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Grundler F, Mesnage R, Ruppert PMM, Kouretas D, Wilhelmi de Toledo F. Long-Term Fasting-Induced Ketosis in 1610 Subjects: Metabolic Regulation and Safety. Nutrients 2024; 16:1849. [PMID: 38931204 PMCID: PMC11206495 DOI: 10.3390/nu16121849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND There is a growing consensus that fasting-induced ketosis has beneficial effects on human physiology. Despite these compelling benefits, fasting-induced ketosis raises concerns in some clinicians because it is often inappropriately compared with the pathologic uncontrolled ketone production in diabetic ketoacidosis. The determinants of the inter-individual differences in the intensity of ketosis during long-term fasting is unknown. METHODS We monitored daily variations in fasting ketonemia, as well as ketonuria, which is less invasive, in a large cohort of 1610 subjects, fasting between 4 and 21 days with the Buchinger Wilhelmi program, minimally supplemented with ~75-250 kcal (daily fruit juice, vegetable soup, and honey). RESULTS Ketonuria was detected in more than 95% of fasting subjects from day 4 onwards. Subjects consuming only soups, without fruit juice or honey, exhibited reduced caloric intake (72 kcal instead of 236 kcal) and carbohydrate intake (15.6 g instead of 56.5 g), leading to more intense ketonuria. Participants with high ketonuria were, in the majority, males, young, had a higher body weight, and had lower HDL-C and urea values. They had a larger decrease in blood glucose, glycated haemoglobin levels, body weight, and waist circumference. Furthermore, in the high-ketonuria group, a larger increase in blood uric acid concentration was observed. CONCLUSION Our study showed that long-term fasting triggered ketosis, never reaching pathological levels, and that ketosis is influenced by age, gender, health, and the level of physical activity. Furthermore, it is modulated but not suppressed by minimal carbohydrate intake. Our study paves the way for better understanding how supplementation can modulate the therapeutic effects and tolerability of long-term fasting.
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Affiliation(s)
- Franziska Grundler
- Buchinger Wilhelmi Clinic, Wilhelmi-Beck-Straße 27, 88662 Überlingen, Germany; (F.G.); (F.W.d.T.)
| | - Robin Mesnage
- Buchinger Wilhelmi Clinic, Wilhelmi-Beck-Straße 27, 88662 Überlingen, Germany; (F.G.); (F.W.d.T.)
- Gene Expression and Therapy Group, King’s College London, Faculty of Life Sciences & Medicine, Department of Medical and Molecular Genetics, 8th Floor, Tower Wing, Guy’s Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Philip M. M. Ruppert
- Department for Biochemistry and Molecular Biology (BMB), University of Southern Denmark, 5230 Odense, Denmark;
| | - Demetrios Kouretas
- Department of Biochemistry-Biotechnology, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece;
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Sant'Anna EM, Paiva SPC, Santos RP, Rodrigues AMS, Davis NA, Nery SF, Maia FP, Ferreira AVM, Reis FM. Mindfulness-based program to support lifestyle modification and weight loss in infertile women: randomized controlled trial. J Psychosom Obstet Gynaecol 2022; 43:136-144. [PMID: 32972271 DOI: 10.1080/0167482x.2020.1823962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE We evaluated the short-term effects of a mindfulness-based program (MBP) on weight loss through lifestyle modification in infertile women who were overweight or obese. METHODS The participants were randomly assigned to 8 consecutive weekly sessions of MBP plus diet or diet alone. Both groups received a customized dietary plan. Body measures were taken and a questionnaire was applied to evaluate dietary habits at baseline and three months later. RESULTS The study was completed by 28 women in the MBP group and 24 in the control group. Body weight decreased 1.8 kg (2.1%) in the MBP group (p = 0.001, follow-up vs. baseline) and 1.7 kg (1.9%) in the control group (p = 0.035). There was an average reduction of 2.9 cm of waist circumference in the MBP group (p = 0.008) and 0.3 cm in the control group (p = 0.633). There was a significant reduction in the daily energy intake of the women attending the MBP (mean difference -430 Kcal/day, p=0.010) whereas no significant change was observed in the control group. CONCLUSION In the short term, this MBP did not affect weight loss in infertile women, but the MBP intervention contributed to reduce waist circumference, possibly due to a significant decrease in food energy intake. TRIAL REGISTRATION NUMBER RBR-7by76r.
