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1.
Medicine (Baltimore) ; 103(23): e38460, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38847730

RESUMO

RATIONALE: Mindfulness-Based Cancer Recovery (MBCR) program is a group course training for cancer patients that combines cancer knowledge and psychological knowledge, emphasizing focusing on the psychosomatic symptoms of cancer patients. Currently, the application value of Mindfulness-Based Cancer Recovery in improving psychosomatic health of cancer patients has been confirmed, however, its intervention effect on breast neoplasm patients has not yet been widely studied in China. PATIENT CONCERNS AND DIAGNOSES: This study introduced the Mindfulness-Based Cancer Recovery protocol into the rehabilitation process of breast cancer patients, aiming to elucidate the effects of Mindfulness-Based Cancer Recovery on anxiety, depression, post-traumatic stress disorder, and cancer-related fatigue in breast neoplasm patients, to provide a practical basis for improving the physical and mental health of breast cancer patients. INTERVENTION: In this study, 80 patients with chemotherapy-stage breast neoplasm attending the oncology department of a tertiary-level hospital from January 2022 to December 2022 were selected, 40 patients attending from January 2022 to June 2022 were included in the study group, and 40 patients attending from July 2022 to December 2022 were included in the control group. The control group was administered conventional care, and the study group was administered Mindfulness-Based Cancer Recovery based on conventional care in the control group for 8 weeks. After the intervention, hospital anxiety and depression scale, impact of event scale-revised, and cancer fatigue scale were used for evaluation. OUTCOMES: After the intervention, hospital anxiety and depression scale scores decreased in both groups compared with pre-intervention, with the study group scoring lower than the control group (P < .05). After the intervention, the impact of event scale-revised scores of the 2 groups decreased from the preintervention period, with the study group scoring lower than the control group (P < .05). After the intervention, cancer fatigue scale scores decreased in the 2 groups compared with the preintervention period, with the study group scoring lower than the control group (P < .05). LESSONS: Mindfulness-Based Cancer Recovery can effectively reduce the levels of anxiety, depression and post-traumatic stress disorder in breast neoplasm patients undergoing chemotherapy, reduce the levels of cancer-related fatigue, and promote the physical and mental health of patients.


Assuntos
Ansiedade , Neoplasias da Mama , Depressão , Fadiga , Atenção Plena , Transtornos de Estresse Pós-Traumáticos , Humanos , Atenção Plena/métodos , Feminino , Neoplasias da Mama/complicações , Neoplasias da Mama/psicologia , Neoplasias da Mama/tratamento farmacológico , Pessoa de Meia-Idade , Fadiga/etiologia , Fadiga/terapia , Fadiga/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Ansiedade/etiologia , Ansiedade/terapia , Depressão/etiologia , Depressão/terapia , Depressão/psicologia , Adulto , China , Antineoplásicos/uso terapêutico , Antineoplásicos/efeitos adversos
2.
Sci Rep ; 14(1): 12691, 2024 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-38830986

RESUMO

Young athletes commonly encounter various mental health challenges due to the distinct pressures inherent in sports environments. This study investigates the effectiveness of mobile-delivered mindfulness meditation interventions in alleviating mental health indicators of depression, perceived stress, and anxiety, and enhancing self-esteem and resilience among young male judo athletes in South Korea. Pre- and post-test questionnaires were completed by 53 judo athletes. Participants were then allocated to the intervention group (N = 27; Mage = 13.77 [SD = 1.11]), which used a mobile meditation software program, or the control group (N = 27; Mage = 13.56 [SD = 1.05]). Data analysis compared intervention and control group scores using multiple statistical methods, including independent sample t-tests, paired sample t-tests, and 2 (time) × 2 (group) repeated measures analysis of variance. Following the intervention, the mindfulness group exhibited significant enhancements in the mental health indicators of depression (GMD = 2.74 [95% CI 0.90-4.56], Cohen's D = 0.84), perceived stress (GMD = 0.35 [95% CI 0.002-0.70], Cohen's D = 0.56), and anxiety (GMD = 0.2 [95% CI 0.001-0.40, Cohen's D = 0.56]. Self-esteem also had a significant increase (GMD = 0.55 [95% CI - 0.22 to - 0.88], Cohen's D = 0.95). The findings of this study underscore the potential benefits of mobile-delivered mindfulness meditation interventions in addressing mental health challenges among young male judo athletes. The significant enhancements observed in scores on measures of depression, perceived stress, anxiety, and self-esteem among participants in the mindfulness group highlight the effectiveness of such interventions in promoting mental health in sports settings.


Assuntos
Ansiedade , Atletas , Depressão , Artes Marciais , Meditação , Saúde Mental , Atenção Plena , Humanos , Masculino , Atenção Plena/métodos , Meditação/métodos , Meditação/psicologia , Atletas/psicologia , República da Coreia , Artes Marciais/psicologia , Adolescente , Depressão/terapia , Depressão/psicologia , Ansiedade/terapia , Ansiedade/psicologia , Estresse Psicológico/terapia , Autoimagem , Inquéritos e Questionários
3.
JMIR Hum Factors ; 11: e53897, 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38885016

RESUMO

Chatbots are increasingly being applied in the context of health care, providing access to services when there are constraints on human resources. Simple, rule-based chatbots are suited to high-volume, repetitive tasks and can therefore be used effectively in providing users with important health information. In this Viewpoint paper, we report on the implementation of a chatbot service called Ask Anxia as part of a wider provision of information and support services offered by the UK national charity, Anxiety UK. We reflect on the changes made to the chatbot over the course of approximately 18 months as the Anxiety UK team monitored its performance and responded to recurrent themes in user queries by developing further information and services. We demonstrate how corpus linguistics can contribute to the evaluation of user queries and the optimization of responses. On the basis of these observations of how Anxiety UK has developed its own chatbot service, we offer recommendations for organizations looking to add automated conversational interfaces to their services.


