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1.
Epidemiol Psychiatr Sci ; 29: e85, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31915097

RESUMO

Given the high prevalence (30-35%) of psychosocial and psychiatric morbidity amongst cancer patients in any phase of the disease trajectory, screening for emotional problems and disorders has become mandatory in oncology. As a process, screening begins at the entry to the cancer care system and continues at clinically meaningful times, periodically during active cancer care, or when clinically indicated. The goal is to facilitate proper referral to psychosocial oncology specialists for more specific assessment and care, as well as treatment and evaluation of the response, according to the implementation of distress management guidelines. In this editorial, we will provide a non-exhaustive overview of relevant protocols, with particular reference to the National Comprehensive Cancer Network (NCCN) Distress Management in Oncology Guidelines, and review the challenges and the problems in implementing screening, and the assessment and management of psychosocial and psychiatric problems in cancer centres and community care.


Assuntos
Programas de Rastreamento/métodos , Neoplasias/psicologia , Estresse Psicológico/diagnóstico , Humanos , Saúde Mental , Neoplasias/complicações , Guias de Prática Clínica como Assunto , Qualidade de Vida/psicologia , Estresse Psicológico/etiologia , Estresse Psicológico/terapia
2.
Adv Exp Med Biol ; 1232: 113-119, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893402

RESUMO

The prefrontal cortex (PFC) is sensitive to the stress exposure and involved in stress coping. And the effects of gum chewing on the stress have been studied using NIRS. However, when measuring NIRS on PFC during gum chewing, blood flows in shallow tissues (scalp, skin, muscle) might be affected. A NIRS used in the present study first, which has a short distance (1 cm) and the usual (3 cm) source-detector (S-D) regression, can allow eliminating shallow tissues effect of gum chewing. The aim of this study was to investigate the hypothesis that gum chewing activates the right prefrontal cortex (PFC) in stress coping against negative sounds (NS) from the International Affective Digitized Sounds-2 (IADS) as a mental stress task. NS showed activation in the right PFC. There was a significant difference between NS, and NS with Gum, where NS with Gum showed an increased PFC activity, increased alpha wave appearance rate, a higher value in heart rate level, and a higher VAS score indicating 'pleasant'. Gum chewing activated right PFC activity while exposed to negative sounds from IADS as a mental stress task.


Assuntos
Goma de Mascar , Mastigação , Som , Estresse Psicológico , Adaptação Psicológica , Adulto , Feminino , Humanos , Masculino , Córtex Pré-Frontal/fisiologia , Córtex Pré-Frontal/efeitos da radiação , Som/efeitos adversos , Estresse Psicológico/terapia , Adulto Jovem
3.
Medicine (Baltimore) ; 98(40): e17452, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577772

RESUMO

BACKGROUND/OBJECTIVE: Different studies have shown the prevalence of high level of stress among undergraduate students. The objective of the present study was to investigate the effect of rational emotive behavioral therapy (REBT) as a stress management intervention among English Education undergraduates in Universities in Southeastern Nigeria. METHOD: The study adopted a group randomized trial design. One hundred sixteen samples of English education undergraduates (with a high level of perceived stress) took part in the study. These students were randomly assigned to groups - intervention group(n = 58) and no-intervention control group (n = 58). The Perceived Stress Scale (PSS-14) was used for data collection. The collected data were analyzed using 2-way mixed repeated measure ANOVA and independent sample t test at 0.05 probability level. RESULT: Results showed that an REBT program significantly reduced the stress among English education undergraduates in the intervention group compared to the students in the control group as measured by PSS-14. Also, the English education undergraduates who benefited from the REBT program maintained the reduction in stress after 3 months when the researchers conducted a follow-up. CONCLUSION: REBT program can be used to equip undergraduate students with the necessary skills to manage stress. The implications for curriculum innovation were highlighted.