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Affiliation(s)
- Edna M Sant'Anna
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sara P C Paiva
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raphael P Santos
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana M S Rodrigues
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Nakita A Davis
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Simone F Nery
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernanda P Maia
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adaliene V M Ferreira
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernando M Reis
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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3
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Savaş BB, Märtens B, Cramer H, Voiss P, Longolius J, Weiser A, Ziert Y, Christiansen H, Steinmann D. Effects of an Interdisciplinary Integrative Oncology Group-Based Program to Strengthen Resilience and Improve Quality of Life in Cancer Patients: Results of a Prospective Longitudinal Single-Center Study. Integr Cancer Ther 2022; 21:15347354221081770. [PMID: 35225054 PMCID: PMC8891834 DOI: 10.1177/15347354221081770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Patients with cancer receiving oncological treatment often suffer from a reduced quality of life (QoL) and resilience. OBJECTIVES The aim of this study was to evaluate the effect of an interdisciplinary integrative oncology group-based program on resilience and quality of life in patients with cancer during or after conventional oncological therapy. METHODS This prospective longitudinal single-center study evaluated the resilience (Resilience Scale), quality of life (EORTC-QLQ C30), anxiety, depression (Hospital Anxiety and Depression Scale), and distress levels (Distress Thermometer) of 60 patients with cancer who participated in a 10-week interdisciplinary integrative oncology group-based program during or after cancer treatment in outpatient clinics. An average of 12 (range 11-13) patients participated in each 10-week group. The program included recommendations for diet, stress management, relaxation, and exercise, as well as naturopathic self-help strategies and psychosocial support. RESULTS There were slight increases in global quality of life scores (week 0: 58.05 ± 20.05 vs week 10: 63.13 ± 18.51, n = 59, P = .063, d = -.25) and resilience scores (week 0: 63.50 ± 13.14 vs week 10: 66.15 ± 10.17, n = 52, P = .222, d = -.17) after the group program compared to before; however, these changes were not statistically significant and had small effect sizes. Patients with at least moderate anxiety symptoms (P = .022, d = .42) and low resilience (P = .006, d = -.54) benefited most from the program. The patients reported no relevant side effects or adverse events from the program. CONCLUSIONS No significant effects on global quality of life or resilience were found in the general sample; notably, patients with anxiety and low initial resilience benefited the most from the program.
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Affiliation(s)
- Burcu Babadağ Savaş
- Department of Radiation Therapy and Special Oncology, Medical School Hannover, Hannover, Germany
| | - Bettina Märtens
- Department of Radiation Therapy and Special Oncology, Medical School Hannover, Hannover, Germany
| | | | - Petra Voiss
- University of Duisburg-Essen, Essen, Germany
| | - Julia Longolius
- Department of Radiation Therapy and Special Oncology, Medical School Hannover, Hannover, Germany
| | - Axel Weiser
- Department of Organisation, Innovation and Quality of Management, Medical School Hannover, Hannover, Germany
| | - Yvonne Ziert
- Institute of Biometrics, Medical School Hannover, Hannover, Germany
| | - Hans Christiansen
- Department of Radiation Therapy and Special Oncology, Medical School Hannover, Hannover, Germany
| | - Diana Steinmann
- Department of Radiation Therapy and Special Oncology, Medical School Hannover, Hannover, Germany
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4
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Johansson LM, Lingfors H, Golsäter M, Kristenson M, Fransson EI. Physical activity related to mastery and vitality in a Swedish adult population with economic difficulties. BMC Public Health 2021; 21:2193. [PMID: 34847894 PMCID: PMC8638203 DOI: 10.1186/s12889-021-12194-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background People with low socio-economic status report lower levels of physical activity (PA). There is insufficient knowledge about the availability of psychological resources for those who are physically active despite having a low socio-economic status. The aim of this study is to investigate the association between PA level and mastery and vitality, respectively, within an adult population with self-reported economic difficulties. Method Data from a cross-sectional, population-based study (n = 817) were used. Linear regression was used to estimate the unstandardised regression coefficient (β) with 95% confidence intervals (95% CI), describing associations between PA levels (independent variable) and scale scores of psychological resources in terms of mastery and vitality (outcome variables). Three models were constructed: Model I unadjusted; Model II adjusted for sex and age; and Model III adjusted for sex, age, smoking and food quality. Result After adjusting for sex, age, smoking and food quality and using low-level PA as the reference, high-level PA, but not intermediate-level PA, was related to higher scale scores of mastery (β = 0.72 [95% CI 0.08 to 1.37]). For vitality, both high-level PA and intermediate-level PA were related to higher scale scores (β = 9.30 [95% CI 5.20 to 13.40] and β = 6.70 [95% CI 1.40 to 12.00] respectively). Conclusion In an adult population with self-reported economic difficulties, higher levels of physical activity were related to higher mastery and vitality. Our results support that the association between physical activity and psychological resources in terms of mastery and vitality should be considered in the context of targeted health dialogues. Trial registration number Not applicable. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12194-6.
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Affiliation(s)
- Lisbeth M Johansson
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden. .,Linköping University, Linköping, Sweden. .,The A.D.U.L.T. Research Group, School of Health and Welfare, Jönköping University, Box 1026, 551 11, Jönköping, Sweden.
| | - Hans Lingfors
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.,Linköping University, Linköping, Sweden
| | - Marie Golsäter
- Linköping University, Linköping, Sweden.,Child Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Margareta Kristenson
- Unit for Health, Medicine and Care, Department of Medicine and Health, Linköping University, Linköping, Sweden
| | - Eleonor I Fransson
- The A.D.U.L.T Research Group, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Boyd B, McAlister C, Arrotta K, Schmitter-Edgecombe M. Self-Reported Behavior Change and Predictors of Engagement With a Multidomain Brain Health Intervention for Midlife and Older Adults: A Pilot Clinical Trial. J Aging Health 2021; 34:109-119. [PMID: 34266343 DOI: 10.1177/08982643211032483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study evaluated the efficacy of a multidomain brain health intervention on health behavior change and sought to understand whether health literacy or brain health knowledge predicted engagement with the intervention. METHODS One-hundred thirty midlife and older adults were assigned to one of three intervention conditions: brain fitness (B-Fit) utilizing education and goal setting, education-only, or waitlist. Questionnaires were completed at baseline and post-intervention. RESULTS Both B-Fit and education-only conditions reported improvements in health behaviors over time. Although effect size for the education-only condition was moderate, only the B-Fit condition differed significantly in health behaviors from the waitlist post-intervention. Lower baseline brain health knowledge predicted improvements in health behaviors for education-only condition. DISCUSSION The multidomain brain health intervention was successful in helping participants change their behaviors, but it was not more effective than the education-only condition. For those with lower brain health knowledge, an education-only intervention may be sufficient to encourage behavior change.
