus (T2DM) and CVD. Abdominal adiposity, a component of metabolic syndrome, is associated with insulin resistance and promotes an atherogenic inflammatory milieu. Cardiometabolic risk (CMR) encompasses metabolic syndrome and incorporates other risk factors such as lifestyle choices, gender, and genetics as risk factors for CVD yet still does not include more recently recognized physiological risk factors such as vitamin D deficiency or psychosocial risk factors such as perceived stress and lack of social support. Because a more comprehensive view of CVD risk factors may facilitate earlier identification and risk reduction, we undertook this exploratory pilot study to answer the question, How do healthy women with and without abdominal adiposity differ physiologically and psychosocially?. We recruited a total of 41 women for a single study visit and assessed a battery of baseline physiological and psychological measures. While the women in this study were free of any diagnoses associated with increased CMR, women with increased waist circumference (WC) exhibited significantly altered levels of several measures associated with impending CMR including insulin sensitivity, lipids, and adiponectin as well as lower social support. These findings suggest that a more comprehensive conceptualization of and refinement of measures for CMR may be useful for identifying and reducing CMR and ultimately CVD in women.


Assuntos
Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Fatores de Risco , Estados Unidos/epidemiologia
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