Assuntos
Ansiedade , Humanos , Reino Unido , Ansiedade/terapia , Ansiedade/psicologia
4.
Radiat Oncol ; 19(1): 73, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862982

RESUMO

BACKGROUND: Patients undergoing radiation therapy (RT) often experience anxiety, which may jeopardize the treatment success. The efficacy of music interventions in reducing anxiety remains contentious. This randomized trial aimed to evaluate the impact of music listening on anxiety symptoms in patients undergoing initial RT. METHODS: First-time RT patients were randomly allocated to experimental and control groups. The Brief Symptom Rating Scale (BSRS-5), Distress Thermometer (DT), and Beck Anxiety Inventory (BAI-C) were administered pre- and post-RT. Changes in physiological anxiety symptoms were monitored over 10 consecutive days starting from the first day of RT. The experimental group received music during RT; the control group did not. The generalized linear mixed model was used to estimate the pre-post difference in the BSRS-5, DT, and BAI-C scores between the music intervention and control group. RESULTS: This study included 50 patients each in the experimental and control groups. BSRS-5 and DT scores were significantly reduced in the experimental group post-RT (p = 0.0114 and p = 0.0023, respectively). When music listening was discontinued, these scores rebounded. While the posttest BAI-C score was significantly lower in the experimental group (p < 0.0001), the pre-post difference between the two groups was not significant (p = 0.0619). On cessation of music listening, the BAI-C score also rebounded. CONCLUSIONS: For cancer patients undergoing initial RT, music listening intervention significantly reduced anxiety symptoms measured using the BSRS-5, DT, and BAI-C scores after two weeks. Our results demonstrate the effectiveness of music listening intervention in reducing anxiety symptoms, thereby potentially improving the quality of life of cancer patients undergoing RT.


Assuntos
Ansiedade , Musicoterapia , Neoplasias , Humanos , Masculino , Feminino , Neoplasias/radioterapia , Neoplasias/psicologia , Ansiedade/etiologia , Ansiedade/terapia , Musicoterapia/métodos , Pessoa de Meia-Idade , Idoso , Adulto , Qualidade de Vida
5.
JMIR Ment Health ; 11: e50503, 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38896474

RESUMO

BACKGROUND: Internet-based cognitive behavioral interventions (iCBTs) are efficacious treatments for depression and anxiety. However, it is unknown whether adding human guidance is feasible and beneficial within a large educational setting. OBJECTIVE: This study aims to potentially demonstrate the superiority of 2 variants of a transdiagnostic iCBT program (human-guided and computer-guided iCBT) over care as usual (CAU) in a large sample of university students and the superiority of human-guided iCBT over computer-guided iCBT. METHODS: A total of 801 students with elevated levels of anxiety, depression, or both from a large university in the Netherlands were recruited as participants and randomized to 1 of 3 conditions: human-guided iCBT, computer-guided iCBT, and CAU. The primary outcome measures were depression (Patient Health Questionnaire) and anxiety (Generalized Anxiety Disorder scale). Secondary outcomes included substance use-related problems (Alcohol Use Disorder Identification Test and Drug Abuse Screening Test-10 items). Linear mixed models were used to estimate the effects of time, treatment group, and their interactions (slopes). The primary research question was whether the 3 conditions differed in improvement over 3 time points (baseline, midtreatment, and after treatment) in terms of depression and anxiety symptoms. Results were analyzed according to the intention-to-treat principle using multiple imputation. Patients were followed exploratively from baseline to 6 and 12 months. RESULTS: In both short-term and long-term analyses, the slopes for the 3 conditions did not differ significantly in terms of depression and anxiety, although both web-based interventions were marginally more efficacious than CAU over 6 months (P values between .02 and .03). All groups showed significant improvement over time (P<.001). For the secondary outcomes, only significant improvements over time (across and not between groups) were found for drug use (P<.001). Significant differences were found in terms of adherence, indicating that participants in the human-guided condition did more sessions than those in the computer-guided condition (P=.002). CONCLUSIONS: The transdiagnostic iCBT program offers a practical, feasible, and efficacious alternative to usual care to tackle mental health problems in a large university setting. There is no indication that human guidance should be preferred over technological guidance. The potential preference of human support also depends on the scale of implementation and cost-effectiveness, which need to be addressed in future trials. TRIAL REGISTRATION: International Clinical Trials Registry Platform NL7328/NTR7544; https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON26795.


Assuntos
Terapia Cognitivo-Comportamental , Estudantes , Terapia Assistida por Computador , Humanos , Terapia Cognitivo-Comportamental/métodos , Masculino , Feminino , Estudantes/psicologia , Universidades , Adulto Jovem , Adulto , Terapia Assistida por Computador/métodos , Intervenção Baseada em Internet , Depressão/terapia , Depressão/diagnóstico , Ansiedade/terapia , Ansiedade/diagnóstico , Países Baixos , Internet , Adolescente , Resultado do Tratamento
6.
BMC Complement Med Ther ; 24(1): 228, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867235

RESUMO

AIM: This study was conducted to determine the effect of music on the pain, anxiety, and comfort levels of patients who underwent bone marrow aspiration and biopsy. METHODS: This study was conducted on patients with hematological malignancies. Music was used with the intervention group. Patients' pain, anxiety, and comfort levels were measured. In addition, qualitative data were obtained through in-depth interviews with patients. RESULTS: A significant difference (p < 0.05) was found between the experimental and control groups regarding pain, comfort and anxiety levels following the application of music. It was found that there was a negative correlation between comfort and pain (r=-0.442 p < 0.001) and between comfort and anxiety (r=-0.544 p < 0.001). As a result of qualitative interviews, patients mentioned the relaxing effect of music and the reduction of anxiety and pain levels. They also stated that music can be utilized as an alternative method. CONCLUSION: According to the results of the present study, music reduced the pain and anxiety levels of the patients in bone marrow aspiration and biopsy and increased their comfort levels. We can say that music can be used in the clinic as a non-pharmacological method for pain, anxiety and comfort. CLINICAL TRIALS NUMBER: NCT05895357 (Date:08/06/2023).