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Affiliation(s)
- Brenna Boyd
- 6760Washington State University, Pullman, WA, USA
| | | | - Kayela Arrotta
- Neurological Institute, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA
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Egoshi S, Hayashi S, Horie J, Shiranita S, Watanabe H, Kawaura F, Takahashi K, Asami T, Sueoka-Aragane N. Effect of health locus of control on physical activity in stable patients with chronic obstructive pulmonary diseases. J Phys Ther Sci 2021; 33:480-488. [PMID: 34177112 PMCID: PMC8219604 DOI: 10.1589/jpts.33.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/26/2021] [Indexed: 12/04/2022] Open
Abstract
[Purpose] A strong correlation exists between low physical activity and the prognosis of patients with chronic obstructive pulmonary disease (COPD). The interaction between psychological factors and low physical activity remains unclear in patients with COPD. Here, we investigated the impact of the health locus of control (HLOC) on the response to an education program in patients with COPD. [Participants and Methods] We assessed the physical activities and HLOC in participants with COPD before and after a five-month education program. We assessed physical activity using the Japanese version of the International Physical Activity Questionnaire (IPAQ). We evaluated the HLOC using the Japanese version of the HLOC scales. We provided an identical educational program to all participants after the initial evaluation. [Results] The total activity and walking scores were significantly elevated after the intervention. We observed a significant negative correlation between the IPAQ Total score after the intervention and the supernatural HLOC. We also observed significant negative correlations between the IPAQ Vigorous score after the intervention and Family HLOC and Chance HLOC. [Conclusion] The response of patients with COPD to self-care educational programs was influenced by the HLOC.
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Affiliation(s)
- Shojiro Egoshi
- Department of Physical Therapy, Faculty of Health Science,
Kyoto Tachibana University: 34 Oyakeyamada-cho, Yamashina-ku, Kyoto 607-8175, Japan
- Specified Nonprofit Corporation Hagakure Respiratory Care
Network, Japan
| | - Shinichiro Hayashi
- Department of Respiratory Medicine, Kohokai Takagi
Hospital, Japan
- Department of Rehabilitation Medicine, Saga University
Hospital, Japan
- Specified Nonprofit Corporation Hagakure Respiratory Care
Network, Japan
| | - Jun Horie
- Department of Physical Therapy, Faculty of Health Science,
Kyoto Tachibana University: 34 Oyakeyamada-cho, Yamashina-ku, Kyoto 607-8175, Japan
- Specified Nonprofit Corporation Hagakure Respiratory Care
Network, Japan
| | - Shuichi Shiranita
- Choseido Watanabe Clinic, Japan
- Specified Nonprofit Corporation Hagakure Respiratory Care
Network, Japan
| | - Hisashi Watanabe
- Choseido Watanabe Clinic, Japan
- Specified Nonprofit Corporation Hagakure Respiratory Care
Network, Japan
| | - Futoshi Kawaura
- Department of Respiratory Medicine, Kohokai Takagi
Hospital, Japan
- Specified Nonprofit Corporation Hagakure Respiratory Care
Network, Japan
| | - Koichiro Takahashi
- Division of Hematology, Respiratory Medicine, and Oncology,
Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
- Specified Nonprofit Corporation Hagakure Respiratory Care
Network, Japan
| | - Toyoko Asami
- Department of Rehabilitation Medicine, Saga University
Hospital, Japan
| | - Naoko Sueoka-Aragane
- Division of Hematology, Respiratory Medicine, and Oncology,
Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
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Litrownik D, Gilliam EA, Wayne PM, Richardson CR, Kadri R, Rist PM, Moy ML, Yeh GY. Development of a Novel Intervention (Mindful Steps) to Promote Long-Term Walking Behavior in Chronic Cardiopulmonary Disease: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e27826. [PMID: 33913819 PMCID: PMC8120426 DOI: 10.2196/27826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite current rehabilitation programs, long-term engagement in physical activity remains a significant challenge for patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF). Novel strategies to promote physical activity in these populations are greatly needed. Emerging literature on the benefits of both mind-body interventions and web-based interventions provide the rationale for the development of the Mindful Steps intervention for increasing walking behavior. OBJECTIVE This study aims to develop a novel multimodal mind-body exercise intervention through adaptation of an existing web-based physical activity intervention and incorporation of mind-body exercise, and to pilot test the delivery of the new intervention, Mindful Steps, in a randomized controlled feasibility trial in older adults with COPD and/or HF. METHODS In phase 1, guided by a theoretical conceptual model and review of the literature on facilitators and barriers of physical activity in COPD and HF, we convened an expert panel of researchers, mind-body practitioners, and clinicians to inform development of the novel, multimodal intervention. In phase 2, we are conducting a pilot randomized controlled feasibility trial of the Mindful Steps intervention that includes in-person mind-body exercise classes, an educational website, online mind-body videos, and a pedometer with step-count feedback and goals to increase walking behavior in patients with COPD and/or HF. Outcomes include feasibility measures as well as patient-centered measures. RESULTS The study is currently ongoing. Phase 1 intervention development was completed in March 2019, and phase 2 data collection began in April 2019. CONCLUSIONS Through the integration of components from a web-based physical activity intervention and mind-body exercise, we created a novel, multimodal program to impact long-term physical activity engagement for individuals with COPD and HF. This developmental work and pilot study will provide valuable information needed to design a future clinical trial assessing efficacy of this multimodal approach. TRIAL REGISTRATION ClinicalTrials.gov NCT03003780; https://clinicaltrials.gov/ct2/show/NCT03003780. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/27826.
