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1.
Integr Cancer Ther ; 19: 1534735419893766, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32009481

RESUMO

Purpose: To assess the feasibility, safety, and preliminary effectiveness of a 12-week multimodal Qigong Mind-Body Exercise (QMBE) program for breast cancer survivors with persistent post-surgical pain (PPSP). Methods: This was a single-arm mixed-methods pilot study. Primary outcome measures were feasibility (recruitment, adherence) and safety. Validated self-report questionnaires were used to evaluate a constellation of interdependent symptoms, including pain, fatigue, mood, exercise, interoceptive awareness, and health-related quality of life at baseline and 12 weeks. A subset of the instruments was administered 6 months postintervention. Shoulder range of motion and grip strength were objectively assessed at baseline and 12 weeks. Qualitative interviews were conducted at baseline and 12 weeks. Results: Twenty-one participants were enrolled; 18 and 17 participants, respectively, completed the 12-week and 6-month outcome assessment. No serious adverse events were reported. Statistically significant improvements were observed at 12 weeks in pain severity and interference, fatigue, anxiety, depression, perceived stress, self-esteem, pain catastrophizing, and several subdomains of quality of life, interoceptive awareness, and shoulder range of motion. Changes in pain, fatigue, pain catastrophizing, anxiety, depression, and quality of life were clinically meaningful. Postintervention effects were sustained at 6 months. Conclusions: QMBE is a safe and gentle multimodal intervention that shows promise in conferring a broad range of psychosocial and physical benefits for breast cancer survivors with PPSP. Results support the value of future studies evaluating the impact of QMBE on multiple outcomes relevant to breast cancer survivors with PPSP.


Assuntos
Neoplasias da Mama/psicologia , Terapia por Exercício/métodos , Terapias Mente-Corpo/métodos , Dor Pós-Operatória/terapia , Qigong , Qualidade de Vida , Adulto , Sobreviventes de Câncer , Exercício , Fadiga/terapia , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Dor , Projetos Piloto , Resultado do Tratamento
2.
BMC Gastroenterol ; 19(1): 115, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266461

RESUMO

BACKGROUND: Patients with Inflammatory Bowel Disease (IBD) also suffer from a wide range of additional disorders, which may be caused by the disease, the side effect of the medication, or a lack of physical activity (PA). This results in reduced physical and psychological wellbeing. However, as known from other chronic diseases exercise could be utilized as supportive therapy for IBD patients. Main goals of this article are (a) collecting data of the effects structured physical activity interventions have on validated clinical parameters of IBD and health related symptoms, (b) developing activity recommendations for this clientele. METHODS: A scoping review was conducted, searching for relevant articles published until May 2018, which investigated the effects of structured exercise interventions in IBD patients. The heterogeneity of the outcomes and the interventions did not support a quantitative synthesis thus, a qualitative discussion of the studies is provided. RESULTS: After reviewing 353 records, 13 eligible articles were identified. Five studies investigated aerobic exercise, three studies resistance exercise, three studies mind-body therapies and two studies yoga. The quality of the studies is mixed, and the duration is rather short for exercise interventions. Only few studies assessed validated IBD activity markers or inflammatory biomarkers. Nevertheless, the patients showed an increase in fitness, bone mineral density (BMD), quality of life and a decrease of IBD induced stress and anxiety. No severe adversial events were reported. CONCLUSION: Even though the evidence is limited the application of exercise interventions in IBD patients can be assumed to be safe and beneficial for the patients' overall-health, and IBD specific physical and psychosocial symptoms. But there is still a high demand for more thoroughly conducted studies, focussing on important clinical outcome parameters.