Assuntos
Ansiedade , Musicoterapia , Humanos , Turquia , Ansiedade/terapia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias Hematológicas/terapia , Neoplasias Hematológicas/psicologia , Medula Óssea , Dor/psicologia , Manejo da Dor/métodos , Idoso , Adulto Jovem , Conforto do Paciente , Medição da Dor , Biópsia
7.
BMC Complement Med Ther ; 24(1): 229, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867254

RESUMO

BACKGROUND: Any illness places a significant burden on patients, including deterioration in quality of life. Animal assisted therapy may be helpful in the rehabilitation process and in the treatment of patients to alleviate this phenomenon. METHODS: A randomized, controlled research was conducted in 2019 and 2020 in a rehabilitation center in Budapest. In our study, the control and experimental groups received the same therapy, but the rehabilitation treatment of the intervention group was complemented by dog therapy. Patients were evaluated by means of the short form Beck Depression Inventory, State-Trait Anxiety Inventory, Illness Intrusiveness Ratings Scale, Visual Analog Scale for pain and the WHO-5 Well-being Index. For statistical analysis paired T-test and ANCOVA was performed. RESULTS: 58 participants in both groups took part in the research. Results confirm that both groups showed statistically significant improvement in all outcome measures, except for depression symptoms in dog therapy group. Quality of life of the participants improved significantly, their pain and anxiety levels were significantly reduced, they felt significantly less burdened by the disease in their daily lives. Therapeutic-dog sessions had a large effect on patients' quality of life and anxiety. CONCLUSIONS: There is a strong case for animal assisted therapy as a complementary therapy in the rehabilitation program, and it is proposed that consideration should be given to the application of this method on a larger scale within health care. The study was retrospectively registered at ISRCTN Registry (registration number: ISRCTN10208787) on 15/03/2022.


Assuntos
Terapia Assistida com Animais , Qualidade de Vida , Humanos , Terapia Assistida com Animais/métodos , Cães , Masculino , Animais , Feminino , Pessoa de Meia-Idade , Adulto , Idoso , Ansiedade/terapia , Depressão/terapia
8.
JMIR Mhealth Uhealth ; 12: e55578, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38865705

RESUMO

BACKGROUND: Depression acts as a significant obstacle to the overall well-being of individuals. Given the significant consequences, timely recognition and proactive steps to manage symptoms of depression become essential. Such actions not only reduce personal distress but also play a crucial role in reducing its far-reaching impact on society as a whole. OBJECTIVE: In response to this concern, the objective of this study was to explore the use of mobile-based interventions as a possible remedy. More specifically, this study aimed to investigate the effectiveness of 2 types of physical activity (PA), progressive and fixed, within a mobile-based app on depression, perceived stress, anxiety, physical health, and psychological health, aiming to contribute to the optimization of mental health benefits. METHODS: Participants (N=60; mean age 25.29, SD 6.10 years) were recruited using a combination of web-based and offline methods, and the study lasted for 8 weeks. The baseline and posttest questionnaires were administered to all participants. The participants were randomly assigned to 1 of the 3 groups: progressive group (n=20; performing mobile-based progressive PA), fixed group (n=20; performing mobile-based fixed intensity PA), and control group C (n=20). Data analysis involved comparing scores between the experimental and control groups using a one-way ANOVA, paired sample t tests (2-tailed), and repeated measures ANOVA with a 3 (group)×2 (time) design. RESULTS: The findings revealed significant improvements in mental health indicators among participants engaged in both fixed and progressive PA groups compared with the control group. However, the fixed PA group demonstrated more significant reductions in symptoms. Specifically, the progressive PA group showed significant reductions in depression (F1,36=6.941; P=.01; ηp2=0.16) and perceived stress (F1,36=5.47; P=.03; ηp2=0.13), while the fixed PA group exhibited significant reductions in depression (F1,37=5.36; P=.03; ηp2=0.12), perceived stress (F1,37=7.81; P=.008; ηp2=0.17), and general anxiety disorder (F1,37=5.45; P=.03; ηp2=0.13) compared with the control group. CONCLUSIONS: This study underscores the potential of mobile-based PA in improving mental health outcomes. The findings offer significant insights for mental health professionals and researchers aiming to optimize mental well-being through innovative mobile therapies. TRIAL REGISTRATION: Clinical Research Information Service KCT0009100; https://tinyurl.com/mr33fmur.