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Affiliation(s)
- Daniel Litrownik
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Elizabeth A Gilliam
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
| | | | - Reema Kadri
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Pamela M Rist
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
| | - Marilyn L Moy
- Pulmonary and Critical Care Section, Department of Medicine, Veterans Administration Boston Healthcare System, Boston, MA, United States
| | - Gloria Y Yeh
- Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, United States
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8
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Cramer H. Eine Frage der Kontrolle: Zunehmende Abgabe der Eigenverantwortung für die Gesundheit und was das mit uns zu tun hat. Complement Med Res 2020; 28:5-8. [PMID: 33373984 DOI: 10.1159/000513876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Holger Cramer
- Klinik für Naturheilkunde und Integrative Medizin, Evang. Kliniken Essen-Mitte, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland,
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9
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Classical Chinese medicine self-care: Participants' perspectives on a pilot program for community health. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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10
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Wells RE. Mindfulness as one component of an integrative approach to migraine treatment in clinical practice: companion editorial. Expert Rev Neurother 2020; 20:199-202. [PMID: 32000542 DOI: 10.1080/14737175.2020.1724783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Rebecca Erwin Wells
- Comprehensive Headache Program, Center for Integrative Medicine, Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC, USA
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Health Locus of Control Is Associated With Physical Activity and Other Health Behaviors in Cardiac Patients. J Cardiopulm Rehabil Prev 2019; 38:394-399. [PMID: 30106790 DOI: 10.1097/hcr.0000000000000350] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Physical inactivity, smoking, and excessive alcohol use are well-recognized modifiable risk factors for cardiovascular disease (CVD), yet uptake of strategies to mitigate these poor health behaviors varies widely among patients with cardiovascular disease. Part of this variation may be explained by health locus of control (HLOC), defined as the extent to which individuals believe their health is a consequence of their own actions, chance, or the influence of others (eg, physicians). METHODS A total of 599 cardiac outpatients (30% female, 61.4 ± 9.4 y of age) completed the Multidimensional Health Locus of Control questionnaire and a structured health behavior questionnaire assessing physical activity, smoking, and alcohol use, at baseline and a 4-y follow-up. Relationships between health behaviors and HLOC were assessed cross-sectionally and longitudinally using general linear models and logistic regression models adjusting for medical and sociodemographic factors. RESULTS Higher Internal HLOC was found to be associated with higher levels of leisure time physical activity (LTPA) (β = .21, P = .0008), while lower Internal HLOC was associated with decreasing levels of alcohol consumption over time (β = .26, P = .03). Increasing Chance HLOC was related to lower levels of leisure time physical activity (β = -.15, P = .047) and increased likelihood of being a smoker (β = .10, P = .01), and increasing physician HLOC was associated with decreased likelihood of being a smoker (β = -.17, P = .01). CONCLUSIONS Associations between HLOC and multiple health behaviors were observed in a large sample of cardiac outpatients. Results suggest that assessing and targeting HLOC beliefs of cardiac patients may be clinically relevant for behavior change in settings, such as in rehabilitation programs where behavior change is a goal.
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How Can Stoic Philosophy Inspire Psychosocial Genetic Counseling Practice? An Introduction and Exploration. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2019. [DOI: 10.1007/s10942-019-00330-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Bishop FL, Lauche R, Cramer H, Pinto JW, Leung B, Hall H, Leach M, Chung VC, Sundberg T, Zhang Y, Steel A, Ward L, Sibbritt D, Adams J. Health Behavior Change and Complementary Medicine Use: National Health Interview Survey 2012. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E632. [PMID: 31554323 PMCID: PMC6843558 DOI: 10.3390/medicina55100632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 12/18/2022]
Abstract
Background and objectives: Complementary and alternative medicine (CAM) use has been associated with preventive health behaviors. However, the role of CAM use in patients' health behaviors remains unclear. This study aimed to determine the extent to which patients report that CAM use motivates them to make changes to their health behaviors. Materials and Methods: This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. Results: Overall, 45.4% of CAM users reported being motivated by CAM to make positive health behavior changes, including exercising more regularly (34.9%), eating healthier (31.4%), eating more organic foods (17.2%), reducing/stopping smoking (16.6% of smokers), or reducing/stopping drinking alcohol (8.7% of drinkers). Individual CAM therapies motivated positive health behavior changes in 22% (massage) to 81% (special diets) of users. People were more likely to report being motivated to change health behaviors if they were: aged 18-64 compared to those aged over 65 years; of female gender; not in a relationship; of Hispanic or Black ethnicity, compared to White; reporting at least college education, compared to people with less than high school education; without health insurance. Conclusions: A sizeable proportion of respondents were motivated by their CAM use to undertake health behavior changes. CAM practices and practitioners could help improve patients' health behavior and have potentially significant implications for public health and preventive medicine initiatives; this warrants further research attention.
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Affiliation(s)
- Felicity L Bishop
- Department of Psychology, University of Southampton, Southampton SO17 1BJ, UK.