Assuntos
Terapias Complementares/métodos , Terapia por Exercício/métodos , Doenças Inflamatórias Intestinais/terapia , Adulto , Terapias Complementares/psicologia , Exercício , Terapia por Exercício/psicologia , Feminino , Humanos , Doenças Inflamatórias Intestinais/psicologia , Masculino , Pessoa de Meia-Idade , Terapias Mente-Corpo/métodos , Treinamento de Resistência/métodos , Resultado do Tratamento , Ioga
3.
Medicina (Kaunas) ; 55(7)2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31262094

RESUMO

Background and objectives: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children and adolescents. Mind-body therapies (MBTs) seem to be effective for improving health in different populations; however, whether a positive effect occurs in children and adolescents with ADHD is still controversial. The main aim of this systematic review was to analyse the interventions based on MBT aimed to improve the main ADHD symptoms in children and adolescents. Materials and Methods: A systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to identify MBT studies on children and adolescents (4-18 years) with a clinical diagnosis of ADHD. Study quality was evaluated by the NIH quality tool (U.S. National Institute of Health). Results: There were positive results in eleven out of twelve included studies regarding the effect of the MBT interventions on ADHD symptoms. With respect to ADHD symptoms, we observed differences across studies. In relation to the studies' quality, eleven studies were rated "poor" and one was rated as "fair". Conclusions: MBTs, such as yoga or mindfulness, could be positive strategies to mitigate ADHD symptoms in children and adolescents. However, further research with high-quality designs, with randomization, greater sample sizes, and more intensive supervised practice programs are needed.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Terapias Mente-Corpo/normas , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Terapias Mente-Corpo/métodos
4.
Complement Ther Med ; 45: 156-166, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331554

RESUMO

PURPOSE: The objective of this study was to conduct a systematic review and meta-analysis to examine the effects of aromatherapy on sleep improvements. METHODS: A search of randomized controlled trials was conducted in four English and two Chinese medical electronic databases. Two authors independently performed the search, assessed the methodological quality, and extracted data. Then, final studies were selected after consensus with the third author. RESULTS: In total, 31 trials met the inclusion criteria, of which four had low risk, while the overall bias in 26 was uncertain in terms of methodological quality. The heterogeneity was high among the trials (Q = 341.544, p < 0.001, I2 = 91.216%). There was a significant effect of aromatherapy on sleep quality (Hedges's g = 1.103 (95% confidence interval: 0.813˜1.393, p < 0.001). There was a publication bias (Egger's regression intercept = 7.127, t = 3.055, p = 0.004 and Begg test, Kendall's tau with continuity correction, tau = 0.335 and Z = 2.651, p = 0.008). The subgroup analysis showed that there was a significant difference in the methodological quality among different studies (Q = 18.350, p <  0.001). Sensitivity analyses still revealed high heterogeneity after omitting one study at a time. CONCLUSIONS: The results showed that aromatherapy can be applied by clinical staff to effectively improve sleep quality. However, because there was a high degree of heterogeneity among studies, the inferences of the results need to be applied with caution.


Assuntos
Óleos Voláteis/uso terapêutico , Sono/efeitos dos fármacos , Sono/fisiologia , Animais , Aromaterapia/métodos , Humanos , Terapias Mente-Corpo/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Sensibilidade e Especificidade
5.
Complement Ther Med ; 45: 280-288, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331575

RESUMO

OBJECTIVE: The purpose was to involve women's personal experiences of daily life with primary dysmenorrhea (PD) and their body perceptions of the dysmenorrhea-related symptoms in relation to the treatment procedure and to explore the perception of Heart Rate Variability Biofeedback (HRV-BF) or Rhythmical Massage (RM) according to Ita Wegman as a therapeutic intervention within the framework of Anthroposophic Medicine (AM). DESIGN: From 60 women who participated in our randomized controlled trial analyzing the effects of HRV-BF or RM, we examined 14 women to get an in-depth understanding of this prevalent disease, using a qualitative design. The women drew their body image before and after the 3-month-intervention on body silhouette diagrams and described their body-perceptions. Semi-structured interviews were conducted and analyzed using content analysis. RESULTS: Women perceive dysmenorrhea as a disturbance of their daily lives. The body images showed the variations of experience, from misbalances of body perception to overwhelming attacks of pain hindering a normal life for several days per month. Perception of therapeutic interventions range from relaxing without effects on complaints to important changes and benefits on the physical, emotional, and/or social level. Both therapies can support stronger self-awareness through enabling a more differentiated sense of body-awareness, sometimes resulting in women experiencing fewer limitations in their daily lives. Effects may be influenced by the readiness to resonate with the therapeutic process. Qualitative interviews and body images can serve as tools to integrate individuality and help to integrate embodied more or less conscious aspects of complaints. CONCLUSIONS: The body silhouette diagram could be used systematically to include reflections of embodiment in the therapeutic and research settings and help to diagnose in advance the ability of participants to resonate with interventions. RM and HRV-BF influence self-awareness and may enable salutogenic and self-management capacities. For more effective treatment it may be helpful to make treatment suggestions based on an integrative individual history that includes preferences, expectations and a body silhouette diagram.