Assuntos
Currículo , Educação Profissionalizante , Psicoterapia Racional-Emotiva , Estresse Psicológico/terapia , Estudantes/psicologia , Feminino , Humanos , Masculino , Nigéria , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-31533214

RESUMO

A potential method of health promotion using the traditional wooden brass instrument the didgeridoo was examined, especially in terms of mood, stress, and autonomic nerve stabilization. Twenty Japanese healthy subjects undertook 10 lessons of the Didgeridoo Health Promotion Method (DHPM) and a moods questionnaire, blood pressure, salivary amylase (sAmy) as a stress marker, pulse rate and autonomic balance expressed by Ln[low frequency (LF)/High frequency (HF) were examined twice before the entire lessons and once before and after each lesson. The subjects had improved total mood disturbance (TMD: overall mood disorder degree) as measured by the Japanese version of the Profile of Mood States 2nd Edition (POMS2) as a result of taking the lessons. The pulse of the subjects decreased after the lessons, which correlated with a reduction in sAmy. Additionally, it was found that sAmy decreased after the lessons with increasing age of the subject, subjects with higher TMD before the lessons, or subjects with higher sAmy values before the lessons. With autonomic balance measured by Ln[LF/HF], subjects who had parasympathetic dominance as a result of the lesson were significantly more frequent. Additionally, it has been shown that Ln[LF/HF] decreased over 10 weeks, and it is also clear that the effect is sustained. Health promotion is an important concern for societies as a whole. In this study, it became clear that the DHPM affected mood, stress, and autonomic stability. Future studies should focus on monitoring the effects of continuing the lessons for a longer period of time. Additionally, physical effects such as strength of respiratory muscles should be examined. DHPM may be employed in the work place to promote the mental health of workers as well as in regional neighborhood associations/communities.


Assuntos
Afeto , Sistema Nervoso Autônomo/fisiologia , Promoção da Saúde/métodos , Estresse Psicológico/terapia , Adulto , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Musicoterapia/instrumentação , Estresse Psicológico/psicologia
6.
Crit Rev Oncol Hematol ; 143: 117-123, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31563078

RESUMO

Advanced cancer patients with cachexia and their families can suffer from eating-related distress. This complex entity encompasses patients' struggle to nourish themselves, emotional and social consequences of their inability to maintain food intake, and profound disturbance in family relationships. With evidence-based nutritional care, as well as symptom management to enable food intake, cachexia can be mitigated to some degree. In addition, patients and families require psychosocial support and education to understand and cope with this condition. Only by taking an integrated approach can health care teams alleviate eating-related distress, improve quality of life (QOL), reduce interpersonal conflicts, and alter perceptions of nutritional neglect for patients and families. However, few studies have investigated eating-related distress among patients and families. The aim of this narrative review is to describe what is known about eating-related distress and the roles of integrated palliative, supportive, and nutritional care in improving QOL of patients and families.


Assuntos
Caquexia/terapia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Neoplasias/terapia , Apoio Nutricional/métodos , Cuidados Paliativos/métodos , Estresse Psicológico/terapia , Caquexia/psicologia , Família/psicologia , Humanos , Neoplasias/metabolismo , Neoplasias/psicologia , Equipe de Assistência ao Paciente , Qualidade de Vida , Estresse Psicológico/psicologia
7.
Nat Med ; 25(9): 1428-1441, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31501614

RESUMO

Psychological distress has long been suspected to influence cancer incidence and mortality. It remains largely unknown whether and how stress affects the efficacy of anticancer therapies. We observed that social defeat caused anxiety-like behaviors in mice and dampened therapeutic responses against carcinogen-induced neoplasias and transplantable tumors. Stress elevated plasma corticosterone and upregulated the expression of glucocorticoid-inducible factor Tsc22d3, which blocked type I interferon (IFN) responses in dendritic cell (DC) and IFN-γ+ T cell activation. Similarly, close correlations were discovered among plasma cortisol levels, TSC22D3 expression in circulating leukocytes and negative mood in patients with cancer. In murine models, exogenous glucocorticoid injection, or enforced expression of Tsc22d3 in DC was sufficient to abolish therapeutic control of tumors. Administration of a glucocorticoid receptor antagonist or DC-specific Tsc22d3 deletion reversed the negative impact of stress or glucocorticoid supplementation on therapeutic outcomes. Altogether, these results indicate that stress-induced glucocorticoid surge and Tsc22d3 upregulation can subvert therapy-induced anticancer immunosurveillance.