Assuntos
Ansiedade , Depressão , Exercício Físico , Qualidade de Vida , Estresse Psicológico , Humanos , Masculino , Feminino , Adulto , República da Coreia , Exercício Físico/psicologia , Depressão/psicologia , Depressão/terapia , Qualidade de Vida/psicologia , Estresse Psicológico/psicologia , Estresse Psicológico/terapia , Inquéritos e Questionários , Ansiedade/psicologia , Ansiedade/terapia , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos
9.
PLoS One ; 19(6): e0300756, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38870156

RESUMO

OBJECTIVE: The purpose of this study was to compare the effect of MediYoga as a group treatment to conventional treatment provided by a physiotherapist for people with perceived stress-related symptoms. DESIGN: Randomized controlled trial. SETTINGS: Primary care rehabilitation, Gothenburg Sweden. SUBJECTS: Fifty-five patients with stress-related symptoms were invited to participate. Nine patients declined, and a total of 46 patients aged 26-70 years (mean 47), 44 women and two men were randomized, 23 to the MediYoga group and 23 to the physiotherapy treatment as usual group. INTERVENTIONS: The MediYoga group performed MediYoga for one hour a week during an 8-week period. The control group received physiotherapy treatment as usual. MAIN MEASURES: Data were mainly collected by self-reported questionnaires. For primary outcome the Swedish version of the Perceived Stress Scale (PSS) was used. Secondary outcomes were the Hospital Anxiety and Depression Scale (HADS), EuroQol-5D (EQ-5D) and EuroQol-Visual Analog Scale (EQ-VAS). Thoracic excursion was the only physical measurement. Mixed effect model was used for analyse. RESULTS: For the primary outcome PSS, there was a close to statistically significant group effect over time advantaging MediYoga over physiotherapy (P = 0.06). For secondary outcomes, the group effect over time was statistically significant in HADS anxiety (P = 0.01) and EQ-VAS (P = 0.03). There was a group trend over time advantaging MediYoga in HADS depression (P = 0.08). CONCLUSION: Despite a large dropout in both groups, MediYoga can be recommended as a treatment option for people suffering from stress-related symptoms. TRIAL REGISTRATION: Registered in: ClinicalTrials.gov NCT02907138.


Assuntos
Modalidades de Fisioterapia , Atenção Primária à Saúde , Estresse Psicológico , Humanos , Pessoa de Meia-Idade , Feminino , Masculino , Adulto , Idoso , Estresse Psicológico/terapia , Suécia , Resultado do Tratamento , Inquéritos e Questionários , Meditação , Ansiedade/terapia
10.
Front Public Health ; 12: 1295033, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38873297

RESUMO

Background: The Syrian conflict has been ongoing since 2011. Practical and scalable solutions are urgently needed to meet an increase in need for specialised psychological support for post-traumatic stress disorder given limited availability of clinicians. Training forcibly displaced Syrians with a mental health background to remotely deliver specialised interventions increases the availability of evidence based psychological support. Little is known about the effectiveness of online therapy for forcibly displaced Syrian women provided by forcibly displaced Syrian women therapists. Purpose: To pilot an evidence-based trauma therapy, Eye Movement Desensitisation and Reprocessing (EMDR), carried out online by trained forcibly displaced Syrian women therapists for forcibly displaced Syrian women who require treatment for post-traumatic stress disorder (PTSD). Methods: 83 forcibly displaced Syrian women, living in Türkiye or inside Syria, with diagnosable PTSD, were offered up to 12 sessions of online EMDR over a period of 3 months. This was delivered by forcibly displaced Syrian women therapists who were trained in EMDR. Data were gathered, using Arabic versions, on PTSD symptoms using the Impact of Events Scale Revised, depression symptoms using the Patient Health Questionnaire-9 and anxiety symptoms using the Generalised Anxiety Disorder Assessment-7 at baseline, mid-point, and end of therapy. Results: PTSD scores, depression scores and anxiety scores all significantly reduced over the course of treatment, with lower scores at midpoint than baseline and lower scores at end of treatment than at midpoint. Only one participant (1%) exceeded the cutoff point for PTSD, and 13 (16%) exceeded the cutoff points for anxiety and depression at the end of treatment. Conclusion: In this pilot study up to 12 sessions of online EMDR were associated with reductions in PTSD, anxiety and depression symptoms in Syrian women affected by the Syrian conflict. The training of forcibly displaced Syrian mental health professionals to deliver online therapy is a relatively low cost, scalable, sustainable solution to ensure that those who are affected by the conflict can access specialised support. Further research is needed using a control group to confirm that the observed effects are due to EMDR treatment, as is research with post-treatment follow-up to ascertain that benefits are maintained.


Assuntos
Dessensibilização e Reprocessamento através dos Movimentos Oculares , Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Feminino , Síria , Transtornos de Estresse Pós-Traumáticos/terapia , Projetos Piloto , Adulto , Refugiados/psicologia , Pessoa de Meia-Idade , Saúde Mental , Depressão/terapia , Inquéritos e Questionários , Ansiedade/terapia
11.
Sci Rep ; 14(1): 13806, 2024 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-38877077

RESUMO

Antenatal anxiety is among the risk factors for adverse birth outcomes, which are common in Pakistan. Between 2019 and 2022, we conducted a randomized controlled trial to evaluate the effects of the Happy Mother-Healthy Baby program, designed to reduce anxiety during pregnancy through use of Cognitive Behavior Therapy, on birth outcomes with 796 women in Rwalpindi, Pakistan. We performed intent-to-treat analysis and per protocol analyses. Intention-to-treat analyses showed no difference in the odds of low birthweight (LBW) (Adj. OR = 0.82, 95% CI 0.55-1.28 p = 0.37), preterm birth (PTB) (Adj. OR = 1.20 95% CI 0.83-1.71, p = 0.33) or small-for-gestational age (SGA) birth, (Adj. OR = 0.76, 95% CI 0.56-1.09, p = 0.16). Among completers who received ≥ 5 intervention sessions, the odds of LBW and SGA were 39% and 32% lower (Adj. OR = 0.61, 95% CI 0.43-0.87, p < 0.01; Adj. OR = 0.68, 95% CI 0.53-0.89, p < 0.01). The significant LBW and SGA results among the intervention completers suggest that the program may be effective when a sufficient dose is received. However, confirmation of these findings is needed due to the fact that randomization is not maintained in completer analyses.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT03880032, 19/03/2019.