Assuntos
Conscientização/fisiologia , Biorretroalimentação Psicológica/fisiologia , Dismenorreia/fisiopatologia , Dismenorreia/terapia , Frequência Cardíaca/fisiologia , Adolescente , Adulto , Feminino , Humanos , Massagem/métodos , Pessoa de Meia-Idade , Terapias Mente-Corpo/métodos , Pesquisa Qualitativa , Adulto Jovem
6.
Complement Ther Med ; 45: 45-49, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331581

RESUMO

BACKGROUND: Systematic and consistent dose delivery is critical in intervention research. Few studies testing complementary health approach (CHA) interventions describe intervention fidelity monitoring (IFM) and measurement. OBJECTIVE: To describe methodological processes in establishing and measuring consistent dose, delivery, and duration of a multi-component CHA intervention. METHODS: Adults with pulmonary hypertension received six weekly, 1-hour Urban Zen Integrative Therapy (UZIT) sessions. A total of 78 sessions were delivered and 33% of these sessions were audited. Intervention dose (time allocated to each component), intervention consistency (protocol adherence audits), and intervention delivery (performance and sequence of components) were captured using remote video observation and review of the recorded video. IFM audits were performed at the beginning (n = 16), middle (n = 5), and end (n = 5) of the study. RESULTS: UZIT interventionists adhered to the intervention protocol (99.3%) throughout the study period. Interventionists delivered UZIT components within the prescribed timeframe: 1) Beginning: gentle body movement (18.9 ± 5.8 min.), restorative pose with guided body awareness meditation (21.3 ± 2.7 min.), and Reiki (22.8 ± 3.1 min.); 2) Middle: gentle body movement (15.9 ± 1.5 min.), pose/body awareness meditation (30.1 ± 6.5 min.), and Reiki (30.1 ± 7.0 min.); 3) End: gentle body movement (18.1 ± 3.6 min.), pose/body awareness meditation (35.3 ± 6.4 min.), and Reiki (34.5 ± 7.0 min.). Essential oil inhalation was delivered during UZIT sessions 100% of the time. Interventionists adhered to treatment delivery behaviors throughout the study period: beginning (98.86%), middle (100%), and end (100%). DISCUSSION: In this pilot study, we demonstrated that the dose, consistency, and delivery of multi-component CHA therapy can be standardized and monitored to ensure intervention fidelity.


Assuntos
Hipertensão Pulmonar/tratamento farmacológico , Hipertensão Pulmonar/terapia , Terapias Complementares/métodos , Assistência à Saúde/métodos , Feminino , Humanos , Masculino , Auditoria Médica/métodos , Terapias Mente-Corpo/métodos , Óleos Voláteis/administração & dosagem , Projetos Piloto
7.
J Altern Complement Med ; 25(8): 840-844, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31237434

RESUMO

Objectives: An estimated 30%-50% of breast cancer survivors (BCSs) report persistent insomnia, which may affect daytime functioning and quality of life, and lead to longer term health complications. Although the gold standard insomnia intervention, cognitive behavioral therapy for insomnia (CBT-I), has demonstrated efficacy, accessibility is limited due to a scarcity of trained providers, and adherence to therapy is variable. Group-delivered alternative therapies may offer an opportunity to reach and treat BCSs with insomnia. This pilot study was designed to assess feasibility of a group-delivered mind-body intervention compared with group-delivered CBT-I among BCSs. Design: The authors recruited n = 25 stages I - IV BCSs to a 9-week trial of group therapy for insomnia. Eligible women were assigned to the next upcoming group until it was full. Primary outcomes were to assess intervention feasibility measured by (1) qualitative focus group feedback and (2) attendance. The feasibility of using the Insomnia Severity Index (ISI) was also assessed in this population and ISI change scores were gathered to allow for power calculations in a future trial. Means and frequencies were used to describe participant demographics and attendance. Results: The authors found higher attendance (86% vs. 67% of sessions) and greater satisfaction with the intervention (84.6% vs. 57.1%) reported among mind-body participants than among CBT-I participants. Qualitative feedback suggested more group cohesion among the mind-body group and lower incentive to attend in-person among the CBT-I group. Conclusions: The results suggest that delivering a mind-body intervention for BCSs is feasible and acceptable, based on attendance and qualitative feedback.