Assuntos
Imunidade Celular , Neoplasias/imunologia , Estresse Psicológico/imunologia , Fatores de Transcrição/genética , Animais , Ansiedade/sangue , Ansiedade/induzido quimicamente , Ansiedade/imunologia , Ansiedade/psicologia , Comportamento Animal/fisiologia , Carcinógenos/toxicidade , Neoplasias Colorretais/sangue , Neoplasias Colorretais/genética , Neoplasias Colorretais/imunologia , Neoplasias Colorretais/psicologia , Corticosterona/sangue , Células Dendríticas/transplante , Regulação Neoplásica da Expressão Gênica , Glucocorticoides/farmacologia , Humanos , Hidrocortisona/sangue , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/psicologia , Ativação Linfocitária/genética , Camundongos , Monitorização Imunológica/métodos , Neoplasias/induzido quimicamente , Neoplasias/genética , Neoplasias/psicologia , Receptores de Glucocorticoides/antagonistas & inibidores , Transdução de Sinais/efeitos dos fármacos , Neoplasias Gástricas/sangue , Neoplasias Gástricas/genética , Neoplasias Gástricas/imunologia , Neoplasias Gástricas/psicologia , Estresse Psicológico/induzido quimicamente , Estresse Psicológico/genética , Estresse Psicológico/terapia , Fatores de Transcrição/imunologia
8.
J Consult Clin Psychol ; 87(9): 787-801, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31403815

RESUMO

OBJECTIVE: Loneliness is a key public health issue for which various interventions have been trialed. However, few directly target the core feature of loneliness-lack of belonging. This is the focus of Groups 4 Health (G4H), a recently developed intervention that targets the development and maintenance of social group memberships to support health. METHOD: To investigate the efficacy of this intervention, a randomized controlled trial was conducted with participants (N = 120) assigned to G4H or treatment-as-usual (TAU) by computer software. Assessment of primary (loneliness) and secondary (depression, social anxiety, general practitioner visits, multiple group membership) outcomes was conducted at baseline and 2-month follow-up using mixed-model repeated-measures analyses. RESULTS: G4H produced a greater reduction in loneliness (d = -1.04) and social anxiety (d = -0.46) than TAU (d = -0.33 and d = 0.03, respectively). G4H was also associated with fewer general practitioner visits at follow-up (d = -0.33) and a stronger sense of belonging to multiple groups (d = 0.52) relative to TAU (d = 0.30 and d = 0.33, respectively). Depression declined significantly in both G4H (d = -0.63) and TAU (d = -0.34), but follow-up analyses showed this was greater in G4H among those not receiving adjunct psychopharmacological treatment and whose symptoms were milder. CONCLUSIONS: Findings suggest that G4H can be a useful way to treat loneliness and highlight the importance of attending to group memberships when tackling this important social challenge. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos de Ansiedade/terapia , Transtorno Depressivo Maior/terapia , Processos Grupais , Solidão , Psicoterapia/métodos , Identificação Social , Estresse Psicológico/terapia , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fobia Social/terapia , Resultado do Tratamento , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-31455015

RESUMO

Accumulated evidence claims that urban green spaces (UGS) have a positive impact on the physical and mental health of humans. However, little information is available to clearly reveal what the most important driving factors are for human psychophysiological restoration. In order to unveil this uncertainty, this study employed virtual reality (VR) technology to investigate the physiological (electroencephalogram, EEG), and psychological (attention, positive mood, negative mood) responses and individual preferences for different urban environments. Participants (120) were recruited and randomly assigned to experience six different types of environments varying in land use and vegetation structures, which were: Grey space, blue space, open green space, partly open green space, partly closed green space, and closed green space. The results showed that the experience of the six environmental types through VR devices had positive restorative effects on the individuals' attentional fatigue and negative mood; however, all the participants obtained the highest levels of physiological stress restoration when asked to close their eyes for relaxation. The physiological measurements of the EEG showed no significant differences among the selected types of environments. Meanwhile, the results of the psychological measures suggested that only negative mood showed significant differences of change among the six types of environments, and while the partly open green space had the most positive effect on negative mood, the closed green space had the worst. The blue space and partly closed green space received higher recreational preference ratings than the other four environments, while the closed green space received the lowest recreational preference rating. Moreover, the findings showed that there was a strong positive correlation between people's preferences and the improvement of their positive mood. This indicated that as the popularity of a natural environment increased, so did the benefits of human health and well-being. In addition, this study shows that VR technology may be utilized as a possible surrogate measure to real scenes in evaluating human physiological and psychological restoration in the future. The present findings can provide the theoretical basis and practical guidance for future optimal planning of urban restorative environments.