Assuntos
Ansiedade , Terapia Cognitivo-Comportamental , Humanos , Feminino , Gravidez , Paquistão/epidemiologia , Terapia Cognitivo-Comportamental/métodos , Adulto , Ansiedade/terapia , Recém-Nascido , Recém-Nascido de Baixo Peso , Nascimento Prematuro/prevenção & controle , Complicações na Gravidez/terapia , Complicações na Gravidez/psicologia , Resultado da Gravidez , Recém-Nascido Pequeno para a Idade Gestacional , Adulto Jovem , Cuidado Pré-Natal/métodos
12.
JAMA Netw Open ; 7(6): e2415842, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38869899

RESUMO

Importance: Chronic pain is common and disabling in older adults, and psychological interventions are indicated. However, the gold standard approach, cognitive-behavioral therapy (CBT), produces only modest benefits, and more powerful options are needed. Objectives: To evaluate whether emotional awareness and expression therapy (EAET) is superior to CBT for treatment of chronic pain among predominantly male older veterans and whether higher baseline depression, anxiety, or posttraumatic stress disorder (PTSD) symptoms-key targets of EAET-moderate treatment response. Design, Setting, and Participants: This 2-arm randomized clinical trial was conducted from May 16, 2019, to September 14, 2023, in the US Department of Veterans Affairs Greater Los Angeles Healthcare System. The trial included a racially and ethnically diverse group of veterans aged 60 to 95 years with at least 3 months of musculoskeletal pain. Interventions: Emotional awareness and expression therapy or CBT, conducted concurrently, each presented as one 90-minute individual session followed by eight 90-minute group sessions. Main Outcomes and Measures: The primary outcome was Brief Pain Inventory pain severity (range, 0 to 10) from baseline to posttreatment (week 10, primary end point) and 6-month follow-up. Secondary outcomes included Patient Reported Outcomes Institute Measurement System Anxiety, Depression, Fatigue, General Life Satisfaction (NIH Toolbox), Pain Interference, and Sleep Disturbance Short Forms, Patient Global Impression of Change (PGIC), and Satisfaction with Therapy and Therapist Scale-Revised. A subset of participants completed the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). All analyses were for the intention-to-treat population and included all randomized participants. Results: Among 126 randomized participants (66 in the EAET group and 60 in the CBT group; mean [SD] age, 71.9 [5.9] years; 116 [92%] male), 111 (88%) completed posttreatment, and 104 (82%) completed the 6-month follow-up. The EAET was superior to CBT for the primary outcome of reduction in pain severity at posttreatment (estimate, -1.59 [95% CI, -2.35 to -0.83]; P < .001) and follow-up (estimate, -1.01 [95% CI, -1.78 to -0.24]; P = .01). A greater percentage of participants in EAET vs CBT had clinically significant (at least 30%) pain reduction (63% vs 17%; odds ratio, 21.54 [95% CI, 4.66-99.56]; P < .001) at posttreatment. In addition, EAET was superior to CBT on 50% pain reduction (35% vs 7%; odds ratio, 11.77 [95% CI, 2.38-58.25]; P = .002), anxiety (estimate, -2.49 [95% CI, -4.30 to -0.68]; P = .006), depression (estimate, -3.06 [95% CI, -5.88 to -0.25]; P = .03), general life satisfaction (estimate, 1.23 [95% CI, 0.36-2.10]; P = .005), PTSD symptoms (estimate, -4.39 [95% CI, -8.44 to -0.34]; P = .03), PGIC score (estimate, 1.46 [95% CI, 0.77-2.15]; P < .001), and global treatment satisfaction (estimate, 0.28 [95% CI, 0.12-0.45]; P < .001) at posttreatment. Higher baseline depression (estimate, -1.55 [95% CI, -0.37 to 2.73]; P < .001), anxiety (estimate, -1.53 [95% CI, -2.19 to -0.88]; P < .001), and PTSD symptoms (estimate, -1.69 [95% CI, -2.96 to -0.42]; P = .009) moderated greater reduction in pain severity after EAET but not CBT. Conclusions and Relevance: The results of this randomized clinical trial suggest that EAET may be a preferred intervention for medically and psychiatrically complex patients with pain. The societal burden of chronic pain could be improved by further incorporating the principles of EAET into mainstream clinical pain medicine. Trial Registration: ClinicalTrials.gov Identifier: NCT03918642.


Assuntos
Dor Crônica , Terapia Cognitivo-Comportamental , Veteranos , Humanos , Masculino , Dor Crônica/terapia , Dor Crônica/psicologia , Veteranos/psicologia , Veteranos/estatística & dados numéricos , Idoso , Terapia Cognitivo-Comportamental/métodos , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Transtornos de Estresse Pós-Traumáticos/terapia , Depressão/terapia , Emoções , Resultado do Tratamento , Conscientização , Ansiedade/terapia , Medição da Dor
13.
BMC Palliat Care ; 23(1): 147, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38872168