Assuntos
Neoplasias da Mama/reabilitação , Sobreviventes de Câncer , Terapia Cognitivo-Comportamental/métodos , Terapias Mente-Corpo/métodos , Distúrbios do Início e da Manutenção do Sono/terapia , Estudos de Viabilidade , Humanos , Satisfação do Paciente
8.
Work ; 63(2): 191-197, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156200

RESUMO

Patients in the medical intensive care unit (MICU) face life-threatening conditions leading to physical and psychological stress, and decreased occupational engagement. Mind-body interventions include techniques based on connecting the mind, body, brain, and behavior to positively influence health. The purpose of this study was to explore the use of mind-body interventions as a tool for use by occupational therapists (OT) to improve health and occupational performance. This was an exploratory case study completed with the patient, "Ann" in a MICU. Ann was a 57-year-old female who was admitted to the MICU for abdominal pain and later diagnosed with septic shock. Two mind-body sessions were completed with Ann and her responses were assessed via multiple variables, including: respiratory rate; blood pressure; heart rate; oxygen saturation; and anxiety. Ann stayed within normal ranges for all variables. This study demonstrates it was feasible to elicit mind-body interventions in this setting, with this patient.


Assuntos
Terapias Mente-Corpo/normas , Terapia Ocupacional/normas , Estudos de Casos e Controles , Colorado , Feminino , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Pessoa de Meia-Idade , Terapias Mente-Corpo/métodos , Terapeutas Ocupacionais/tendências , Terapia Ocupacional/métodos , Estresse Psicológico/psicologia , Estresse Psicológico/terapia
9.
Br J Anaesth ; 123(2): e263-e272, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31053232

RESUMO

BACKGROUND: Pain is recognised to have both a sensory dimension (intensity) and an affective dimension (unpleasantness). Pain feels like a single unpleasant bodily experience, but investigations of human pain have long considered these two dimensions of pain to be separable and differentially modifiable. The evidence underpinning this separability and differential modifiability is seldom presented. We aimed to fill this gap by evaluating the current evidence base for whether or not the sensory and affective dimensions of pain can be selectively modulated using cognitive manipulations. METHODS: A rigorous systematic search, based on a priori search terms and consultation with field experts, yielded 4270 articles. A detailed screening process was based on the following recommendations: (i) evaluation of effectiveness; (ii) examination of methodological rigour, including each study having an a priori intention to cognitively modulate one of the two dimensions of pain; and (iii) sound theoretical reasoning. These were used to ensure that included studies definitively answered the research question. RESULTS: After in-depth critique of all 12 articles that met the inclusion criteria, we found that there is no compelling evidence that the sensory and affective dimensions of pain can be selectively and intentionally modulated using cognitive manipulations in humans. CONCLUSIONS: We offer potential explanations for this discrepancy between assumptions and evidence and contend that this finding highlights several important questions for the field, from both the research and clinical perspectives.


Assuntos
Afeto , Terapias Mente-Corpo/métodos , Medição da Dor/métodos , Percepção da Dor , Dor/fisiopatologia , Dor/psicologia , Humanos
10.
Medicine (Baltimore) ; 98(19): e15639, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083263