Assuntos
Planejamento Ambiental , Fadiga/terapia , Terapia de Relaxamento/métodos , Estresse Fisiológico , Estresse Psicológico/terapia , Realidade Virtual , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
10.
Int J Radiat Oncol Biol Phys ; 105(4): 760-764, 2019 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-31415797

RESUMO

PURPOSE: To compare 4 Gy × 5 (1 week) to 3 Gy × 10 (2 weeks) in relieving pain and distress in patients with metastatic epidural spinal cord compression (MESCC). METHODS AND MATERIALS: The randomized SCORE-2 trial compared 4 Gy × 5 (n = 101) to 3 Gy × 10 (n = 102) for MESCC. In this additional analysis, these regimens were compared for their effect in relieving pain and distress. Distress was evaluated with the distress-thermometer (0 = no distress, 10 = extreme distress) and pain on a linear scale (0 = no pain, 10 = worst pain). Relief of distress was defined as decrease of ≥2 points; complete and partial pain relief were defined as achieving a score of 0 points and a decrease ≥2 points, respectively, without increase of analgesic use. This prospective secondary analysis of the SCORE-2 trial aimed to show that 4 Gy × 5 was not inferior to 3 Gy × 10 regarding distress and pain relief. Analyses were performed using the unconditional test of noninferiority for binomial differences based on restricted maximum likelihood estimates (noninferiority margin: -20%). Evaluations were performed before, directly after, and 1, 3, and 6 months after radiation therapy. (ClinicalTrials.gov: NCT02189473). RESULTS: At baseline, median distress scores were 8 (2-10) points in the 4 Gy × 5 group and 8 (2-10) points in the 3 Gy × 10 group. At 1 month, distress relief rates were 58.1% (43/74) and 62.7% (47/75) (difference: -4.6%; 95% confidence interval, -20.0% to +11.1%; P = .025). At baseline, median pain scores were 7 (2-10) and 7 (2-10) points, respectively. At 1 month, complete pain relief rates were 23.5% (16/68) versus 20.0% (14/70) (difference, +3.5%; 95% confidence interval, -10.4% to +17.5%; P < .001), and overall pain relief rates were 52.9% (36/68) versus 57.1% (40/70) (difference, -4.2%; 95% confidence interval, -20.5% to +12.3%; P = .029). Distress and pain relief rates after 4 Gy × 5 were largely comparable to 3 Gy × 10 at all time points. Associated 95% confidence intervals did not point toward any relevant differences. CONCLUSIONS: In patients with MESCC and poor to intermediate survival prognoses, 4 Gy × 5 appeared noninferior to 3 Gy × 10 regarding pain and distress relief.


Assuntos
Manejo da Dor/métodos , Medidas de Resultados Relatados pelo Paciente , Compressão da Medula Espinal/radioterapia , Neoplasias da Coluna Vertebral/radioterapia , Estresse Psicológico/terapia , Idoso , Feminino , Humanos , Masculino , Medição da Dor/estatística & dados numéricos , Prognóstico , Estudos Prospectivos , Qualidade de Vida , Dosagem Radioterapêutica , Compressão da Medula Espinal/complicações , Neoplasias da Coluna Vertebral/complicações , Fatores de Tempo
11.
J Autism Dev Disord ; 49(11): 4646-4657, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31463630

RESUMO

In a context described as a challenge in parenting (having an autistic child), we sought to highlight the emotional skills that mothers gain as a result of interacting with their child, and how they then use these skills. Mothers of autistic children (n = 136) and mothers of non-autistic children (n = 139) responded to emotional intelligence, resilience, and coping scales. Comparisons revealed smaller differences between groups than expected. Nevertheless, mothers of autistic children showed greater resilience abilities than mothers of non-autistic children. Moreover, we noted differences between both groups regarding their use of emotional skills. Emotional intelligence is a resource that deserves to be explored in terms of its clinical implications, especially among the parents of autistic children.