RESUMO

PURPOSE: This study aimed to assess the therapeutic efficacy of Reiki therapy in alleviating anxiety. METHODS: In adherence to academic standards, a thorough search was conducted across esteemed databases such as PubMed, Web of Science, Science Direct, and the Cochrane Library. The primary objective of this search was to pinpoint peer-reviewed articles published in English that satisfied specific criteria: (1) employing an experimental or quasi-experimental study design, (2) incorporating Reiki therapy as the independent variable, (3) encompassing diverse patient populations along with healthy individuals, and (4) assessing anxiety as the measured outcome. RESULTS: The study involved 824 participants, all of whom were aged 18 years or older. Reiki therapy was found to have a significant effect on anxiety intervention(SMD=-0.82, 95CI -1.29∼-0.36, P = 0.001). Subgroup analysis indicated that the types of subjects (chronically ill individuals and the general adult population) and the dosage/frequency of the intervention (≤ 3 sessions and 6-8 sessions) were significant factors influencing the variability in anxiety reduction. CONCLUSION: Short-term Reiki therapy interventions of ≤ 3 sessions and 6-8 sessions have demonstrated effectiveness in reducing health and procedural anxiety in patients with chronic conditions such as gastrointestinal endoscopy inflammation, fibromyalgia, and depression, as well as in the general population. It is important to note that the efficacy of Reiki therapy in decreasing preoperative anxiety and death-related anxiety in preoperative patients and cancer patients is somewhat less consistent. These discrepancies may be attributed to individual pathophysiological states, psychological conditions, and treatment expectations.


Assuntos
Ansiedade , Toque Terapêutico , Humanos , Ansiedade/terapia , Ansiedade/psicologia , Toque Terapêutico/métodos , Adulto
14.
PLoS One ; 19(6): e0301226, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38875241

RESUMO

OBJECTIVES: To assess the efficacy of acceptance and commitment therapy (ACT) for patients with chronic pain. MATERIALS AND METHODS: The research conducted a systematic search of the Cochrane Library, Web of Science, PubMed, EMBASE, PsycINFO, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases following the PRISMA guidelines. The retrieval time limit was from the establishment of the database to October 2023. A meta-analysis was carried out for the randomized controlled trials (RCTs) that meet the inclusion and exclusion criteria by using RevMan 5.3. RESULTS: Twenty-one RCTs were included. At post-treatment, a significant medium effect size (ES) was found in measuring pain interference, functional impairment, pain acceptance, psychological inflexibility, and depression; Pain intensity, anxiety, and quality of life (QOL) had a small ES. At three months post-treatment, a large ES was found in measuring functional impairment, and a medium ES was found in the other indicators. CONCLUSION: The researchers provided evidence for the effectiveness of ACT as an intervention for patients with chronic pain, which can be applied by clinicians or nurses in practice. Future research should explore the applicability of ACT to different pain conditions and modalities. IMPLICATIONS FOR NURSING: Post-treatment data highlight the efficacy of ACT in moderating pain-related outcomes. Clinical nurses are encouraged to incorporate ACT into routine patient education and interventions, including promoting pain acceptance, promoting mindfulness practices, and using cognitive stress reduction techniques. Standardized follow-up after an ACT intervention for patients with chronic pain is critical, including regular assessment, feedback, and realignment of treatment strategies. Overall, ACT became an important tool for nurses to improve the lives of patients with chronic pain.


Assuntos
Terapia de Aceitação e Compromisso , Dor Crônica , Qualidade de Vida , Humanos , Dor Crônica/terapia , Dor Crônica/psicologia , Terapia de Aceitação e Compromisso/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Ansiedade/terapia , Ansiedade/psicologia
15.
J Med Internet Res ; 26: e52341, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38861710

RESUMO

BACKGROUND: Coronary heart disease (CHD) is the leading cause of death globally. In addition, 20% to 40% of the patients with CHD have comorbid mental health issues such as anxiety or depression, affecting the prognosis and quality of life (QoL). Mobile health (mHealth) interventions have been developed and are widely used; however, the evidence for the effects of mHealth interventions on QoL, anxiety, and depression in patients with CHD is currently ambiguous. OBJECTIVE: In this study, we aimed to assess the effects of mHealth interventions on QoL, anxiety, and depression in patients with CHD. METHODS: We searched the Cochrane Library, PubMed, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure, and Wanfang databases from inception to August 12, 2023. Eligible studies were randomized controlled trials that involved patients with CHD who received mHealth interventions and that reported on QoL, anxiety, or depression outcomes. We used the Cochrane risk-of-bias tool for randomized trials to evaluate the risk of bias in the studies, ensuring a rigorous and methodologically sound analysis. Review Manager (desktop version 5.4; The Cochrane Collaboration) and Stata MP (version 17.0; StataCorp LLC) were used to conduct the meta-analysis. The effect size was calculated using the standardized mean difference (SMD) and its 95% CI. RESULTS: The meta-analysis included 23 studies (5406 participants in total) and showed that mHealth interventions significantly improved QoL in patients with CHD (SMD 0.49, 95% CI 0.25-0.72; Z=4.07; P<.001) as well as relieved their anxiety (SMD -0.46, 95% CI -0.83 to -0.08; Z=2.38; P=.02) and depression (SMD -0.34, 95% CI -0.56 to -0.12; Z=3.00; P=.003) compared to usual care. The subgroup analyses indicated a significant effect favoring the mHealth intervention on reducing anxiety and depressive symptoms compared to usual care, especially when (1) the intervention duration was ≥6 months (P=.04 and P=.001), (2) the mHealth intervention was a simple one (only 1 mHealth intervention was used) (P=.01 and P<.001), (3) it was implemented during the COVID-19 pandemic (P=.04 and P=.01), (4) it was implemented in low- or middle-income countries (P=.01 and P=.02), (5) the intervention focused on mental health (P=.01 and P=.007), and (6) adherence rates were high (≥90%; P=.03 and P=.002). In addition, comparing mHealth interventions to usual care, there was an improvement in QoL when (1) the mHealth intervention was a simple one (P<.001), (2) it was implemented in low- or middle-income countries (P<.001), and (3) the intervention focused on mental health (P<.001). CONCLUSIONS: On the basis of the existing evidence, mHealth interventions might be effective in improving QoL and reducing anxiety and depression in patients with CHD. However, large sample, high-quality, and rigorously designed randomized controlled trials are needed to provide further evidence. TRIAL REGISTRATION: PROSPERO CRD42022383858; https://tinyurl.com/3ea2npxf.