RESUMO

BACKGROUND: Type 2 diabetes is one of the most common and complex chronic disease. A lot of clinical researches have focused on meditative movement for type 2 diabetes. However, there is no systematic review and meta-analysis has been conducted. We aim to systematically review the effect of meditative movement on the type 2 diabetes care. METHODS: The databases including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Ovid LWW, EMBASE will be searched. Studies published from the time when the database establishment to December 2018 will be retrieved. RCTs study on meditative movement for glucose control in patients with type 2 diabetes will be included. The primary outcomes are HbA1c, fasting blood glucose, and postprandial blood glucose (PPBG). RevMan V.5.3 software will be used to perform the analyses. RESULTS: This study will provide high-quality synthesis of effectiveness and safety of meditation movement for type 2 diabetes. CONCLUSION: This systematic review will provide high-quality evidence to judge whether the meditative movement is beneficial to glucose control in patients with type 2 diabetes.PROSPERO registration number: CRD42019128495.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Metanálise como Assunto , Terapias Mente-Corpo , Revisão Sistemática como Assunto , Glicemia , Diabetes Mellitus Tipo 2/sangue , Humanos , Terapias Mente-Corpo/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
J Neurooncol ; 143(3): 505-513, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31049826

RESUMO

PURPOSE: To test the feasibility, acceptability, and preliminary efficacy of a mind-body program for patients with neurofibromatosis 2 (NF2) who are deaf or have significant hearing loss (d3RP-NF2) against an attention placebo control (dHEP-NF2) in a single-blind randomized control trial. Both were delivered using Communication Access Real-Time Translation and live group videoconferencing. METHODS: Forty-five adults with NF2 were randomized. Co-primary outcomes were physical quality of life (QoL) and psychological QoL and secondary outcomes were social QoL and environmental QoL, all measured with the World Health Organization Quality of Life Abbreviated Instrument (WHOQOL-BREF). Assessments were conducted at baseline, post-treatment, and six-month follow-up. RESULTS: Forty-one participants (91%) completed the intervention, and 29 (64%) completed the six-month follow up. Participants in the d3RP-NF2 showed significantly greater improvements from baseline to post-treatment on physical QoL (14.79, 95% CI 5.41-24.18; p ≤ 0.001), psychological QoL (18.77, 95% CI 7.09-30.44, p ≤ 0.001), and environmental QoL (13.25, 95% CI 1.10-25.39, p = 0.03) compared to the dHEP-NF2. Social QoL also significantly increased in the d3RP-NF2 (16.32, 95% CI 6.66-25.97, p = 0.001), but improvement was not beyond the dHEP-NF2. Gains in QoL were clinically meaningful and maintained at the 6-month follow-up for d3RP-NF2 participants across all QoL domains. There were more treatment responders in the d3RP-NF2 compared to the dHEP-NF2. CONCLUSIONS: The d3RP-NF2 was well accepted, highly feasible, and resulted in sustained improvements in QoL in patients with NF2 who are deaf or have significant hearing loss.


Assuntos
Surdez/complicações , Perda Auditiva/complicações , Terapias Mente-Corpo/métodos , Neurofibromatose 2/terapia , Psicoterapia de Grupo/métodos , Qualidade de Vida , Videoconferência , Atividades Cotidianas , Adulto , Idoso , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neurofibromatose 2/etiologia , Prognóstico , Método Simples-Cego , Inquéritos e Questionários , Telemedicina , Adulto Jovem
12.
Drug Alcohol Depend ; 198: 140-149, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30928884

RESUMO

BACKGROUND: Training in interoceptive awareness is a promising behavioral approach for improving substance use disorder (SUD) treatment. This study examined the longitudinal effects of Mindful Awareness in Body-oriented Therapy (MABT) as an adjunct to women's SUD treatment. MABT teaches interoceptive awareness skills to promote self-care and emotion regulation. METHODS: Women in intensive outpatient treatment for SUD at three community clinics were recruited and randomly assigned to one of three study conditions Treatment as Usual (TAU) + MABT, TAU + Women's Health Education (WHE), and TAU only. Four assessments were delivered over one year (N = 187) baseline, 3, 6 and 12 months to examine primary outcome of percent days abstinent from substance use, and secondary outcomes of emotion dysregulation, craving, psychological distress, mindfulness and interoceptive awareness. Changes in outcomes across time were assessed using multilevel mixed effects linear regression. RESULTS: Substance use improved significantly for MABT vs. TAU at 6 months and 12 months. Positive longitudinal effects on secondary outcomes for MABT were evident on respiratory sinus arrhythmia (RSA), a physiological index of emotion regulation; on craving; and on interoceptive awareness skills. Analyses based on participants who completed >75% of the intervention sessions revealed additional immediate significant improvements for MABT vs. TAU and WHE on depressive symptoms and emotion regulation difficulties and longitudinal improvement on mindfulness skills. CONCLUSIONS: Results show MABT to be efficacious for longitudinal health outcomes to support women's recovery as an adjunct to community-based SUD treatment.