Assuntos
Adaptação Psicológica/fisiologia , Transtorno Autístico/psicologia , Inteligência Emocional/fisiologia , Mães/psicologia , Poder Familiar/psicologia , Resiliência Psicológica , Adolescente , Adulto , Transtorno Autístico/diagnóstico , Transtorno Autístico/terapia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pais/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/psicologia , Estresse Psicológico/terapia , Adulto Jovem
12.
Prim Care ; 46(3): 373-386, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31375187

RESUMO

Patients with serious illness and their family caregivers face numerous ongoing psychological and social concerns and stressors throughout the disease trajectory. Common challenges relate to the need to manage the disease by making complex and often difficult medical decisions. In addition, the presence of psychological and psychiatric distress, including depression and anxiety, may significantly add to the overall symptom burden for the patient and family caregivers. These challenges negatively impact mood, cognitive function, interpersonal relationships, and medical decision making. If not recognized and adequately addressed, they can seriously undermine coping and resilience, eroding psychological well-being and quality of life.


Assuntos
Adaptação Psicológica , Luto , Estado Terminal/psicologia , Família/psicologia , Atenção Primária à Saúde/organização & administração , Afeto , Ansiedade/epidemiologia , Ansiedade/terapia , Competência Cultural , Depressão/epidemiologia , Depressão/terapia , Humanos , Relações Interpessoais , Relações Médico-Paciente , Qualidade de Vida , Apoio Social , Estresse Psicológico/epidemiologia , Estresse Psicológico/terapia
13.
J Couns Psychol ; 66(6): 726-735, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31368721

RESUMO

The 2016 U.S. national election brought increased anxiety, relationship conflict, and counseling utilization for many Americans, especially among women, millennials, racial and ethnic minority (REM) members, and economically disadvantaged persons. The present study examined psychological symptoms, interpersonal tension, and counseling service requests over 36 months of data (April 2015-March 2018) from 56 clients and 14 therapists engaged in a routine outcomes monitoring project at a training community counseling center. Clients resided in a Democratic-leaning area in a Republican-voting state, and 78% were women, 53% were under 30 years of age, 33% were an REM, and 92% earned below the median state income level. Symptoms did not show an association with the political climate, and interpersonal problems reduced during counseling. Although interpersonal conflict decreased prior to the election, it increased afterward, largely due to problems of dominance and control in relationships. Younger and REM individuals showed larger increases in interpersonal tension after the election than did older and non-REM persons. Alliances decreased over the entire data-collection period. Counseling intakes increased after the election, although potentially due to seasonal patterns. With attention to the effect of political events on individuals, the field of counseling psychology may be able to help clients and the larger society manage difficult interactions around real differences in political opinions and disparities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Aconselhamento/métodos , Política , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Idoso , Aconselhamento/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/terapia , Estados Unidos/epidemiologia , Adulto Jovem
14.
Psiquiatr. biol. (Internet) ; 26(2): 73-79, mayo-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185034

RESUMO

Objetivos: Explorar las diferencias entre el efecto de un programa presencial u online de reducción del estrés basado en mindfulness (REBM) sobre el malestar psicológico general en población española. Además, se estudia si la adhesión y satisfacción con el programa difiere entre ambas modalidades. Metodología: Estudio cuasiexperimental en el que 373 participantes realizaron un programa REBM de 8 semanas. Se compararon 2modalidades: presencial (n = 109) y online (n = 264). Resultados: Los participantes de ambas modalidades presentaron reducciones significativas de malestar (p < 0,001). No hubo una diferencia significativa en la reducción de malestar entre ambas modalidades (p = 0,314). La adhesión (p < 0,001) y satisfacción (p = 0,024) fueron significativamente superiores en los participantes de la modalidad presencial (p < 0,001) que en los de la modalidad online. Conclusiones: Ambas modalidades de REBM (presencial y online) reducen el malestar psicológico general. Sin embargo, la modalidad presencial tiene mayores niveles de adhesión y satisfacción