Assuntos
Ansiedade , Doença das Coronárias , Depressão , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Telemedicina , Humanos , Qualidade de Vida/psicologia , Doença das Coronárias/psicologia , Doença das Coronárias/complicações , Doença das Coronárias/terapia , Depressão/terapia , Depressão/psicologia , Ansiedade/terapia , Ansiedade/psicologia , Masculino , Feminino , Pessoa de Meia-Idade
16.
Med Educ Online ; 29(1): 2364486, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38861675

RESUMO

Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve the physical and mental well-being of learners. This study aimed to evaluate the effectiveness of yoga intervention in improving cardiopulmonary parameters such as blood pressure, heart rate, pulmonary function tests and psychosomatic symptoms such as depression, anxiety and stress in medical and dental students. Using the PRISMA protocol, a search from databases such as PubMed, Scopus, and Embase resulted in 304 relevant articles. After screening the title and abstracts, 47 papers were analyzed thoroughly and included in the qualitative analysis. 18 articles with homogenous statistical data on physiology and psychological parameters were included for meta-analysis. In comparison to the control group, the study showed a significant reduction of systolic blood pressure (SBP: 6.82 mmHg, z = -3.06, p = 0.002), diastolic blood pressure (DBP: 2.92 mmHg, z = -2.22, p = 0.03), and heart rate (HR: 2.55 beats/min, z = -2.77, p = 0.006). Additionally, data from 4 studies yielded a significant overall effect of a stress reduction of 0.77 on standardized assessments due to the yoga intervention (z = 5.29, p < 0.0001). Lastly, the results also showed a significant (z = -2.52, p = 0.01) reduction of 1.2 in standardized anxiety tests in intervention group compared to the control. The findings offer promising prospects for medical educators globally, encouraging them to consider reformation and policymaking in medical curricula to enhance academic success and improve the overall quality of life for medical students worldwide.


Assuntos
Ansiedade , Pressão Sanguínea , Frequência Cardíaca , Estresse Psicológico , Yoga , Humanos , Estresse Psicológico/terapia , Ansiedade/terapia , Educação Médica , Depressão/terapia , Estudantes de Medicina/psicologia , Testes de Função Respiratória
17.
Complement Ther Clin Pract ; 56: 101865, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38824831

RESUMO

BACKGROUND AND PURPOSE: Compared with parents of neurotypical children or children diagnosed with other disabilities, parents of children with autism spectrum disorder (ASD) often experience poorer mental health, greater stress, and more depression and anxiety symptoms. This study aimed to assess the effects of a web-based 24-h movement behavior lifestyle education program on mental health and psychological well-being in parents of children with ASD. METHODS: This study employed a randomized controlled trial utilizing the Health Action Process Approach (HAPA) as a theoretical framework. A total of 318 parents of children with ASD were enrolled and randomly assigned to the experimental or control group. The experimental group received an 8-week web-based 24-h movement behavior lifestyle education program, while the control group followed their usual routine. Two instruments, the Depression Anxiety and Stress Scale (DASS-21) and the Satisfaction With Life Scale (SWLS), were used to measure mental health and psychological well-being, respectively. The data were collected at two time points-at the beginning and the end of the intervention. RESULTS: Compared with the baseline and control groups, the experimental group demonstrated significant improvements in all outcome measures (p < 0.01). There were significant differences in the DASS-21 and SWLS scores between the two groups before and after the intervention (p ≤ 0.01). CONCLUSION: This study represents the first randomized controlled trial involving a web-based 24-h movement behavior lifestyle education program specifically designed to address the mental health and psychological well-being of parents of children with ASD. The findings confirm the potential impact of 24-h movement behavior lifestyle education as a functional and effective strategy for parents of children with ASD.


Assuntos
Transtorno do Espectro Autista , Estilo de Vida , Saúde Mental , Pais , Humanos , Transtorno do Espectro Autista/terapia , Masculino , Feminino , Pais/psicologia , Pais/educação , Adulto , Criança , Depressão/terapia , Ansiedade/terapia , Pessoa de Meia-Idade , Estresse Psicológico/terapia , Internet , Educação em Saúde/métodos , Intervenção Baseada em Internet , Bem-Estar Psicológico
18.
Rev Prat ; 74(5): 529-532, 2024 May.
Artigo em Francês | MEDLINE | ID: mdl-38833237

RESUMO

ECO-ANXIETY: AN EMERGING DISORDER LINKED TO CLIMATE CHANGE. Eco-anxiety is the chronic fear of an environmental disaster, particularly in relation to global warming. Emerging in the 1990s, this concern is increasingly developing in all countries, especially among younger generations. It is not currently recognized as a diagnosis in psychiatric classifications, but some people (about 3% of the population) experience significant suffering and symptoms that can impair their quality of life. The role of the physician is then to look for an underlying anxiety or depressive disorder, or to assess the intensity of a possible specific Eco-anxiety Disorder. Treatment is based primarily on psychotherapeutic listening, stress and anxiety management methods, and cognitive behavioral therapy aimed at giving the patient better control over their emotions and means of action.