Assuntos
Interocepção , Terapias Mente-Corpo/métodos , Atenção Plena/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Conscientização , Depressão , Emoções , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do Tratamento , Adulto Jovem
13.
Complement Ther Med ; 43: 44-48, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935553

RESUMO

BACKGROUND AND PURPOSE: Fatigue is one of the most prevalent adverse events reported by cancer patients. The aim of this study was to investigate the association between traditional Chinese medicine body constitution (TCMBC) and moderate-to-severe cancer-related fatigue in cancer patients. MATERIALS AND METHODS: A cross-sectional study was conducted on cancer patients recruited from a regional hospital in southern Taiwan. The association between TCMBC, measured using the Constitution in Chinese Medicine Questionnaire (CCMQ) and moderate-to-severe cancer-related fatigue (based on the Taiwanese version of the Brief Fatigue Inventory score ≥ 4) was evaluated using multiple logistic regression analysis. RESULTS: Of the 170 participants, 37 (21.8%) had moderate-to-severe fatigue. Yang-deficiency (adjusted odds ratio [aOR] = 3.55, 95% confidence interval [CI] = 1.50-8.40) and Qi-deficiency (aOR = 2.84, 95% CI = 1.18-6.82) TCMBC were significantly associated with moderate-to-severe cancer-related fatigue. CONCLUSION: TCMBC could be used as a clinical tool to identify cancer patients prone to experience moderate-to-severe cancer-related fatigue, and to provide Chinese medicine practitioners a basis for selecting an appropriate treatment approach based on TCMBC.


Assuntos
Constituição Corporal/fisiologia , Fadiga/tratamento farmacológico , Fadiga/etiologia , Neoplasias/complicações , Estudos Transversais , Feminino , Humanos , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Terapias Mente-Corpo/métodos , Prevalência , Qi , Taiwan , Deficiência da Energia Yang/tratamento farmacológico
14.
Complement Ther Clin Pract ; 35: 361-367, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31003683

RESUMO

BACKGROUND AND PURPOSE: A massage therapy program was implemented to address the psychological well-being of family caregivers to patients in a rehabilitation hospital. The impact of massage "dosage" on caregiver stress and psychological well-being was examined in this study. Participants' perspectives on the program were also explored. MATERIALS AND METHODS: Thirty-eight family caregivers were randomized to receive either one massage per week or three massages per week for two weeks. Caregivers reported psychological symptoms and stress pre- and post-program. Program acceptability was assessed via responses on an exit survey. RESULTS: Overall, 79% of massages were received (89% among program completers). Post-program symptom scores were lower than baseline scores for both groups (F (1, 31) = 8.74 - 24.50, P < 0.01). Exit surveys indicated high program acceptability and perceived benefits. CONCLUSION: Findings suggest that massage services would be welcomed, utilized, and beneficial for improving the psychological well-being of family caregivers in a rehabilitation hospital.


Assuntos
Cuidadores/psicologia , Família/psicologia , Massagem/métodos , Terapias Mente-Corpo/métodos , Reabilitação/métodos , Estresse Psicológico/reabilitação , Adulto , Idoso , Feminino , Hospitais de Reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
15.
J Crohns Colitis ; 13(6): 673-685e, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-30820529

RESUMO

Patients with inflammatory bowel disease [IBD] increasingly use alternative and complementary therapies, for which appropriate evidence is often lacking. It is estimated that up to half of all patients with IBD use various forms of complementary and alternative medicine during some point in their disease course. Considering the frequent use of such therapies, it is crucial that physicians and patients are informed about their efficacy and safety in order to provide guidance and evidence-based advice. Additionally, increasing evidence suggests that some psychotherapies and mind-body interventions may be beneficial in the management of IBD, but their best use remains a matter of research. Herein, we provide a comprehensive review of some of the most commonly used complementary, alternative and psychotherapy interventions in IBD.