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Sozialstiftung Bamberg, 96049 Bamberg, Germany.
| | - Holger Cramer
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Department of Internal and Integrative Medicine, University of Duisburg-Essen, 45276 Essen, Germany.
| | - Jonquil W Pinto
- Department of Psychology, University of Southampton, Southampton SO17 1BJ, UK.
| | - Brenda Leung
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Faculty of Health Sciences, University of Lethbridge, Alberta T1K 3M4, Canada.
| | - Helen Hall
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Faculty of Medicine, Monash University, Clayton, VIC 3800, Australia.
| | - Matthew Leach
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Department of Rural Health, University of South Australia, Whyalla Norrie SA 5608, Australia.
| | - Vincent Ch Chung
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Jockey Club School of Public Health & Primary Care and School of Chinese Medicine, The Chinese University of Hong Kong, Sha Tin 999077, Hong Kong.
| | - Tobias Sundberg
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Musculoskeletal & Sports Injury Epidemiology Center (MUSIC), Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | - Yan Zhang
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, Texas 76109, USA.
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
| | - Lesley Ward
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK.
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
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14
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Harvie A, Steel A, Wardle J. Traditional Chinese Medicine Self-Care and Lifestyle Medicine Outside of Asia: A Systematic Literature Review. J Altern Complement Med 2019; 25:789-808. [PMID: 31274332 DOI: 10.1089/acm.2018.0520] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Chinese medicine, when applied as a whole system of care, traditionally incorporates self-care techniques and patient understanding as key aspects of patient recovery and health maintenance. Objectives: This review aims to explore the literature to date on Traditional Chinese Medicine (TCM) self-care in settings outside of Asia, beyond the sole application of t'ai chi or qigong, to consider simple self-care techniques as health care interventions that may be generalized to a wider population. Design: AMED, CINAHL, EMBASE, PubMed, and MEDLINE databases were searched for articles from inception to July 2018. Studies were included, which were undertaken in settings outside of Asia and/or Asian communities, and were excluded if they solely examined t'ai chi or qigong. Results: Findings of the included studies (n = 37) were categorized into four key areas in relation to the TCM self-care component evaluated: self-acupressure, self-acupuncture, self-moxibustion, and the adoption of prescribed lifestyle, diet, and exercise advice based on a TCM diagnosis. The studies included randomized clinical trials, case studies, hospital audits, and qualitative evaluations. The studies assessed TCM self-care in relation to a wide range of health conditions, with the majority of studies concluding positive findings. Conclusion: This review draws attention to the potential role of TCM self-care techniques, in settings outside of Asia, beyond the sole practices of t'ai chi and qigong, as an adjunct to health maintenance and recovery. Only tentative conclusions can be drawn from the existing research, however, due to variability across studies in reporting transparency and the overall low number of studies retrieved. Further research is warranted.
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Affiliation(s)
- Alaia Harvie
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Amie Steel
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia.,2Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Wardle
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia.,2Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Characteristics of yoga and meditation users among older Australian women - results from the 45 and up study. Complement Ther Clin Pract 2019; 35:219-223. [PMID: 31003661 DOI: 10.1016/j.ctcp.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE Yoga and meditation are predominantly utilised by healthy well-educated young women, but little is known about utilisation by older chronically ill women. Therefore, the purpose of this study was to investigate the characteristics of yoga and meditation use among middle-to-higher aged Australian women with chronic conditions. MATERIALS AND METHODS This is a sub-study of the 45 and Up Study including 1925 Australian women aged 53-95 years diagnosed with chronic conditions (asthma, depression, diabetes, osteoarthritis, and osteoporosis). Information on yoga and meditation use frequencies (categories: 'no yoga', 'at least once daily', 'at least once weekly', and 'at least once monthly'), self-perceived effectiveness and communication with health care providers were assessed via self-report. Logistic regression analyses were conducted to identify independent predictors of yoga and meditation use, using SPSS 24.0. RESULTS Overall 6.8% and 10.7% of women reported the use of yoga and meditation respectively. Meditation was rarely practiced supervised (11.7%), compared to significant higher rates in yoga (53.2%). Predictors for yoga and meditation use were marital status (married/in relationship > not married/in relationship), higher health related hardiness, and higher education, whereas obesity, and diabetes decreased likelihood of use. While the majority found yoga and meditation helpful for their condition, the use was rarely monitored by or discussed with health care practitioners. CONCLUSION This study finds that yoga and meditation are used by middle-to-higher aged Australian women with chronic illnesses. The lack of communication with health care providers is concerning and might hinder coordinated and effective health care around chronic illness. Further research is necessary to help understand possible concurrent health care use and thereby help inform safe, effective and coordinate health seeking amongst those with chronic illness.