Objectives: Explore the reduction in general psychological distress after a face-to-face versus an online mindfulness-based stress reduction (MBSR) program in a Spanish population. In addition, we study if program adherence and satisfaction differ between modalities. Methods: We performed an 8-week quasi-experimental study in which 373 participants took part in an MBSR program in which face-to-face (n=109) and online (n=264) modalities were compared. Results: Participants in both modalities showed a significant reduction in distress (P<0.001). However, there was no significant difference in this reduction between modalities (P=0.314). Adherence (P<0.001) and satisfaction (P=0.024) were significantly better in face-to-face sessions (P<0.001) compared to online ones. Conclusions: The MBSR program reduces general psychological distress in both modalities (face-to-face and online). However, the face-to-face modality has higher levels of adherence and program satisfaction


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estresse Psicológico/terapia , Atenção Plena/métodos , Meditação/métodos , Resultado do Tratamento , Sistemas On-Line/estatística & dados numéricos , Telepsicologia , Educação de Pacientes como Assunto/métodos
15.
J Autism Dev Disord ; 49(10): 4280-4293, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31342445

RESUMO

We examined the relationship between initial parenting stress and change in parental responsivity for 56 culturally and socioeconomically diverse families in a 12 week randomized control trial of Pathways Early ASD Intervention. Families were randomized into the Pathways (n = 32) or treatment-as-usual (TAU n = 24) group. Overall, Pathways parents experienced decreased stress, while TAU parents experienced an increase. The relationship between initial parental stress and change in parent responsivity was moderated by group membership. Pathways parents became more responsive but responsivity was not influenced by initial parental stress. In contrast, responsivity was negatively affected by initial parenting stress in the TAU group. Results are discussed in terms of components of a parent-mediated ASD intervention that may reduce parental stress.


Assuntos
Transtorno do Espectro Autista/psicologia , Pais/psicologia , Psicoterapia/métodos , Estresse Psicológico/terapia , Pré-Escolar , Feminino , Humanos , Masculino , Relações Pais-Filho , Poder Familiar/psicologia , Estresse Psicológico/psicologia
16.
Schmerz ; 33(6): 539-548, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31346772

RESUMO

BACKGROUND: The treatment of patients with chronic pain should be carried out in interdisciplinary multimodal pain programs of which relaxation methods represent an integral part. The German disease management guidelines (NDGM) on nonspecific low back pain currently do not recommend biofeedback as a relaxation technique for chronic low back pain due to inadequate data. Furthermore, health insurances do not cover the costs of this treatment. METHODS: The efficacy of a 2-week biofeedback treatment was evaluated in a study of 10 patients with chronic nonspecific low back pain and 10 healthy, age and gender-matched subjects. The parameters "well-being", "depressive mood" and "pain-related disability" were assessed based on three psychometric tests (KAB, ADS and PDI). The pain intensity was measured using a numeric rating scale (NRS) and biofeedback measurement parameters themselves as well as stress markers in blood (noradrenaline, cortisol and MMP-2) were also measured. RESULTS: The relaxation response was demonstrated by the biofeedback-parameters. The treatment led to an improvement in well-being, depressive mood and pain-related disability. These results correlated with a reduction of noradrenaline and MMP-2 blood levels, whereas cortisol concentrations showed no change. CONCLUSION: Biofeedback relaxation is a suitable method in the treatment of chronic non-specific low back pain. Its use in interdisciplinary multimodal pain programs should be encouraged.