ÉCO-ANXIÉTÉ : UN TROUBLE ÉMERGENT LIÉ AU DÉRÈGLEMENT CLIMATIQUE. L'éco-anxiété est la crainte chronique d'une catastrophe environnementale, notamment en rapport avec le réchauffement climatique. Apparue dans les années 1990, cette inquiétude se développe de plus en plus dans tous les pays, surtout parmi les jeunes générations. Il ne s'agit pas d'un diagnostic reconnu à ce jour dans les classifications psychiatriques, mais certaines personnes (environ 3 % de la population) présentent une souffrance importante ainsi que des symptômes pouvant altérer leur qualité de vie. Le rôle du médecin est alors de rechercher un trouble anxieux ou dépressif sous-jacent, ou d'évaluer l'intensité d'un possible trouble éco-anxiété spécifique. Le traitement repose essentiellement sur une écoute psychothérapeutique, des méthodes de gestion du stress et de l'anxiété, et la thérapie comportementale et cognitive, visant à redonner au patient un meilleur contrôle de ses émotions et des moyens d'agir.


Assuntos
Mudança Climática , Humanos , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Ansiedade/terapia , Ansiedade/diagnóstico
19.
Sci Rep ; 14(1): 13495, 2024 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-38866860

RESUMO

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women that is associated with an increased risk of anxiety and depression and with a lower health-related quality of life (HRQoL). PCOS is closely associated with obesity, which per se can lead to symptoms of anxiety and depression and lower HRQoL. The first-line treatment for PCOS is weight loss through lifestyle intervention, which has been shown to improve all symptoms of the syndrome. The aim of this study was to investigate symptoms of anxiety and depression and HRQoL in women with severe obesity (BMI ≥ 35) with and without PCOS, and to evaluate the effect of a one-year structured weight loss intervention. A total of 246 women with severe obesity (PCOS n = 63, non-PCOS n = 183) were included. The comprehensive psychopathological rating scale self-rating scale for affective symptoms (CPRS-S-A) and the short form-36 (SF-36) were used to assess symptoms of anxiety and depression and HRQoL. In total 72 women of the 246 women with severe obesity completed a one-year weight loss programme and were followed up and compared with baseline data. In women with severe obesity, there were no differences in symptoms of anxiety and depression and HRQoL between women with and without PCOS at baseline. Clinically relevant anxiety symptoms were present in 71.3% (PCOS) and 65.6% (non-PCOS), and depression symptoms were present in 56.4% (PCOS) and 52.2% (non-PCOS). Significant weight loss improved physical HRQoL in all women, but reduced symptoms of anxiety and depression only in women without PCOS. There were no differences when comparing the changes between the groups. Women with severe obesity are severely affected by symptoms of anxiety and depression, independent of PCOS. Weight loss improved symptoms of anxiety and depression in women without PCOS, but there were no differences between groups in change from baseline to follow-up.Trial registration number: Clinical trial.gov: NCT01319162, March 18, 2011. Date of registration and enrolment of the first subject September 2011.


Assuntos
Ansiedade , Depressão , Síndrome do Ovário Policístico , Qualidade de Vida , Redução de Peso , Humanos , Feminino , Síndrome do Ovário Policístico/psicologia , Síndrome do Ovário Policístico/terapia , Síndrome do Ovário Policístico/complicações , Adulto , Ansiedade/terapia , Depressão/terapia , Obesidade Mórbida/psicologia , Obesidade Mórbida/terapia , Programas de Redução de Peso/métodos
20.
PLoS One ; 19(6): e0286899, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38843272

RESUMO

BACKGROUND: Reduced Environmental Stimulation Therapy via floatation (floatation-REST) is a behavioral intervention designed to attenuate exteroceptive sensory input to the nervous system. Prior studies in anxious and depressed individuals demonstrated that single sessions of floatation-REST are safe, well-tolerated, and associated with an acute anxiolytic and antidepressant effect that persists for over 48 hours. However, the feasibility of using floatation-REST as a repeated intervention in anxious and depressed populations has not been well-investigated. METHODS: In this single-blind safety and feasibility trial, 75 individuals with anxiety and depression were randomized to complete six sessions of floatation-REST in different formats: pool-REST (weekly 1-hour float sessions), pool-REST preferred (float sessions with flexibility of duration and frequency), or an active comparator (chair-REST; weekly 1-hour sessions in a Zero Gravity chair). Feasibility (primary outcome) was assessed via an 80% rate of adherence to the assigned intervention; tolerability via study dropout and duration/frequency of REST utilization; and safety via incidence of adverse events and ratings about the effects of REST. RESULTS: Of 1,715 individuals initially screened, 75 participants were ultimately randomized. Six-session adherence was 85% for pool-REST (mean, M = 5.1 sessions; standard deviation, SD = 1.8), 89% for pool-REST preferred (M = 5.3 sessions; SD = 1.6), and 74% for chair-REST (M = 4.4 sessions; SD = 2.5). Dropout rates at the end of the intervention did not differ significantly between the treatment conditions. Mean session durations were 53.0 minutes (SD = 12.3) for pool-REST, 75.4 minutes (SD = 29.4) for pool-REST preferred, and 58.4 minutes (SD = 4.3) for chair-REST. There were no serious adverse events associated with any intervention. Positive experiences were endorsed more commonly than negative ones and were also rated at higher levels of intensity. CONCLUSIONS: Six sessions of floatation-REST appear feasible, well-tolerated, and safe in anxious and depressed individuals. Floatation-REST induces positively-valenced experiences with few negative effects. Larger randomized controlled trials evaluating markers of clinical efficacy are warranted. CLINICAL TRIAL REGISTRATION IDENTIFIER: NCT03899090.


Assuntos
Ansiedade , Depressão , Estudos de Viabilidade , Humanos , Masculino , Feminino , Adulto , Ansiedade/terapia , Depressão/terapia , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do Tratamento , Terapia Comportamental/métodos
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