Assuntos
Terapias Complementares , Doenças Inflamatórias Intestinais/terapia , Psicoterapia , Terapia Cognitivo-Comportamental/métodos , Terapias Complementares/métodos , Consenso , Suplementos Nutricionais , Europa (Continente) , Medicina Herbária/métodos , Humanos , Terapias Mente-Corpo/métodos , Psicoterapia/métodos , Sociedades Médicas
16.
Breast ; 44: 135-143, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30776733

RESUMO

OBJECTIVE: Depressive symptoms are common comorbidities among breast cancer (BC) patients. Non-pharmacological therapies (NPTs) such as exercise and psychotherapy may reduce depressive symptoms; however, the evidence is inconclusive. The objective of this study is to evaluate if NPTs reduce depressive symptoms among BC patients. METHODS: A systematic review and meta-analysis of randomized clinical trials (RCTs) of NPTs for BC patients were performed. A literature search was conducted from eight databases in English, Portuguese and Spanish from 2006 to 2017. Inclusion criteria were: RCTs that evaluated depressive symptoms as a primary or secondary outcome that did not include pharmacological interventions and did include a non-intervened control group, with at least 30 participants in non-terminal BC stage with no current psychiatric illness. A meta-analysis for each NPT was performed with DerSimonian and Laird's method for the random effects model. Sensitivity analyses were conducted. Heterogeneity and publication bias were assessed. RESULTS: A total of 41 eligible RCTs were identified. Overall, NPTs significantly reduced depressive symptoms (Summary standardized mean difference (SMD) = -0.516; 95%CI: -0.814, -0.218; I2 = 96.2). Of the types of NPTs, psychotherapy significantly reduced depressive symptoms (Summary SMD = -0.819; 95% CI: -1.608, -0.030; I2 = 91.53). A significant difference emerged for Mindfulness (Summary SMD = -0.241; 95% CI: -0.412, -0.070; I2 = 28.6%) and yoga (Summary SMD = -0.305; 95% CI: -0.602, -0.007; I2 = 41.0%) when the heterogeneity was reduced. No evidence of publication bias was observed. CONCLUSIONS: Psychotherapy and mind-body therapies may reduce depressive symptoms in women with BC. Laughter and couples therapy warrant attention in future studies.


Assuntos
Neoplasias da Mama/terapia , Transtorno Depressivo/terapia , Terapias Mente-Corpo/métodos , Psicoterapia/métodos , Biorretroalimentação Psicológica/métodos , Neoplasias da Mama/complicações , Neoplasias da Mama/psicologia , Transtorno Depressivo/etiologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Relaxamento/métodos
17.
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
18.
Explore (NY) ; 15(2): 115-125, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30262161

RESUMO

INTRODUCTION: Healing is reported to be used by 16.8% of the population, however utilization may be considerably higher in selected patient groups. The aim of this study was to map the symptoms the participants reported when visiting a healer for the first time, and to evaluate the subjectively experienced benefits and risks from the healing sessions. METHOD: Data were obtained from the Measure Yourself Medical Outcome Profile (MYMOP) questionnaire. One-hundred adults who, for the first time, referred themselves to a healer in southern Norway between January 2016 and January 2017 were included in the study. Eligible for analyses were 92 participants who fulfilled their treatment plan and returned both the baseline (pre) and post-treatment questionnaire. The occurring symptoms were grouped according to their nature into four symptom groups: pain, psychological problems, fatigue and other. With regard to the observational character of the study, all results were described and interpreted descriptively and exact p-values were given and interpreted as measures of effect. RESULTS: The participants who visited the healers in this study were mainly women (80%) with chronic disease (82%), with pain, fatigue and/or psychological problems as main complaints. They experienced an improvement of symptoms, well-being and improved activity level of approximately 50% regardless of the nature of the complaints. Women reported more improvement than men did. The pre-post changes was found after an average of 4.1 treatments. Forty percent of the participants reported adverse effects, which occurred directly after the healing session, generally lasting for less than one day. CONCLUSION: The study participants reported substantial improvement of, and major reduction of the burden of symptoms, improved well-being and activity level after healing sessions. Due to the observational nature of the study, no interpretations about specificity of the descriptive results or the mechanisms of effect can be made.