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16
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Fortney L. Recommending Meditation. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00100-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Coping Styles Mediate the Relationship Between Self-esteem, Health Locus of Control, and Health-Promoting Behavior in Chinese Patients With Coronary Heart Disease. J Cardiovasc Nurs 2017; 32:331-338. [DOI: 10.1097/jcn.0000000000000357] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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18
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Lee AC, Harvey WF, Price LL, Morgan LPK, Morgan NL, Wang C. Mindfulness is associated with psychological health and moderates pain in knee osteoarthritis. Osteoarthritis Cartilage 2017; 25:824-831. [PMID: 27349461 PMCID: PMC5183521 DOI: 10.1016/j.joca.2016.06.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 05/05/2016] [Accepted: 06/17/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Previous studies suggest that higher mindfulness is associated with less pain and depression. However, the role of mindfulness has never been studied in knee osteoarthritis (OA). We evaluate the relationships between mindfulness and pain, psychological symptoms, and quality of life in knee OA. METHOD We performed a secondary analysis of baseline data from our randomized comparative trial in participants with knee OA. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). We measured pain, physical function, quality of life, depression, stress, and self-efficacy with commonly-used patient-reported measures. Simple and multivariable regression models were utilized to assess associations between mindfulness and health outcomes. We further tested whether mindfulness moderated the pain-psychological outcome associations. RESULTS Eighty patients were enrolled (60.3 ± 10.3 years; 76.3% female, body mass index: 33.0 ± 7.1 kg/m2). Total mindfulness score was associated with mental (beta = 1.31, 95% CI: 0.68, 1.95) and physical (beta = 0.69, 95% CI:0.06, 1.31) component quality of life, self-efficacy (beta = 0.22, 95% CI:0.07, 0.37), depression (beta = -1.15, 95% CI:-1.77, -0.54), and stress (beta = -1.07, 95% CI:-1.53, -0.60). Of the five facets, the Describing, Acting-with-Awareness, and Non-judging mindfulness facets had the most associations with psychological health. No significant association was found between mindfulness and pain or function (P = 0.08-0.24). However, we found that mindfulness moderated the effect of pain on stress (P = 0.02). CONCLUSION Mindfulness is associated with depression, stress, self-efficacy, and quality of life among knee OA patients. Mindfulness also moderates the influence of pain on stress, which suggests that mindfulness may alter the way one copes with pain. Future studies examining the benefits of mind-body therapy, designed to increase mindfulness, for patients with OA are warranted.
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Affiliation(s)
- Augustine C. Lee
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - William F. Harvey
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Lucas P. K. Morgan
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA; I Ola Lahui Rural Hawai'i Behavioral Health, Honolulu, HI, USA
| | - Nani L. Morgan
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA,Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
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19
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Daniel M, Abendroth M, Erlen JA. Barriers and Motives to PA in South Asian Indian Immigrant Women. West J Nurs Res 2017; 40:1339-1356. [PMID: 28281387 DOI: 10.1177/0193945917697218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The high prevalence of chronic illnesses in South Asian Indian immigrant women underscores the need for identifying factors that could influence their PA. The purpose of this qualitative study was to examine the perspectives of South Asian Indian immigrant women related to barriers to and motives for lifestyle PA within the PA Framework for South Asian Indian Immigrants. Forty women participated in focus groups that were conducted in English and Hindi. Focus group questions were open-ended and semistructured. Transcribed and de-identified audiotaped sessions were coded and analyzed using Atlas.ti software. Role expectation was a core theme for barriers with four subthemes: lack of time, loss of interest, diminished social support, and environmental constraints. Self-motivation was a core theme for motives with three subthemes: optimal physical and psychological health, emphasis on external beauty, and strong social support. Future PA interventions need to target these culturally sensitive factors.
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20
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Ostermann T, Lauche R, Cramer H, Dobos G. Comparative cost analysis of inpatient integrative medicine-Results of a pilot study. Complement Ther Med 2016; 32:129-133. [PMID: 28619299 DOI: 10.1016/j.ctim.2016.11.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 09/26/2016] [Accepted: 11/27/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Costs of integrative treatment alone and in comparison with other treatment approaches have scarcely been reported in the past. This study presents results of a comparative cost analysis of an inpatient integrative medicine treatment costs. METHODS Data from 2006 for inpatients referred to a Department of Integrative Medicine in Germany were used. Case-related treatment costs were calculated, and transformed into Casemix-Indices and revenues per DRG. Costs were compared between departments at the same hospital and between different hospitals using univariate statistics and Chi-Square tests. RESULTS In total 1253 inpatients (81.4% female, 61.1±14.4years) were included in the current analysis. Most patients were treated for diseases of the musculoskeletal system (57.2%), followed by diseases of the digestive system (11.4%), and diseases of the nervous system (10.4%). The department received an additional payment for most of the patients (88.0%), which led to an effective appreciation of 10.8% per case compared to the standardized Casemix-Index. In-house comparisons with other departments found the department in close vicinity to the departments of Internal medicine with regards to CMI and mean revenue, however the Patient Clinical Complexity Level was significantly lower in the Integrative medicine department. The interhospital comparison revealed comparable Casemix-Index and DRG-revenue, however the additional payment increased the mean revenue significantly. CONCLUSION Modern integrative in-patient treatment is mostly cost-equivalent to conventional treatment. Cost effectiveness studies should be considered to further investigate the potential of integrative in patient treatment.
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Affiliation(s)
- Thomas Ostermann
- Chair of Research Methodology and Statistics in Psychology, Department of Psychology and Psychotherapy, Faculty of Health, University of Witten-Herdecke, Witten, Germany.
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Holger Cramer
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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21
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Gause NK, Elliott JC, Delker E, Stohl M, Hasin D, Aharonovich E. Association between change in self-efficacy to resist drinking and drinking behaviors among an HIV-infected sample: Results from a large randomized controlled trial. J Health Psychol 2016; 23:829-839. [PMID: 27577039 DOI: 10.1177/1359105316664127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Heavy drinking among HIV-infected individuals is associated with health complications. Health-behavior self-efficacy may be characteristically low among this population or negatively affected by HIV-infected status. We assessed whether self-efficacy to resist drinking increased during brief educational and motivational drinking-reduction interventions within HIV primary care and whether increases in self-efficacy predicted drinking among HIV-infected heavy drinkers. Results indicate that increases in self-efficacy from baseline to end-of-intervention inversely predicted drinking at end-of-intervention and at follow-up. Findings suggest that brief treatment interventions within HIV primary care may promote self-efficacy and that increases in self-efficacy predict initiation and maintenance of drinking reductions among HIV patients.