Assuntos
Biorretroalimentação Psicológica , Dor Crônica , Dor Lombar , Estresse Psicológico , Biomarcadores/sangue , Estudos de Casos e Controles , Humanos , Dor Lombar/terapia , Terapia de Relaxamento , Estresse Psicológico/terapia , Resultado do Tratamento
17.
J Cancer Res Clin Oncol ; 145(8): 2141-2148, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31278473

RESUMO

PURPOSE: Many cancer patients (PTS) suffer from somatic or non-somatic symptoms. Studies have shown positive effects of music intervention (MI) on aspects of quality of life or symptom management. METHODS: Since there are poor data available about patient's needs regarding the use of MI as an adjunct to cancer treatment, n = 548 tumor PTS were polled anonymously at the outpatient department of the University Hospital Mannheim Tumor Center using a self-designed questionnaire. Univariate and multivariate analyses were performed. RESULTS: 486 data sets were eligible for analysis. 240 of the PTS were male and median age was 63 years. 38% had metastatic disease. 81% (n = 386) were currently receiving anti-tumor treatment. The majority of the PTS stated to have somatic symptoms. However, some of the PTS reported non-somatic symptoms like anxiety, loneliness, and depression. N = 187 (40%) of the PTS reported interest in complementary MI. In the univariate and multivariate analyses, especially PTS with non-somatic complaints and PTS, actively playing or making music showed significantly more interest in complementary MI, hoping for a relaxing therapeutic effect. PTS who play instruments would prefer more active forms of MI. CONCLUSION: 40% of PTS reported interest in additional MI during cancer treatment. PTS with non-somatic symptoms as well as patients affine to music might benefit from the use of MI potentially reducing their symptom burden. The inconsistent and heterogeneous data from randomized trials underline the importance of systematic research approaches with more relevant and standardized endpoints.


Assuntos
Terapias Complementares/métodos , Musicoterapia , Música , Neoplasias/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/complicações , Ansiedade/epidemiologia , Ansiedade/psicologia , Ansiedade/terapia , Terapias Complementares/psicologia , Terapias Complementares/estatística & dados numéricos , Depressão/complicações , Depressão/epidemiologia , Depressão/psicologia , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Música/psicologia , Neoplasias/epidemiologia , Neoplasias/patologia , Neoplasias/psicologia , Qualidade de Vida , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Estresse Psicológico/terapia , Inquéritos e Questionários , Adulto Jovem
18.
J Clin Nurs ; 28(21-22): 3747-3758, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31267619

RESUMO

AIMS AND OBJECTIVES: To explore the studies that used interventions based on the Mindfulness-Based Stress Reduction (MBSR) for decreasing psychological distress among nurses. BACKGROUND: Because of the demanding nature of their work, nurses often have significantly high levels of stress, anxiety and depression. MBSR has been reported to be an effective intervention to decrease psychological distress. DESIGN: Systematic review. METHODS: The databases included were Science Direct, PubMed, EBSCO host, Springer Link and Web of Science from 2002 to 2018. Interventional studies published in English that used MBSR among nurses to reduce their psychological distress were retrieved for review. The PRISMA guideline was used in this systematic review. The included studies were assessed for quality using "The Quality Assessment Tool For Quantitative Studies (QATFQS)." RESULTS: Nine studies were found to be eligible and included in this review. Many benefits, including reduced stress, anxiety, depression, burnout and better job satisfaction, were reported in these studies. CONCLUSION: The adapted/brief versions of MBSR seem promising for reducing psychological distress in nurses. Future research should include randomised controlled trials with a larger sample size and follow-up studies. There should also be a focus on creative and effective ways of delivering MBSR to nurses. RELEVANCE TO CLINICAL PRACTICE: The results of this review are substantial for supporting the use of MBSR for nurses' psychological well-being.