Assuntos
Fadiga/terapia , Transtornos Mentais/terapia , Terapias Mente-Corpo/métodos , Manejo da Dor/métodos , Adulto , Idoso , Doença Crônica/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapias Mente-Corpo/efeitos adversos , Estudos Prospectivos , Autorrelato , Inquéritos e Questionários
19.
Psychother Res ; 29(2): 234-250, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-28532254

RESUMO

OBJECTIVE: Increasing evidence supports the efficacy of body-oriented psychotherapy (BPT) for schizophrenia. Yet, so far no research has investigated outcome in relation to therapy process: Why and how BPT is effective. In this study, we qualitatively explore participants' experience of a manualized BPT for schizophrenia to shed light on the process of therapeutic change. METHOD: We conducted in-depth interviews with 6 participants who completed a 10-week BPT group intervention. Interviews explored participants' experience of change and helpful aspects of therapy and were analysed using interpretative phenomenological analysis. FINDINGS: We identified six master themes across the interviews: (i) Being a whole: body-mind connection; (ii) Being agentic and being able; (iii) Being unique and worthy: Being accepted for who one is; (iv) Changing interactions: Engaging in authentic interpersonal contact; (v) Being part of a group: Feeling integrated; and (vi) Hope and investing in the future. CONCLUSION: We discuss the clinical implications for each theme and bring the findings together by describing therapeutic change in schizophrenia as a recovery of sense of self at different but interlocked levels. Moreover, we put forward recommendations for both specific and common factors for schizophrenia therapy. Clinical or methodological significance of this article: The clinical significance of this study is twofold. On the one hand, the findings of this analysis might inform the theory and practice of BPT and might directly feedback into a further development of the manual guidelines. On the other hand, common helpful factors have been identified thatmight also be relevant for the more general clinical practice concerning patients with schizophrenia. Here, we summarize our key messages for the clinical practitioner emerging from the findings: The inclusion of bodily aspects and a focus on pre-reflective experience in psychotherapy can help persons with schizophrenia recover the sense of being a body-mind unity. Empowering persons with schizophrenia, instead of instructing them, seems to foster a sense of agency and self-confidence, which are crucial to the recovery process. A twofold therapeutic stance characterized by openness towards the other and authenticity was experienced by patients as facilitating the rapport building. This might help persons with schizophrenia engage in the relation. Social inclusion might enhance therapeutic change and recovery in schizophrenia. Group therapy might be helpful for fostering a feeling of social belonging, but the inclusion in the wider social and community context remains a critical issue. The experience of joyful moments in psychotherapy might positively contribute to therapeutic change in that it fosters a sense of hope for the future. Overall our paper contributes to the literature aiming at expanding the range of therapeutic modalities, focussing on the creation and use of mixed models of therapy within and beyond talking practices.


Assuntos
Ego , Terapias Mente-Corpo/métodos , Satisfação do Paciente , Psicoterapia/métodos , Transtornos Psicóticos/terapia , Esquizofrenia/terapia , Autoimagem , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
20.
Med Clin North Am ; 103(1): 137-152, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30466670

RESUMO

Irritable bowel syndrome (IBS) is present in patients with symptoms of chronic abdominal pain and altered bowel habits but no identifiable organic etiology. Rome IV classification groups patients based on predominant stool pattern. Low-FODMAP diets have been helpful in providing symptom relief, as have cognitive behavioral and mind-body techniques that help patients manage symptoms. Targeted symptomatic relief for the patient's predominant symptoms provides relief in addition to effective older medications that are inexpensive and reliable. Newer treatments for IBS-D, such as eluxadoline, and IBS-C, with linaclotide, lubiprostone, plecanatide, also can provide durable relief.


Assuntos
Síndrome do Intestino Irritável/terapia , Dieta/métodos , Gerenciamento Clínico , Feminino , Fármacos Gastrointestinais/uso terapêutico , Humanos , Síndrome do Intestino Irritável/diagnóstico , Masculino , Terapias Mente-Corpo/métodos
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