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Affiliation(s)
- Nicole K Gause
- 1 Department of Psychology, University of Cincinnati, USA.,2 New York State Psychiatric Institute, USA
| | - Jennifer C Elliott
- 2 New York State Psychiatric Institute, USA.,3 Department of Psychiatry, Columbia University Medical Center, USA
| | - Erin Delker
- 4 Department of Epidemiology, San Diego State University/University of California, USA
| | | | - Deborah Hasin
- 2 New York State Psychiatric Institute, USA.,3 Department of Psychiatry, Columbia University Medical Center, USA.,5 Department of Epidemiology, Mailman School of Public Health, Columbia University, USA
| | - Efrat Aharonovich
- 2 New York State Psychiatric Institute, USA.,3 Department of Psychiatry, Columbia University Medical Center, USA
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22
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Griffin KH, Nate KC, Rivard RL, Christianson JB, Dusek JA. Referrals to integrative medicine in a tertiary hospital: findings from electronic health record data and qualitative interviews. BMJ Open 2016; 6:e012006. [PMID: 27456330 PMCID: PMC4964262 DOI: 10.1136/bmjopen-2016-012006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To examine patterns of, and decision-making processes, informing referrals for inpatient access to integrative medicine (IM) services at a large, acute care hospital. DESIGN Retrospective electronic health record review and structured qualitative interviews. SETTING A 630-bed tertiary care hospital with an IM service available to inpatients. PARTICIPANTS IM referrals of all inpatients aged ≥18 years between July 2012 and December 2014 were identified using the hospital's electronic health record. Fifteen physicians, 15 nurses and 7 administrators were interviewed to better understand roles and perspectives in referring patients for IM services. RESULTS In the study hospital, primary sources of referrals for IM services were the orthopaedic and neuroscience/spine service lines. While the largest absolute number of IM referrals was made for patients with lengths of stay of 3 days or fewer, a disproportionate number of total IM referrals was made for patients with long lengths of stay (≥10 days), compared with a smaller percentage of patients in the hospital with lengths of stay ≥10 days. Physicians and nurses were more likely to refer patients who displayed strong symptoms (eg, pain and anxiety) and/or did not respond to conventional therapies. IM referrals were predominantly nurse-initiated. A built-in delay in the time from referral initiation to service delivery discouraged referrals of some patients. CONCLUSIONS Conventional providers refer patients for IM services when these services are available in a tertiary hospital. Referral patterns are influenced by patient characteristics, operational features and provider perspectives. Nurses play a key role in the referral process. Overcoming cultural and knowledge differences between conventional and IM providers is likely to be a continuing challenge to providing IM in inpatient settings.
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Affiliation(s)
- Kristen H Griffin
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Kent C Nate
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Rachael L Rivard
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Jon B Christianson
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Jeffery A Dusek
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
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23
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Saha FJ, Brüning A, Barcelona C, Büssing A, Langhorst J, Dobos G, Lauche R, Cramer H. Integrative medicine for chronic pain: A cohort study using a process-outcome design in the context of a department for internal and integrative medicine. Medicine (Baltimore) 2016; 95:e4152. [PMID: 27399133 PMCID: PMC5058862 DOI: 10.1097/md.0000000000004152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables. METHODS Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients' pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed. RESULTS A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P < 0.05). Ability to change and implementation, disease acceptance, mindfulness, life and health satisfaction, and light heartedness/easiness likewise improved (all P < 0.05). Improved outcomes were associated with increases in process variables, mainly ability to change and implementation, disease acceptance, life and health satisfaction, and light heartedness/easiness (R = 0.03-0.40). CONCLUSIONS Results of this study suggest that a 2-week integrative medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction.
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Affiliation(s)
- Felix J Saha
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen Center for Integrative Medicine, Faculty of Medicine, University of Witten/Herdecke, Herdecke, Germany Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
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24
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Ramondetta LM, Meyer LA, Schmeler KM, Daheri ME, Gallegos J, Scheurer M, Montealegre JR, Milbourne A, Anderson ML, Sun CC. Avoidable tragedies: Disparities in healthcare access among medically underserved women diagnosed with cervical cancer. Gynecol Oncol 2015; 139:500-5. [PMID: 26498912 PMCID: PMC7418500 DOI: 10.1016/j.ygyno.2015.10.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/19/2015] [Accepted: 10/20/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND The purpose was to identify barriers including logistical and health belief correlates of late stage presentation of cervical cancer (CxCa) among medically underserved women presenting to a safety net health care system. METHODS Women presenting with newly diagnosed CxCa were asked to complete a detailed health belief survey that included questions about barriers to care and their knowledge of CxCa. All information was collected prior to initiating cancer treatment. Comparisons were made among women diagnosed at early stages of disease amendable to surgical treatment (≤IB1) and those diagnosed at a stage requiring local-regional or systemic/palliative treatment (≥IB2). RESULTS Among the 138 women, 21.7% were diagnosed with ≤lB1 disease, while 78.3% were diagnosed with ≥IB2 disease. Late-stage diagnosis was associated with a greater number of emergency room (ER) visits (p<.001) and blood transfusions (p<.001) prior to diagnosis. Compared to 88% with ≤lB1 disease, only 53% of patients with ≥IB2 disease had a car (p=.003). Women with ≥IB2 disease were more likely to be without a primary care provider (75.0% vs. 42.3%, p=.001). CONCLUSION Access to transportation and lack of a regular primary care provider or a medical home are associated with late-stage of CxCa at diagnosis. Many medically underserved women continue to use the ER as their primary source of health care, and as a result their CxCa is diagnosed in advanced stages, with higher medical costs and lower chances of cure. The lack of Medicaid expansion in Texas may result in a worsening of this situation.