Assuntos
Atenção Plena , Enfermeiras e Enfermeiros/psicologia , Estresse Psicológico/terapia , Ansiedade/psicologia , Depressão/psicologia , Feminino , Humanos , Satisfação no Emprego , Estresse Psicológico/psicologia
19.
Trials ; 20(1): 408, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288829

RESUMO

BACKGROUND: Critical illness increases the risk for poor mental health outcomes among both patients and their informal caregivers, especially their surrogate decision-makers. Surrogates who must make life-and-death medical decisions on behalf of incapacitated patients may experience additional distress. EMPOWER (Enhancing & Mobilizing the POtential for Wellness & Emotional Resilience) is a novel cognitive-behavioral, acceptance-based intervention delivered in the intensive care unit (ICU) setting to surrogate decision-makers designed to improve both patients' quality of life and death and dying as well as surrogates' mental health. METHODS: Clinician stakeholder and surrogate participant feedback (n = 15), as well as results from an open trial (n = 10), will be used to refine the intervention, which will then be evaluated through a multisite randomized controlled trial (RCT) (n = 60) to examine clinical superiority to usual care. Feasibility, tolerability, and acceptability of the intervention will be evaluated through self-report assessments. Hierarchical linear modeling will be used to adjust for clustering within interventionists to determine the effect of EMPOWER on surrogate differences in the primary outcome, peritraumatic stress. Secondary outcomes will include symptoms of post-traumatic stress disorder, prolonged grief disorder, and experiential avoidance. Exploratory outcomes will include symptoms of anxiety, depression, and decision regret, all measured at 1 and 3 months from post-intervention assessment. Linear regression models will examine the effects of assignment to EMPOWER versus the enhanced usual care group on patient quality of life or quality of death and intensity of care the patient received during the indexed ICU stay assessed at the time of the post-intervention assessment. Participant exit interviews will be conducted at the 3-month assessment time point and will be analyzed using qualitative thematic data analysis methods. DISCUSSION: The EMPOWER study is unique in its application of evidence-based psychotherapy targeting peritraumatic stress to improve patient and caregiver outcomes in the setting of critical illness. The experimental intervention will be strengthened through the input of a variety of ICU stakeholders, including behavioral health clinicians, physicians, bereaved informal caregivers, and open trial participants. Results of the RCT will be submitted for publication in a peer-reviewed journal and serve as preliminary data for a larger, multisite RCT grant application. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03276559 . Retrospectively registered on 8 September 2017.


Assuntos
Cuidadores/psicologia , Comportamento de Escolha , Terapia Cognitivo-Comportamental , Cuidados Críticos , Emoções , Saúde Mental , Procurador/psicologia , Resiliência Psicológica , Estresse Psicológico/terapia , Consentimento do Representante Legal , Estudos de Equivalência como Asunto , Humanos , Unidades de Terapia Intensiva , Estudos Multicêntricos como Assunto , Cidade de Nova Iorque , Qualidade de Vida , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Fatores de Tempo , Resultado do Tratamento
20.
Med Humanit ; 45(2): 190-198, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31289220

RESUMO

Animal cafés-businesses in which customers pay by the hour to have a drink and relax in a space filled with cats, rabbits or other animals-began to appear in Japan in 2004, as a part of the iyashi healing boom. The iyashi boom, in goods and experiences that offer emotional and physical healing, was a response to problems of economic and social precarity triggered by the end of the Japanese bubble and the changing economic situation, particularly among younger Japanese facing the loss of earlier forms of social support and community. Animal cafés offer iyashi to their customers by providing them a refuge from the stress of their everyday lives, where they can relax through engagement with companion animals, rather than returning to tiny, empty apartments. The focus of these businesses is to offer the opportunity to develop positive affective relationships with the animals, who offer stress relief, physical affection, and a listening ear to the visitors who come to spend time with them.This research explores the way that affective relationships with animals in these cafés are being used as a method to maintain emotional well-being and control stress levels. Based on 18 months of anthropological fieldwork in Tokyo, Japan, this paper draws on the narratives of café visitors to argue that the popularity of these businesses is indicative of a shift towards the commodification of care relationships, and that visitors are using animals to reduce their stress in order to further productivity, by investigating how affective connections with non-human animals helps them feel 'healed"', and to explore how this relates to larger social considerations about healing and wellness in modern Japan.


Assuntos
Animais de Estimação/psicologia , Estresse Psicológico/terapia , Animais , Gatos , Humanos , Japão , Coelhos , Apoio Social , Estresse Psicológico/psicologia
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