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Affiliation(s)
- Lois M Ramondetta
- Department of Gynecologic Oncology and Reproductive Medicine, M. D. Anderson Cancer Center, Houston, TX 77030, United States; Lyndon Baines Hospital, Division Gynecologic Oncology, Harris Health System, Houston, TX 77026, United States.
| | - Larissa A Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, M. D. Anderson Cancer Center, Houston, TX 77030, United States; Lyndon Baines Hospital, Division Gynecologic Oncology, Harris Health System, Houston, TX 77026, United States
| | - Kathleen M Schmeler
- Department of Gynecologic Oncology and Reproductive Medicine, M. D. Anderson Cancer Center, Houston, TX 77030, United States; Lyndon Baines Hospital, Division Gynecologic Oncology, Harris Health System, Houston, TX 77026, United States
| | - Maria E Daheri
- Cervical Cancer Case Management, Harris Health System, Houston, TX 77054, United States
| | - Jessica Gallegos
- Department of Gynecologic Oncology and Reproductive Medicine, M. D. Anderson Cancer Center, Houston, TX 77030, United States; Lyndon Baines Hospital, Division Gynecologic Oncology, Harris Health System, Houston, TX 77026, United States
| | - Michael Scheurer
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, United States
| | - Jane R Montealegre
- Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, United States
| | - Andrea Milbourne
- Department of Gynecologic Oncology and Reproductive Medicine, M. D. Anderson Cancer Center, Houston, TX 77030, United States; Lyndon Baines Hospital, Division Gynecologic Oncology, Harris Health System, Houston, TX 77026, United States
| | - Matthew L Anderson
- Departments of Obstetrics & Gynecology, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, United States
| | - Charlotte C Sun
- Department of Gynecologic Oncology and Reproductive Medicine, M. D. Anderson Cancer Center, Houston, TX 77030, United States; Lyndon Baines Hospital, Division Gynecologic Oncology, Harris Health System, Houston, TX 77026, United States
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25
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Liu R, Chang A, Reddy S, Hecht FM, Chao MT. Improving Patient-Centered Care: A Cross-Sectional Survey of Prior Use and Interest in Complementary and Integrative Health Approaches Among Hospitalized Oncology Patients. J Altern Complement Med 2015; 22:160-5. [PMID: 26505257 DOI: 10.1089/acm.2015.0061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To describe cancer inpatients' prior-year use of complementary and integrative health (CIH) therapies and interest in receiving CIH therapies while in the hospital. DESIGN Observational, cross-sectional survey of prior-year use of 12 different CIH approaches and interest in receiving any of 7 CIH services in the hospital. SETTING Surgical oncology ward of an academic medical center. PARTICIPANTS 166 hospitalized oncology patients, with an average age of 54 years. RESULTS The most commonly used CIH approach was vitamins/nutritional supplements (67%), followed by use of a special diet (42%) and manual therapies (39%). More than 40% of patients expressed interest in each of the therapies if it was offered during their hospital stay, and 95% of patients were interested in at least one. More than 75% expressed interest in nutritional counseling and in massage. CIH use and interest varied somewhat by demographic and clinical characteristics. CONCLUSION Rates of CIH use among patients with cancer were high, as were their preferences to have these services available in the inpatient setting. Hospitals have the opportunity to provide patient-centered care by developing capacity to provide inpatient CIH services.
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Affiliation(s)
- Rhianon Liu
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA
| | - Alexandra Chang
- 2 Departments of Anesthesiology and Internal Medicine, Loma Linda University , Loma Linda, CA
| | - Sanjay Reddy
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA.,3 Division of Hospital Medicine, University of California , San Francisco, San Francisco, CA
| | - Frederick M Hecht
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA
| | - Maria T Chao
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA.,4 Division of General Internal Medicine at San Francisco General Hospital, University of California , San Francisco, San Francisco, CA
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26
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Shin S, Kim J, Jung D. Traditional Yangsaeng oriental health promotion in patients with cardiovascular disease. Int Nurs Rev 2015; 62:312-20. [DOI: 10.1111/inr.12187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. Shin
- Department of Nursing; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - J.H. Kim
- Department of Nursing; College of Health Sciences; Dankook University; Cheonan South Korea
| | - D. Jung
- Division of Nursing Science; College of Health Sciences; Ewha Womans University; Seoul South Korea
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Abstract
Physical inactivity is a worldwide public health problem. Primary care physicians are in an excellent position to prescribe exercise and physical activity to their patients. This article discusses theories and methods of behavior change to help physicians motivate their patients to become more physically active. Calls to action for physicians are discussed.
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Affiliation(s)
- Ann Blair Kennedy
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (ABK)
- Department of Exercise Science and Department of Epidemiology/Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (SNB)
| | - Steven N. Blair
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (ABK)
- Department of Exercise Science and Department of Epidemiology/Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina (SNB)
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